scholarly journals A Rare Case of Intraductal Papillary Mucinous Neoplasm of the Biliary Duct in a Patient with Prostate Adenocarcinoma

2016 ◽  
Vol 10 (3) ◽  
pp. 743-748
Author(s):  
Ravish Parekh ◽  
Gregory Krol ◽  
Cyrus Piraka ◽  
Surinder Batra
Keyword(s):  
Soft Tissue ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Hepatic Duct ◽  
Prostate Adenocarcinoma ◽  
Common Hepatic Duct ◽  
Left Hepatic Duct ◽  
Ductal System ◽  
Mucinous Neoplasm ◽  
The Common ◽  
The Right

Intraductal papillary mucinous neoplasms (IPMNs) are mucin-producing papillary neoplasms of the pancreatic or biliary ductal system that exhibit variable cellular atypia and cause ductal dilation. There are few reported cases of IPMN arising from the biliary tree in the literature. It has a higher propensity to undergo malignant transformation compared to IPMN arising from the pancreatic duct. An 80-year-old male underwent cross-sectional tomography (CT) imaging of the abdomen for evaluation of prostate adenocarcinoma, which revealed an incidental 2.3 × 2.7 cm soft tissue mass centered at the porta hepatis with diffuse dilatation of the left intrahepatic biliary ductal system and mild prominence of the right intrahepatic ductal system. Endoscopic ultrasound showed 2 adjacent hilar masses involving the common hepatic duct and the left hepatic duct with protrusion of the tissue into the lumen of the duct and upstream ductal dilatation. Endoscopic retrograde cholangiopancreatography revealed a large filling defect in the common hepatic duct extending into the left hepatic duct. A large amount of clot and soft tissue with a fish-egg appearance was retrieved. The patient underwent left hepatic lobectomy, radical resection of the common hepatic duct with Roux-en-Y hepaticojejunostomy to the right hepatic duct. Histopathological examination of the resected specimen revealed intraductal papillary mucinous neoplasm with diffuse high-grade dysplasia. Follow-up CT scan of the abdomen 2 months after the surgery was negative for any masses.

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.

scholarly journals Right Hepatic Artery: A Cadaver Investigation and Its Clinical Significance

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Usha Dandekar ◽  
Kundankumar Dandekar ◽  
Sushama Chavan
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Artery ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Normal Anatomy ◽  
Surgical Safety ◽  
Right Hepatic Artery ◽  
The Common ◽  
The Right

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals The Morphometry Extrahepatic Bile Ducts

2018 ◽  
Vol 24 (4) ◽  
pp. 184-189
Author(s):  
Trantu Dina Elena ◽  
Bordei Petru ◽  
Ispas Viorel
Keyword(s):  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Ct Scanner ◽  
A Value ◽  
Extrahepatic Bile Ducts ◽  
Biliary Ducts ◽  
The Common ◽  
The Right

Abstract The extrahepatic bile duct morphometry was determined by the analysis of the colangiographies performed at Medimar Imaging Services SRL of the “St. Andrei “in Constanta on a General Electric Brightspeed Select CT scanner 16 slides. For the left liver duct found a caliber of 3.5-6.6 mm, its length ranging from 4.2-24.9 mm, and the right hepatic duct had a caliber ranging from 4.2-7.2 mm, the length being between 3.0-25.0 mm. At the confluence of the two hepatic ducts an angle of 35.0-124.1° was formed. In the common hepatic duct we found a caliber of 3.9-9.7 mm, in length between 20.2-52.9 mm. Cystic duct having a size of 2.4 to 5.5 mm, finding a length ranging from 24.6 to 66.4 mm. The angle formed at the end of the cystic duct in the hepatic duct had a value between 6.2-55.8°, and between the cystic and biliary ducts an angle of between 88.5-170.4° was formed. The coledoc duct had a caliber of 3.1-14.7 mm and a length of 19.8-57.3 mm.

RIGHT HEPATIC ARTEY: CLINICAL SIGNIFICANCE OF VARIATIONS IN THE ORIGIN AND ITS RELATIONS WITH THE COMMON HEPATIC DUCT

2021 ◽  
pp. 45-47
Author(s):  
Sabeersha. S ◽  
K.S. Krishnakumari
Keyword(s):  
Hepatic Artery ◽  
Hepatic Duct ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Middle Part ◽  
Common Hepatic Duct ◽  
Medical College ◽  
Right Hepatic Artery ◽  
The Common ◽  
The Right

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver . It also supplies the gall bladder, cystic duct, common hepatic duct and upper and middle part of common bile duct. Normal hepatic arterial anatomy occurs in approximately in 80% of cases, for the remaining 20% multiple variations have been described. Misinterpretation of anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. Materials and Methods: This descriptive study conducted on 50 cadavers in Department of Anatomy,Govt Medical College, Kozhikode to document the normal anatomy and different variations of right hepatic artery regarding its origin and relation with the common hepatic duct. Results : Right hepatic artery had its origin from proper hepatic artery in 47 (94%) cases, in one case the artery came from common hepatic artery, aberrant origin of right hepatic artery was seen in 4% cases, one case from celiac trunk directly and the other from superior mesenteric artery. Relation with common hepatic duct : In 46 cases (92%) the artery (normal and aberrant) passes posterior to common hepatic duct. In 6%, the artery was related anterior to common hepatic duct. In one case the artery was medial to the common hepatic duct. Conclusions : This study highlights the importance of knowledge of such anomalies since their awareness will decrease morbidity and help to keep away from a number of surgical complications.

scholarly journals Severe case of post cholecystectomy vasculobiliary injury successfully treated by right hepatectomy with a jump graft to the remaining left hepatic lobe

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Carlo Marino ◽  
Ignacio Obaid ◽  
Gabriela Ochoa ◽  
Nicolás Jarufe ◽  
Jorge A Martínez ◽  
...  
Keyword(s):  
Hepatic Duct ◽  
Open Cholecystectomy ◽  
Severe Case ◽  
Common Hepatic Duct ◽  
Right Hepatectomy ◽  
Left Hepatic Lobe ◽  
Left Hepatic Duct ◽  
Hepatic Lobe ◽  
The Right ◽  
Vasculobiliary Injury

Abstract Vasculobiliary injuries (VBI) caused by cholecystectomies are infrequent but extremely serious. We report a case of a severe VBI successfully treated at our center. A 22-year-old woman underwent an open cholecystectomy as treatment for acute cholecystitis and bile duct stones. She was transferred to our center on postoperative Day 4 because of progressive jaundice and encephalopathy. After a proper investigation, we found an extreme VBI with infarction of the right hepatic lobe associated with complete interruption of the portal vein and proper hepatic artery flows and full section of the common hepatic duct. Right hepatectomy with portal—Rex shunt revascularization of the left hepatic lobe and Roux-en-Y hepaticojejunostomy to the left hepatic duct was done. The patient was discharged on the 60th postoperative day. Discussion: This case shows the successful surgical treatment of a severe cholecystectomy’s VBI, avoiding an emergency liver transplant.

Compression of the common hepatic duct by the right hepatic artery

2005 ◽  
Vol 29 (5) ◽  
pp. 342-344 ◽  
Author(s):  
Kunihiko Izuishi ◽  
Yoshihiro Toyama ◽  
Hisao Wakabayashi ◽  
Hisashi Usuki ◽  
Hajime Maeta
Keyword(s):  
Hepatic Artery ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Right Hepatic Artery ◽  
The Common ◽  
The Right

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

2019 ◽  
Vol 17 (01) ◽  
pp. 90-93
Author(s):  
Akinchan Kafle ◽  
Bidur Adhikari ◽  
Rajani Shrestha ◽  
Nirju Ranjit
Keyword(s):  
Hepatic Duct ◽  
Clinical Importance ◽  
Left Lobe ◽  
Common Hepatic Duct ◽  
Blue Dye ◽  
Left Hepatic Duct ◽  
Cross Sectional ◽  
Bile Duct Wall ◽  
Split Liver ◽  
The Right

Background: Right hepatic duct, formed by the confluence of the anterior and posterior right sectorial ducts, joins left hepatic duct to form common hepatic duct. This fashion of confluence does not prevail in all cases. The sectorial ducts can aberrantly meet left duct and rest of the ducts from the left lobe of liver. Presence of such variation imposes clinical importance during peri-hilar, split liver transplant surgery or cholecystectomy. Nepalese population has not been explored before disregarding clinical necessity as MRI or cholangiography. Methods: Descriptive cross sectional study was conducted in 107 cases dissecting the main portal fissure separating hemi liver and extrahepatic biliary confluences. Methylene blue dye was injected and bile duct wall was cut open to the study pattern of the confluence. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.Results: Normal variant of confluence was found in 72% cases, aberrant right posterior sectorial duct joins left hepatic duct in 9.3% and aberrant right anterior duct or low insertion of the right posterior sectorial duct was found in 1.9%. 9.3% of cases there is no true right hepatic duct often described as triple confluence. 0.9% cases showed no particular pattern of confluence where common hepatic duct is formed by multiple confluence. Quadrate lobe was found to be draining into right anterior sectorial duct in a single case.Conclusions: Right hepatic duct confluence pattern is variable and all the evidence occurs at the main portal fissure. Right sectorial duct may join the left duct avoiding normal confluence pattern. Right posterior sectorial duct may be inserted low in the common bile duct.Keywords: Duct; hepatic; sectorial; variation.

scholarly journals Macro-Microscopic Characteristics of the Glands of the Hepatic Ducts in Postnatal Human Ontogenesis

2021 ◽  
Vol 10 (1) ◽  
pp. 21-26
Author(s):  
S. V. Klochkova ◽  
M. K. Allakhverdiev ◽  
N. T. Alexeeva ◽  
A. G. Kvaratskhelia ◽  
S. O. Fetisov ◽  
...  
Keyword(s):  
Data Processing ◽  
Statistical Data ◽  
Hepatic Duct ◽  
Initial Section ◽  
Individual Characteristics ◽  
Common Hepatic Duct ◽  
Statistical Data Processing ◽  
Age Related ◽  
The Common ◽  
The Right

The aim was to study the macro-microanatomy and morphometric characteristics of the glands of the right, left and common hepatic ducts in people of different ages under conditions of relative norm.Material and methods. The experimental material included a complex consisting of the left, right and common hepatic ducts obtained from the corpses of 126 persons of different age groups who died from causes not related to the pathology of the digestive system. The glands of the hepatic ducts were selectively stained with methylene blue according to R.D. Sinelnikov, followed by fixation in a saturated solution of ammonium picric acid. The macroscopic structure and microstructure of gels were studied using an MBS-9 stereomicroscope. The analysis included the percentage of glands with different numbers of initial divisions. The studied morphometric parameters included the total number of glands, the length and width of their initial part. Methods of parametric statistics based on the Statistica 6.0 software were used for statistical data processing. Statistical data processing included the calculation of the arithmetic mean indicators, their errors, the analysis of the amplitude of the variation series of each indicator was carried out.Results. According to the results of the study, the number of glands in the walls of the common hepatic duct during postnatal ontogenesis was 1.30–1.84 times higher (p<0.05) compared to the right hepatic duct and 1.39–2.13 times higher (p<0.05) than the same indicator in the walls of the left hepatic duct. There was also a tendency according to which the size of the initial section of the glands of the common hepatic duct was larger than that of the right and left hepatic ducts. The minimum and maximum individual values of the total number of glands, the length and width of the initial section in the walls of the common hepatic duct were also higher in comparison with the analogous parameters of the right and left hepatic ducts.Conclusion. Age-related, regional and individual characteristics of the number and size of the glands of the hepatic ducts have been revealed; variants of the shape of the glands in different age periods have been determined, which is important not only for the development of a new scientific direction – morphological exocrinology, but also for gastroenterology, surgery of the extrahepatic biliary tract.

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