Expression of c-FLIP and caspase-8 during the formation of canine benign biliary strictures after bile duct injury

The most common cause of Benign Biliary Stricture is post cholecystectomy bile duct injury. Following introduction of the laparoscopic cholecystectomy procedure the incidence of bile duct injury and stricture has increased. The studies suggest that the incidence remained stable even after the improved learning curve. The early diagnosis and prompt management is the key in preventing devastating sequelae of this benign condition. The management of post cholecystectomy biliary strictures involves a multidisciplinary approach. Our review aims to describe the present strategy in management of post cholecystectomy biliary strictures.

Download Full-text

Su1450 Feasibility of a Modified Fully Covered Self-Expandable Metallic Stents Placement Above the Papilla to Minimize Stent-Induced Bile Duct Injury for Benign Biliary Strictures

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2011.03.503 ◽

2011 ◽

Vol 73 (4) ◽

pp. AB269

Author(s):

Jong Ho Moon ◽

Hyun Jong Choi ◽

Hee Yong Yoo ◽

Jong Chan Lee ◽

Hyun Cheol Koo ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Injury ◽

Metallic Stents ◽

Biliary Strictures ◽

Benign Biliary Strictures ◽

Expandable Metallic Stents

Download Full-text

Feasibility of placing a modified fully covered self-expandable metal stent above the papilla to minimize stent-induced bile duct injury in patients with refractory benign biliary strictures (with videos)

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2012.01.016 ◽

2012 ◽

Vol 75 (5) ◽

pp. 1080-1085 ◽

Cited By ~ 45

Author(s):

Jong Ho Moon ◽

Hyun Jong Choi ◽

Hyun Cheol Koo ◽

Seung Hyo Han ◽

Tae Hoon Lee ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Injury ◽

Metal Stent ◽

Biliary Strictures ◽

Benign Biliary Strictures ◽

Self Expandable Metal Stent

Download Full-text

Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

Surgical Case Reports ◽

10.1186/s40792-020-01080-9 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Hiroki Horinouchi ◽

Eisuke Ueshima ◽

Keitaro Sofue ◽

Shohei Komatsu ◽

Takuya Okada ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Bile Duct ◽

Biliary Obstruction ◽

Hepatic Duct ◽

Drainage Tube ◽

Biliary Strictures ◽

Hepatic Bile ◽

Hepatic Bile Duct ◽

Benign Biliary Strictures ◽

The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

Download Full-text

Bile duct injuries and benign biliary strictures

Surgical Management of Hepatobiliary and Pancreatic Disorders ◽

10.3109/9781841847603-43 ◽

2010 ◽

pp. 372-384

Keyword(s):

Bile Duct ◽

Biliary Strictures ◽

Bile Duct Injuries ◽

Benign Biliary Strictures

Download Full-text

Biliary reconstruction and Roux-en-Y hepaticojejunostomy for the management of complicated biliary strictures after bile duct injury

International Surgery Journal ◽

10.5455/2349-2902.isj20150511 ◽

2015 ◽

Vol 2 (2) ◽

pp. 179

Author(s):

Han Liu ◽

Sheng Shen ◽

Yueqi Wang ◽

Houbao Liu

Keyword(s):

Bile Duct ◽

Bile Duct Injury ◽

Biliary Reconstruction ◽

Biliary Strictures

Download Full-text

X-ray surgery for benign biliary strictures after cholecystectomy

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2019183-91 ◽

2019 ◽

Vol 24 (1) ◽

pp. 83-91

Author(s):

O. I. Okhotnikov ◽

M. V. Yakovleva ◽

O. S. Gorbacheva

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Balloon Dilatation ◽

Hepatic Duct ◽

Primary Repair ◽

Common Hepatic Duct ◽

Biliary Strictures ◽

Biliodigestive Anastomosis ◽

X Ray ◽

Benign Biliary Strictures

Aim.To determine the role of antegrade X-ray surgical interventions in the treatment of benign postoperative biliary strictures.Material and methods.A retrospective analysis of treatment of 36 patients with benign biliary strictures was performed. Isolated stricture of biliodigestive anastomosis was diagnosed in 25 cases, partial clipping of common hepatic duct proximal to biliodigestive anastomosis – in 3 cases, partial clipping of bile duct – in 3 patients, isolated biliary strictures – in 5 patients including 4 of them with stricture within previously deployed T-shaped drainage. At the first stage, percutaneous transhepatic cholangiostomy was performed. According to antegrade cholangiography data, structure type “+1, +2” by H. Bismuth classification in modification of E. I. Galperin was diagnosed in 16 (55.2%) patients, proximal biliary strictures (“0”–“−2”) in 13 patients. Three patients with partial clipping of common bile duct and 4 patients with benign biliary stricture in the area of previously deployed T-shaped drainage were not classified. Recanalization of strictures by “catheter-guide” system was followed by antegrade dilatation of the stricture. Final stage was frame external-internal drainage for 6–12 months with stepwise redo balloon dilatation every 3 months (35 patients). The criterion for the end of minimally invasive treatment was the absence of balloon waist in the stricture zone observed during the next procedure but not earlier than in 6 months from primary balloon dilatation. Surgical correction was indicated for recurrent stricture.Results.Direct technical success was achieved in 35 patients. There was 1 case of recurrent strictures within 1 year among 3 cases of primary repair of biliary strictures in the area of previously installed T-shaped drainage. Resection of common bile duct stricture was followed by Roux-en-Y hepaticojejunostomy. Recurrence-free period among 36 patients ranged from 1 to 10 years, median – 56 months. There were no mortality and complications after X-ray surgery.Conclusion.Antegrade recanalization and balloon dilatation of the stricture followed by long-term external-internal biliodigestive frame drainage are effective for both stricture of biliodigestive anastomosis and partial clipping of bile duct. Conventional surgical procedures should be preferred for cicatricial strictures of extrahepatic bile ducts after previous T-shaped drainage deployment.

Download Full-text