scholarly journals Hepatolithiasis Associated With Anomalous Biliary Anatomy and a Vascular Compression Hepatolithiasis and Anomalous Anatomy

HPB Surgery ◽  
1991 ◽  
Vol 3 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Graham Cullingford ◽  
Brian Davidson ◽  
James Dooley ◽  
Nagy Habib
Keyword(s):  
Liver Function ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Vascular Compression ◽  
Biliary Anatomy ◽  
Endoscopic Retrograde ◽  
The Right

Biliary tract abnormalities occur in about one of every three people, usually being minor and of no clinical significance.Major abnormalities, however, may present in an unusual manner and provide a major hazard to the unsuspecting surgeon.A patient presenting with cholangitis without jaundice or abnormal liver function tests is reported. Endoscopic retrograde cholangiography failed to demonstrate any bile ducts in the right postero-lateral segments of the liver, the “naked segment sign”. A percutaneous transhepatic cholangiogram demonstrated a stricture obstructing the right posterior segmental hepatic duct with hepatolithiasis above the stricture. At operation an anomalous vessel was found at the site of the stricture.This case highlights the unusual way in which biliary tract anomalies may present and the importance of adequate pre-operative investigation.

scholarly journals Biliary Cystadenocarcinoma: An Unusual Cause for Recurrent Hemobilia

2015 ◽  
Vol 100 (4) ◽  
pp. 702-704 ◽  
Author(s):  
Sunu Philip ◽  
Armin Kamyab ◽  
Michael Jacobs
Keyword(s):  
Liver Function ◽  
Biliary Tract ◽  
Liver Tumors ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Function Tests ◽  
Uncommon Presentation ◽  
Biliary Cystadenocarcinoma ◽  
Right Lobe ◽  
Primary Presentation

Hemobilia is an uncommon presentation of biliary tract or pancreatic disease. The investigation and management of this clinical problem is challenging. We report on a case of biliary tract hemorrhage from an otherwise asymptomatic right lobe biliary cystadenocarcinoma and review the literature on this unusual presentation. Hemobilia from primary or secondary liver tumors is not frequently reported in the literature. Hemobilia in this setting is usually observed in association with an obvious liver mass or abnormal liver function tests. This is a report of a case of hemobilia as the primary presentation of a small right lobe cystadenocarcinoma. Literature on the incidence and treatment of hemobilia associated with liver tumors has been reviewed. Hemobilia is investigated and definitively treated with angiography. In our case, initial imaging was equivocal and the lesion was only demonstrated after rebleeding, requiring a second angiogram. Surgical resection of the mass was required for definitive control of bleeding. This case illustrates the difficulties of investigating and treating hemobilia caused by primary or secondary liver tumors. Cystadenocarcinoma of the liver is not a common tumor, and biliary tract hemorrhage as the primary presentation of this tumor in the absence of a significant mass or abnormal liver function tests has not been previously described.

Case 3.20

2014 ◽  
pp. 171-172
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Hepatic Lobe ◽  
Hepatic Mass ◽  
Function Tests ◽  
The Right ◽  
Delayed Phase ◽  
T2 Weighted Images

56-year-old man with abnormal liver function tests; abdominal US revealed a large hepatic mass Axial fat-suppressed FSE T2-weighted images (Figure 3.20.1) demonstrate a large heterogeneous, hyperintense mass in the right hepatic lobe. Arterial, portal venous, equilibrium, and delayed-phase postgadolinium 3D SPGR images (...

Alpha 1 Anti Trypsin Levels in Asymptomatic Patients with Abnormal Liver Function Tests

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
BJ Egan ◽  
S Sarwar ◽  
M Anwar ◽  
C O'Morain ◽  
B Ryan
Keyword(s):  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Function Tests ◽  
Asymptomatic Patients

scholarly journals Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

2021 ◽  
Vol 10 (8) ◽  
pp. 1730
Author(s):  
Hiroshi Miyama ◽  
Yasuyuki Shiraishi ◽  
Shun Kohsaka ◽  
Ayumi Goda ◽  
Yosuke Nishihata ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Function ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
Long Term Outcomes ◽  
Function Tests ◽  
Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

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 Frequency and Prognostic Significance of Abnormal Liver Function Tests in Patients With Cardiogenic Shock

2017 ◽  
Vol 120 (7) ◽  
pp. 1090-1097 ◽  
Author(s):  
Toni Jäntti ◽  
Tuukka Tarvasmäki ◽  
Veli-Pekka Harjola ◽  
John Parissis ◽  
Kari Pulkki ◽  
...  
Keyword(s):  
Liver Function ◽  
Cardiogenic Shock ◽  
Prognostic Significance ◽  
Liver Function Tests ◽  
Abnormal Liver Function ◽  
Function Tests

scholarly journals Surgical management of cystic dilatation bile ducts in adults

2015 ◽  
Vol 28 (1) ◽  
pp. 17-19
Author(s):  
Olival Cirilo Lucena da FONSECA-NETO ◽  
Moacir Cavalcante de ALBUQUERQUE-NETO ◽  
Antonio Lopes de MIRANDA
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rare Disease ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Adult Population ◽  
Ultrasound Scanning ◽  
Resonance Imaging ◽  
Cystic Dilatation ◽  
Initial Examination ◽  
Endoscopic Retrograde

BACKGROUND: The cystic dilatation of the biliary tract is a rare disease and uncertain origin. It is recognized more frequently in children; however, its incidence comes increasing in adults, representing 20% of the cases. AIM: To evaluate morbimortality rates, evolution and handing of patients with cystic dilatation bile ducts in adults. METHODS: Were evaluated, retrospectively, five adults who had the diagnosis of choledochal cyst and that had been submitted to some surgical procedure. RESULTS: Abdominal pain was the commonest complain to all patients. Jaundice was present in 80%. Ultrasound scanning was done in all the cases as initial examination. CT scan, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography were also done in some patients; however, the diagnosis was established intra-operatively in all cases. The cyst resection with reconstruction of the biliary tract was done in 60%; the cystojejunostomy in 20%; and in 20% biliary tract drainage. CONCLUSIONS: Biliary tract cystic dilatation is a rare disease. However, its incidence is increasing in the adult population, so, it must be thought as differential diagnosis when facing obstructive jaundice.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

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