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  • Küçük Resim Yok
    Öğe
    Can quantitative surface antigen levels and systemic immune-inflammation index be predictive as a new indicator for the initiation of treatment in chronic hepatitis b?
    (Lippincott Williams & Wilkins, 2024) Koroglu, Mehmet; Ayvaz, Muhammed Ali; Bakan, Suat Baran; Sirin, Abdullatif; Akyuz, Umit
    Objectives The natural history of chronic HBV infection (CHB) is generally divided into four phases: HBeAg-positive chronic HBV infection (EPCI) and -hepatitis (EPCH), HBeAg-negative chronic HBV infection (ENCI) and -hepatitis (ENCH). This study aimed to investigate changes in serum quantitative surface antigen (qHBsAg), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in a large number of CHB patients. Method Three hundred seventy-two CHB patients who underwent liver biopsy between January 2015 and February 2020 were evaluated. Results The SII-values were strongly significant between EPCI-EPCH (P = 0.002), however, there was significant difference between ENCI-ENCH (P = 0.025). Considering the SIRI results, there was a significant difference between both EPCI-EPCH (P = 0.009) and ENCI-ENCH (P = 0.118). In HBeAg-positive patients HBV-DNA, qHBsAg, and SII were found to be predictive (P = 0.029, P = 0.039, P = 0.027, respectively) while in HBeAg-negative patients, age, AST, HBV-DNA, qHBsAg, SII, and SIRI were found to be predictive (P = 0.047, P = 0.084, P = <0.001, P = 0.001, P = 0.012, P = 0.002, respectively). In EPCH phase, whereby accuracy rate results of HBV-DNA, qHBsAg, and SII were 75.3%, 73.4%, and 60.4%, respectively, while in the ENCH phase the accuracy rates of age, AST, HBV-DNA, qHBsAg, SII, and SIRI values were 57.8%, 65.6%, 68.3%, 63.8%, 57.3% and 53.2%, respectively. Conclusion HBV-DNA, qHBsAg, and SII are predictive in EPCH patients. Age, AST, HBV-DNA, qHBsAg, SII and SIRI are all predictive in ENCH patients. In patients with CHB, we recommend using SII to distinguish between EPCI-EPCH and ENCI-ENCH. Based on its sensitivity and features, we believe that qHBsAg and SII are suitable measuring instruments in discrimination both of EPCI-EPCH and ENCI-ENCH.
  • Küçük Resim
    Öğe
    Unpredictable Event during EUS-Guided Hepaticojejunostomy
    (Duzce Univ, Fac Medicine, 2023) Sirin, Abdullatif; Cetin, Mehmet Fuat; Tokmak, Salih
    Endoscopic ultrasound (EUS)-guided biliary drainage is a therapeutic alternative method in patients with cholestasis where the ampulla of Vater cannot be reached because several reasons. An unfortunate complication during EUS-guided biliary drainage was presented in this report. A 53 -year -old male patient presented with jaundice and pruritus. He had a history of total gastrectomy due to gastric cancer. An abdominal tomography scan detected a tumoral mass in the common bile duct due to the recurrence of gastric cancer. We decided to perform EUS-guided hepaticojejunostomy because biliary drainage cannot be obtained by conventional methods and percutaneous drainage impairs patient comfort. A double pigtail plastic stent was placed from the jejunum into the segment -3 bile duct towards the hilus. After that echoduodenoscope was removed to the outside gently. We noticed that the stent was stuck in the echoduedonoscope elevator. We reached into the bile duct again and placed a doublepigtail plastic stent successfully.