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.

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.

Mechanical jaundice caused by common bile duct obstruction due to hepato-biliary ascariasis

2021 ◽  
pp. 20-24
Author(s):  
Zaipula Zulbegovich Nazhmudinov ◽  
Abdulkamal Guseynovich Guseynov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Surgical Intervention ◽  
Duct Obstruction ◽  
Biliary Ascariasis ◽  
Modern Methods ◽  
Common Bile Duct Obstruction ◽  
The Common ◽  
The Right

The paper presents a case of successful surgical treatment of a patient with common bile duct ascariasis, which caused obstructive jaundice. Modern methods of examining a patient with obstructive jaundice did not allow to make the right diagnosis of the common bile duct ascariasis before surgical intervention. The rarity of this pathology arouses interest in this material.

scholarly journals Duodenal peripapillary adenocarcinoma causing extrahepatic biliary obstruction and icterus in a cat

2020 ◽  
Vol 89 (5) ◽  
pp. 273-277
Author(s):  
T. Rick ◽  
E. Stock ◽  
I. Van de Maele ◽  
E. Kammergruber ◽  
J. Saunders
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Duodenal Wall ◽  
Abdominal Ultrasonography ◽  
Extrahepatic Biliary Obstruction ◽  
History Of ◽  
The Common ◽  
Distal Aspect

A six-year-old, female, neutered domestic shorthair cat was presented with chronic weight loss and a two-day history of partial anorexia and lethargy. Abdominal ultrasonography revealed a regional thickening of the duodenal wall with loss of normal layering, a normally walled segmentally dilated distal aspect of the common bile duct containing slightly hyperechoic bile, and a mild to moderately enlarged major duodenal papilla. Based on the ultrasound examination, the primary differential diagnosis was a peripapillary duodenal neoplastic or less likely, an inflammatory or infectious process with secondary extrahepatic biliary obstruction. Postmortem examination revealed a duodenal, peripapillary adenocarcinoma with metastasis into the liver and lymph nodes, and external compressive obstruction of cystic- and common bile duct.

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 Antegrade X-ray surgical interventions in patients with choledocholithiasis in case of failed endoscopic procedures

2019 ◽  
Vol 24 (2) ◽  
pp. 48-59
Author(s):  
O. I. Okhotnikov ◽  
M. V. Yakovleva ◽  
S. N. Grigoriev ◽  
V. I. Pakhomov ◽  
N. I. Shevchenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Postoperative Mortality ◽  
Endoscopic Papillotomy ◽  
X Ray ◽  
Endoscopic Procedures ◽  
Rendezvous Technique ◽  
Antegrade Approach ◽  
The Common

Objective. To analyze safety and efficacy of X-ray surgical treatment of choledocholithiasis in case of failed endoscopic procedures. Material and methods. A retrospective analysis included 195 patients with choledocholithiasis who underwent X-ray surgical treatment. Primary X-ray surgical intervention was antegrade cholangiostomy. Data of antegrade cholangiography were used to determine type of endobiliary intervention. Antegrade mechanical and pneumatic choledocholithotripsy and lithoextraction, balloon dislocation of stones of the common bile duct into duodenum or jejunum, lithoextraction using rendezvous technique after endoscopic papillotomy through transpapillary drainage tube or a wire were applied. Results. Puncture and drainage of non-dilated bile ducts were successfully performed in 30 (15.4%) patients. There were 212 procedires of cholangiostomy in 195 patients including redo interventions. Complications after cholangiostomy were absent in 92.9% of cases. Minor complications occurred in 7.1% of cases. Antegrade mechanical and pneumatic choledocholithotripsy and lithoextraction was performed in 118 (98.3%) patients. Balloon dislocation of stones of the common bile duct into duodenum was applied in 52 (81.3%) patients. Lithoextraction using rendezvous technique after previous endoscopic papillosphincterotomy was performed in 12 (60%) patients. Six patients underwent transpapillary external-internal drainage of common bile duct. Five patients had stricture of biliodigestive anastomosis complicated by cholelithiasis. Lithotripsy and lithoextraction through antegrade approach or dislocation of stones into jejunum after previous balloon dilatation were performed in these patients. Postoperative mortality was 1.5%. Minimally invasive techniques were absolutely effective for choledocholithiasis in 187 (98.9%) patients. Conclusion. Antegrade X-ray surgical management is effective and safe in patients with choledocholithiasis and unsuccessful previous endoscopic procedures. Integral efficiency of antegrade management of cholelithiasis was 88.8%.

scholarly journals Biliary atresia with cystic dilatation of the common bile duct

2018 ◽  
Vol 38 ◽  
pp. 16-18
Author(s):  
Toshiro Kimura ◽  
Takeshi Hirabayashi ◽  
Keinosuke Ishido ◽  
Tamotsu Kobayashi ◽  
Takeshi Saito ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Atresia ◽  
Cystic Dilatation ◽  
The Common

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.

Primary Small Cell Carcinoma of the Common Bile Duct, in Which Surgical Treatment was Performed After Neoadjuvant Chemotherapy: Report of a Case

Surgery Today ◽  
2003 ◽  
Vol 33 (11) ◽  
pp. 870-872 ◽  
Author(s):  
Kazuaki Hazama ◽  
Yasuhiro Suzuki ◽  
Motoo Takahashi ◽  
Yasuhiro Takahashi ◽  
Tatsuya Yoshioka ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Neoadjuvant Chemotherapy ◽  
Common Bile Duct ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Small Cell ◽  
The Common

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, >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.

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