scholarly journals Gallstone-Induced Perforation of the Common Bile Duct in Pregnancy

HPB Surgery ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-3 ◽  
Author(s):  
N. Dabbas ◽  
M. Abdelaziz ◽  
K. Hamdan ◽  
B. Stedman ◽  
M. Abu Hilal
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Emergency Laparotomy ◽  
Gallstone Pancreatitis ◽  
Third Trimester ◽  
Rare Presentation ◽  
Distal Common Bile Duct ◽  
The Third ◽  
The Common ◽  
Acute Gallstone Pancreatitis

Spontaneous perforation of the extrahepatic biliary system is a rare presentation of ductal stones. We report the case of a twenty-year-old woman presenting at term with biliary peritonitis caused by common bile duct (CBD) perforation due to an impacted stone in the distal common bile duct. The patient had suffered a single herald episode of acute gallstone pancreatitis during the third trimester. The patient underwent an emergency laparotomy, bile duct exploration, and removal of the ductal stone. The postoperative course was uneventful.

scholarly journals The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis: is magnetic resonance cholangiopancreatography needed?

2019 ◽  
Vol 101 (6) ◽  
pp. 428-431 ◽  
Author(s):  
A Thacoor ◽  
TW Pike ◽  
S Pathak ◽  
J Dixon ◽  
C Macutkiewicz ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Primary Objective ◽  
Intraoperative Cholangiography ◽  
Gallstone Pancreatitis ◽  
The Common ◽  
Acute Gallstone Pancreatitis

IntroductionIntraoperative cholangiography is sporadically used in patients undergoing laparoscopic cholecystectomy to delineate common bile duct anatomy and exclude retained stones. In patients with acute gallstone pancreatitis, intraoperative cholangiography may reduce the need for preoperative magnetic resonance cholangiopancreatography.Materials and methodsA retrospective review of a prospectively collected patient database was undertaken over a 15-year period. The primary objective was to evaluate intraoperative assessment of the common bile duct with intraoperative cholangiography in patients with acute gallstone pancreatitis.ResultsA total of 2215 patients underwent laparoscopic cholecystectomy between October 1998 and December 2013; 113 patients (of whom 77 were women) with a mean age of 54 years (range 16–88 years) were diagnosed with acute gallstone pancreatitis. Of these, 102 patients (90%) underwent laparoscopic cholecystectomy with intraoperative cholangiography, which was normal in 89 cases. Thirteen patients had choledocholithiasis on intraoperative cholangiography, 11 of whom were managed with concomitant trans-cystic duct exploration and clearance. Two patients required postoperative endoscopic retrograde cholangiopancreatography.ConclusionsIn patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay.

scholarly journals Pancreatic fistula through the distal common bile duct

2002 ◽  
Vol 130 (5-6) ◽  
pp. 201-203
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Vesna Masirevic ◽  
Ljiljana Ivic
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Fistula ◽  
Pancreatic Juice ◽  
Gastric Artery ◽  
Distal Common Bile Duct ◽  
Life Threatening ◽  
The Common ◽  
The Right ◽  
High Output

Pancreatic fistula is usually caused by acute or chronic pancreatitis, injury and operations of the pancreas. The pancreatic juice comes either from the main pancreatic duct or from side branches. Extremely rare pancreatic fistula may come through the distal end of the common bile duct that is not properly sutured or ligated after traumatic or operative transaction. We present a 58-year old man who developed a life threatening high output pancreatic fistula through the distal end of the common bile duct that was simply ligated after resection for carcinoma. Pancreatic fistula was developed two weeks after original surgery and after two emergency reoperations for serious bleeding from the stump of the right gastric artery resected and ligated during radical limphadenectomy. The patient was treated conservatively by elevation of the drain- age bag after firm tunnel round the drain was formed so that there was no danger of spillage of the pancreatic juice within abdomen.

scholarly journals Sump Syndrome: A Rare Long-Term Complication of Choledochoduodenostomy

2017 ◽  
Vol 11 (2) ◽  
pp. 428-433 ◽  
Author(s):  
Hrudya Abraham ◽  
Sajan Thomas ◽  
Amit Srivastava
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Clinical Manifestations ◽  
Rare Condition ◽  
Endoscopic Retrograde ◽  
Distal Common Bile Duct ◽  
History Of ◽  
The Common

Biliary sump syndrome is a rare condition. It is seen as a rare long-term complication in patients with a history of a side-to-side choledochoduodenostomy. In the era before endoscopic retrograde cholangiopancreatography, side-to-side choledochoduodenostomy was a common surgical procedure for the management of biliary obstruction. In the setting of a side-to-side choledochoduodenostomy, the bile does not drain through the distal common bile duct anymore. Therefore, the part of the common bile duct distal from the choledochoduodenostomy anastomosis consequently transforms into a poorly drained reservoir, making this so-called “sump” prone to accumulation of debris. These patients are prone to cholangitis. We present a 64-year-old man with a history of side-to-side choledochoduodenostomy who presented with manifestations of cholangitis. An endoscopic retrograde cholangiopancreatography confirmed a diagnosis of sump syndrome. The etiology, clinical manifestations, and treatment of biliary sump syndrome are discussed in this article.

scholarly journals Natural Progression of Biochemical Markers of Biliary Tract Obstruction in Patients with Gallstone Pancreatitis

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Mikael Petrosyan ◽  
Joaquin J. Estrada ◽  
Sirius Chan ◽  
Heather Rosen ◽  
Thomas V. Berne ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tract ◽  
Biochemical Markers ◽  
Older Patients ◽  
Gallstone Pancreatitis ◽  
Younger Patients ◽  
Natural Progression ◽  
The Common

The presenting pattern and natural progression of biochemical markers of biliary tract obstruction in patients with gallstone pancreatitis have not been elucidated. We analyzed serial values of bilirubin levels following admission to discharge in 143 patients. Ninety-four of patients demonstrated a Decrescendo (falling) pattern of bilirubin levels from admission until normalization at 21 hours (median). Forty-nine patients demonstrated a Crescendo-Decrescendo (initially rising) pattern with peak levels of bilirubin occurring at 39 hours after admission followed by a subsequent normalization after a median of 119 hours. Patients in the Decrescendo group were significantly younger (33 versus 41 years,P=.02) and more patients had experienced symptoms for greater than 48 hours (65% versus 47%,P=.05). Ten percent of patients in the Decrescendo group and 29% of patients in the Crescendo-Decrescendo group underwent ERCP (P=.02). Normalization of biochemical markers after ERCP was significantly delayed in both groups compared to no ERCP. Older patients present earlier, with higher bilirubin levels and normalize slower than younger patients, perhaps due to fibrosis of the ampulla and decreased compliance of the common bile duct. Patients who disobstruct spontaneously (90%) normalize quicker than patients undergoing ERCP.

Heterotopic Gastric Mucosa in the Common Bile Duct With Cholangiocarcinoma

2018 ◽  
Vol 26 (8) ◽  
pp. 745-748 ◽  
Author(s):  
Yeseul Kim ◽  
Min Jung Jung ◽  
Su-Jin Shin
Keyword(s):  
Bile Duct ◽  
Gastric Mucosa ◽  
Common Bile Duct ◽  
Heterotopic Gastric Mucosa ◽  
Resected Specimen ◽  
Wall Thickening ◽  
Distal Common Bile Duct ◽  
Gastric Heterotopia ◽  
Radiologic Findings ◽  
The Common

Gastric heterotopia within the biliary system is extremely rare. Moreover, the combination of gastric heterotopia in the bile duct with cholangiocarcinoma has not been reported. We describe a case of heterotopic gastric mucosa in the common bile duct with cholangiocarcinoma. An 80-year-old male was admitted with abdominal pain. Abdominal computed tomography revealed wall thickening from the hilar duct to the distal common bile duct. Biopsy from the distal bile duct showed only benign gastric foveolar-type epithelium and fundic glands. Although the diagnosis of the biopsy was benign, malignancy was strongly suspected from the radiologic findings, and excision of the bile ducts was performed. Microscopically, the resected specimen showed poorly formed malignant glands and gastric heterotopia also identified in the common bile duct. Three months later, the patient’s state worsened due to recurrence, and he died. To our knowledge, this is the first report of gastric heterotopia in the bile duct accompanying cholangiocarcinoma.

scholarly journals PHOTODYNAMIC THERAPY OF EXPERIMENTAL CHOLANGITIS

2021 ◽  
Vol 19 (1) ◽  
pp. 96-105
Author(s):  
R. S. Shyla ◽  
◽  
E. М. Mahiliavets ◽  
K. S. Belyuk ◽  
N. I. Procopchik ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Laser Irradiation ◽  
Acute Cholangitis ◽  
White Blood Cells ◽  
Laser Action ◽  
Bactericidal Effect ◽  
The Third ◽  
The Common

Background. Photodynamic therapy of acute cholangitis involves the introduction of a photosensitizer into the common bile duct and subsequent laser irradiation of the liver. The study of combined laser action on the liver is promising. Purpose of the study. To evaluate in an experiment the effectiveness of photodynamic therapy of acute cholangitis with the introduction of a photosensitizer into the common bile duct and combined laser irradiation of the liver. Material and methods. Acute cholangitis was modeled in rabbits. In the first group, a saline solution was introduced into the common bile duct, in the second and third – "Photolon". Then, in the second group, photodynamic therapy with endocholedocheal laser irradiation of the liver was performed, in the third group – with combined irradiation. The general condition of the animals, their laboratory, microscopic and microbiological parameters were evaluated. After the autopsy, a histological examination of the liver and common bile duct was performed. Results. On the 2nd day of the experiment, all rabbits developed acute cholangitis. After treatment in the group "Experience 3", in comparison with other groups, there was a greater decrease in the indicators of inflammation and cholestasis in the blood, the number of microorganisms and white blood cells in the bile. In the first group, the formation of liver abscesses was histologically noted. Pathological changes in the wall of the common bile duct and liver in the third group were less pronounced than in the second. Conclusions. 1. The experimental model allows on the second day to reproduce acute cholangitis in rabbits. 2. Photodynamic therapy with Photolon photosensitizer with combined (endocholedocheal and surface) laser irradiation of the liver has a more pronounced bactericidal effect compared to endocholedocheal irradiation.

Embryonal rhabdomyosarcoma of the common bile duct and porta hepatis in an infant: A rare presentation

2015 ◽  
Vol 25 (1) ◽  
pp. 254-255 ◽  
Author(s):  
Nesrin Ugras ◽  
Ulviye Yalcinkaya ◽  
Betul Sevinir ◽  
Remzi Emiroglu
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Embryonal Rhabdomyosarcoma ◽  
Porta Hepatis ◽  
Rare Presentation ◽  
The Common

scholarly journals Proposal of a new technique for bile duct reconstruction after iatrogenic injury: study in dogs and review of the literature

2007 ◽  
Vol 22 (3) ◽  
pp. 162-167 ◽  
Author(s):  
Eduardo Crema ◽  
Eliane Anrain Trentini ◽  
Juan Carlos Llanos
Keyword(s):  
Alkaline Phosphatase ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Total Bilirubin ◽  
Review Of The Literature ◽  
Distal Common Bile Duct ◽  
Bile Duct Reconstruction ◽  
Jejunal Tube ◽  
The Common ◽  
A New Technique

PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.

scholarly journals Spontaneous common bile duct perforation in full term pregnancy: a rare case report and review of literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matiullah Masroor ◽  
Mohammad Arif Sarwari
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Exploratory Laparotomy ◽  
Interesting Case ◽  
High Morbidity ◽  
Rare Presentation ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis ◽  
Rare Case Report ◽  
The Common

Abstract Background Spontaneous biliary system perforation is a rare presentation in clinical practice especially in adults. It is rarely suspected and diagnosed preoperatively due to small number of cases, vague sign and symptoms, and ambiguous presentation. Case presentation We describe an interesting case of spontaneous perforation of the common bile duct in a 16 year-old female who presented a week after her first birth to the emergency department with complaints of diffuse abdominal pain, abdominal distention, fever, vomiting, and constipation. She was having generalized peritonitis but the etiology was unclear despite a thorough workup. She underwent exploratory laparotomy, and a perforation in the supra duodenal region of the common bile duct was found intraoperatively. The common bile duct was repaired over T-tube, and cholecystectomy was performed; the patient was recovered uneventfully. Conclusion Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy. Its delayed diagnoses and management can lead to a high morbidity and mortality. All physicians, especially surgeons, should be aware of this possibility and consider it a cause of peritonitis on differential diagnosis particularly when there is no apparent etiology available for presentation.

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