Surgical Treatment and Outcomes in Carcinoma of the Extrahepatic Bile Ducts—Invited Critique

2001 ◽  
Vol 136 (2) ◽  
pp. 215
Author(s):  
Gerald W. Peskin
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Extrahepatic Bile Ducts

scholarly journals PECULIARITIES OF CLINICAL PRESENTATION AND SURGICAL TREATMENT OF PATIENTS WITH OCCULT CARCINOMA OF GALLBLADDER

2018 ◽  
pp. 87-91
Author(s):  
V. I. Кolomiytsev ◽  
О. M. Syroid ◽  
О. V. Lukavetskiy
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Bile Ducts ◽  
Clinical Presentation ◽  
Distant Metastases ◽  
The Body ◽  
Treatment Result ◽  
Extrahepatic Bile Ducts ◽  
Calculous Cholecystitis ◽  
Carcinoma Of Gallbladder

141 patients with gallbladder cancer (GBC) were operated from 2003 to 2016. 29 (20.6 %) patients were diagnosed with occult GBC. In most (88.4–100 %) cases, GBC was accompanied by cholelithiasis; furthermore, cholelithiasis lasted much longer if patients had occult GBC (P = 0.032). The signs of acute or chronic calculous cholecystitis were clinically detected in patients with occult GBC. For this group of patients, tumours were more often located in the body or fundus of gallbladder (P < 0.05) and were less locally spread (P < 0.04); however, the level of differentiation (P > 0.3) and the presence of distant metastases (P > 0.4) were not statistically different from those in patients with manifest GBC. Cholecystectomy was performed in all patients with occult GBC and in 50 (44.6 %) patients with manifest GBC (P < 0.001). Liver resection and/or operation on the extrahepatic bile ducts was performed in 8 (27.6 %) and 50 (44.6 %) patients, respectively (P < 0.001). Postoperative complications were detected in 2 (6.9 %) patients with occult GBC and in 27 (24.1 %) patients with manifest GBC (P < 0.05). ІІІ–ІV stage of tumour was identified in 5 (17.2 %) patients with occult GBC. Treatment result in this case was less satisfactory.

scholarly journals PECULIARITIES OF CLINICAL PRESENTATION AND SURGICAL TREATMENT OF PATIENTS WITH OCCULT CARCINOMA OF GALLBLADDER

2018 ◽  
pp. 87-91
Author(s):  
V. I. Кolomiytsev ◽  
О. M. Syroid ◽  
О. V. Lukavetskiy
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Bile Ducts ◽  
Clinical Presentation ◽  
Distant Metastases ◽  
The Body ◽  
Treatment Result ◽  
Extrahepatic Bile Ducts ◽  
Calculous Cholecystitis ◽  
Carcinoma Of Gallbladder

141 patients with gallbladder cancer (GBC) were operated from 2003 to 2016. 29 (20.6 %) patients were diagnosed with occult GBC. In most (88.4–100 %) cases, GBC was accompanied by cholelithiasis; furthermore, cholelithiasis lasted much longer if patients had occult GBC (P = 0.032). The signs of acute or chronic calculous cholecystitis were clinically detected in patients with occult GBC. For this group of patients, tumours were more often located in the body or fundus of gallbladder (P < 0.05) and were less locally spread (P < 0.04); however, the level of differentiation (P > 0.3) and the presence of distant metastases (P > 0.4) were not statistically different from those in patients with manifest GBC. Cholecystectomy was performed in all patients with occult GBC and in 50 (44.6 %) patients with manifest GBC (P < 0.001). Liver resection and/or operation on the extrahepatic bile ducts was performed in 8 (27.6 %) and 50 (44.6 %) patients, respectively (P < 0.001). Postoperative complications were detected in 2 (6.9 %) patients with occult GBC and in 27 (24.1 %) patients with manifest GBC (P < 0.05). ІІІ–ІV stage of tumour was identified in 5 (17.2 %) patients with occult GBC. Treatment result in this case was less satisfactory.

scholarly journals SURGICAL TREATMENT OF CARCINOMA OF THE EXTRAHEPATIC BILE DUCTS

1976 ◽  
Vol 9 (3) ◽  
pp. 301-307
Author(s):  
Akihiko GOTOH ◽  
Junji HAYASHI ◽  
Yasutoshi IWASHIMA ◽  
Akinori OKADA ◽  
Takeshi SUZUKI ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Extrahepatic Bile Ducts

scholarly journals Results of surgical treatment of extrahepatic bile duct injuries

2020 ◽  
Vol 37 (1) ◽  
pp. 63-72
Author(s):  
L. P. Kotelnikova ◽  
I. G. Burnyshev ◽  
O. V. Bazhenova ◽  
D. V. Trushnikov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Bile Duct ◽  
Bile Ducts ◽  
Bile Leakage ◽  
Biliary Reconstruction ◽  
Long Term Outcomes ◽  
Endoscopic Retrograde ◽  
Extrahepatic Bile Ducts

Aim. To evaluate the short-and long-term outcomes after surgical repair of iatrogenic lesions of extrahepatic bile ducts depending on the timing of diagnosis in conditions of specialized clinic. Materials and methods. Our study involved a retrospective analysis of 159 patients who were treated for iatrogenic lesions of extrahepatic bile ducts during 1987-2017. These patients were divided into two groups depending on the timing of surgical treatments: early biliary reconstruction ( 5 days after bile duct transection) and late biliary reconstruction ( 5 days post-transection). These groups were compared on the basis of postoperative morbidity and long-term outcomes. Results. Following laparoscopic cholecystectomy, 2 patients received endoscopic retrograde stents due to bile leakage from the cystic ducts, and 14 patients underwent hepaticocholedochostomy using Ker drainage. The incidence of bile leakage was observed in 14. 3 % of cases during the early post-operative period, strictures appeared in 28.6 % of cases. Hepaticojejunostomy was performed in 91 cases: in 62 with stents and in 29 without stents. Bile leakage was observed in 17.6 % of cases, and strictures in 19.8 % of cases. Our statistical analyses revealed no significant differences between the two groups (i.e., early and late timing of surgical treatment) in the rates of bile leakage and strictures. The extent of surgeons experience in bile surgery significantly correlated with positive outcomes. Conclusions. Endoscopic retrograde stent proved to be an effective and fast solution in cases of bile leakage from cystic ducts following laparoscopic cholecystectomy. Although it is preferable to perform reconstructive surgeries within the first five days after bile duct injury, our results indicated that in the presence of external bile fistula without peritonitis and severe cholangitis, reconstructive surgery can be performed in specialized surgical departments later than 5 days with satisfactory results.

scholarly journals ROLE OF TRANSDERMAL AND ENDOSCOPIC TECHNIQUES IN THE TREATMENT OF PATIENTS WITH GALLSTONE DISEASE AND ITS COMPLICATIONS

2020 ◽  
pp. 109-114
Author(s):  
B. S. Zaporozhchenko ◽  
K. V. Kravets ◽  
O. B. Zubkov ◽  
I. V. Gomonyuk
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Stone Disease ◽  
Endoscopic Techniques ◽  
Surgical Department ◽  
Steady Growth ◽  
Gall Stone Disease ◽  
Extrahepatic Bile Ducts

Summary. In recent years, along with the steady growth of patients with gall-stone disease (cholelithiasis), the growth of its complicated forms is also noted. Most of these patients are elderly and senile people with various concomitant diseases. They constitute the so-called risk group. Materials and methods. The present work is based on an analysis of the results of surgical treatment of 320 patients with complicated forms of cholelithiasis for the period from 2015 to 2020, who were treated at the surgical department of the Department of Surgery KNP «OOKMT» OOR Department of Surgery No. 2 of ONMedU. Results. LCE was performed in 133 (67.2 %) patients, MLCE was performed in 39 (19.7 %) patients, and TCE was performed in 26 (13.1 %) patients. A phased method of surgical treatment was used in 70 (35.4 %) patients with acute cholecystitis with concomitant cardiopulmonary pathology. In 52 patients with choledocholithiasis and obstructive jaundice, in whom it was not possible to eliminate choledocholithiasis using endoscopic transpapillary interventions after external drainage of the bile ducts and resolution of jaundice, the second stage was performed cholecystectomy with correction of the pathology of extrahepatic bile ducts. Conclusions. Realized tactics of stage treatment in patients with concomitant pathology of cardiovascular pathology, as well as the widespread use of minimally invasive technologies, have reduced mortality and the incidence of postoperative complications in patients with concomitant cardiopulmonary pathology.

scholarly journals DIAGNOSTICS AND SURGICAL TREATMENT OF POSTTRAUMATIC CICATRICIAL STRICTURES OF THE EXTRAHEPATIC BILE DUCTS

2021 ◽  
pp. 72-76
Author(s):  
A. D. Shatalov ◽  
V. V. Khatsko ◽  
S. A. Shatalov ◽  
D. M. Kosse ◽  
I. F. Polulyakh-Chоrnovol ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Postoperative Complications ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Main Research ◽  
Iatrogenic Injuries ◽  
The Past ◽  
Reconstructive Operations ◽  
Extrahepatic Bile Ducts

Summary. The aim of the work is to improve the results of surgical treatment of iatrogenic injuries of the extrahepatic bile ducts. Materials and methods. The experience of treating 362 patients with iatrogenic injuries of the extrahepatic bile ducts, obtained mainly in other hospitals over the past 18 years, is presented. In the clinic, these patients are reoperated. Among them were 258 (71.3 %) women and 104 (28,7 %) men aged 20 to 80 years. Results and discussion.Damage and stricture of the bile duct were noted during laparotomic (299) and laparoscopic (63) cholecystectomy. Damage to the hepatic duct was seen in 235 patients, choledochus — in 127. The main research methods were: percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography, fistulocholangiography. In the clinic, all 362 patients were operated. In 47 of them were performed restorative operations, and in 315 of them were performed reconstructive ones. At the first stage (until 2004), restorative and reconstructive operations (with transhepatic frame drainage) were used more often. At the 2nd stage (since 2005), the operation of choice was a high hepaticoduodenostomy in 2 modified versions. Over the past 7 years, the number of postoperative complications has been reduced by 8,3 %, mortality from 6,8 to 1,5 %. Conclusions. The operation of choice in case of complete damage to the bile duct is the formation of a high hepaticojejunoanastomosis according to our modified methods. Reconstructive operations are indicated only in case of partial damage to the bile duct. A multidisciplinary approach to the correction of duct damage is advisable, which should be carried out in specialized surgical hepatological centers. The use of modified methods of reconstructive surgery contributed to a decrease in postoperative complications by 8,3 % and mortality by 5,3 % (95 % CI, p <0.05).

Iatrogenic hepatic damage as a problem of modern surgery (literature review)

2021 ◽  
Vol 22 (3) ◽  
pp. 94-101
Author(s):  
Ya. A. Chakhchakhov ◽  
◽  
B. K. Gibert ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Bile Ducts ◽  
Diagnostic Algorithm ◽  
Controversial Issues ◽  
Surgical Interventions ◽  
Iatrogenic Damage ◽  
Extrahepatic Bile Ducts ◽  
The Russian Federation

Iatrogenic damage to the extrahepatic bile ducts occurs in a fairly large number of observations, despite constant work aimed at improving surgical interventions. The most optimal chosen therapeutic tactics, as well as the timing of the revealed damage to the bile ducts, determine the effectiveness and quality of care provided to this category of patients. We also have to state that, to date, in the Russian Federation there is no unambiguously generally accepted and approved therapeutic and diagnostic algorithm for iatrogenic damage to the extrahepatic bile ducts. One of the main aspects of the effectiveness of the applied treatment tactics is the level of quality of life of patients who underwent surgical treatment. Treatment and management of patients with iatrogenic damage to the extrahepatic bile ducts still have a fairly large number of controversial issues, the solution of which should improve the immediate results of surgical treatment of this category of patients.

Spontaneous Perforation of the Extrahepatic Bile Ducts in an Infant

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 601-603
Author(s):  
Dan Andersson ◽  
Ingemar Helin ◽  
Sven-Caspar Nettelblad ◽  
Clas-Göran Cederlund
Keyword(s):  
Surgical Treatment ◽  
Obstructive Jaundice ◽  
Biliary Atresia ◽  
Bile Ducts ◽  
Surgical Intervention ◽  
Rare Condition ◽  
First Year ◽  
Spontaneous Perforation ◽  
Extrahepatic Bile Ducts ◽  
First Year Of Life

Spontaneous perforation of the extrapepatic bile ducts, with an accumulation of bile in the peritoneal cavity, is a rare condition. Nevertheless, it is second in frequency to biliary atresia as the cause of obstructive jaundice during the first year of life.1 Although approximately 60 cases of this condition have been described in the literature, it is only occasionally listed in pediatric textbooks. Nevertheless, it is important that the condition be recognized in time to perform lifesaving surgical intervention. We therefore consider it instructive to present a patient with the classic features of this condition who was cured by surgical treatment on the 29th day of life.

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