Choledochoscopic Examination of a 3-Dimensional Printing Model Using Augmented Reality Techniques: A Preliminary Proof of Concept Study

Background. We applied augmented reality (AR) techniques to flexible choledochoscopy examinations. Methods. Enhanced computed tomography data of a patient with intrahepatic and extrahepatic biliary duct dilatation were collected to generate a hollow, 3-dimensional (3D) model of the biliary tree by 3D printing. The 3D printed model was placed in an opaque box. An electromagnetic (EM) sensor was internally installed in the choledochoscope instrument channel for tracking its movements through the passages of the 3D printed model, and an AR navigation platform was built using image overlay display. The porta hepatis was used as the reference marker with rigid image registration. The trajectories of the choledochoscope and the EM sensor were observed and recorded using the operator interface of the choledochoscope. Results. Training choledochoscopy was performed on the 3D printed model. The choledochoscope was guided into the left and right hepatic ducts, the right anterior hepatic duct, the bile ducts of segment 8, the hepatic duct in subsegment 8, the right posterior hepatic duct, and the left and the right bile ducts of the caudate lobe. Although stability in tracking was less than ideal, the virtual choledochoscope images and EM sensor tracking were effective for navigation. Conclusions. AR techniques can be used to assist navigation in choledochoscopy examinations in bile duct models. Further research is needed to determine its benefits in clinical settings.

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

Anatomy Research International ◽

10.1155/2012/838179 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 3

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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A rare cause of biliary obstruction – intraductal neuroendocrine tumor of the right hepatic biliary duct: a case report

Medical Ultrasonography ◽

10.11152/mu-2503 ◽

2020 ◽

Author(s):

Mirela Danila ◽

Roxana Sirli ◽

Alina Popescu ◽

Nicoleta Iacob ◽

Ana-Maria Ghiuchici

Keyword(s):

Neuroendocrine Tumors ◽

Biliary Obstruction ◽

Ultrasound Examination ◽

Hepatic Duct ◽

Biliary Duct ◽

Presumptive Diagnosis ◽

Additional Imaging ◽

Biliary Ducts ◽

Well Differentiated ◽

The Right

Primary biliary tract neuroendocrine tumors (NETs) are extremely rare tumors that account for 0.2-2% of all gastrointestinal neuroendocrine tumors. The typical presentation is with jaundice and other symptoms related to biliary obstruction.We present a case of right hepatic duct NET in a 27-year-old female patient, asymptomatic, presented for a routine ultrasound examination that revealed moderate dilatation of the intrahepatic biliary ducts and a 20 mm hyperechoic lesion in the right hepatic biliary duct. Additional imaging was performed with the presumptive diagnosis of cholangiocarcinoma. After surgery, the histopathological and immunohistochemical report was conclusive for the diagnosis of G2 well-differentiated NET

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Proximal Extrahepatic Bile Ducts: Comprehensive Review

Journal of oncology: diagnostic radiology and radiotherapy ◽

10.37174/2587-7593-2021-4-1-74-93 ◽

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.

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Leakage Via Aberrant Bile Duct Due to Cholangiocarcinoma

HPB Surgery ◽

10.1155/1998/61506 ◽

1998 ◽

Vol 11 (2) ◽

pp. 125-128 ◽

Cited By ~ 3

Author(s):

R. Stanton ◽

P. I. Craig ◽

J. O. Jorgensen ◽

D. L. Morris

Keyword(s):

Bile Duct ◽

Hepatic Duct ◽

Open Cholecystectomy ◽

Bile Leak ◽

Biliary Tree ◽

Unusual Presentation ◽

Subsequent Investigation ◽

The Right ◽

Aberrant Bile Duct

The case of a male who had an open cholecystectomy complicated by presistent bile leak from an aberrant bile duct is presented. The persistence and volume of bile leak resulted in subsequent investigation of the biliary tree which demonstrated a cholangiocarcinoma of the right hepatic duct. This case is presented as an unusual presentation of cholangiocarcinoma and to highlight the value of modern techniques in imaging the biliary tree.

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Biliobronchial fistula due to hydatidosis of the liver and choledocholithiasis

Medicinski pregled ◽

10.2298/mpns0906281b ◽

2009 ◽

Vol 62 (5-6) ◽

pp. 281-284 ◽

Cited By ~ 1

Author(s):

Dragoljub Bilanovic ◽

Darko Zdravkovic ◽

Borisav Toskovic

Keyword(s):

Bile Ducts ◽

Hepatic Duct ◽

Liver Cyst ◽

Bronchial Tree ◽

Liver Lobe ◽

X Ray ◽

Abdominal Approach ◽

Chest X Ray ◽

The Right ◽

And Control

INTRODUCTION Biliobronchial fistula (BBF) is an abnormal communication between the biliary system and bronchial tree due to trauma, hemiheptectomy benign biliary stricture with cholangitis and necrotic hepatic infections such as hydatid disease. Intratoracic rupture of a hydatis cyst of the liver is a rare but severe complication with an incidence about 1% and mortality rate about 10%. CASE REPORT A 50-year-old male patient presented with cough, episodes of biliary expectoration and haemoptysis followed with fever, fatigue and dyspnea. The diagnosis was set by echosonography, Chest x-ray finding, CT scan, bronchoscope aspirates while bronchography did not show results. The surgery was done through right subcostal laparotomy. A hydatid cyst was found in the right liver lobe its diameter being 10 cm, fixed with diaphragm. Intraoperative cholangiography revealed choledocholithiasis (two calculi), dilatation of bile ducts and communication of right hepatic duct with the irregular liver cavity as well as with the bronchi of the right lower pulmonary lobe. Cholecystectomy, choledocholitotomy with drainage lavage of bile ducts pericystectomy and cyst evacuation was performed, followed by diaphragm necrosectomy. The postoperative period and control cholangiography through T drain were normal. DISCUSSION The surgical treatment has five goals: to treat the liver cyst, secure free biliary drainage, perform hepatodiaphragmatic disconection, solve intratoracic lesion and restore ti diaphragm. We believe these goals could be achieved through abdominal approach except for irreversible bronchiectasis, intratoracal collection and chronic pulmonary sepsis. CONCLUSION In any case, a surgery still remains the treatment of choice in cases of echinococcosis. Most cases can be solved by laparo-tomy.

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A rare anatomical variation of the bile ducts: Cystic duct draining to the right hepatic duct

The Turkish Journal of Gastroenterology ◽

10.5152/tjg.2018.18321 ◽

2019 ◽

Vol 30 (4) ◽

pp. 375-376

Author(s):

Feyyaz Gungor ◽

◽

Yunus Sur ◽

Emine Ozlem Gur ◽

Osman Nuri Dilek ◽

...

Keyword(s):

Cystic Duct ◽

Bile Ducts ◽

Hepatic Duct ◽

Anatomical Variation ◽

The Right

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Modern view of biliary atresia in children

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-173-1-40-55 ◽

2020 ◽

pp. 40-55 ◽

Cited By ~ 1

Author(s):

G. V. Volynets ◽

A. I. Khavkin ◽

A. V. Nikitin

Keyword(s):

Biliary Atresia ◽

Bile Ducts ◽

Hepatic Duct ◽

Abdominal Cavity ◽

Clinical Manifestations ◽

Biliary Tree ◽

Common Hepatic Duct ◽

Type I ◽

Blood Biochemical ◽

The Common

Atresia of the biliary tract, or biliary atresia (BA), is a destructive, inflammatory disease in which progressive biliary tree fibrosis in an infant leads to obstruction of the bile ducts and, as a result, to cirrhosis of the liver. If untreated, progressive cirrhosis leads to death by 2 years. Biliary atresia can be divided into 3 types, each of which depends on the level closest to biliary obstruction. Type I (obstruction of the common bile duct), type II (patency of the bile ducts to the level of the common hepatic duct), type III (obstruction at the level of the gates of the liver). It is very important to distinguish between types of BA and conduct differential diagnosis with other cholestatic diseases. There are nonsyndromic, syndromic, and BA, combined with other malformations. In diagnostics, in addition to clinical manifestations and specific changes in blood biochemical parameters characterizing cholestasis, an ultrasound examination of the abdominal cavity organs, gepatobiliscintigraphy, magnetic resonance cholecystopancreatocholangiography, according to indications, a puncture biopsy of the liver and histological examination are performed. The main method of treatment is hepatoportoenterostomy according to Kasai, which must be performed no later than 3 months, and with liver cirrhosis and hepatic insufficiency, liver transplantation. Additional methods of treatment include the use of ursodeoxycholic acid, fat-soluble vitamins.

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Implementasi Metode Euclidean Distance untuk Rekomendasi Ukuran Pakaian pada Aplikasi Ruang Ganti Virtual

Jurnal Teknologi Informasi dan Ilmu Komputer ◽

10.25126/jtiik.201852592 ◽

2018 ◽

Vol 5 (2) ◽

pp. 129

Author(s):

Rezky Rizaldi ◽

Arik Kurniawati ◽

Cucun Very Angkoso

Keyword(s):

Augmented Reality ◽

Euclidean Distance ◽

Recommendation System ◽

Three Dimensional ◽

Positive Influence ◽

The Body ◽

Online Store ◽

3 Dimensional ◽

Potential Buyer ◽

The Right

Perkembangan jual beli garmen secara online, dihadapkan pada kenyataan adanya 70% pengembalian produk oleh pembeli, akibat ketidaksesuaian antara harapan dan kenyataan model serta ukuran garmen. Kehadiran virtual fitting room secara online, diharapkan mampu mengurangi adanya pengembalian produk, memberikan pengaruh positif terhadap keistimewaan suatu produk, keinginan untuk membeli dan kepastian membeli secara online. Virtual Fitting Room ini bisa diimplementasikan pada toko online ataupun toko baju seperti biasa. Tahapan penelitian meliputi : penerapan teknologi kinect untuk mendapatkan data skeleton dari calon pembeli yang digunakan sebagai dasar untuk memberikan rekomendasi ukuran pakaian, selanjutnya perhitungan euclidean distance digunakan untuk menghitung ukuran punggung calon pembeli dan terakhir penerapan teknologi augmented reality untuk menampilkan pakaian virtual 3 dimensi yang melekat tepat di badan calon pembeli. Sistem rekomendasi ini mampu menampilkan calon pembeli dengan menggunakan baju virtual 3 dimensi yang sesuai dengan ukuran rekomendasi dari sistem (S,M,L, atau XL). Sistem ini juga memberikan fitur bagi calon pembeli untuk mencoba model pakaian lainnya. Sistem dapat memperlihatkan baju virtual 3 dimensi yang tetap melekat pada badan calon pembeli, ketika melakukan rotasi ke kanan 900, ke kiri 900, balik kanan 1800 dan balik kiri 1800. Hasil uji coba sistem rekomendasi ukuran pakaian ini akan berjalan secara optimal jika pengaturan ketinggian kinect sebesar 55 cm dari tanah. Untuk ketinggian kinect 55cm, 65cm dan 75 cm dari tanah, sistem ini mampu menyajikan kesesuaian rekomendasi ukuran dibandingkan dengan ukuran asli dari calon pembeli sebesar 70%. Kata kunci: kinect, augmented reality, euclidean distance, virtual fitting room AbstractThe development of online garment sale, faced with the fact that there is 70% return of product by the buyer, due to a mismatch between expectation and reality of model and garment size. The presence of virtual fitting room in the online store is expected to reduce the return of products, give a positive influence on the privilege of a product, the desire to buy and certainty to buy online. Virtual Fitting Room can be implemented in the online store or clothing store as usual. The research stages include the application of Kinect technology to obtain skeleton data from prospective buyers used as a basis for providing system recommendations, then euclidean distance calculation is used to calculate the size back potential buyers, and lastly application of augmented reality technology to display the right three-dimensional virtual clothing in potential buyer body. This recommendation system can present potential buyers by using 3-dimensional virtual shirts attached to their bodies by the recommended size of the system (S, M, L, or XL). This system also provides features for potential buyers to try other clothing models. The system can show a 3-dimensional virtual shirt that remains attached to the body of potential buyers, while rotating right 900, left 900, right turn 1800 and left turn 1800. The test results of this clothing size recommendation system will run optimally if the Kinect height setting of 55 cm from the ground. For the Kinect height of 55cm, 65cm and 75cm from the ground, the system can present the recommended size with the original size of the potential buyer of 70%. Keywords: kinect, augmented reality, euclidean distance, virtual fitting room

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Evaluation of the precision of operative augmented reality compared to standard neuronavigation using a 3D-printed skull

Neurosurgical FOCUS ◽

10.3171/2020.10.focus20789 ◽

2021 ◽

Vol 50 (1) ◽

pp. E17

Author(s):

Julien Haemmerli ◽

Alioucha Davidovic ◽

Torstein R. Meling ◽

Lara Chavaz ◽

Karl Schaller ◽

...

Keyword(s):

Augmented Reality ◽

Frontal Sinus ◽

Median Number ◽

Mr Image ◽

Assisted Navigation ◽

3D Printed ◽

Surgical Field ◽

Surgical Conditions ◽

The Right ◽

First Time

OBJECTIVEAugmented reality (AR) in cranial surgery allows direct projection of preregistered overlaid images in real time on the microscope surgical field. In this study, the authors aimed to compare the precision of AR-assisted navigation and standard pointer-based neuronavigation (NV) by using a 3D-printed skull in surgical conditions.METHODSA commercial standardized 3D-printed skull was scanned, fused, and referenced with an MR image and a CT scan of a patient with a 2 × 2–mm right frontal sinus defect. The defect was identified, registered, and integrated into NV. The target was physically marked on the 3D-printed skull replicating the right frontal sinus defect. Twenty-six subjects participated, 25 of whom had no prior NV or AR experience and 1 with little AR experience. The subjects were briefly trained in how to use NV, AR, and AR recalibration tools. Participants were asked to do the following: 1) “target the center of the defect in the 3D-printed skull with a navigation pointer, assisted only by NV orientation,” and 2) “use the surgical microscope and AR to focus on the center of the projected object” under conventional surgical conditions. For the AR task, the number of recalibrations was recorded. Confidence regarding NV and AR precision were assessed prior to and after the experiment by using a 9-level Likert scale.RESULTSThe median distance to target was statistically lower for AR than for NV (1 mm [Q1: 1 mm, Q3: 2 mm] vs 3 mm [Q1: 2 mm, Q3: 4 mm] [p < 0.001]). In the AR task, the median number of recalibrations was 4 (Q1: 4, Q3: 4.75). The number of recalibrations was significantly correlated with the precision (Spearman rho: −0.71, p < 0.05). The trust assessment after performing the experiment scored a median of 8 for AR and 5.5 for NV (p < 0.01).CONCLUSIONSThis study shows for the first time the superiority of AR over NV in terms of precision. AR is easy to use. The number of recalibrations performed using reference structures increases the precision of the navigation. The confidence regarding precision increases with experience.

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Right Posterior Segmental Hepatic Duct: Role of Intraoperative Cholangiogram to Prevent Extrahepatic Biliary Duct Injuries

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v14i2.425 ◽

2020 ◽

Vol 14 (2) ◽

Author(s):

Ikhwan SM ◽

Hairol O ◽

Razman J ◽

Zamri Z ◽

Affirul C

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Hepatic Duct ◽

Biliary Tree ◽

Common Bile Duct Exploration ◽

Biliary Duct ◽

Anatomic Site ◽

Distal Common Bile Duct ◽

Intraoperative Cholangiogram ◽

Bile Duct Injuries

Extrahepatic bile ducts constitute a significant anatomic site for surgeons when performing hepatobiliary operations from minor procedure such as cholecystectomy to major operation such as hepatectomy. The challenges for surgeon in performing such cases increase when congenital variance of biliary tree occurs which may lead to unintentional bile duct injuries. We reported a case of a lady who presented with obstructive jaundice secondary to huge distal common bile duct stone. The presence of right posterior segmental hepatic duct, which rarely occurs, was discovered during intraoperative cholangiogram before common bile duct exploration. The operation was successful without incidence of biliary duct injury.

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