scholarly journals On the question of primary malignant neoplasms of ductus hepatici

2021 ◽  
Vol 22 (7) ◽  
pp. 781-784
Author(s):  
N. I. Vylegzhanin
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Malignant Neoplasms ◽  
Papilla Vateri ◽  
Extrahepatic Bile Ducts ◽  
Frequent Site ◽  
The Common

Among the neoplasms of large extrahepatic bile ducts, cancers occupy the first place in terms of frequency and importance, and the common bile duct, especially its beginning the place where it flows into the duodenum (papilla Vateri), is the most frequent site of cancer localization.

scholarly journals TOTAL HEPATOCYTES VOLUME AS THE SURVIVAL FACTOR IN EXPERIMENTAL OBSTRUCTION OF THE BILIARY PATHWAYS

2020 ◽  
pp. 21-26
Author(s):  
I. М. Mamontov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Fatal Outcome ◽  
Liver Volume ◽  
Volume Density ◽  
Morphometric Study ◽  
Survival Factor ◽  
Extrahepatic Bile Ducts ◽  
The Common

Abstract. The aim of the research was to studying histological and some morphomethrics feathers of the liver and related with them lethality during experimental complete and partial obstruction of the extrahepatic bile ducts (COEHBD and POEHBD). Materials and methods. The experiment was included 83 rats that were sacrificed on the 3rd, 7th, 14th, 21st, 28th and 35th days. COEHBD was modeled by ligation and transaction of the common bile duct, POEHBD was modeled by ligation of the common bile duct with a needle of a given diameter. Histological analyses of the liver was performed together with morphometric study. Results. The death of rats occurs during the first 3 days of the experiment and after 14 days, with a predominance of mortality on 14-35 days compared to the period up to 14 days (p<0.05). Death after 14 days of the experiment occurs in the model of complete cholestasis. From the all investigated morphometric measures such as the hepatocytes volume density (HVD), liver volume (LV), total hepatocytes volume (THV), the last one is the most accurately reflects the compensatory capabilities of the liver in conditions of complete and partial cholestasis and can serve as a criteria for predicting of the fatal outcome. Conclusion. The THV most accurately reflects the compensatory capabilities of the liver in experimental COEHBD and POEHBD and can serve as a criterion for predicting a fatal outcome.

CHOLANGITIS AS A SYSTEMIC MANIFESTATION OF ACUTE BILIARY INFECTION

2020 ◽  
pp. 43-47
Author(s):  
A. O. Nekludov ◽  
M. O. Klosova ◽  
O. V. Volchenko ◽  
M. M. Goloborodko ◽  
A. Yu. Korolevska
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Water Column ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Inflammatory Process ◽  
Acute Cholangitis ◽  
Biliary Infection ◽  
The Common ◽  
Further Development

The main causes of cholangitis are hypertension in the biliary ducts and infection. In order to determine the place of the infectious factor in the acute cholangitis development, a retrospective and prospective analysis of case histories of 176 patients with choledocholithiasis and manifestations of acute and chronic cholangitis was performed. Bile from the common bile duct in the patients with obstruction of the biliary tract was studied. In the patients with mechanical jaundice without and with cholangitis, the intraductal pressure in the common bile duct averaged 227.3±26.1 mm of water column, in the patients without signs of cholangitis that was 97.5±8.3 mm of water column. With mechanical jaundice without acute cholangitis, it was slightly elevated if compared to normal. This suggests that the increase in pressure in the bile ducts in acute cholangitis is not influenced by the fact of obstruction of the biliary tract, and the development of the inflammatory process in them. In the patients with cholangitis, the initial values of the number of colonizing units were much higher than in "pure" choledocholithiasis. After endoscopic papillosphincterotomy in the patients with vivid clinical cholangitis, in whom decompression was achieved, in the control study, this value decreased by 100−500 times, which was accompanied by clinical improvement. According to the results of the study, it was noted that in the patients with a manifested clinic sign of cholangitis there is a significant decrease in the number of colonizing units on the third day after endoscopic papillosphincterotomy. At the stone stuck in a papilla the choledoch turns into so−called analog of an abscess. The opening of the papilla provides a free passage of the contents of the choledochus (i.e. pus) into the duodenum, so there is an almost instant therapeutic effect. The increase in pressure in the bile ducts in acute cholangitis is influenced by the development of an inflammatory process, which indicates the manifestations of biliary infection. The presented research has a prospective character and needs further development. Key words: cholangitis, biliary infection, intraductal pressure, bile.

scholarly journals LAPAROSCOPIC CHOLEDOCH REVISION FOR THE TREATMENT OF CHOLEDOCHOLITHIASIS IN AN INFANT

2019 ◽  
Vol 23 (4) ◽  
pp. 220-223
Author(s):  
M. Yu. Kozlov ◽  
Anton S. Malashenko ◽  
A. A. Shchebeteev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Bile Ducts ◽  
Open Abdomen ◽  
Unified Approach ◽  
Endoscopic Retrograde ◽  
Surgical Practice ◽  
Percutaneous Puncture ◽  
The Common

Choledocholithiasis is a rare pathology in children. Various techniques have been proposed for removing calculi from the common bile duct: percutaneous puncture drainage of bile ducts, endoscopic retrograde cholangiopancreatography with papillosphincterotomy as well as revision of the common bile duct which can be done laparoscopically or in the open abdomen. However at present, there is no any unified approach to managing this pahtology in children. The article describes authors’ experience of laparoscopic revision of the common bile duct in an infant with choledocholithiasis. The authors consider that this technique can be applied in pediatric surgical practice.

scholarly journals Cystic form of biliary atresia. Treatment experience

2020 ◽  
Vol 10 (1) ◽  
pp. 17-24
Author(s):  
Irina I. Borisova ◽  
Anatoliy V. Kagan ◽  
Svetlana A. Karavaeva ◽  
Aleksey N. Kotin
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Atresia ◽  
Bile Ducts ◽  
Surgical Intervention ◽  
Ultrasound Examination ◽  
Duct Cyst ◽  
Cystic Form ◽  
The Common

Background. The cystic form of biliary atresia is a rare form of atresia of the biliary tract, which is a relatively favorable variant of the defect and can be diagnosed antenatally. In practice, it is important not only to suspect this diagnosis, but also to differentiate this variant of impaired development of the external bile duct from the cyst of the common bile duct. This is due to the difference in approaches and methods of surgical treatment of choledochal cysts and biliary atresia. Obliteration (atresia) of the bile ducts in the absence of timely surgical intervention quickly leads to the progression of cirrhosis and the development of liver failure. The method of choice in the treatment of AD is Kasai surgery, often palliative in nature, but allowing to delay the time until liver transplantation. The cyst of the common bile duct rarely requires early surgical treatment, and the risk of cirrhosis is significantly lower. Surgical intervention is aimed at removing the cyst and restoring the flow of bile by anastomosing the external bile ducts with the intestines, which is a radical method of treatment and leads to the recovery of the child. External similarity in ultrasound examination of the fetus and newborn baby of the cystic form of biliary atresia of the bile ducts with a cyst of the common bile duct does not always allow differentiation of one defect from another, which can lead to untimely correction of the defect and an unfavorable outcome. Aim. Demonstrate a rare type of biliary atresia. Materials and methods. Between 2001 and 2019, 33 patients with biliary atresia were treated in the Childrens City Multidisciplinary Clinical Specialized Center for High Medical Technologies in St. Petersburg, only two patients had a cystic form. Both children were initially treated as patients with bile duct cyst. Children were operated on at the age of 2 and 3.5 months. The first patient underwent surgery Kasai, the second hepaticoyunoanastomosis. Results. During the observation period (9 years and 4 years), the synthetic function of the liver is normal, and there are currently no indications for transplantation. Conclusion. If a fetus or a newborn with neonatal jaundice is detected during ultrasound examination of a cystic formation in the gates of the liver, it is very important to correctly and quickly make a differential diagnosis between the cystic form of biliary atresia of the biliary tract and the common bile duct cyst.

scholarly journals Structure and Innervation of the Extrahepatic Biliary System in the Australian Possum, Trichosurus Vulpecula

HPB Surgery ◽  
1993 ◽  
Vol 7 (2) ◽  
pp. 125-140 ◽  
Author(s):  
R. T. A. Padbury ◽  
R. A. Baker ◽  
J. P. Messenger ◽  
J. Toouli ◽  
J. B. Furness
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Internal Sphincter ◽  
External Sphincter ◽  
Duodenal Wall ◽  
Sphincter Muscle ◽  
Trichosurus Vulpecula ◽  
Nerve Fibres ◽  
The Common

The morphology, microanatomy and innervation of the biliary tree of the Australian possum, Trichosurus vulpecula, was examined. The gross morphology of the gallbladder, hepatic and cystic ducts, and the course of the common bile duct, conforms to those of other species. The sphincter of Oddi has an extraduodenal segment that extends 15mm from the duodenal wall; within this segment the pancreatic and common bile ducts are ensheathed together by sphincter muscle. Their lumens unite to form a common channel within the terminal intraduodenal segment.Nerve cell bodies of the gallbladder were found in an inter-connecting network of ganglia that were located in the serosa, muscularis and mucosa. Nerve fibres innervated the muscle, arterioles and the mucosa. Few ganglia were found along the supra sphincteric portion of the common bile duct. Nerve trunks followed the duct and a dense nerve fibre plexus was found in the mucosa. In the sphincter most ganglia were located in two plexuses, the first between the layers of the external sphincter muscle, which was continuous with the external muscle of the duodenum, and the second was associated with the internal sphincter muscle. Nerve fibres were numerous in the sphincter muscle, and were also found in the subepithelial and periglandular plexuses of both the pancreatic and common bile ducts.

scholarly journals THE EFFECT OF LIGATION OF THE COMMON BILE DUCT ON CHOLESTEROL SYNTHESIS IN THE RAT

1954 ◽  
Vol 99 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Donald S. Fredrickson ◽  
Alden V. Loud ◽  
Beverly T. Hinkelman ◽  
Henny S. Schneider ◽  
Ivan D. Frantz
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Cholesterol Synthesis ◽  
Intact Animal ◽  
Experimental Animals ◽  
Liver Slices ◽  
The Common ◽  
Ad Libitum

The effect on cholesterol synthesis of ligation of the common bile duct was studied in the rat. The bile ducts of rats were ligated; 24 to 48 hours later, estimates of the rate of cholesterol synthesis were made, either by injection of labelled water or acetate into the intact animal, or by incubation of slices or homogenates of the liver in the presence of 1-C14-acetate. These various criteria all indicated that cholesterol synthesis was increased following ligation of the bile duct. The average ratios of the rate of synthesis in the experimental animals to that in the controls were as follows: 1. Synthesis from C14-carboxyl-labelled acetate: (a) in the intact rat fed ad libitum, 19; (b) in liver slices from the fasted rat, 23; (c) in liver slices from the rat fed ad libitum, 4; (d) in cell-free homogenates from the fasted rat, &gt;27; (e) in cell-free homogenates from the rat fed ad libitum, 17. 2. Synthesis from tritium-labelled water in the intact rat fed ad libitum, 4.

scholarly journals FIBROCHOLODOSCOPY IN DIAGNOSTICS AND TREATMENT OF COMPLEX FORMS OF CHOLEDOCHOLITHIASIS

2019 ◽  
Vol 21 (1) ◽  
pp. 43-46
Author(s):  
K V Pavelets ◽  
A K Ushkats ◽  
D V Gacko
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tract ◽  
Surgical Procedures ◽  
Bile Ducts ◽  
Diagnosis And Treatment ◽  
The Common ◽  
Complex Forms

Relevance of the topic: endoscopic intraoperative choledochoscopy with traditional surgical procedures is a highly informative research in the diagnosis and treatment of choledocholithiasis. Objective: to evaluate the effectiveness of intraoperative use of fibrocholedochoscopy in the diagnosis and treatment of "complex" forms of choledocholithiasis. Materials and methods: Between 2011 and 2017, 88 patients underwent treatment for "complicated" forms of choledocholithiasis using intraoperative fibrocholedochoscopy. Results: after dissection of the choledochal wall and extraction of large concrements from the lumen, a fibrocholedochoscopy was performed. The fibrocholedochoscope was inserted into the lumen of the common bile duct through a formed opening with examination of the biliary tract. An obligatory condition for assessing the permeability of the distal sections of the bile ducts was the carrying out of an endoscope through the OBD zone. The remaining remaining calculi were recovered with the help of Dormia baskets (15 (17%) cases). In 86 (97.7%) patients, the operation is completed by the imposition of a hollow stitch of choledoch (priority reference No. 2018122530, 2018). Conclusion: fibrocholedochoscopy in the treatment of complex forms of choledocholithiasis allows to methodically evaluate the biliary tract, perform lithoextraction from the proximal and distal sections.

scholarly journals Cholestatic hepatitis as a clinical mask of choledocholithiasis

2016 ◽  
Vol 97 (3) ◽  
pp. 439-442
Author(s):  
D V Pikulev ◽  
O N Vorob’eva
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Hiatal Hernia ◽  
Bile Ducts ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Cholestatic Hepatitis ◽  
The Common

The variety of cholelithiasis clinical manifestations, seriously impeding the timely diagnosis, are well known. This is determined by multiple impairment of interorgan communication in cholelithiasis. The most difficult form of cholelithiasis both for identification, and for treatment is choledocholithiasis. Diagnosis of stones in the common bile duct is based on a complex of clinical, laboratory and instrumental data. The appearance of jaundice amid the abdominal pain and revealing signs of biliary hypertension during instrumental examination are considered typical for choledocholithiasis. Particular difficulties for the diagnosis are choledocholithiasis cases with atypical pain syndrome, the absence of jaundice and non-dilated bile ducts. One of the reasons for the variability of pain syndrome in cholelithiasis is polymorbidity of these patients. Relatively frequently, bile duct stones are combined with a hiatal hernia, which is pathogenetically interdependent. Clinical manifestations in such cases depends on what syndrome is the dominant. Non-dilated bile ducts in patients with proven choledocholithiasis was detected in 5.8% of patients. In this situation, the presence of cholestasis and cytolysis biochemical markers in the absence of instrumental signs of biliary hypertension can simulate intrahepatic cholestasis. Clinical case demonstrating the difficulty of choledocholithiasis diagnosis is presented. In a given clinical observation the patient with a history of cholecystectomy for cholelithiasis; with intense abdominal pain, primarily appraised as a manifestation fixed hiatal hernia; pronounced anicteric cholestatic syndrome, was presented. No signs of biliary hypertension in the standard transabdominal ultrasound examination of the abdomen required exclusion of intrahepatic causes of cholestasis. In-depth instrumental and laboratory examination allowed to diagnose in patient choledocholithiasis. It is proposed to mark out variant of the cholelithiasis course with the stones localization in the common bile duct under the guise of cholestatic hepatitis.

scholarly journals Morphological features of the wall of common bile duct under the conditions of experimental opioid exposure

2020 ◽  
Vol 26 (2) ◽  
pp. 26-31
Author(s):  
L.R. Mateshuk-Vatseba ◽  
I.I. Hirniak ◽  
U.Y. Pidvalna
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
White Male ◽  
Acute Cholangitis ◽  
Medical Science ◽  
Male Rats ◽  
Pathological Changes ◽  
White Rats ◽  
The Common

The morphological condition of the bile ducts remains one of the most important problems of modern medical science. In order to obtain an analgesic effect in patients with acute cholangitis, opioids are often used. However, information on the effectiveness of opioids in the treatment of pathological conditions of the bile ducts is contradictory. The rapidly progressive destruction of the intrahepatic bile ducts associated with the use of narcotic agents has been described. Further study of the effect of opioids on the structural organization of the common bile duct is relevant. In order to establish the morphological state of the common bile duct under conditions of long-term opioid exposure, a study was performed on 24 sexually mature white male rats, aged 3.5-5.0 months and weighing 180-200 g, which were injected intramuscularly with Nalbuphine for 6 weeks. The study material is represented by histological specimens of the common bile duct of white rats. The “Aver Media” computer system was used to photograph microspecimens. The “ImageJ” computer program was used to measure the diameter of the lumen and the wall thickness of the common bile duct. After 2 weeks of Nalbuphine administration to white rats, plethora of wall microvessels and a significant increase in the longitudinal diameter of the lumen of the common bile duct were observed. After 4 weeks of the experiment, the common bile duct was dilated, the transverse and longitudinal diameters of its lumen almost doubled, pathological changes in its wall had all the signs of inflammation. In the later stages of the experiment (introduction of Nalbuphine for 6 weeks), the pathological changes increased and manifested by destructuring the wall of the common bile duct, disorganization of cholangiocytes, thinning of the cell layer due to detachment of cholangiocytes, polymorphism of their nuclei, destruction of intercellular junctions, stratification of its own plate, vacuolar dystrophy of the muscular membrane “varicose” expansion of venules, significant smooth muscle hyperplasia of arterioles, the presence of perivascular lymphocytic infiltrates in the duct wall.

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