scholarly journals Anatomical variations of the hepatobiliary system in Sudanese patients undergoing endoscopic retrograde cholangiopancreatography (ERCP)

2017 ◽  
Vol 5 (1) ◽  
pp. 105
Author(s):  
Wael Doush ◽  
Mohammed A/Galil ◽  
Shakir Ibrahim
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Cystic Duct ◽  
Congenital Anomalies ◽  
Vascular Anatomy ◽  
Invasive Procedure ◽  
Anatomical Variations ◽  
Ampulla Of Vater ◽  
University Hospital ◽  
Endoscopic Retrograde ◽  
Hepatobiliary System

Background: The meticulous identification of the hepatobiliary tree system normal anatomy during surgical operations is crucial in iatrogenic injury prevention. Equally important, an understanding of the congenital variations of biliary and vascular anatomy, as the literature abounds with reports of specific anatomical variations, and their surgical implications.Aim: This study aimed to study the presence of anatomical variations within the hepatobiliary system in Sudanese population undergoing endoscopic retrograde cholangiopancreatography (ERCP).Patients and methods: The records of patients undergoing ERCP in Soba University Hospital during 2004 to 2008 were analyzed. There were 277 Sudanese patients who had complained of right hypochondrial abdominal pain & history of jaundice (obstructive jaundice) that underwent ERCP were included within this study. The exclusion criteria included the following: Sudanese patients in whom ERCP failed or patients who had advanced hepatobiliary disease like cancers, strictures either cancerous or iatrogenic, fistula and iatrogenic biliary leak.Results: The analysis of 277 Sudanese patients undergoing ERCP of the hepatobiliary system showed the following results regarding the variations: The choledochal cyst type one (fusiform type) was present in 3 (1.08%) patients; very low cystic duct insertion (parallel) was present in 1 (0.36%) patient and long cystic duct was present in 3 (1.08%) patients. The ampulla of Vater size variations occurred as A) Normal in 158 (57%) patient, B) Small in 56 (20.2%) patients, C) Large in 29 (10.5%) patients, D) Periampullary diverticula in 4 (1.4%) patients and E) unclassified in 30 (10.8%) patients. Other forms of congenital anomalies were not found.Conclusion: The using of endoscopic retrograde cholangiopancreatography (ERCP) is a reliable radiological method for depicting congenital anomalies of the hepatobiliary system, but it is an invasive procedure.

scholarly journals Endoscopic retrograde cholangiopancreatography in infants and children

2021 ◽  
Vol 09 (03) ◽  
pp. E292-E296
Author(s):  
Tone Lise Åvitsland ◽  
Lars Aabakken
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Records ◽  
Pediatric Patients ◽  
Biliary Stricture ◽  
Infants And Children ◽  
University Hospital ◽  
Older Children ◽  
Endoscopic Retrograde ◽  
Procedure Codes ◽  
In Infants And Children

Abstract Background and study aims Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods Patients < 18 years who underwent ERCP between April 1999 and November 2017 were identified using procedure codes. Medical records were examined for age, gender, diagnosis, indications, type of sedation, findings, interventions, and complications. Results A total of 244 procedures were performed in 158 patients. Fifty-six of these were in 53 infants (age ≤ 1 year). Mean age was 8.8 years. The youngest patient was 8 days old. Mean weight was 5.0 kg in infants, the smallest weighing 2.9 kg. Cannulation failed in 19 (7.8 %). The main indication in infants was suspicion of biliary atresia (n = 38). Six of the procedures (10.7 %) were therapeutic. In children the main indications were biliary stricture (n = 64) and investigation of primary sclerosing cholangitis (PSC) (n = 45). 119 (63.2 %) of these procedures were therapeutic.Complications were uncommon in infants; only two episodes of infection were registered. In children (> 1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.

Laparoscopic Common Duct Exploration in 90-Bed Rural Hospital

2010 ◽  
Vol 76 (6) ◽  
pp. 626-629
Author(s):  
Eugene H. Shively ◽  
Malcolm Richardson ◽  
Robert Romines ◽  
Graham Englund ◽  
James Watkins
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Cystic Duct ◽  
Common Duct ◽  
Biliary Tract Disease ◽  
Common Bile Duct Exploration ◽  
Endoscopic Retrograde ◽  
Tract Disease

Laparoscopic common bile duct exploration (LCBDE) is an effective procedure when endoscopic retrograde cholangiopancreatography is not available. From January 2004 until December 2009, 1254 patients presented with biliary tract disease. Laparoscopic cholecystectomy was attempted in 1240 (98%) cases and completed in 1232 (98%) cases. Laparoscopic cholangiograms were performed in 627 (50%) cases. LCBDE was carried out in 33 (2.6%) cases. Of the 33 LCBDEs, 29 (2.3%) were via the cystic duct, four (0.32%) through a choledochotomy; eight (0.64%) of the total laparoscopic cholecystectomies were converted to open cholecystectomies. LCBDE can be done safely in small hospitals and is very useful when endoscopic retrograde cholangiopancreatography is not available.

scholarly journals Complex Cystic Duct is Associated With Cholelithiasis

HPB Surgery ◽  
1998 ◽  
Vol 11 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Georgi P. Deenitchin ◽  
Junichi Yoshida ◽  
Kazuo Chijiiwa ◽  
Masao Tanaka
Keyword(s):  
Cystic Duct ◽  
Case Series ◽  
Acute Angle ◽  
Endoscopic Retrograde Cholangiography ◽  
University Hospital ◽  
Endoscopic Retrograde ◽  
Retrospective Survey ◽  
Inner Diameter ◽  
The Relationship

The relationship between complex cystic ducts and cholelithiasis has seldom been investigated quantitatively. Thus we attempted a retrospective survey on two case series with and without cholelithiasis in a university hospital. A total of 500 patients who underwent endoscopic retrograde cholangiography were reviewed, 250 of whom had cholelithiasis and another 250 no gallstones. They were sampled at random during the period from 1979 through 1993. Parameters including the length, inner diameter and configuration of the cystic duct, and the angle formed by the cystic duct, and the axis of the gallbladder were compared between the groups with or without cholelithiasis. The patients with gallstones has significantly (p<0.001) longer and narrower cystic ducts (a mean of 48mm and 4mm in length and diameter, respectively) than did those without stones (a mean of 28mm and 7mm, respectively). Moreover, patients with gallstones showed a significantly (p<0.001) more acute angle between the gallbladder and the cystic duct than those without (a mean angle of 84° and 119° respectively). The overall frequency of the disfigurements of the cystic duct was significantly higher in the group with gallstones (99%) than in the group without (29%). The results therefore suggested that complex cystic ducts are associated with cholelithiasis.

scholarly journals Double Cystic Duct as Rare Anatomic Variant

2019 ◽  
Vol 12 (1) ◽  
pp. 69-71
Author(s):  
Antonio Serafin Valero-Liñán ◽  
Toni I. Stoyanov ◽  
Alba Sanchez-Gallego ◽  
Elías Garcia-Grimaldo ◽  
José Antonio Gonzalez-Masiá ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Biliary Tree ◽  
Anatomical Variations ◽  
University Hospital ◽  
Digestive Surgery ◽  
Anatomical Arrangement ◽  
Rare Anatomic Variant ◽  
Anatomical Finding ◽  
The University ◽  
Rule Out

Summary The variations of the cystic duct are so common that only 30% of all humans present the classical anatomical arrangement between the common bile duct (CBD), the cystic duct, and adjacent arteries. Thus, it could be considered that anomalies of the biliary tree are a rule rather than an exception. Duplication of the cystic duct, however, is a very uncommon anatomical finding. In the Department of General and Digestive Surgery of the University Hospital Complex Albacete, a 73-year-old patient was admitted with symptoms of cholangitis. He underwent emergency surgery that found exacerbated chronic cholecystitis and dilation of the CBD. Cholecystectomy was performed with identification of a double cystic duct that drained separately in the CBD and exploration of the last revealed cholangitis without choledocholithiasis. The postoperative period progressed favourably, proceeding to discharge from the hospital with Kehr drainage closed. In conclusion, we consider that the routine use of intraoperative cholangiography when there is suspicion of anatomical variations of the biliary tree is mandatory to rule out lesions or alterations thereof.

scholarly journals Cystic duct remnant stone removal by endoscopic retrograde cholangiopancreatography

2016 ◽  
Vol 07 (02) ◽  
pp. 065-067 ◽  
Author(s):  
Yogesh Harwani ◽  
Mahesh Goenka ◽  
Vijay Rai ◽  
Usha Goenka
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Female Patient ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Cystic Duct ◽  
Endoscopic Retrograde ◽  
Biliary Pain ◽  
Postcholecystectomy Syndrome

AbstractCystic duct remnant calculus (CDRC) is an important cause of postcholecystectomy syndrome.[1] Open assess cholecystectomy or laparoscopic cholecystectomy of the remnant duct is effective and considered to be preferred treatment. We report a case of 65-year-old female patient, a poor surgical candidate with CDRC who presented to us with biliary pain and obstructive jaundice secondary to common bile duct (CBD) stones, in whom CDRC was extracted during CBD clearance by endoscopic retrograde cholangiopancreatography.

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