scholarly journals Laparoscopic Management of Remnant Cystic Duct Calculi: A Retrospective Study

2009 ◽  
Vol 91 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Chinnusamy Palanivelu ◽  
Muthukumaran Rangarajan ◽  
Priyadarshan Anand Jategaonkar ◽  
Madhupalayam Velusamy Madankumar ◽  
Natesan Vijay Anand
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Imaging Modality ◽  
Operating Time ◽  
Laparoscopic Management ◽  
Subtotal Cholecystectomy ◽  
Laparoscopic Excision ◽  
The Common ◽  
The Mean

INTRODUCTION Even though cholecystectomy relieves symptoms in the majority of cases, a significant percentage suffer from ‘postcholecystectomy syndrome’. Cystic duct/gall bladder remnant calculi is a causative factor. We present our experience with the laparoscopic management of cystic duct remnant calculi. PATIENTS AND METHODS We managed 15 patients with cystic duct remnant calculi from 1996 to 2007 in our institute. All these patients had earlier undergone laparoscopic subtotal cholecystectomy at our centre. They were successfully managed by laparoscopic excision of the remnant. RESULTS The mean duration between first and second surgery was 8.35 months (range, 6–10.7 months). The mean operating time was 103.5 min (range, 75–132 min). Duration of hospital stay was 4–12 days. There was a higher incidence of remnant duct calculi following laparoscopic subtotal cholecystectomy than conventional laparoscopic cholecystectomy 13/310 (4.19%) versus 2/9590 (0.02%). The morbidity was 13.33%, while there were no conversions and no mortality. CONCLUSIONS Leaving behind a cystic duct stump for too long predisposes stone formation, while dissecting too close to the common bile duct and right hepatic artery in acute inflammatory conditions is dangerous. We believe that the former is a wiser policy to follow, as cystic duct remnant calculi are easier to manage than common bile duct or vessel injury. Laparoscopic excision of the remnant is effective, especially when performed by experienced laparoscopists. ‘T’-tube is used to canulate the common bile duct in case the tissue is friable. Magnetic resonance cholangiopancreaticography is the imaging modality of choice, and is mandatory.

Laparoscopic management of type VI choledochal cyst with common bile duct stone: report of a case and review of literature

2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Incidental Finding ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Type I ◽  
Laparoscopic Management ◽  
Cyst Excision

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

Sphincter of oddi dysfunction: sonographic examination in opiate addicts

2011 ◽  
Vol 26 (S2) ◽  
pp. 107-107
Author(s):  
M. Soltan ◽  
M. Abd Ghaffar
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Age Groups ◽  
Sphincter Of Oddi Dysfunction ◽  
Sonographic Examination ◽  
Significant Difference ◽  
The Common ◽  
The Mean ◽  
Opiate Addicts ◽  
Group 1

ObjectiveTo benefit from the usefulness of ultrasonography in measurement of common bile duct in opiate addicts and to correlate between the common bile duct (CBD) diameter and the duration of addiction.Materials and methodFifteen addicts, diagnosed according to DSM IV diagnostic criteria, were examined by abdominal ultrasound. The common bile duct is measured and the results were analyzed with other factors like age, the period of addiction, laboratory findings.ResultsAccording to the findings, there is a significant increase in the range of the CBD diameter in comparison with normal bile ducts. Also, the mean diameter of the CBD in the different age groups showed a significant difference (p < 0.01) and there was a positive significant correlation between the CBD diameter and the period of addiction (p < 0.05, r = 0.875); the multiple comparisons shows that the significant difference between the 3 age groups were due to a significance between group (1) & (2), and group (1) & (3) but no significance between group (2) & (3). So, with the increased length of the addiction period, the mean CBD diameter increases.ConclusionIn opiate addicts, the common bile duct is found to be dilated; however with normal serum bilirubin and alkaline phosphatase level and no obstructive causes by ultrasound examination, no need for any further assessment.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

scholarly journals Difficult cannulation of the common bile duct due to a low junction with the cystic duct

2013 ◽  
Vol 83 (1) ◽  
pp. 202-203
Author(s):  
Teppei Tagawa ◽  
Toshiyuki Baba ◽  
Natsuko Nakazaki ◽  
Chitose Oishi ◽  
Rena Kaneko ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
The Common

scholarly journals Measurement of the Diameter of the Common Bile Duct and Pancreatic Duct among Healthy Adult Sudanese Subjects using Magnetic Resonance Cholangiopancreatography

2020 ◽  
Vol 10 (4) ◽  
pp. 392-396
Author(s):  
Rani Abu Elgasim ◽  
Ahmed Abukonna ◽  
Ala Elgyoum ◽  
Mogahid Zidan ◽  
Mustafa Mahmoud ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Healthy Adult ◽  
Body Height ◽  
Biliary Tract Disease ◽  
Magnetic Resonance Cholangiopancreatography ◽  
The Common ◽  
The Mean

The purpose of our study was to evaluate the common bile duct (CBD) and pancreatic duct (PD) diameter among healthy adult Sudanese subjects using magnetic resonance cholangiopancreatography (MRCP). In addition, this study aimed to determine the effects of age, gender, and body height and weight on the CBD and PD diameters to establish a reference range for these ducts on MRCP, which is very useful in a daily clinical setting where MRCP is commonly performed to evaluate suspected biliary tract disease. Methods and Results: This study included 80 asymptomatic subjects who underwent MRCP. The widest diameter of the CBD and PD was measured perpendicular to their long axes using the electronic caliper. The applied MRCP imaging technique was in line with the guidelines used by Chen et al.(2012) The age, gender, medical history, body height and body weight were recorded. Among the 80 subjects, the mean CBD diameter on MRCP was 6.17±0.69 mm (range of 4-8 mm). There was a significant correlation between the CBD diameter and weight (r=0.407, P<0.001). The mean PD diameter on MRCP was 3.80±0.50mm (range of 2-5 mm). There was also a significant correlation between the PD diameter and weight (r=0.407, P<0.001). In the cohort of 80 subjects, the mean CBD diameter in females was larger than in males(6.50±0.632mm and 5.95±0.677mm, respectively), and this difference was statistically significant (P<0.05). Also, the mean PD diameter in females was statistically larger than in males (6.03±0.66mm and 5.58±0.675mm, respectively), and this difference was statistically significant (P<0.05). Our results demonstrate no significant correlation between the diameter of CBD and PD and participants' height and age. Conclusion: The importance of the current study lies in it’s being one of the few studies whose intention was to use MRCP to bridge the knowledge gap in the literature about the measurement of the CBD and PD diameter among healthy adult Sudanese subjects.

scholarly journals Post cholecystectomy common bile duct dilatation: a study from upper hills of Himachal Pradesh, India

2020 ◽  
Vol 8 (4) ◽  
pp. 1254
Author(s):  
Rajan Sood ◽  
Rinku Singh ◽  
Sumit Chawla
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Elective Surgery ◽  
Study Group ◽  
Bile Duct Dilatation ◽  
Post Operative Period ◽  
Ethical Approval ◽  
Common Bile Duct Dilatation ◽  
The Common ◽  
The Mean

Background: Relationship between cholecystectomy followed by postoperative dilatation of the common bile duct is uncertain. Various studies have shown variable results regarding the dilatation of common bile duct after cholecystectomy.Methods: This study was a 1-year prospective study conducted at IGMC, Shimla with consent and ethical approval from the committee. Total 50 cases of symptomatic cholelithiasis belonging to either sex admitted in Surgical Wards of IGMC Shimla for elective surgery were selected for the present study. Cholecystectomy was done in all cases, after doing all the investigations.Results: The mean preoperative CBD diameter in the study group was 4.2mm, 48 hours postoperatively was 5.58mm and at 1-month interval following cholecystectomy was 6.02mm, so the mean postoperative diameter observed was (6.02+5.58=5.8mm).Conclusions: Significant dilatation does occur in CBD which is purely compensatory as there was no evidence of any pathological dilatation. This dilatation occur only in early post-operative period till the CBD adapts to contain bile equal to the Gall Bladder.

scholarly journals Agenesis of the gallbladder and cystic duct

2002 ◽  
Vol 120 (6) ◽  
pp. 192-194 ◽  
Author(s):  
Jaques Waisberg ◽  
Paulo Engler Pinto Júnior ◽  
Paula Regina Gusson ◽  
Paola Rossini Fasano ◽  
Antônio Cláudio de Godoy
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Intraoperative Cholangiography ◽  
Diagnostic Aspects ◽  
Rare Anomaly ◽  
The Common

Agenesis of the gallbladder and cystic duct is a rare anomaly that is usually asymptomatic. The patient may present symptoms characteristic of cholelithiasis. Its surgical confirmation requires careful dissection of the common bile duct and intraoperative cholangiography or ultrasonography to be performed, to exclude the possibility of an ectopic gallbladder. The authors describe two cases of this unusual affection and comment on its clinical, pathophysiological and diagnostic aspects.

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