{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:07:14Z","timestamp":1791619634888,"version":"4.3.4"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2495,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2008,11]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      <jats:bold>Transient elastography (FibroScan [FS]) is a novel non-invasive tool to assess liver fibrosis\/cirrhosis. However, it remains to be determined if other liver diseases such as extrahepatic cholestasis interfere with fibrosis assessment because liver stiffness is indirectly measured by the propagation velocity of an ultrasound wave within the liver. In this study, we measured liver stiffness immediately before endoscopic retrograde cholangiopancreatography and 3 to 12 days after successful biliary drainage in patients with extrahepatic cholestasis mostly due to neoplastic invasion of the biliary tree. Initially elevated liver stiffness decreased in 13 of 15 patients after intervention, in 10 of them markedly. In three patients, liver stiffness was elevated to a degree that suggested advanced liver cirrhosis (mean, 15.2 kPa). Successful drainage led to a drop of bilirubin by 2.8 to 9.8 mg\/dL whereas liver stiffness almost normalized (mean, 7.1 kPa). In all patients with successful biliary drainage, the decrease of liver stiffness highly correlated with decreasing bilirubin (Spearman's \u03c1 = 0.67,<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>&lt; 0.05) with a mean decrease of liver stiffness of 1.2 \u00b1 0.56 kPa per 1 g\/dL bilirubin. Two patients, in whom liver stiffness did not decrease despite successful biliary drainage, had advanced liver cirrhosis and multiple liver metastases, respectively. The relationship between extrahepatic cholestasis and liver stiffness was reproduced in an animal model of bile duct ligation in landrace pigs where liver stiffness increased from 4.6 kPa to 8.8 kPa during 120 minutes of bile duct ligation and decreased to 6.1 kPa within 30 minutes after decompression.<\/jats:bold>\n                      <jats:bold>Conclusion:<\/jats:bold>\n                      <jats:bold>Extrahepatic cholestasis increases liver stiffness irrespective of fibrosis. Once extrahepatic cholestasis is excluded (e.g., by liver imaging and laboratory parameters) transient elastography is a valuable tool to assess liver fibrosis in chronic liver diseases. (Hepatology 2008.)<\/jats:bold>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.22577","type":"journal-article","created":{"date-parts":[[2008,8,14]],"date-time":"2008-08-14T15:53:18Z","timestamp":1218729198000},"page":"1718-1723","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":515,"title":["Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis"],"prefix":"10.1097","volume":"48","author":[{"given":"Gunda","family":"Millonig","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank M.","family":"Reimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Friedrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Fonouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianeb","family":"Mehrabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus W.","family":"B\u00fcchler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut Karl","family":"Seitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Mueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-42-20241201","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJM200102153440706","article-title":"Liver biopsy.","volume":"344","author":"Bravo","year":"2001","journal-title":"N Engl J Med"},{"key":"R2-42-20241201","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1001\/archinte.1979.03630430043014","article-title":"Sampling variability on percutaneous liver biopsy.","volume":"139","author":"Abdi","year":"1979","journal-title":"Arch Intern Med"},{"key":"R3-42-20241201","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/j.hep.2003.09.022","article-title":"Sampling variability of liver fibrosis in chronic hepatitis C.","volume":"38","author":"Bedossa","year":"2003","journal-title":"HEPATOLOGY"},{"key":"R4-42-20241201","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1053\/jhep.2000.16602","article-title":"Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF).","volume":"32","author":"Cadranel","year":"2000","journal-title":"HEPATOLOGY"},{"key":"R5-42-20241201","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/S0140-6736(86)90883-4","article-title":"Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver.","volume":"1","author":"Maharaj","year":"1986","journal-title":"Lancet"},{"key":"R6-42-20241201","doi-asserted-by":"crossref","first-page":"2614","DOI":"10.1111\/j.1572-0241.2002.06038.x","article-title":"Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection.","volume":"97","author":"Regev","year":"2002","journal-title":"Am J Gastroenterol"},{"key":"R7-42-20241201","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/j.ultrasmedbio.2003.07.001","article-title":"Transient elastography: a new noninvasive method for assessment of hepatic fibrosis.","volume":"29","author":"Sandrin","year":"2003","journal-title":"Ultrasound Med Biol"},{"key":"R8-42-20241201","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/00042737-200604000-00015","article-title":"Prevalence and factors associated with failure of liver stiffness measurement using FibroScan in a prospective study of 2114 examinations.","volume":"18","author":"Foucher","year":"2006","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R9-42-20241201","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1055\/s-2006-957180","article-title":"Transient elastography for diagnosing liver cirrhosis.","volume":"131","author":"Erhardt","year":"2006","journal-title":"in German Dtsch Med Wochenschr"},{"key":"R10-42-20241201","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1053\/j.gastro.2004.11.018","article-title":"Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C.","volume":"128","author":"Castera","year":"2005","journal-title":"Gastroenterology"},{"key":"R11-42-20241201","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1002\/hep.21420","article-title":"Accuracy of liver stiffness measurement for the diagnosis of cirrhosis in patients with chronic liver diseases.","volume":"44","author":"GanneCarrie","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R12-42-20241201","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1053\/j.gastro.2008.01.034","article-title":"Performance of transient elastography for the staging of liver fibrosis: a metaanalysis.","volume":"134","author":"FriedrichRust","year":"2008","journal-title":"Gastroenterology"},{"key":"R13-42-20241201","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/j.1365-2893.2006.00811.x","article-title":"Transient elastography: a new surrogate marker of liver fibrosis influenced by major changes of transaminases.","volume":"14","author":"Coco","year":"2007","journal-title":"J Viral Hepatol"},{"key":"R14-42-20241201","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1002\/hep.22007","article-title":"Acute viral hepatitis increases liver stiffness values measured by transient elastography.","volume":"47","author":"Arena","year":"2008","journal-title":"HEPATOLOGY"},{"key":"R15-42-20241201","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1002\/hep.22056","article-title":"Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage.","volume":"47","author":"Sagir","year":"2008","journal-title":"HEPATOLOGY"},{"key":"R16-42-20241201","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1148\/radiology.172.2.2526349","article-title":"Cirrhosis: diagnosis with sonographic study of the liver surface.","volume":"172","author":"Di Lelio","year":"1989","journal-title":"Radiology"},{"key":"R17-42-20241201","doi-asserted-by":"crossref","first-page":"S2064","DOI":"10.1016\/S0016-5085(08)61434-1","article-title":"Diagnosis of cirrhosis in alcoholic liver disease (ALD): is there a place for transient elastography?","volume":"134","author":"Mueller","year":"2008","journal-title":"Gastroenterology"},{"key":"R18-42-20241201","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1002\/hep.21151","article-title":"Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC.","volume":"43","author":"Corpechot","year":"2006","journal-title":"HEPATOLOGY"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.22577","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200811000-00042","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T08:40:54Z","timestamp":1733042454000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200811000-00042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,11]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2008]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.22577","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1127188.584348","asserted-by":"object"}]},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2008,11]]}}}