Dynamics of bile flow through the human choledochal sphincter following exploration of the common bile duct

Mongrel dogs were prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of gastric and duodenal cannulas. The common bile duct was cannulated through the duodenal fistula. After bile flow had been stabilized by intravenous infusion of sodium taurocholate the dogs were given an intravenous injection of insulin or 0.9% NaCl (control). Insulin caused marked increases in bile flow, chloride output, and biliary clearance of erythritol and small increases in bicarbonate output and bile salt output. The increased erythritol clearance indicates that canalicular secretion contributes to insulin choleresis in dogs.

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Intraoperative measurement of the bile flow resistance in the terminal portion of the common bile duct and its clinical significance in biliary surgery

Gastroenterologia Japonica ◽

10.1007/bf02781765 ◽

1977 ◽

Vol 12 (3) ◽

pp. 209-217 ◽

Cited By ~ 2

Author(s):

Tohji Tomita ◽

Minora Uekusa

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Clinical Significance ◽

Bile Flow ◽

Flow Resistance ◽

Terminal Portion ◽

Biliary Surgery ◽

The Common

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Significant Contribution of the Portal Vein to Blood Flow Through the Common Bile Duct

Annals of Surgery ◽

10.1097/sla.0b013e31824714d0 ◽

2012 ◽

Vol 255 (3) ◽

pp. 523-527 ◽

Cited By ~ 28

Author(s):

Juliette C. Slieker ◽

Waqar R. R. Farid ◽

Casper H. J. van Eijck ◽

Johan F. Lange ◽

Jasper van Bommel ◽

...

Keyword(s):

Blood Flow ◽

Bile Duct ◽

Common Bile Duct ◽

Portal Vein ◽

Significant Contribution ◽

Flow Through ◽

The Common

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Expression of protein c-fos in cerebellum neurons of rats at cholestasis

Proceedings of the National Academy of Sciences of Belarus Medical series ◽

10.29235/1814-6023-2019-16-2-135-141 ◽

2019 ◽

Vol 16 (2) ◽

pp. 135-141

Author(s):

S. V. Emelyanchik ◽

O. A. Karniushko ◽

S. M. Zimatkin

Keyword(s):

Nervous System ◽

Bile Duct ◽

Common Bile Duct ◽

Bile Flow ◽

Protein C ◽

White Male ◽

Male Rats ◽

Experimental Animals ◽

The Common

Cholestasis (disturbance of the liver bile outﬂow into the duodenum) is a frequent complication of cholelithiasis and other pathologies of the hepatobiliary system. In this case, all metabolism types are disturbances and all body organs and systems, including the nervous system, are aﬀected. The objective of the study was to establish changes in the c-fos immunoreactivity in the cerebellum neurons of rats at diﬀerent time after modeling subhepatic cholestasis. In this work, we used a material of 60 white male rats 200–250 g in weight. In experimental animals, the ligation of the common bile duct was carried out, in control animals – a false operation while maintaining a physiological bile ﬂow in the duodenum throughout the experiment. Subhepatic cholestasis in rats is accompanied by an increase in the cortex cerebellum on the 2–20th days after the ligation of the common bile duct of the number of neurons with the increased c-fos-immunoreactivity, with the maximum one on the 10th day of the experiment. In surviving animals, after the removal of cholestasis in the long term (45–90 days), the number of neurons with the increased c-fos immunoreactivity, as well as the expression of this protein in neurons is normalized.

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Bile flow and electrolyte composition of bile associated with maximum bilirubin excretion in sheep

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y79-107 ◽

1979 ◽

Vol 57 (7) ◽

pp. 710-716 ◽

Cited By ~ 3

Author(s):

James L. Barnhart ◽

Dan W. Upson

Keyword(s):

Steady State ◽

Bile Duct ◽

Common Bile Duct ◽

Biliary Excretion ◽

Bile Flow ◽

Bile Salts ◽

Mixed Micelles ◽

Electrolyte Composition ◽

Bilirubin Excretion ◽

The Common

Changes in the composition of bile accompanying the maximum biliary excretion (Emax) of bilirubin were investigated in sheep. Sheep fitted with chronic 'T-tubes' in the common bile duct were infused with taurocholate and bilirubin at various rates. Bile collected during both pre- and post-bilirubin steady-state periods was analyzed for the biliary concentration of electrolytes, bile salts, and bilirubin. Bilirubin Emax was 24.6 μmol/min while bile salt excretion during this period was 103 μmol/min. At Emax bilirubin entry into bile reached a concentration of 16.1 μmol/mL, increased the biliary concentration of sodium, did not change osmolarity of bile, and did not increase bile flow. The data suggest that bilirubin either interacts with mixed micelles in bile or forms molecular aggregates.

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Ultrasonography in diagnosis of the common bile duct pathology and pathology of the major duodenal papilla, complicated by mechanical jaundice

Hirurg (Surgeon) ◽

10.33920/med-15-2104-01 ◽

2021 ◽

pp. 5-17

Author(s):

Vladimir Alexandrovich Ivanov ◽

Roman Nikolaevich Malushenko ◽

Alexander Evgenievich Denisov ◽

Elena Nikolaevna Kondrashenko

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Bile Flow ◽

Clinical Syndrome ◽

Review Of The Literature ◽

Duodenal Papilla ◽

Important Place ◽

Major Duodenal Papilla ◽

The Common ◽

Diagnostic Capabilities

Mechanical jaundice is a clinical syndrome that develops due to the bile flow impairment along the bile ducts to the duodenum, remains one of the urgent problems of medicine. Of great importance among the causes of mechanical jaundice are diseases of the common bile duct and the major duodenal papilla, the diagnosis of which to this day remains a rather difficult task. The use of MRCP, ERСP, endo-ultrasonography and other highly informative bile tract imaging methods, despite great diagnostic capabilities, is associated with a number of limitations. In this regard, an important place, especially in the primary examination of patients, is occupied by transabdominal ultrasound, the advantages of which are non-invasiveness, portability, accessibility, safety, the possibility of multiple reiteration. A review of the literature presents domestic and foreign data of researchers regarding the possibility of ultrasonography in diagnostics of the common bile duct pathology and the pathology of the major duodenal papilla that are complicated by mechanical jaundice, as well as the greatest difficulties in diagnosing this pathology.

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Continuous positive-pressure ventilation and choledochoduodenal flow resistance

Journal of Applied Physiology ◽

10.1152/jappl.1975.39.6.937 ◽

1975 ◽

Vol 39 (6) ◽

pp. 937-942 ◽

Cited By ~ 50

Author(s):

E. E. Johnson ◽

J. Hedley-Whyte

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Positive Pressure Ventilation ◽

Venous Pressure ◽

Intermittent Positive Pressure Ventilation ◽

Intravenous Fluid ◽

Positive Pressure ◽

Flow Through ◽

The Common ◽

Continuous Positive Pressure

Resistance to flow through the choledochoduodenal junction was measured during constant perfusion (0.8 ml saline/min). In eight dogs, intermittent positive-pressure ventilation (IPPV) and continuous positive-pressure ventilation (CPPV) were compared. Pressure in the common bile duct was always higher during JPPV than IPPV. With the first application of CPPV the rate of intravenous fluid was adjusted to maintain constant Hct. Mean hepatic venous pressure (Phv) increased from 6.6 to 11.5 cmH2O (P less than 0.001). Mean pressure in the common bile duct increased (P less than 0.001) from 11.6 to 14.1 cmH2O. The average increase in resistance was 21%. Changes reversed with return to IPPV. During the second application of CPPV, intravenous fluid was increased to maintain constant arterial pressure. Phv increased to 12.8 cmH2O and pressure in the common bile duct increased to 15.0 cmH2O (30% increase). In four additional dogs, choledochoduodenal resistance during continuous CPPV was reduced by intravenous vasopressin, intravenous norepinephrine and intraducta phenylephrine. CPPV increases resistance to flow through the choledochoduodenal junction, probably by vascular engorgement.

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Endoscopic Treatment of Anastomotic Biliary Stenosis in Patients With Orthotopic Liver Transplantation

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.2.93 ◽

1995 ◽

Vol 2 (2) ◽

pp. 93-97 ◽

Cited By ~ 1

Author(s):

Alfredo Rossi ◽

Claudio Grosso ◽

Giulio Zanasi ◽

Pietro Gambitta ◽

Marta Bini ◽

...

Keyword(s):

Liver Transplantation ◽

Bile Duct ◽

Common Bile Duct ◽

Acute Cholangitis ◽

Balloon Dilation ◽

Endoscopic Stenting ◽

Endoscopic Retrograde ◽

Flow Through ◽

The Common

The choledocho-choledochostomy stricture is one of the most frequent complications occurring after liver transplantation. Today endoscopic retrograde cholangiopancreatography may be considered one of the most common methodologic approaches for the diagnosis; at the same time it provides an effective treatment of the stenosis, avoiding more invasive surgery. Biliary flow through a strictured anastomosis definitely improves after endoscopic stenting which, in most cases, resolves the biliary obstruction syndrome; moreover, the stent could allow restoration of the anatomical and functional integrity of the common bile duct. We have successfully treated eight liver transplanted patients with biliary anastomotic stenosis by endoscopic stenting of the common bile duct or by balloon dilation (one patient). The stents were replaced every 3 to 4 months and then removed after 1 year of follow-up. We observed one patient with acute cholangitis due to the clogging of the prosthetic device.

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