Bile duct hemorrhage: a biopsy finding after cholangiography or biliary tree manipulation

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

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Automatic Intrahepatic Biliary Segmentation Based Image Processing Techniques using Magnetic Resonance Images

10.21203/rs.3.rs-106936/v1 ◽

2020 ◽

Author(s):

Mohammad Atallah AL-Oudat ◽

Mohammad AL Oudat ◽

Hazem Migdady ◽

Tariq AL Munaizel ◽

Mohammad Awni Mahmoud ◽

...

Keyword(s):

Bile Duct ◽

Magnetic Resonance ◽

Bile Ducts ◽

Medical Condition ◽

Biliary Tree ◽

Extraction Process ◽

Magnetic Resonance Images ◽

Papilla Of Vater ◽

Feed Forward Neural Network ◽

Important Indicator

Abstract A set of tubes known as bile ducts connects the liver to an organ below it directly that is called Gallbladder. The dilation of a bile duct is an important indicator regarding any serious issue in the human body. Number of reasons may cause bile duct dilation, such as: stones, tumors which commonly occur due to pancreas or papilla of vater. In this paper, the main contributions are: 1) a novel framework that consists of three phases to be applied on a set of Magnetic Resonance Imaging (MRI) images 2) an extracted set of features with their accurate values that express the condition of the biliary trees from the MRI images. Such dataset can be used in several applications to determine whether a bile duct is dilated or not. The dataset is organized as the following: half of the MRI images are for normal bile ducts, while the other half is for dilated bile ducts. To extract the useful features to diagnose the medical condition of the bile ducts from the MRI images, we implemented and applied the proposed framework that is started by using the enhanced active contour technique without edges in combination with Denoising Convolutional Neural Networks (DnCNN) to perform the segmentation and features extraction process. After that, the output of the segmentation process is the segmented biliary tree that will be used later to extract the needful features to make a diagnostic decision whether there is a dilation or not by comparing the features values of the normal versus the dilated bile ducts. We applied the feed forward neural network with backpropagation training algorithm for classification purposes. According to the experiments, the overall accuracy of the proposed framework was 90.00%. Such approach improves and increases the accuracy of the physicians’ diagnostic decisions which is considered as of significant importance for treatment and cure.

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Proximal Extrahepatic Bile Ducts: Comprehensive Review

Journal of oncology: diagnostic radiology and radiotherapy ◽

10.37174/2587-7593-2021-4-1-74-93 ◽

2021 ◽

Vol 4 (1) ◽

pp. 74-93

Author(s):

M. A. Shorikov ◽

O. N. Sergeeva ◽

M. G. Lapteva ◽

N. A. Peregudov ◽

B. I. Dolgushin

Keyword(s):

Bile Duct ◽

Bile Flow ◽

Bile Ducts ◽

Extrahepatic Bile Duct ◽

Hepatic Duct ◽

Biliary Tree ◽

Comprehensive Review ◽

Extrahepatic Bile Ducts ◽

And Function ◽

Variant Anatomy

Proximal extrahepatic bile ducts are the biliary tree segment within formal boundaries from cystic ductcommon hepatic duct junction to sectoral hepatic ducts. Despite being a focus of attention of diagnostic and interventional radiologists, endoscopists, hepatobiliary surgeons and transplantologists they weren’t comprehensively described in available papers. The majority of the authors regard bile duct confluence as a group of merging primitively arranged tubes providing bile flow. The information on the proximal extrahepatic bile duct embryonal development, variant anatomy, innervation, arterial, venous and lymphatic supply is too general and not detailed. The present review brought together and systemized exiting to the date data on anatomy and function of this biliary tract portion. Unique, different from the majority of hollow organs organization of the proximal extrahepatic bile duct adapts them to the flow of the bile, i.e. viscous aggressive due to pH about 8.0 and detergents fluid, under higher wall pressure than in other parts of biliary tree.

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Laparoscopic exploration of bile ducts in patients with calculosis. indications, methods and first results

Folia Medica ◽

10.2478/folmed-2013-0025 ◽

2013 ◽

Vol 55 (3-4) ◽

pp. 33-38 ◽

Cited By ~ 1

Author(s):

Rosen S. Dimov ◽

Rangel I. Kantchev ◽

Boris G. Boev ◽

Todor I. Ivanov ◽

Ilia A. Apostolov ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Gall Stone ◽

Sphincter Of Oddi ◽

Biliary Tree ◽

Stone Extraction ◽

Average Hospital ◽

Laparoscopic Exploration ◽

Ultrasound Study ◽

The Common

ABSTRACT INTRODUCTION: In the last few years there has been a resurgence of laparoscopic exploration of the common bile duct as an alternative to endoscopic retrograde cholangiopancreatography (ERCP), the primary method for diagnosis and treatment of biliary tract calculosis. AIM: The aim of this study was to clarify the indications and methods for performing laparoscopic bile duct exploration, based on our experience in the field and data from the literature. PATIENTS AND METHODS: We recruited 12 patients who underwent laparoscopic exploration and stone extraction from the common bile duct (CBD) in the surgical ward of Kaspela Hospital, Plovdiv over the period January 2011 to January 2012. The diagnostic and therapeutic modalities used in the study included laboratory tests, ultrasound study, CT, ERCP, digital cholangiography, clamp and balloon stone extraction, primary suture and choledochoduodenostomy. RESULTS: Stone extraction was successfully performed in 8 patients using the transcystic approach through an incision used in the cholangiography. The procedure failed in the remaining four patients and we used here 2-cm longitudinal choledochotomy. In two patients the control cholangiography following the extraction of stones demonstrated complete clearance of the biliary tree and free passage of contrast agent from bile duct to duodenum (patent ampulla of Vater). In these two patients we performed a primary closure of the choledochotomy with a single interrupted suture (“ideal choledochotomy”). In two patients from the choledochotomy group, the control cholangiography showed the presence of residual stones or fragments trapped above the sphincter of Oddi with no contrast medium in the duodenum. In these cases we completed this procedure with latero-lateral choledochoduodenostomy by Flërken. All patients had a smooth postoperative course with no recorded complications. The average hospital stay was 5 days. CONCLUSIONS: Laparoscopic exploration of the biliary ducts in calculosis is an efficient, safe and reliable method to manage this serious complication of gall-stone disease in the hands of an experienced laparoscopic surgeon. The results of its application are comparable and in some cases even better than those of ERCP used as a therapeutic procedure as regards clearance of the CBD and the complications involved in these two procedures.

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Gallbladder and Biliary Tree

DeckerMed Surgery ◽

10.2310/surg.2246 ◽

2017 ◽

Author(s):

Stephen Gray

Keyword(s):

Bile Duct ◽

Key Words ◽

Biliary Tract ◽

Bile Salts ◽

Biliary Tree ◽

Comprehensive Understanding ◽

Biliary Anatomy

Understanding gallbladder and biliary anatomy is paramount to the surgeon. A comprehensive understanding of the gallbladder and biliary tree is necessary to properly treat a variety of surgical pathologies. Understanding the usual anatomy and the variations will help prevent iatrogenic biliary injuries. Moreover, anatomic consideration dictates oncologic therapies for gallbladder and biliary tract malignancies. Key words: bile duct, bile salts, biliary tree, cholecystectomy, gallbladder

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Common Bile Duct MALT Lymphoma: Case Report and Review of the Literature

The American Surgeon ◽

10.1177/000313480607200122 ◽

2006 ◽

Vol 72 (1) ◽

pp. 85-88

Author(s):

Justin Boccardo ◽

Anjay Khandelwal ◽

Dongjiu Ye ◽

Bruce E. Duke

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Malt Lymphoma ◽

Lymphoid Tissue ◽

Treatment Options ◽

Partial Gastrectomy ◽

Biliary Tree ◽

Review Of The Literature ◽

Helicobacter Pylori Treatment ◽

Rare Diagnosis

We report a rare case of common bile duct mucosa-associated lymphoid tissue (MALT) lymphoma treated with pancreatico-duodenectomy with a partial gastrectomy. MALT lymphoma involving the biliary tree is extremely rare. Diagnosis is difficult and treatment options are controversial. Even though Helicobacter pylori treatment is effective in the early stages of the disease, surgery is still helpful especially when obstruction, perforation, or bleeding is present.

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FLORID DUCT LESIONS AND EXTENSIVE BILE DUCT LOSS OF THE INTRAHEPATIC BILIARY TREE IN CHRONIC LIVER DISEASES OTHER THAN PRIMARY BILIARY CIRRHOSIS

Pathology International ◽

10.1111/j.1440-1827.1983.tb02155.x ◽

1983 ◽

Vol 33 (6) ◽

pp. 1095-1104

Author(s):

Yasuni Nakanuma ◽

Goroku Ohta ◽

Haruo Takeshita ◽

Yoshikiyo Yamazaki ◽

Kenji Doishita ◽

...

Keyword(s):

Bile Duct ◽

Primary Biliary Cirrhosis ◽

Liver Diseases ◽

Biliary Tree ◽

Chronic Liver ◽

Biliary Cirrhosis ◽

Chronic Liver Diseases

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Is There Common Duct Enlargement Present Ultrasonically: How do you Measure Yours? (Survey of Departmental Practice)

Ultrasound ◽

10.1258/ult.2011.011031 ◽

2011 ◽

Vol 19 (4) ◽

pp. 203-208

Author(s):

Tom Fitzgerald

Keyword(s):

Bile Duct ◽

Current Practice ◽

Common Duct ◽

Biliary Tree ◽

Practice Variation ◽

Tree Diameter ◽

Ultrasonic Evaluation ◽

Normal Ranges ◽

The Many ◽

Special Causes

A departmental survey of personal methodology in the measurement of bile duct diameter was carried out by means of a representative diagram of a typical bile duct image configuration. The results revealed considerable differences in measurement practice, and factors that may explain the patterns of interobserver variation, among 20 respondents in this task, were postulated. There was considerable scope for error, by a factor of three times between the smallest and largest diameter selected noted within current practice variation. This reflects similar disparity found in the literature. Within the setting of the development of current therapeutic strategies, there may be a need for confirmation and/or re-establishment of contemporary normal ranges for biliary tree diameter. A study of reasonable magnitude would be required to clarify the many and complex common and special causes of variation in ultrasonic evaluation outlined towards enhancing the utility of this useful and hitherto important ultrasonic sign.

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Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder mucocele: A multi‐institutional retrospective study

Veterinary Surgery ◽

10.1111/vsu.13542 ◽

2020 ◽

Author(s):

Hunter J. Piegols ◽

Galina M. Hayes ◽

Samantha Lin ◽

Ameet Singh ◽

Daniel K. Langlois ◽

...

Keyword(s):

Retrospective Study ◽

Biliary Tree ◽

Tree Manipulation

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Is Preoperative Evaluation of the Biliary Tree Necessary in Uncomplicated Gallstone Disease?

Scandinavian Journal of Surgery ◽

10.1177/145749690509400108 ◽

2005 ◽

Vol 94 (1) ◽

pp. 31-33 ◽

Cited By ~ 8

Author(s):

J. Järhult

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Statistical Difference ◽

Preoperative Evaluation ◽

Gallstone Disease ◽

Common Bile Duct Stones ◽

Biliary Tree ◽

Control Group ◽

Bile Duct Stones ◽

Intravenous Cholangiography

Aim: To analyse if preoperative radiology is of value in patients with uncomplicated gallstone disease. Material: 312 patients intended for laparoscopic cholecystectomy were randomly allocated to undergo preoperative radiology (intravenous cholangiography or magnetic resonance cholangiography) or to a control group. Intraoperative cholangiography was not used routinely in either group. Results: There was no bile duct injury and no difference in complication frequency between the two groups. The incidence of common bile duct stones was 3,8 % within the first postoperative year with no statistical difference between the two groups. Conclusions: Routine preoperative evaluation of the bile tree seems unnecessary before laparoscopic cholecystectomy in patients with uncomplicated gallstone disease.

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