Antegrade transhepatic papillodilatation and dislocation of bile stones in duodenum in management of cholelitiasis

2016 ◽  
Vol 21 (1-2) ◽  
pp. 44-46 ◽  
Author(s):  
Oleg I. Okhotnikov ◽  
M. V Yakovleva ◽  
A. P Kalutskiy
Keyword(s):  
Palliative Care ◽  
Cystic Duct ◽  
Biliary Tree ◽  
Scar Tissue ◽  
Internal Drainage ◽  
Stepwise Manner ◽  
Distal Occlusion ◽  
Peripapillary Area

Endobiliary antegrade stenting by self-expanding stents was performed in 32 patients with unresectable tumors of pancreatobiliary area. Uncoated stents were used in 15 patients with the proximal obstruction of the biliary tree. Uncoated stents prevent the blockade of lobar, segmental and cystic duct. Covered self-expanding stents were used in 17 cases of distal occlusion and obstruction of the peripapillary area. Antegrade stenting drainages of 8Fr were performed in a stepwise manner, consistently performing outside, then outward-internal drainage of the biliary tree, which was transformed into endobiliary stenting. Hybrid endobiliary antegrade stenting, which involves maintaining outward-internal drainage in lumen installed endobiliary stent, was performed in 14 patients. Hybrid antegrade stenting endobiliary allowed to keep endobiliary access to palliative care for all the time, monitor and correct the patency of the stent, by releasing from intraluminal sludge, to carry out a successful reparative stenting “stent to stent” in case of the invasion of tumor or scar tissue in to the lumen of the stent or around of its proximal end.

Percutaneous brush biopsy and internal drainage of biliary tree through endoprosthesis

1980 ◽  
Vol 134 (4) ◽  
pp. 653-659 ◽  
Author(s):  
G Mendez ◽  
E Russell ◽  
JU Levi ◽  
H Koolpe ◽  
M Cohen
Keyword(s):  
Biliary Tree ◽  
Internal Drainage ◽  
Brush Biopsy

scholarly journals Visualization of biliary ducts while doing laparoscopy, using HEV LapVision

2018 ◽  
Vol 85 (4) ◽  
pp. 9-11
Author(s):  
О. V. Ogurtsov ◽  
О. V. Lukavetskyy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Simple Procedure ◽  
Biliary Tree ◽  
High Energy ◽  
Biliary Duct ◽  
Critical View ◽  
Fluorescent Cholangiography ◽  
Biliary Ducts ◽  
Intraoperative Visualization

Objective. To determine efficacy of intraoperative visualization of biliary tree, using fluorescent cholangiography (FCH) and a high–energy visible laparoscopy vison (HEV LapVison) while laparoscopic cholecystectomy performance (LCHE). Маterials and methods. In 25 patients LCHE was performed. Preoperatively fluorescein was injected intravenously for guaranteeing of the FCH performance. HEV LapVison was applied for intraoperative visualization of fluorescence. Results. Visualization of the cystic duct and its inflow into common biliary duct was guaranteed in 90% patientsх. In 13 (52%) patients the anatomic picture was typical while in 7 (28%) some variants were observed: a parallel course of cystic duct and common biliary duct, and low level of the cystic duct inflow into hepaticocholedochus. Conclusion. FCH is a simple procedure for intraoperative navigation doing and guaranteeing of «critical view on security» while performance of LCHE. FCH together with HEV LapVison constitutes a new surgical procedure, making possible revealing of extrahepatic biliary ducts. This method may be applied as additional one while doing LCHE, preventing damage of biliary ducts.

scholarly journals Rare Biliary Anatomy in Two Patients Presenting with Biliary Obstruction Diagnosed with ERCP

1991 ◽  
Vol 5 (5) ◽  
pp. 161-164
Author(s):  
Gary R May ◽  
David S Reid ◽  
Noel B Hershfield
Keyword(s):  
Cystic Duct ◽  
Incidental Findings ◽  
Biliary Obstruction ◽  
Biliary Tree ◽  
Stone Extraction ◽  
Biliary Anatomy ◽  
Endoscopic Retrograde ◽  
Potential Problems ◽  
Therapeutic Procedures ◽  
Rare Anatomic Variant

Anatomic anomalies of the exrrahepatic biliary tree are common and often incidental findings at endoscopic retrograde cholangiopancreatography; however, they rarely complicate therapeutic procedures such as stone extraction. The cases of two patients with biliary obstruction due to stones are presented, who were found to have the cystic duct a rising almost directly from the ampulla. This rare anatomic variant posed problems both in terms of interpretation of the cholangiogram and removal of stones. Therapeutic endoscopists should be aware of this and other anomalies of the biliary tract and of the potential problems faced in both interpretation of the cholangiogram and in therapeutic procedures.

scholarly journals Anomalous anatomical variation in extrahepatic biliary tree and pancreas and its related vessels: a cadaveric study

2019 ◽  
Vol 6 (9) ◽  
pp. 3111
Author(s):  
Mahim Koshariya ◽  
Sheikh Behram ◽  
Jay Prakash Singour ◽  
Shashikant Tiwari ◽  
Vidhu Khare
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Anatomical Variation ◽  
Clinical Importance ◽  
Biliary Tree ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Left Hepatic Duct ◽  
Extrahepatic Biliary Tree ◽  
Insight Into

Background: Congenital anamolies of extrahepatic biliary apparatus and pancreas have long been recognized and are of clinical importance because when present may surprise the surgeon during surgery and lead to iatrogenic injuries. Surgeries on extra-hepatic biliary apparatus and pancreas are regularly performed throughout the world. Thus insight into the normal anatomy and congenital variations will reduce complication and definitely improve outcome.Methods: Study was conducted in department of surgery GMC Bhopal and dissection was carried out in Department of Forensic Medicine on 100 cadavers with approval from ethical committee.Results: In 100 cases 70 were male and 30 female. The most common variation in extra hepatic biliary apparatus was short cystic duct was found in 6% cases then formation of common hepatic duct by union of right hepatic duct and left hepatic duct was intrahepatic in 3% cases. There was low insertion of cystic duct with common hepatic duct in 1% case. Cystic artery originating from left hepatic artery in 1% case, in 1% case cystic artery was anterior to common hepatic duct. In Pancreas anterior arterial arcade was absent in 2% cases and its origin varied in 2% case. Posterior pancreatic arcade absent in 1% cases and variation in origin was present in 1% case. The variation in pancreatic duct course was present in 22% cases.Conclusions: Thus significant variation was seen and it could definitely be helpful to hepatobiliary, laproscopic surgeons, radiologist and will further contribute to literature on variation of extrahepatic biliary apparatus and pancreas and its related vessels.

scholarly journals Spread of Intraductal Papillary Neoplasm Arising from the Cystic Duct of the Biliary Tree

2016 ◽  
Vol 10 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Yoshihiko Kadowaki ◽  
Yuki Yokota ◽  
Satoshi Komoto ◽  
Nobuhito Kubota ◽  
Takahiro Okamoto ◽  
...  
Keyword(s):  
Bile Duct ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Carcinoma ◽  
Biliary Tree ◽  
Duct Carcinoma ◽  
Intraductal Growth ◽  
Intraductal Papillary Neoplasm ◽  
Extrahepatic Bile Duct Resection ◽  
Papillary Neoplasm

Intraductal papillary neoplasm of the bile duct (IPNB) is a variant type of the bile duct carcinoma characterized by intraductal growth. IPNB is also recognized as a precursor of invasive carcinoma. We describe herein an extremely rare case of IPNB arising from the cystic duct. A 68-year-old man was admitted to our hospital for investigation of epigastralgia and abnormal levels of biliary tract enzyme. Computed tomography and magnetic resonance imaging showed a mass lesion spreading from the cystic duct to the upper-middle bile duct. Endoscopic retrograde cholangiography demonstrated diffuse duct dilation with a grossly visible intraductal mass and amorphous blobs, suggesting the presence of mucobilia or scattered tumors. We performed extrahepatic bile duct resection with lymphadenectomy. Macroscopically, a friable papillary tumor originated from the cystic duct grows intraluminally into the bile duct. Pathologically, the tumor was found to be intramucosal adenocarcinoma spreading to the whole extrahepatic bile duct, which was compatible with IPNB. We should discuss the features and progression processes of IPNB through this precious case.

scholarly journals Left-sided gall bladder found incidentally during emergency laparoscopic appendectomy due to acute appendicitis

2017 ◽  
Vol 5 (9) ◽  
pp. 4161
Author(s):  
Jurij Janež
Keyword(s):  
Acute Appendicitis ◽  
Gall Bladder ◽  
Male Patient ◽  
Laparoscopic Appendectomy ◽  
Cystic Duct ◽  
Congenital Anomalies ◽  
Young Male ◽  
Biliary Tree ◽  
Biliary Surgery ◽  
Liver Segment

The gallbladder is affected by a large number of congenital anomalies, which may affect its location, number, size, or form. Some of these malformations are very rare and may lead to misdiagnosis. Knowledge of the location of the gallbladder is of great importance for the surgeon, particularly when cholecystectomy or other biliary surgery is to be performed. There are many variants not only of the position of the gallbladder but also in the way the cystic duct joins the biliary tree. The left-sided gallbladder remains a scarce anomaly with prevalence of 0.3%. This report presents a case of a young male patient, who was operated due to acute appendicitis. Laparoscopic appendectomy was performed and at laparoscopy a left-sided gallbladder was found, located on the III liver segment, on the left side of the round ligament.

Biliary Tree

2020 ◽  
pp. 27-41
Author(s):  
Jad M. Abdelsattar ◽  
Moustafa M. El Khatib ◽  
T. K. Pandian ◽  
Samuel J. Allen ◽  
David R. Farley
Keyword(s):  
Cystic Duct ◽  
Broad Spectrum ◽  
Biliary Tree ◽  
Gallbladder Stones ◽  
Broad Spectrum Antibiotics ◽  
Left And Right

The biliary tree forms in the endodermal diverticulum of the caudal foregut. The left and right hepatic ducts drain the hepatic sinusoids and join to form the CHD, which joins the cystic duct to form the CBD. Hepatocytes produce bile, which passes through ducts and empties into the CHD and into the GB for storage. Small gallbladder stones occasionally descend into the CBD. Dilatation of the CHD (>4 mm) or CBD (>7 mm) is diagnosed with US. Patients with cholangitis should be resuscitated, given broad-spectrum antibiotics, and have the biliary tree drained with ERCP in preparation for cholecystectomy. ERCP can result in hemorrhage, injury to the duodenum, and pancreatitis.

scholarly journals Successful Elimination of Gallbladder Ascariasis by Conservative Therapy, Followed by Cholecystectomy due to Developing Cholecystitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Ahmad Alhamid ◽  
Ziad Aljarad ◽  
Ahmad Ghazal ◽  
Ahmad Mouakeh ◽  
Ahmad Sankari Tarabishi ◽  
...  
Keyword(s):  
Small Intestine ◽  
Cystic Duct ◽  
Ascaris Lumbricoides ◽  
Conservative Therapy ◽  
Parasitic Infection ◽  
Biliary Tree ◽  
Diagnostic Tools ◽  
Initial Management ◽  
Case Presentation

Background. Ascaris lumbricoides is the most common parasitic infection in human. The worm is usually located in the small intestine, but may invade into the pancreatic or biliary tree, but rarely into gallbladder because of the anatomic features of the cystic duct. Case Presentation. We report a case of gallbladder ascariasis that was diagnosed incidentally in a 70-year-old man, with negative ova and parasite test and no eosinophilia. We also compared echography and computerizied tomograph as diagnostic tools for gallbladder ascariasis. The patient was managed conservatively, but he underwent cholecyctectomy later because of developing cholecystitis. Conclusion. Depending on this case, we suggest cholecyctectomy as an initial management of gallbladder ascariasis.

scholarly journals Infectious Complications after Different Percutaneous External-Internal Biliary Drainage Techniques for Malignant Jaundice

2021 ◽  
Vol 4 (2) ◽  
pp. 51-59
Author(s):  
O. I. Okhotnikov ◽  
M. V. Yakovleva ◽  
S. N. Grigoriev ◽  
V. I. Pakhomov ◽  
N. N. Grigoriev ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Acute Cholangitis ◽  
Biliary Tree ◽  
Infectious Complications ◽  
Internal Drainage ◽  
Malignant Jaundice ◽  
Liver Abscesses ◽  
Biliary Reflux ◽  
Different Types ◽  
Transpapillary Drainage

Purpose: Analysis of infectious complications incidence in different types of percutaneous externalinternal biliary drainage in patients with obstructive jaundice of tumor genesis.Material and methods: The results of using antegrade external-internal drainage of the biliary tree in transpapillary and suprapapillary variants in 110 patients were analyzed. External-internal biliary drainage was performed in stages, after percutaneous transhepatic cholangiostomy or involuntarily primary with proximal obstruction of the biliary tree with bile duct segregation if it is impossible to form a fixing element of drainage proximal to the obstruction zone.Results: In the first group, transpapillary external-internal drainage was performed in 30 patients with peripapillary tumor obstruction. Of the 26 patients with proximal obstruction, suprapapillary external-internal drainage was performed in 8 patients, transpapillary — in 18 patients. Postmanipulation cholangitis in the first group occurred in 16 cases (28.6 %), liver abscesses developed 4 cases (7.1 %). In the second group, among 30 patients with transpapillary drainage on the background of peripapillary tumor obstruction, signs of acute cholangitis developed in 4 cases. Cholangitis was stopped by timely transfer of external-internal drainage to external. Among 24 patients with proximal obstruction of the biliary tree, suprapapillary external-internal drainage without complications was performed in 18 cases, transpapillary in 6 patients with the proximal block without disconnecting of the biliary tree. Acute cholangitis developed in 2 cases. Patients of the second group had no liver cholangigenic abscesses. There were no cases of hospital mortality in both groups.Conclusion: Factors in the development of postmanipulation cholangitis and liver abscesses during external-internal drainage of the biliary tree against the background of its tumor obstruction are the transpapillary position of endobiliary drainage with duodeno-biliary reflux in persistent biliary hypertension. In the case of suprapapillary location of the working end of external-internal drainage during antegrade drainage of the proximal tumor obstruction of the biliary tree with dissociation, the risk of postmanipulation cholangitis in non-drained liver segments is minimal. In the event of post-manipulation cholangitis in the case of transpapillary drainage of the biliary tree, a temporary transformation of external-internal drainage into external cholangiostomy is necessary.

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.

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