tbuckley/cabot-search huggingface dataset:
IL-36-driven pustulosis: Transcriptomic signatures match between generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis (AGEP)
Authors: Theresa Benezeder, Natalie Bordag, Johannes Woltsche, Katharina Falkensteiner, Thomas Graier, Eva Schadelbauer, Lorenzo Cerroni, Damian Meyersburg, Valeria Mateeva, Adam Reich, Marta Kołt-Kamińska, Gudrun Ratzinger, Julia-Tatjana Maul, Barbara Meier-Schiesser, Alexander A Navarini, Romana Ceovic, Knut Prillinger, Maruska Marovt, Lev Pavlovksy, Andrea Szegedi, Maria Sanzharovskaja, Herwig Zach, Peter Wolf
Journal: Journal of Allergy and Clinical Immunology (2025)

Due to similarities, the distinction between generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis (AGEP) has been a matter of debate for long time. Our aim was to define the molecular features of GPP and AGEP. We analyzed skin biopsy samples and clinical data from 125 patients with AGEP, GPP, palmoplantar pustulosis (PPP), plaque psoriasis (PSO), and non-pustular cutaneous adverse drug reactions (ADRs), as well as from healthy skin controls using RNA sequencing and blinded histopathological analyses. The transcriptome and histopathologic features of AGEP and GPP samples exhibited significant overlap (177 differentially expressed genes (DEGs) in GPP and AGEP compared to healthy skin, only 2 DEGs comparing AGEP and GPP), yet displayed marked differences from those of PPP, PSO, and ADR samples, with a notable number of DEGs (131 DEGs comparing AGEP and PSO, 75 DEGs comparing AGEP and PPP and 52 DEGs comparing AGEP and ADR) and pathways. A transcriptome profile subgroup evaluation of more than 13,000 analyzed genes did not reveal any differentially expressed genes in drug-induced GPP and AGEP. Moreover, the immune response pattern and immune cell composition did not differ between drug-induced GPP and AGEP, whereas non-drug-induced GPP had higher expression of Th17-related genes and a higher neutrophil count than AGEP. We propose that AGEP is a drug-induced variant of GPP and therefore part of IL-36-related pustulosis. A key signature overarching this spectrum was identified, thereby opening the therapeutic approach of IL-36 inhibition to all subtypes of the disease.
Comparison of Standard-of-Care Idecabtagene Vicleucel and Ciltacabtagene Autoleucel in Relapsed/Refractory Multiple Myeloma
Authors: Doris K. Hansen, Lauren C. Peres, Danai Dima, Alicia Richards, Leyla Shune, Aimaz Afrough, Shonali Midha, Binod Dhakal, Mehmet H. Kocoglu, Shebli Atrash, Christopher Ferreri, Omar Castaneda, James A. Davis, Evguenia Bhurtel, Joseph McGuirk, Charlotte Wagner, Radhika Bansal, Patrick Costello, Kinaya Smith, Alex Lieberman-Cribbin, Gabriel De Avila, Sneha Purvey, Hitomi Hosoya, Lekha Mikkilineni, Laura B. Oswald, Gurbakhash Kaur, Oren Pasvolsky, Mahmoud Gaballa, Megan M. Herr, Peter Forsberg, Murali Janakiram, Myo Htut, Sireesha Asoori Maringanti, Nilesh Kalariya, Hamza Hashmi, Ran Reshef, Douglas W. Sborov, Omar Nadeem, Faiz Anwer, Jack Khouri, Shahzad Raza, Djordje Atanackovic, Melissa Alsina, Ciara L. Freeman, Frederick L. Locke, Peter Voorhees, Larry D. Anderson, Shambavi Richard, Thomas Martin, Yi Lin, Krina K. Patel, Surbhi Sidana
Journal: Journal of Clinical Oncology (2025)

PURPOSE Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), two B-cell maturation antigen–directed chimeric antigen receptor (CAR) T-cell therapies have demonstrated remarkable efficacy in relapsed/refractory multiple myeloma (RRMM). We compare safety, efficacy, and survival among patients with RRMM treated with standard-of-care (SOC) ide-cel or cilta-cel. METHODS Data were from a retrospective chart review of patients with RRMM leukapheresed by December 31, 2022, with the intent to receive SOC ide-cel or cilta-cel at 19 institutions. An inverse probability of treatment weighting (IPTW) approach was used to compare outcomes by therapy type. RESULTS A total of 641 patients were leukapheresed by December 31, 2022, with ide-cel (n = 386) and cilta-cel (n = 255). Five hundred eighty-six patients were infused (n = 350 for ide-cel; n = 236 for cilta-cel) with a median follow-up of 12.6 and 13.0 months for ide-cel and cilta-cel, respectively. After IPTW, patient characteristics were well balanced. Cilta-cel was associated with higher likelihood of grade ≥3 cytokine release syndrome (CRS; odds ratio [OR], 6.80 [95% CI, 2.28 to 20.33]), infections (OR, 2.03 [95% CI, 1.41 to 2.92]), second primary malignancies (OR, 1.77 [95% CI, 0.89 to 3.56]), and delayed neurotoxicity (OR, 20.07 [95% CI, 4.46 to 90.20]). Cilta-cel was also associated with better treatment responses (≥complete response: OR, 2.42 [95% CI, 1.63 to 3.60]), longer progression-free survival (hazard ratio [HR], 0.48 [95% CI, 0.36 to 0.63]), and longer overall survival (HR, 0.67 [95% CI, 0.46 to 0.97]). No associations were observed between therapy type and immune effector cell–associated neurotoxicity syndrome, any CRS, severe cytopenia at days 30 and 90, or nonrelapse mortality. We observed consistent findings when repeating the analyses restricting the ide-cel cohort to patients infused during the same time period as Food and Drug Administration approval for cilta-cel (≥March 2022). CONCLUSION Cilta-cel demonstrated superior efficacy and survival, with higher incidence of certain toxicities, compared with ide-cel.
Co-Occurrence of Cytogenetic Abnormalities and High-Risk Disease in Newly Diagnosed and Relapsed/Refractory Multiple Myeloma
Authors: Martin F. Kaiser, Pieter Sonneveld, David A. Cairns, Marc S. Raab, Jesús San-Miguel Izquierdo, Rick Zhang, Jorge Acosta, Alessandra Larocca, Rakesh Popat, Cong Li, Marc-A. Baertsch, Sarah R. Brown, JuanJose Lahuerta Palacios, Anita K. Gandhi, Sandrine Macé, Pellegrino Musto, Kwee Yong, Elias K. Mai, Franck Dubin, Joan Blade, Andrea Capra, Gordon Cook, Uta Bertsch, María-Victoria Mateos, Mario Boccadoro, Graham H. Jackson, Norma C. Gutiérrez, Francesca Gay, Niels Weinhold
Journal: Journal of Clinical Oncology (2025)

PURPOSE Survival for patients with multiple myeloma (MM) has improved but outcomes remain heterogeneous. Consistent diagnostic identification of high-risk disease is desirable to address unmet patient need. The aim was to investigate the consistency of association of co-occurrence of high-risk cytogenetic abnormalities (HRCAs) with prognosis in patients with newly diagnosed MM (NDMM) and relapsed/refractory MM (RRMM), and across a range of treatment modalities. METHODS A systematic review of randomized controlled trials of MM that reported testing for HRCA between January 1, 2000, and December 9, 2021, was performed. Groups were contacted and asked to locally perform a novel, federated analysis of their data for single hit (one HRCA) and double hit (≥two HRCAs), using a centrally provided algorithm. Analysis results were centrally collated and meta-analyzed to assess the hazard ratio (HR) for progression-free survival (PFS) and overall survival (OS) for one/≥two HRCAs across patient subgroups using random-effects models. RESULTS Twenty-four trials including 13,926 patients were included. The median age of participants was 66.5 years (IQR, 59-72) and 56.5% were male (IQR, 52-60). The HR for PFS was 2.28 (95% CI, 2.05 to 2.54) for patients with ≥two HRCAs and 1.51 (95% CI, 1.38 to 1.65) for patients with one HRCA. The HR for OS was 2.94 (95% CI, 2.49 to 3.47) and 1.69 (95% CI, 1.52 to 1.88) for the two subgroups, respectively. In studies initiated since 2015, the effect abides (≥two HRCA PFS, HR, 2.39 [95% CI, 1.96 to 2.91]; OS, 3.10 [95% CI, 2.10 to 4.60]) both for NDMM and RRMM. Heterogeneity related to transplant eligibility and relapsed/refractory status was as expected. CONCLUSION The association of ≥two HRCAs with the poorest outcome in NDMM and RRMM, and across treatment modalities, as demonstrated here for the first time to our knowledge, allows for more focused development of novel approaches to these patients with high unmet need.
Mentalisation-based treatment for antisocial personality disorder in males convicted of an offence on community probation in England and Wales (Mentalization for Offending Adult Males, MOAM): a multicentre, assessor-blinded, randomised controlled trial
Authors: Peter Fonagy, Elizabeth Simes, Karen Yirmiya, James Wason, Barbara Barrett, Alison Frater, Angus Cameron, Stephen Butler, Zoe Hoare, Mary McMurran, Paul Moran, Mike Crawford, Stephen Pilling, Elizabeth Allison, Jessica Yakeley, Anthony Bateman
Journal: The Lancet Psychiatry (2025)
Early childhood developmental concerns following SARS-CoV-2 infection and COVID-19 vaccination during pregnancy: a Scottish population-level retrospective cohort study
Authors: Iain Hardie, Louise Marryat, Aja Murray, Josiah King, Kenneth Okelo, James P Boardman, Michael V Lombardo, Sarah J Stock, Rachael Wood, Bonnie Auyeung
Journal: The Lancet Child & Adolescent Health (2025)

Understanding the effects of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy can help inform clinical guidance and tackle vaccine hesitancy. We examined relationships between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and early child developmental concerns in children aged 13-15 months in Scotland. We created a large, population-level linked administrative health dataset, combining the COVID-19 in Pregnancy in Scotland (COPS) dataset with age 13-15 month child health review data and other datasets. We included children estimated to have been conceived after May 18, 2020, and born before Sept 30, 2021, and their mothers. We used logistic regression modelling to investigate associations between SARS-CoV-2 infection during pregnancy, COVID-19 vaccination during pregnancy, and developmental concerns (ie, parent or caregiver developmental concerns and health visitor-identified concerns regarding speech-language-communication, problem solving, gross motor, personal-social, and emotional-behavioural development) measured during routine child health reviews at age 13-15 months, including adjustment for confounders and covariates. A total of 24 919 child-mother pairs (12 752 [51·2%] male children; 12 167 [48·8%] female children) were included. 1631 (6·5%) children were prenatally exposed to SARS-CoV-2 and 4943 (19·8%) to COVID-19 vaccination. We found no associations between SARS-CoV-2 infection during pregnancy and developmental concerns. After confounder and covariate adjustment, COVID-19 vaccination during pregnancy was associated with reduced odds of developmental concerns regarding problem solving (odds ratio 0·78 [95% CI 0·64-0·95]), personal-social (0·76 [0·61-0·95]), and emotional-behavioural (0·67 [0·48-0·92]) development, but had no associations with other developmental concerns. SARS-CoV-2 infections during pregnancy do not appear to be linked to early childhood developmental concerns, and COVID-19 vaccinations during pregnancy appear to be safe from the perspective of early childhood developmental concerns. As some developmental concerns do not become apparent until children are older than 13-15 months, future research should continue to monitor outcomes as children grow and develop. Economic and Social Research Council.
Ethical and legal considerations in the care of children and young people with high consequence infectious diseases (HCIDs): an approach to decision making
Authors: Elizabeth Whittaker, Ruchi Sinha, Andrew Riordan, Alejandra Alonso, Marieke Emonts, Stephen Owens, Jonathan Cohen, Sarah Mahoney, David Porter, Beatriz Larru, Shelley Segal, Joe Brierley
Journal: The Lancet Child & Adolescent Health (2025)
The effect of ixekizumab treatment on MRI sacroiliac joint structural lesions in patients with radiographic axial spondyloarthritis: post-hoc analysis of a 52-week, randomised, placebo-controlled trial with an active reference arm
Authors: Walter P Maksymowych, Robert G W Lambert, Rebecca J Bolce, Natalia Bello, Baojin Zhu, Jeffrey R Lisse, Mikkel Østergaard
Journal: The Lancet Rheumatology (2025)
Mitigation of Arteriosclerosis through Transcriptional Regulation of Ferroptosis and Lipid Metabolism by Magnesium
Authors: Han Yu, Changyi Zhou, Shi Yang, Jinlong Yu, Xiyue Zhang, Zhaojia Liang, Shuang Tan, Yang Song, Wenhui Wang, Yu Sun, Rui Zan, Hua Qiu, Li Shen, Xiaonong Zhang
Journal: Biomaterials (2025)
A systematic review and meta-analysis of sleep following mild traumatic brain injury: a synthesis of the literature according to age and time-since-injury.
Authors: S S H Roberts, P J Owen, S A Warmington, J Trevenen, K Caeyenberghs, S J McDonald, E R Facer-Childs, A McKay, E J Bradshaw, S Kara, B Aisbett, G E Vincent
Journal: Sleep Medicine Reviews (2025)

This systematic review and meta-analysis (PROSPERO: CRD42021287081) compared sleep in individuals with prior mTBI against that of controls. PubMed, Scopus, and EMBASE were searched through to November 2, 2024. Mean differences were calculated for objective (sleep duration, sleep efficiency, sleep stage [N1-3, REM] proportions) and subjective (Pittsburgh Sleep Quality Index [PSQI]) sleep measures, with analyses conducted based on age (adult ≥18y; child <18y) and time-since-injury/recovery phase (<1w, <1m, 1-12m, ≥1y). Qualitative syntheses were also conducted according to age and recovery phase. Sixty-nine studies met criteria. In children and adults, mean differences in objective sleep duration and sleep efficiency were not statistically significant for any recovery phase. Relative to controls, adults with mTBI had proportionately more N1 (Mean diff. [95%CI], 1.28 % [0.63 %,1.93 %], p = 0.014) and less N3 (-1.16 % [-2.08 %,-0.23 %], p = 0.033) sleep at 1-12-month follow-up, and less REM (-3.37 % [-6.28 %,-0.46 %], p = 0.023) at ≥1 year follow-up; however, these statistical differences did not remain when studies confounded by selection bias were removed. Subjectively, relative to controls, adults with mTBI had higher PSQI scores at <1-week (2.53 [1.43,3.62] points, p = 0.005), <1-month (2.26 [1.47, 3.04], p < 0.001), 1-12-month (2.86 [1.26,4.45], p < 0.001) and ≥1-year (2.62 [1.96, 3.28], p < 0.001) follow-up. The literature suggests individuals with prior mTBI have poorer subjective sleep than controls, but supportive objective data are limited. A limitation to consider when interpreting these findings is that a minority (45 %) of studies had low risk of bias. More research examining objective sleep post-mTBI is needed, especially for children with mTBI.
Correction to “Impact of surrogates for insulin resistance on mortality and life expectancy in primary care: a nationwide cross-sectional study with registry linkage (LIPIDOGRAM2015)” [The Lancet Regional Health – Europe 49 (2025) 101182]
Authors: Yang Chen, Ziyi Zhong, Ying Gue, Maciej Banach, Garry McDowell, Dimitri P Mikhailidis, Peter P Toth, Peter E Penson, Tomasz Tomasik, Adam Windak, Marek Gierlotka, Tadeusz Osadnik, Agnieszka Kuras, Marcin Miga, Jacek Jozwiak, Gregory Y H Lip
Journal: The Lancet Regional Health - Europe (2025)
Laparoscopic and endoscopic cooperative surgery for a gastrointestinal stromal tumor
Authors: Teona Ingrid Amza, Ovidiu Mihai Arășanu, Marian Forminte, Cristiana Popp, Andrei Mihai Voiosu
Journal: Endoscopy (2025)

A 67-year-old woman presented to the outpatient clinic with new-onset epigastric pain, with an initial abdominal ultrasound revealing a probable gastric mass. At endoscopy, we observed an approximately 5-cm subepithelial gastric tumor on the lesser curvature of the stomach and performed bite-on-bite biopsy, with a resulting histopathologic diagnosis of gastric leiomyoma being made ([Fig. 1]). We considered submucosal tunneling techniques for removal, but, owing to the large tumor size and its position, our team opted for laparoscopic and endoscopic cooperative surgery (LECS) [1] [2] for local tumor resection ([Fig. 2]; [Video 1]).
A treatment option for rectal gastrointestinal stromal tumor: endoscopic submucosal dissection combined with endoscopic hand-suturing
Authors: Lizhou Dou, Angshu Cai, Shibo Song, Guiqi Wang, Shun He
Journal: Endoscopy (2025)

Rectal gastrointestinal stromal tumors (GISTs) are very rare, accounting for about 5% of all GISTs [1]. Treatment for a rectal GIST should be carefully selected to avoid postoperative complications and impairment of anal sphincter function [2] [3]. Recently, several cases of endoscopic resection for rectal GISTs have been reported, but there is a lack of reports on strategies for defect closure [4] [5]. We report a novel method for treating a rectal GIST via a combination of endoscopic hand-suturing (EHS) with endoscopic submucosal dissection (ESD).
Innovative endoscopic device for efficient management of a giant gastric bezoar
Authors: Jieyu Peng, Weixing Yang, Lei Shi, Muhan Lü, Xiaowei Tang
Journal: Endoscopy (2025)

A 54-year-old man presented to the emergency department with abdominal pain. The patient had a history of persimmon consumption prior to admission. Abdominal computed tomography revealed significant gastric distension. Small bowel radiography indicated a filling defect within the gastric cavity. Gastroscopy confirmed a large bezoar, measuring 5 × 8 cm, in the gastric fundus and body, with a firm texture upon contact ([Fig. 1]).
Cholangioscopy-guided lithotripsy and extraction of gallbladder stones through the natural lumen
Authors: Tong Xiao, Changqin Xu, Hongwei Xu, Yuemin Feng, Tong Su, Lechang Zhang, Shulei Zhao
Journal: Endoscopy (2025)

In recent years, the integration of endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy has emerged as a prominent method for managing complex cholelithiasis [1] [2] [3]. We present a case demonstrating an innovative and effective approach to gallbladder stone extraction via the natural lumen ([Video 1]).
A phase III randomised study of first-line NUC-1031/cisplatin vs. gemcitabine/cisplatin in advanced biliary tract cancer
Authors: Jennifer J Knox, Mairéad G McNamara, Igor S Bazin, Do-Youn Oh, Oleksii Zubkov, Valeriy Breder, Li-Yuan Bai, Alan Christie, Lipika Goyal, David P Cosgrove, Christoph Springfeld, Katrin M Sjoquist, Joon Oh Park, Helena Verdaguer, Chiara Braconi, Paul J Ross, Aimery De Gramont, Rachna T Shroff, John R Zalcberg, Daniel H Palmer, Jonathan R Smith, Elisabeth Oelmann, Theresa Bruce, Juan W Valle
Journal: Journal of Hepatology (2025)
Endoscopic ultrasound-guided hepaticogastrostomy using a novel double-lumen tapered dilator combined with a 22-G needle
Authors: Takeshi Ogura, Kimi Bessho, Takafumi Kanadani, Nobuhiro Hattori, Hiroki Nishikawa
Journal: Endoscopy (2025)

Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) can be indicated for failed endoscopic retrograde cholangiopancreatography (ERCP). Recently, various transendoscopic ultrasonography/endosonography-created route procedures have been developed, such as antegrade bile duct stone removal and stricture management [1]. These procedures may be mainly indicated for benign biliary disease. Compared with malignant biliary disease, EUS-HGS might be challenging in cases of benign biliary disease because the intrahepatic bile duct is not very dilated. Indeed, compared with a meta-analysis of EUS-HGS for malignant biliary disease [2], the technical success rate might be lower for benign biliary disease [3]. A 22 G needle may improve the technical success of bile duct puncturing. However, because a 0.018-inch guidewire, which has little stiffness, should be used, device insertion into the biliary tract may be challenging. To overcome this, a novel dilation device (Meissa; Japan Lifeline, Tokyo, Japan) has been developed ([Fig. 1]). This device has a 2.3-Fr tip and a maximum diameter of 7.4 Fr. In addition, a 2-cm side hole is provided from the tip. Contrast medium injection, aspiration of bile juice, and 0.025-inch guidewire insertion can be performed. Therefore, if this device is used, the double-guidewire technique can be performed without additional device exchange with a 0.018-inch guidewire. A challenging case of EUS-HGS due to a non-dilated bile duct is described.
Developing splice-switching oligonucleotides for urea cycle disorder using an integrated diagnostic and therapeutic platform
Authors: Jin Rong Ow, Eri Imagawa, Feng Chen, Wei Yuan Cher, Shermin Yu Tung Chan, Rajasekhar Reddy Gurrampati, Venkataramanan Ramadass, Mun Fai Loke, Tommaso Tabaglio, Hikaru Nishida, Toshiki Tsunogai, Masahide Yazaki, Gaik Siew Ch'ng, Manikandan Lakshmanan, Su Seong Lee, Jackie Yi-Ru Ying, Ernesto Guccione, Kimihiko Oishi, Keng Boon Wee
Journal: Journal of Hepatology (2025)
Cataract and Risk of Fracture: a Systematic Review, Meta-Analysis, and Bayesian Network Meta-Analysis
Authors: Gabriele Gallo Afflitto, Francesco Aiello, Pier Luigi Surico, Davina A Malek, Tommaso Mori, Swarup S Swaminathan, Vincenzo Maurino, Carlo Nucci
Journal: Ophthalmology (2025)

To evaluate the odds ratio (OR) and hazard ratio (HR) of bone fracture in phakic subjects with cataract compared to phakic subjects without cataract and pseudophakic individuals. Despite the growing recognition of the potential link between cataract and fracture, the available evidence remains inconclusive. The results of this systematic review and meta-analysis were reported according to the PRISMA guidelines. The study protocol was prospectively registered on the International Prospective Register of Systematic Reviews (ID: CRD42024587477). Four electronic databases were searched from their inception to May 2024: PubMed, EMBASE, Web of Science, and CINAHL. Two independent reviewers performed title and abstract screening, full-text assessment, and study quality appraisal. Frequentist inference meta-analysis and Bayesian network meta-analysis (NMA) were conducted to assess OR and HR of fracture among the three groups of interest. Sixteen articles met the predefined inclusion and exclusion criteria, with 11 included in the quantitative synthesis, encompassing a population of 4,713,458 subjects and reporting on 284,811 fractures. The certainty of evidence was rated from low to moderate. Compared to subjects without cataract, the OR and the HR for fractures in the cataract group were 1.44 (95% CI: 0.75 to 2.75; p > 0.05) and 1.51 (95% CI: 1.14 to 2.01; p = 0.0152), respectively. Bayesian NMAs indicated that subjects with cataracts have an increased odds and hazard of fractures compared to both phakic subjects without cataracts (OR: 3.0 [95% Credible Interval (95% CrI): 2.8 to 3.3]; HR 1.1 [95%CrI: 1.09 to 1.12]) and pseudophakic individuals (OR: 1.7 [95%CrI: 1.6 to 1.8]; HR: 1.28 [95%CrI: 1.24 to 1.31]). Pseudophakic individuals exhibit a 27% reduction in fracture risk compared to phakic individuals with cataract, with 1 fewer fracture event occurring for every 8 pseudophakic subjects. Low-certainty evidence suggests a higher fracture risk in individuals with cataract compared to those without. Moderate-certainty evidence indicates that pseudophakic individuals have the lowest fracture risk compared to phakic patients, with or without cataracts. Further research should explore the causal link between cataracts and fracture risk and evaluate the impact of cataract surgery on fracture prevention.
Endoscopic retrograde cholangiopancreatography combined with peroral choledochoscope for the treatment of complete bile duct rupture
Authors: Qingsong Wu, Ming Zhang, Donghai Zhuang, Baochang Shi, Jinglong Guo, Yannan Yin, Kai Zhang
Journal: Endoscopy (2025)

Iatrogenic bile duct injury is one of the serious complications of laparoscopic cholecystectomy [1] [2]. Here, we present a patient with massive bile leakage due to complete bile duct rupture after the procedure. A 69-year-old man was admitted to the hospital due to skin and sclera jaundice with a fever for half a month. He underwent laparoscopic cholecystectomy in another hospital 20 days ago. The abdominal drainage tube drained about 800 ml of bile daily. Magnetic resonance cholangiopancreatography (MRCP) showed localized ascites and discontinuity of the common bile duct (CBD) ([Fig. 1]).