scholarly journals Robot-Assisted Laparoscopic Resection of a Todani Type II Choledochal Malformation

2019 ◽  
Vol 13 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Anneke ten Hove ◽  
Ruben H.J. de Kleine ◽  
Maarten W. Nijkamp ◽  
Annet S.H. Gouw ◽  
Timco Koopman ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Extrahepatic Bile Duct ◽  
Squamous Metaplasia ◽  
Biliary Tree ◽  
Type Ii ◽  
Robot Assisted ◽  
Cyst Excision ◽  
Extrahepatic Bile Duct Resection ◽  
Different Types ◽  
Choledochal Malformation

Choledochal malformation (CM) comprise various congenital cystic dilatations of the extrahepatic and/or intrahepatic biliary tree. CM is classified into five different types. Our case describes a 58-year-old man presenting with acute abdominal pain. Further examination showed a Todani type II CM. Treatment for type II is complete cyst excision without the need for an extrahepatic bile duct resection. A robot-assisted laparoscopic resection of the CM was performed and the patient recovered without complications. Pathology results showed a Todani type II malformation in which complete squamous metaplasia has occurred. In this paper, we report, to the best of our knowledge, the first description of a robot-assisted laparoscopic resection of a type II CM.

scholarly journals Spread of Intraductal Papillary Neoplasm Arising from the Cystic Duct of the Biliary Tree

2016 ◽  
Vol 10 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Yoshihiko Kadowaki ◽  
Yuki Yokota ◽  
Satoshi Komoto ◽  
Nobuhito Kubota ◽  
Takahiro Okamoto ◽  
...  
Keyword(s):  
Bile Duct ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Carcinoma ◽  
Biliary Tree ◽  
Duct Carcinoma ◽  
Intraductal Growth ◽  
Intraductal Papillary Neoplasm ◽  
Extrahepatic Bile Duct Resection ◽  
Papillary Neoplasm

Intraductal papillary neoplasm of the bile duct (IPNB) is a variant type of the bile duct carcinoma characterized by intraductal growth. IPNB is also recognized as a precursor of invasive carcinoma. We describe herein an extremely rare case of IPNB arising from the cystic duct. A 68-year-old man was admitted to our hospital for investigation of epigastralgia and abnormal levels of biliary tract enzyme. Computed tomography and magnetic resonance imaging showed a mass lesion spreading from the cystic duct to the upper-middle bile duct. Endoscopic retrograde cholangiography demonstrated diffuse duct dilation with a grossly visible intraductal mass and amorphous blobs, suggesting the presence of mucobilia or scattered tumors. We performed extrahepatic bile duct resection with lymphadenectomy. Macroscopically, a friable papillary tumor originated from the cystic duct grows intraluminally into the bile duct. Pathologically, the tumor was found to be intramucosal adenocarcinoma spreading to the whole extrahepatic bile duct, which was compatible with IPNB. We should discuss the features and progression processes of IPNB through this precious case.

Robot-assisted and open resections for perihilar cholangiocarcinoma. Comparative analysis of the immediate outcomes

2020 ◽  
Vol 25 (4) ◽  
pp. 60-70
Author(s):  
M. G. Efanov ◽  
R. B. Alikhanov ◽  
I. V. Kazakov ◽  
A. N. Vankovich ◽  
O. V. Melekhina ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Extrahepatic Bile Duct ◽  
Radical Resection ◽  
Vascular Reconstruction ◽  
Perihilar Cholangiocarcinoma ◽  
Initial Experience ◽  
Robot Assisted ◽  
Bile Duct Resection ◽  
Single Center Experience ◽  
Extrahepatic Bile Duct Resection

Background. Minimally invasive radical surgery for perihilar cholangiocarcinoma is in its early stages. Aim. A comparative analysis of the initial experience of robot-assisted and open resections for perihilar cholangiocarcinoma. Material and methods. The single-center experience, accumulated over the period from 2014 to 2018, is analyzed. Robot-assisted procedures included major liver resection and caudate lobectomy with extrahepatic bile duct resection and lymphadenectomy. The need for vascular reconstruction was considered a contraindication to surgery. Results. Thirteen robot-assisted resections were performed. The perihilar cholangiocarcinoma was confirmed by pathologic examination in 10 patients. The immediate outcomes were compared with that in 88 open procedures. There were no significant differences in blood loss, the rate of severe morbidity, mortality, and hospital stay. The duration of the robot-assisted surgical resections was significantly longer. Conclusion. Analysis of initial experience justifies the robotic approach for radical resection in highly selected patients.

Immunological Determined Plasminogen Groups And Its Possible Biological Relevance

1981 ◽  
Author(s):  
V Sachs ◽  
R Dörner ◽  
E Szirmai
Keyword(s):  
Human Plasma ◽  
Type I ◽  
Type Ii ◽  
Precipitation Line ◽  
Gene Frequencies ◽  
Type Iii ◽  
Different Types ◽  
Human Plasminogen ◽  
Gel Diffusion ◽  
Good Agreement

Anti human plasminogen sera of the rabbit precipitate human plasma in the agar gel diffusion test by means of intra-basin absorption with plasminogenfree human plasma with three different types: type I is represented by one strong precipitation line, type II by two lines, a big one and a small one, and type III by three slight but distinct lines. The following frequencies of the different types have been observed in a sample of 516 human plasmas: type I 65%, type II 33% and type III 2%. Suppose the types are phenotypical groups of a diallelic system where the types I and III represent the homozygous genotypes and the type II the heterozygous the estimated gene frequencies are in good agreement with the expected values. There is also a good agreement of the distribution of plasminogen groups determined by electrofocussing from RAUM et al. and HOBART. The plasminogen groups possibly may have also a biological meaning because the plasmas of type III always have a lesser fibrinolytic activity than the plasmas of the other types.

scholarly journals Robot-assisted treatment of benign diseases of extrahepatic bile duct

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e521-e522
Author(s):  
E.F. Kauffmann ◽  
N. Napoli ◽  
F. Costa ◽  
F. Menonna ◽  
S. Iacopi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Robot Assisted ◽  
Benign Diseases

Indication of extrahepatic bile duct resection for gallbladder cancer

2017 ◽  
Vol 403 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Hiroshi Kurahara ◽  
Kosei Maemura ◽  
Yuko Mataki ◽  
Masahiko Sakoda ◽  
Satoshi Iino ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gallbladder Cancer ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection

scholarly journals A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shunryo Minezaki ◽  
Takeyuki Misawa ◽  
Makoto Watanabe ◽  
Hideki Takahashi ◽  
Takashi Koenuma ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gastrointestinal Bleeding ◽  
Pathological Condition ◽  
Extrahepatic Bile Duct ◽  
Pathological Examination ◽  
Emergency Setting ◽  
Internal Drainage ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection ◽  
Life Threatening

Abstract Background Currently, there is an unwavering consensus that the standard surgery for congenital biliary dilation (CBD) is extrahepatic bile duct resection and choledochojejunostomy. However, decades prior, choledochocyst–gastrointestinal anastomosis without extrahepatic bile duct resection (internal drainage surgery, IDS) was preferred for CBD because of its simplicity. Currently, there is almost no chance of a surgeon encountering a patient who has undergone old-fashioned IDS, which has been completely obsolete due to the risk of carcinogenesis from the remaining bile duct. Moreover, the pathological condition long after IDS is unclear. Herein, we report a case of life-threatening bile duct bleeding as well as carcinoma of the bile duct 62 years after IDS in a patient with CBD. Case presentation An 82-year-old Japanese woman with hemorrhagic shock due to gastrointestinal bleeding was transferred to our hospital. She had a medical history of unspecified surgery for CBD at the age of 20. Based on imaging findings and an understanding of the historical transition of the surgical procedure for CBD, the cause of gastrointestinal bleeding was determined to be rupture of the pseudoaneurysm of the dilated bile duct that remained after IDS. Hemostasis was successfully performed by transcatheter arterial embolization (TAE) in an emergency setting. Then, elective surgery for extrahepatic bile duct resection and choledochojejunostomy was performed to prevent rebleeding. Pathological examination revealed severely and chronically inflamed mucosa of the bile duct. Additionally, cholangiocarcinoma (Tis, N0, M0, pStage 0) was incidentally revealed. Conclusion It has been indicated that not only carcinogenesis, but also a risk of life-threatening bleeding exists due to long-lasting chronic inflammation to the remnant bile duct after IDS for CBD. Additionally, both knowledge of which CBD operation was performed, and an accurate clinical history are important for the diagnosis of hemobilia.

scholarly journals Proximal Extrahepatic Bile Ducts: Comprehensive Review

2021 ◽  
Vol 4 (1) ◽  
pp. 74-93
Author(s):  
M. A. Shorikov ◽  
O. N. Sergeeva ◽  
M. G. Lapteva ◽  
N. A. Peregudov ◽  
B. I. Dolgushin
Keyword(s):  
Bile Duct ◽  
Bile Flow ◽  
Bile Ducts ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Comprehensive Review ◽  
Extrahepatic Bile Ducts ◽  
And Function ◽  
Variant Anatomy

Proximal extrahepatic bile ducts are the biliary tree segment within formal boundaries from cystic ductcommon hepatic duct junction to sectoral hepatic ducts. Despite being a focus of attention of diagnostic and interventional radiologists, endoscopists, hepatobiliary surgeons and transplantologists they weren’t comprehensively described in available papers. The majority of the authors regard bile duct confluence as a group of merging primitively arranged tubes providing bile flow. The information on the proximal extrahepatic bile duct embryonal development, variant anatomy, innervation, arterial, venous and lymphatic supply is too general and not detailed. The present review brought together and systemized exiting to the date data on anatomy and function of this biliary tract portion. Unique, different from the majority of hollow organs organization of the proximal extrahepatic bile duct adapts them to the flow of the bile, i.e. viscous aggressive due to pH about 8.0 and detergents fluid, under higher wall pressure than in other parts of biliary tree. 

scholarly journals Comparative Characteristics of Sensorimotor Reactions of Highly Qualified Athletes with Different Types of Heart Rate Regulation

2021 ◽  
Vol 6 (5) ◽  
pp. 456-464
Author(s):  
A. P. Romanchuk ◽  
◽  
O. V. Guzii ◽  
A. V. Maglyovanyi ◽  
◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Type I ◽  
Sensorimotor Function ◽  
Type Ii ◽  
Highly Qualified ◽  
Rate Regulation ◽  
Type Iv ◽  
Heart Rate Regulation ◽  
Different Types

The purpose of the study was a comparative analysis of sensorimotor reactions in highly trained athletes with different types of heart rate regulation. Materials and methods. 202 highly trained male athletes aged 22.6±2.8 years, who are engaged in acyclic sports – martial arts (karate, taekwondo, kickboxing, boxing, freestyle wrestling, Greco-Roman wrestling, judo, sambo) and games (water polo, soccer) were examined. The experience in sports was 10.3±3.1 years. All studies were conducted in the pre-competition period in the morning. Based on the study of heart rate variability in athletes, the type of heart rate regulation was determined. The basis for determining the types of regulation is the classification of heart rate variability indicators, taking into account their inclusion in certain limits. Heart rate variability indicators that reflect the dual-circuit model of heart rate regulation and are used for diagnosis include: total heart rate variability – total power (ms2), very low frequency (ms2), and stress-index (e.u.), which reflect the various chains of regulatory effects on heart rate. According to certain data types, 4 groups were formed. 1 group (type I) consisted of 42 athletes, 2 (type II) – 28 athletes, 3 (type III) – 88 athletes, 4 (type IV) – 44 athletes. The study of sensorimotor function was performed using the device KMM-3. Results and discussion. It is shown that the most balanced sensorimotor reactions are in athletes with type III regulation of heart rate. The most strain sensorimotor reactions are observed in type II regulation of heart rate, which is reflected in the pronounced central asymmetry of movement control with acceleration to the left against the background of deteriorating accuracy of right (due to flexors) and left (due to extensors) limbs, and the right-hand predominance. Sensorimotor reactions are quite strain in type IV of heart rate regulation, which is characterized by slow reactions at the synaptic and peripheral levels. In type I of heart rate regulation, the disorders observed at the central level of regulation relate to the asymmetry of short-term motor memory processes, which are significantly reduced in the left hemisphere. Conclusion. The study shows that the differences in the regulatory support of heart rate in highly qualified athletes are accompanied by characteristic differences in sensorimotor function. The latter can be useful for the diagnosis and further correction of conditions associated with the development of overexertion and overtraining

Electroreception in Gymnotus carapo: pre-receptor processing and the distribution of electroreceptor types

2000 ◽  
Vol 203 (21) ◽  
pp. 3279-3287 ◽  
Author(s):  
M.E. Castello ◽  
P.A. Aguilera ◽  
O. Trujillo-Cenoz ◽  
A.A. Caputi
Keyword(s):  
Electric Fields ◽  
Electric Fish ◽  
Fish Tissue ◽  
Field Vector ◽  
The Body ◽  
Type I ◽  
Type Ii ◽  
Field Patterns ◽  
Different Types ◽  
Very High

This paper describes the peripheral mechanisms involved in signal processing of self- and conspecific-generated electric fields by the electric fish Gymnotus carapo. The distribution of the different types of tuberous electroreceptor and the occurrence of particular electric field patterns close to the body of the fish were studied. The density of tuberous electroreceptors was found to be maximal on the jaw (foveal region) and very high on the dorsal region of the snout (parafoveal region), decaying caudally. Tuberous type II electroreceptors were much more abundant than type I electroreceptors. Type I electroreceptors occurred exclusively on the head and rostral trunk regions, while type II electroreceptors were found along as much as 90 % of the fish. Electrophysiological data indicated that conspecific- and self-generated electric currents are ‘funnelled’ by the high conductivity and geometry of the body of the fish. These currents are concentrated at the peri-oral zone, where most electroreceptors are located. Moreover, within this region, field vector directions were collimated, constituting the most efficient stimulus for electroreceptors. It can be concluded that the passive properties of the fish tissue represent a pre-receptor device that enhances exafferent and reafferent electrical signals at the fovea-parafoveal region.

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