Adenoma of the Major Duodenal Papilla with Intraductal Extension into the Lower Common Bile Duct

2007 ◽  
Vol 12 (6) ◽  
pp. 1146-1148 ◽  
Author(s):  
Shuichiro Uchiyama ◽  
Kazuo Chijiiwa ◽  
Naoya Imamura ◽  
Masahide Hiyoshi ◽  
Jiro Ohuchida ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla ◽  
Intraductal Extension

scholarly journals Laser papillosphincterotomy in choledocholithiasis and acute biliary pancreatitis

2021 ◽  
Vol 25 (2) ◽  
pp. 48-54
Author(s):  
V. A. Lazarenko ◽  
Y. V. Kanishchev ◽  
P. M. Nazarenko ◽  
D. P. Nazarenko ◽  
T. A. Samgina ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Laser Light ◽  
Biliary Pancreatitis ◽  
Duodenal Papilla ◽  
Surgical Time ◽  
Acute Biliary Pancreatitis ◽  
Major Duodenal Papilla ◽  
The Russian Federation ◽  
The Common

Objective. The radical elimination of extrahepatic biliary tract pathology in choledocholithiasis and acute biliary pancreatitis (ABP) reduces the risk of infection and eliminates the source of endogenous intoxication; so, the search of safe and effective techniques for endoscopic papillosphincterotomy (EPT) is important.Purpose: to assess outcomes of laser-assisted endoscopic papillosphincterotomy.Material and methods. 288 patients with “wedged” (n = 111) and “valve” (n = 177) choledocholithiasis and acute biliary pancreatitis were divided into two groups depending on EPT technique: in the control group, a papillotome with electrocoagulation cord was used (n = 195); in the main group, laser scalpel was used (n = 93).Results. 87 patients with “wedged” choledocholithiasis were treated with EPT and an end electrode on the wedged stone. 16 patients out of them had mild bleeding which was stopped by irrigation with epinephrine solution (1 : 10 000) followed by the targeted coagulation. The average surgical time was 38 ± 16 min. In 24 patients with rigid and edematous medial wall of the duodenum due to acute biliary pancreatitis, the proposed device plus laser technique for papillosphincterotomy were used (patent of the Russian Federation No. 2614891). There was no bleeding, the average surgical time was 24 ± 12 min. In “valve” choledocholithiasis, laparoscopic cholecystectomy (LCE) was performed; calculi from the common bile duct were removed. In 108 patients during LCE, EPT was made via an antegrade catheter. In 69 patients with anatomical and physiological obstacles caused by the major duodenal papilla, we performed LCE and EPT with laser light via an antegrade guide light made of fluoroplastics (patent of the Russian Federation No. 41594). Concrements from the common bile duct were removed with the Dormia basket.Conclusions. Laser light causes less damage, reliably provides hemostasis along the incision line on the anterior wall of the major duodenal papilla; in addition, a wedged calculus in “wedged” choledocholithiasis and a fluoroplastic light guide in “valve” choledocholithiasis reliably protect the posterior wall of the major duodenal papilla from laser light damage. Laser techniques used in EPT make the treatment of choledocholithiasis in patients with ABP having anatomical and physiological problems due to the major duodenal papilla safe and effective.

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

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.

Clinical case of palliative antegrade surgical treatment of cancer of the major duodenal papilla

2016 ◽  
Vol 21 (5) ◽  
pp. 244-249
Author(s):  
Yury S. Vinnik ◽  
E. V Serova ◽  
D. A Chernykh ◽  
A. V Kovalev ◽  
D. V Stratovich ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Malignant Tumors ◽  
Internal Drainage ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla ◽  
Duct Cancer ◽  
The Common

In the structure of malignant tumors, accompanied by obstructive jaundice, there are most occurred such as the lesion of the pancreas (47%), bile duct cancer (20%) also papillary carcinoma (MDP) and gall bladder cancer (about 15%). In the case of inoperable tumor, in elderly and senile patients with severe concomitant somatic pathology, there are indicated palliative interventions as follows: percutaneous transhepatic external or external-internal drainage of the biliary tract with possible subsequent percutaneous transhepatic stenting of the common bile duct. Under our observation there was a patient of 75 years with verified major duodenal papilla cancer, complicated by obstructive jaundice, to whom as the first step there was performed percutaneous transhepatic external-internal drainage of the biliary tract, and as the second one - percutaneous transhepatic stenting of the common bile duct.

scholarly journals Short-Term Biliary Stent Placement Contributing Common Bile Duct Stone Disappearance with Preservation of Duodenal Papilla Function

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Tatsuki Ueda ◽  
Masataka Kikuyama ◽  
Yuzo Kodama ◽  
Takafumi Kurokami
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Stent Placement ◽  
Bile Ducts ◽  
Common Bile Duct Stones ◽  
Biliary Stent ◽  
Duodenal Papilla ◽  
Short Term ◽  
Endoscopic Retrograde ◽  
Obstructive Cholangitis

Aims. To investigate the effect of biliary stent placement without endoscopic sphincterotomy (EST) on common bile duct stones (CBDS) disappearance and the contribution of preserving the duodenal papilla function to reduce recurrence of CBDS.Methods. Sixty-six patients admitted for acute obstructive cholangitis due to CBDS who underwent biliary stent placement without EST for 2 years from March 2011 were evaluated retrospectively. The second endoscopic retrograde cholangiopancreatography (ERCP) was performed for treatment of CBDS 3 to 4 months after the first ERCP. We estimated the rate of stone disappearance at the time of second ERCP.Results. CBDS disappearance was observed in 32 (48.5%) of 66 patients. The diameter of the bile ducts and the diameter of CBDS in patients with CBDS disappearance were significantly smaller than in those with CBDS requiring extraction (p=0.007andp<0.001, resp.). Stone disappearance was evident when the diameter of bile ducts and that of CBDS were <10 and 7 mm, respectively (p=0.002).Conclusions. Short-term stent placement without EST eliminates CBDS while preserving duodenal papilla function and may be suitable for treating CBDS in patients with nondilated bile ducts and small CBDS.

scholarly journals Mobilization cholangiography

1981 ◽  
Vol 62 (5) ◽  
pp. 41-42
Author(s):  
O. S. Kochnev ◽  
V. N. Biryaltsev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tract ◽  
The State ◽  
Duodenal Papilla ◽  
Terminal Part ◽  
Surgical Interventions ◽  
Intraoperative Diagnosis ◽  
The Common

Determination of the state of the biliary tract and the terminal part of the common bile duct is one of the most difficult issues of intraoperative diagnosis in complicated cholecystitis. Currently, none of the surgeons doubts the need for intraoperative cholangiography and its value. It is she who allows to identify in many patients the presence of calculi in the biliary tract, to determine the degree of expansion of the common bile duct and bile hypertension, the state of the terminal part of the common bile duct. However, the analysis of radiographs performed during 170 surgical interventions for various degrees of stenosis of the large duodenal papilla showed that even this most reliable method of intraoperative diagnosis has a significant drawback.

scholarly journals NUMBER OF COMMON BILE DUCT STONES WITHOUT CHOLANGITIS CORRELATES WITH BACTERIOLOGIC ASSESSMENT OF BILE

2019 ◽  
pp. 26-29
Author(s):  
I. N. Mamontov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Mirizzi Syndrome ◽  
Bile Duct Stones ◽  
Duodenal Papilla ◽  
E Coli ◽  
Factors Influencing ◽  
The Common ◽  
Impacted Stone

Abstract. Aim: to determine the factors influencing on bacteribilia in patients with benign obstruction of the extrahepatic biliary tract (BOEBT). Materials and Methods. A study of 30 cases of BOEBT with bacteriologic bile assessment was performed. A comparison of the incidence of different factors in patients with or without bacteriobilia was done. Results. Positive bile culture was in 22 (73.3%) patients. The most common were E. coli and Klebsiella (68.2%). There was no difference (p<0.05) in sex, age, bilirubin level, gallbladder condition, common bile duct size, major duodenal papilla (MDP) size, common bile duct stones, sludge, Mirizzi syndrome, impacted stone in MDP. Significant differences were found in number of common bile duct stones: 1-2 stones (p<0,001) and multiple stones (p<0,05). Conclusions. Risk factors for bacteriobilia is 1-2 stones in the common bile duct (p<0,001). Multiple stones (≥3) are not associated with bacteriobilia (p<0,05).

scholarly journals TRANSFISTULAR NANOELECTROIMPULSE LITHOTRIPSY IN THE TREATMENT OF CHOLEDOCHOLITHIASIS

2019 ◽  
Vol 21 (1) ◽  
pp. 25-28
Author(s):  
A I Babak ◽  
E A Mozhaeva ◽  
D A Raskovalov ◽  
I S Andrienko ◽  
M I Prudkov
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
New Method ◽  
Bile Duct Stones ◽  
Duodenal Papilla ◽  
Nanosecond Duration ◽  
Safe Method ◽  
Electrohydraulic Lithotripsy ◽  
Major Duodenal Papilla ◽  
Highly Effective

In 2003, Russian developers proposed a new method of crushing stones by electric impulses of nanosecond duration, which has several advantages over contact electrohydraulic lithotripsy. The aim of the study was to evaluate the possibilities of transfistular nanoelectroimpulse lithotripsy (NEIL) in the treatment of choledocholithiasis. A nanoelectroimpulse lithotriptor "Urolit", manufactured by Medline Ltd. (Tomsk, Russia), was used to break down the gallstones. 66 patients with large and/or unmovable bile duct stones and bile ducts drains were performed transfistular NEIL. It was successful in 63 patients (95.5%). NEIL made it possible to perform removal of large and/or unmovable gallstones without destroying the sphincters of the major duodenal papilla in 89% cases. Transfistular NEIL is a new highly effective and safe method of crushing gallstones.

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