scholarly journals Rare Biliary Anatomy in Two Patients Presenting with Biliary Obstruction Diagnosed with ERCP

1991 ◽  
Vol 5 (5) ◽  
pp. 161-164
Author(s):  
Gary R May ◽  
David S Reid ◽  
Noel B Hershfield
Keyword(s):  
Cystic Duct ◽  
Incidental Findings ◽  
Biliary Obstruction ◽  
Biliary Tree ◽  
Stone Extraction ◽  
Biliary Anatomy ◽  
Endoscopic Retrograde ◽  
Potential Problems ◽  
Therapeutic Procedures ◽  
Rare Anatomic Variant

Anatomic anomalies of the exrrahepatic biliary tree are common and often incidental findings at endoscopic retrograde cholangiopancreatography; however, they rarely complicate therapeutic procedures such as stone extraction. The cases of two patients with biliary obstruction due to stones are presented, who were found to have the cystic duct a rising almost directly from the ampulla. This rare anatomic variant posed problems both in terms of interpretation of the cholangiogram and removal of stones. Therapeutic endoscopists should be aware of this and other anomalies of the biliary tract and of the potential problems faced in both interpretation of the cholangiogram and in therapeutic procedures.

scholarly journals Endoscopic and Surgical Management of Intrabiliary Rupture of Hydatid Liver Cyst

1992 ◽  
Vol 6 (3) ◽  
pp. 135-139 ◽  
Author(s):  
Sebastian Leong ◽  
Young-In Kim ◽  
Robin Gray ◽  
Paul Kortan ◽  
Gregory Haber
Keyword(s):  
Surgical Management ◽  
Biliary Obstruction ◽  
Bile Ducts ◽  
Biliary Tree ◽  
Liver Cyst ◽  
Endoscopic Management ◽  
Endoscopic Retrograde ◽  
Intrabiliary Rupture ◽  
Definitive Surgery ◽  
Cyst Rupture

A man with hydatid disease complicated by intraabdominal cyst rupture 15 years earlier, presented with cholestatic jaundice. There was intrabiliary rupture of a hydatid liver cyst on endoscopic retrograde cholangiography. Sphincterotomy was performed allow clearance of hydatid material obstructing the bile ducts and insertion of a nasobiliary catheter for irrigation and drainage. Definitive surgery was performed. While endoscopic management is gaining recognition for relieving biliary obstruction in hydatid cystobiliary rupture, surgery is still required for patients who continue to pass hydatid debris obstructing the biliary tree and increasing the risk of cholangitis.

scholarly journals Comparison of spectral characteristics in human and pig biliary system with hyperspectral imaging (HSI)

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Gary Sean Cooney ◽  
Manuel Barberio ◽  
Michele Diana ◽  
Robert Sucher ◽  
Claire Chalopin ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Hyperspectral Imaging ◽  
Spectral Characteristics ◽  
Biliary Tree ◽  
Disease Diagnosis ◽  
Surrounding Tissue ◽  
Bile Pigment ◽  
Biliary Anatomy ◽  
Therapeutic Procedures ◽  
Absorbance Spectra

AbstractInjuries to the biliary tree during surgical, endoscopic or invasive radiological diagnostic or therapeutic procedures involving the pancreas, liver or organs of the upper gastrointestinal tract give rise to the need to develop a method for clear discrimination of biliary anatomy from surrounding tissue. Hyperspectral imaging (HSI) is an emerging optical technique in disease diagnosis and image-guided surgery with inherent advantages of being a non-contact, non-invasive, and non-ionizing technique. HSI can produce quantitative diagnostic information about tissue pathology, morphology, and chemical composition. HSI was applied in human liver transplantation and compared to porcine model operations to assess the capability of discriminating biliary anatomy from surrounding biological tissue. Absorbance spectra measured from bile ducts, gall bladder, and liver show a dependence on tissue composition and bile concentration, with agreement between human and porcine datasets. The bile pigment biliverdin and structural proteins collagen and elastin were identified as contributors to the bile duct and gall bladder absorbance spectra.

scholarly journals Double Cystic Duct as Rare Anatomic Variant

2019 ◽  
Vol 12 (1) ◽  
pp. 69-71
Author(s):  
Antonio Serafin Valero-Liñán ◽  
Toni I. Stoyanov ◽  
Alba Sanchez-Gallego ◽  
Elías Garcia-Grimaldo ◽  
José Antonio Gonzalez-Masiá ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Biliary Tree ◽  
Anatomical Variations ◽  
University Hospital ◽  
Digestive Surgery ◽  
Anatomical Arrangement ◽  
Rare Anatomic Variant ◽  
Anatomical Finding ◽  
The University ◽  
Rule Out

Summary The variations of the cystic duct are so common that only 30% of all humans present the classical anatomical arrangement between the common bile duct (CBD), the cystic duct, and adjacent arteries. Thus, it could be considered that anomalies of the biliary tree are a rule rather than an exception. Duplication of the cystic duct, however, is a very uncommon anatomical finding. In the Department of General and Digestive Surgery of the University Hospital Complex Albacete, a 73-year-old patient was admitted with symptoms of cholangitis. He underwent emergency surgery that found exacerbated chronic cholecystitis and dilation of the CBD. Cholecystectomy was performed with identification of a double cystic duct that drained separately in the CBD and exploration of the last revealed cholangitis without choledocholithiasis. The postoperative period progressed favourably, proceeding to discharge from the hospital with Kehr drainage closed. In conclusion, we consider that the routine use of intraoperative cholangiography when there is suspicion of anatomical variations of the biliary tree is mandatory to rule out lesions or alterations thereof.

scholarly journals Clearance of Cystic Duct Remnant Stones Using a SpyGlass Retrieval Basket during Single-Operator Cholangioscopy at ERCP

2021 ◽  
Vol 12 (01) ◽  
pp. 056-057
Author(s):  
James Hawken ◽  
Jim Portal
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Cystic Duct ◽  
Extraction Method ◽  
Surgical Intervention ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Electrohydraulic Lithotripsy ◽  
Single Operator

AbstractExtraction of stones from a cystic duct remnant following cholecystectomy poses a significant therapeutic dilemma. Surgical intervention has historically been required due to difficulty accessing the cystic duct remnant during conventional endoscopic retrograde cholangiopancreatography. Single-operator cholangioscopy can access the cystic duct remnant, enabling electrohydraulic lithotripsy and stone extraction. Method of stone extraction has seldom been described in this developing field. Clearing duct remnant stones using guidewire placement and an extractor balloon have been reported. This is the first reported case of cystic duct remnant stone extraction using a SpyGlass retrieval basket.

scholarly journals Tomato peel: rare cause of biliary tract obstruction

2011 ◽  
Vol 152 (47) ◽  
pp. 1907-1910 ◽  
Author(s):  
Krisztina Hagymási ◽  
Zoltán Péter ◽  
Éva Csöregh ◽  
Emese Szabó ◽  
Zsolt Tulassay
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Tract ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Biliary Obstruction ◽  
Foreign Bodies ◽  
Biliary Tree ◽  
Endoscopic Retrograde ◽  
Ductus Choledochus ◽  
History Of

Foreign bodies in the biliary tree are rare causes of obstructive jaundice. Food bezoars are infrequent as well. They can cause biliary obstruction after biliary tract interventions, or in the presence of biliary-bowel fistula or duodenum diverticulum. Food bezoars usually pass the gastrointestinal tract without any symptoms, but they can cause abdominal pain and obstructive jaundice in the case of biliary tract obstruction. Endoscopic retrograde cholangio-pancreatography has the major role in the diagnosis and the treatment of the disease. Authors summarize the medical history of a 91-year-old female patient, who developed vomiting and right subcostal pain due to the presence of tomato peel within the ductus choledochus. Orv. Hetil., 2011, 152, 1907–1910.

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

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.

scholarly journals A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Hirao ◽  
HiroHisa Okabe ◽  
Daisuke Ogawa ◽  
Daisuke Kuroda ◽  
Katsunobu Taki ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Case Presentation ◽  
Endoscopic Nasobiliary Drainage ◽  
Subtotal Cholecystectomy ◽  
Upper Abdominal ◽  
The Right ◽  
Nasobiliary Drainage

Abstract Background Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined. Case presentation A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed. Conclusions The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.

scholarly journals Single Balloon Enteroscopy for Endoscopic Retrograde Cholangiography in a Patient with Hepaticojejunostomy after Liver Transplant

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Marta Di Pisa ◽  
Roberto Miraglia ◽  
Riccardo Volpes ◽  
Salvatore Gruttadauria ◽  
Mario Traina
Keyword(s):  
Small Bowel ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Biliary Tree ◽  
Endoscopic Retrograde ◽  
Balloon Enteroscopy ◽  
Post Transplant ◽  
Biliary Anastomosis ◽  
Single Balloon ◽  
Single Balloon Enteroscopy

We report a case of a post-transplant patient with hepaticojejunostomy in whom we used a single balloon enteroscopy to access the biliary tree. This procedure seems to be safe and feasible for approaching the biliary anastomosis by means of the overtube and fixation of the small bowel by the balloon.

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