14^th International Conference on Liver Diseases & Hepatology May 17-18, 2023 Amsterdam, Netherlands

Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders.Disorders includes

• Hepatitis infections.
• Fatty liver disease
• Jaundice.
• Cirrhosis.
• Metabolic liver diseases.
• Liver cancer.

Cirrhosis, also referred to as liver cirrhosis, hepatic cirrhosis, and end-stage liver disease, is a condition in which the liver's ability to perform its normal functions is compromised by the development of fibrosis, or scar tissue, because of liver disease-related damage. Damage triggers tissue healing and the subsequent formation of scar tissue, which over time can displace normally functional tissue and result in cirrhosis, a condition that impairs the function of the liver.

Symptoms may include tiredness, weakness, loss of appetite, unexplained weight loss, nausea and vomiting, and discomfort in the right upper quadrant of the abdomen. As the disease worsens, symptoms may include itchiness, swelling in the lower legs, fluid build-up in the abdomen, jaundice, bruising easily, and the development of spider-like blood vessels in the skin.

Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodeling and the formation of permanent scar tissue.

When fibroblasts unintentionally produce an excessive amount of extracellular matrix components, like collagen, they can cause fibrosis, which results in a permanent fibrotic scar. This condition is common in people who sustain repeated injuries, chronic inflammation, and need to repair them.

The liver is inflamed by hepatitis. The disorder could be self-limiting, or it might worsen and lead to cirrhosis, liver cancer, or fibrosis (scarring). The most frequent cause of hepatitis in the world is hepatitis viruses, although it can also be brought on by autoimmune illnesses, other infections, and toxic substances (including alcohol and other medications).

There are five different forms of hepatitis viruses: hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E. (HEV). Due to the weight of illness and death they produce as well as the possibility of outbreaks and epidemic spread, these 5 categories are the most concerning. In hundreds of millions of people, types B and C coupled with cancer are the most common causes of chronic illness and liver cirrhosis.

The term "non-alcoholic fatty liver disease" (NAFLD) or "metabolic (dysfunction) associated fatty liver disease" (MAFLD) refers to an abnormal accumulation of fat in the liver that has no other obvious cause, such as alcohol consumption. There are 2 types: non-alcoholic steatohepatitis (NASH), which also causes liver inflammation, and non-alcoholic fatty liver (NAFL). Non-alcoholic fatty liver usually does not proceed to NASH and is less harmful than NASH. When NAFL eventually transforms into NASH, it may also bring on side effects like cirrhosis, liver cancer, liver failure, or cardiovascular disease.

Obesity and type 2 diabetes are strong risk factors for NAFLD. Other risks include being overweight, metabolic syndrome (defined as at least three of the five following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum HDL cholesterol), a diet high in fructose, and older age. NAFLD and alcoholic liver disease are types of fatty liver disease. Obtaining a sample of the liver after excluding other potential causes of fatty liver can confirm the diagnosis.

High bilirubin levels cause jaundice, also known as icterus, which is a yellowish or greenish discoloration of the skin and sclera. Adults with jaundice frequently have underlying conditions that involve aberrant heme metabolism, liver malfunction, or biliary-tract obstruction. While jaundice in babies is frequent, with an estimated 80% of cases occurring in the first week of life, it is uncommon in adults. Itching, pale stools, and dark urine are the three symptoms of jaundice that are most frequently seen.

Cancer that originates in the liver is called liver cancer, often referred to as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy. Liver cancer may manifest as primary (originating in the liver) or secondary (meaning cancer which has spread from elsewhere to the liver, known as liver metastasis). Compared to liver cancer, liver metastasis is more frequent. Globally, there is an increase in liver cancer.

The leading cause of liver cancer is cirrhosis due to hepatitis B, hepatitis C or alcohol. Other causes include aflatoxin, non-alcoholic fatty liver disease and liver flukes.

Your doctor will first review your medical history to identify any potential risk factors for either infectious or non-infectious hepatitis before diagnosing a patient of hepatitis. The effectiveness of your liver's function can be assessed using blood samples.

A strained, injured, or improperly functioning liver may show high levels of liver enzymes. The organs inside your belly can be visualized via an abdominal ultrasound by using ultrasound waves. It may show the presence of liver tumors, liver dysfunction, or gall bladder abnormalities. Your kind of hepatitis and whether it is acute or   will impact your treatment options.

Wilson's disease is a hereditary condition in which the body accumulates too much copper. The liver and brain are frequently the sources of symptoms. Vomiting, weakness, fluid retention in the abdomen, swelling of the legs, yellowish skin, and itching are only a few of the symptoms of the liver. Tremors, stiffness in the muscles, difficulty speaking, personality changes, anxiety, and psychosis are a few symptoms associated with the brain.

The Wilson disease protein (ATP7B) gene mutation is the primary cause of Wilson's disease. This protein moves surplus copper into the bile, where it is eliminated in waste materials. Because the disorder is autosomal recessive, a person must inherit a mutant copy of the gene from both parents to be affected. The process of diagnosis, which frequently combines blood, urine, and liver tests, can be challenging.

Wilson's disease is typically treated with dietary changes and medication. Dietary changes involve eating a low-copper diet and not using copper cookware. Medications used include chelating agents such as trientine and d-penicillamine and zinc supplements.

Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team.

Hemochromatosis, also known as iron overload, is the term for the increased overall buildup of iron in the body due to a variety of causes, which can lead to organ damage. The two main contributing factors are trans fusional iron overload, which can happen because of frequent blood transfusions, and hereditary haemochromatosis (HH or HHC), a genetic condition.

Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes in order of frequency include:

• 
  A gallstone impacted in the common bile duct beyond the point where the pancreatic duct joins it


• 
  Heavy alcohol use


• 
  Systemic disease


• 
  Trauma


• 
  Mumps

Acute pancreatitis may be a single event; it may be recurrent; or it may progress to chronic pancreatitis.Mild cases are usually successfully treated with conservative measures: hospitalization, pain control, nothing by mouth, intravenous nutritional support, and intravenous fluid rehydration. Severe cases often require admission to an intensive care unit to monitor and manage complications of the disease. Complications are associated with a high mortality, even with optimal management.

 A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of migrated gallstones within bile ducts.

Most people with gallstones (about 80%) are asymptomatic. However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic This happens in 1–4% of those with gallstones each year.[4] Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), obstructive jaundice, and infection in bile ducts (cholangitis) Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, dark urine, and pale stools.

Cholestasis is a condition where bile cannot flow from the liver to the duodenum. The two basic distinctions are an obstructive type of cholestasis where there is a mechanical blockage in the duct system that can occur from a gallstone or malignancy, and metabolic types of cholestasis which are disturbances in bile formation that can occur because of genetic defects or acquired as a side effect of many medications. Classification is further divided into acute or chronic and extrahepatic or intrahepatic.

Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells can invade other parts of the body. Several types of pancreatic cancer are known.

The most common, pancreatic adenocarcinoma, accounts for about 90% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type. These adenocarcinomas start within the part of the pancreas that makes digestive enzymes. Several other types of cancer, which collectively represent most of the non-adenocarcinomas, can also arise from these cells. About 1–2% of cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma.

Signs and symptoms of the most-common form of pancreatic cancer may include yellow skin, abdominal or back pain, unexplained weight loss, light-colored stools, dark urine, and loss of appetite.