STUDY OF THE ACTIVITY OF SOME RAT SERUM ENZYMES IN THE DYNAMICS OF EXTRAHEPATIC CHOLESTASIS

Extrahepatic cholestasis occurs with mechanical obstruction of the main extrahepatic or main intrahepatic ducts. The most common cause of extrahepatic cholestasis is common bile duct stones. This article describes hypertension in the bile ducts and acholysis developing in cholestasis, which cause serious functional and morphological changes in the liver and lead to the rapid growth of liver insufficiency. Thus, in the dynamics of extrahepatic cholestasis development there are significant shifts in blood serum of experimental animals, manifested by hyperfermentemia. These changes indicate the involvement of the liver in the pathological process, which naturally requires their correction.

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Common bile duct stones in non-dilated bile ducts? An ultrasound study

Australasian Radiology ◽

10.1111/j.1440-1673.1996.tb00389.x ◽

1996 ◽

Vol 40 (3) ◽

pp. 221-222 ◽

Cited By ~ 19

Author(s):

David R Hunt

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Bile Ducts ◽

Common Bile Duct Stones ◽

Bile Duct Stones ◽

Ultrasound Study

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Reoperation After Cholecystectomy. The Role of the Cystic Duct Stump

HPB Surgery ◽

10.1155/1991/57017 ◽

1991 ◽

Vol 4 (2) ◽

pp. 129-135 ◽

Cited By ~ 22

Author(s):

M. A. Rogy ◽

R. Függer ◽

F. Herbst ◽

F. Schulz

Keyword(s):

Chronic Pancreatitis ◽

Cystic Duct ◽

Bile Ducts ◽

Gastrointestinal Symptoms ◽

Pathological Finding ◽

Common Bile Duct Stones ◽

Sphincter Of Oddi ◽

Bile Duct Stones ◽

Total Excision

The so-called “Postcholecystectomy Syndrome” may be due to various pathological biliary causes. The aim of this study was to evaluate the significance of the cystic duct stump syndrome and if so, how often a long (>1.5 cm) cystic duct stump was an indication for reoperation on the bile ducts after cholecystectomy in our patients. Three hundred and twenty two patients underwent a second operation on the bile ducts after cholecystectomy in the last ten years. In 35 patients (10.8%) a striking finding was a long cystic duct stump (>1.5 cm). In 24 of these patients, a pathological finding, in addition to the long cystic duct stump, was found on exploration. Out of these 24 patients there were 14 with common bile duct stones; 6 with stenosis of the sphincter of Oddi; 3 with chronic pancreatitis and in one patient hepatitis was the cause of the symptoms. From the remaining 11 patients 8 had a stone in a partial gall bladder or cystic duct stump. One patient had a fistula between the cystic duct stump and duodenum and one a suture granuloma. There was only one patient where a 1.5 cm long cystic duct stump remnant was the only pathological finding. Four years after reoperation this patient is still suffering from the same intermittent gastrointestinal symptoms. We conclude that the cystic duct stump is hardly ever a cause for recurrent symptoms in itself. Total excision of the cystic duct does not eliminate the existence of postcholecystectomy symptoms.

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Consequences of Stenting and Endoscopic Papillary Balloon Dilatation in Treatment of Large and Multiple Common Bile Duct Stones

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.150 ◽

2019 ◽

Vol 11 (4) ◽

pp. 205-210

Author(s):

Ahmad Hormati ◽

Mohammad Reza Ghadir ◽

Ali Hasanpour Dehkordi ◽

Farshad Yadollahi ◽

Shahriar Salehitali ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Balloon Dilatation ◽

Bile Ducts ◽

Common Bile Duct Stones ◽

Allocation Rule ◽

Bile Duct Stones ◽

Significant Difference ◽

Endoscopic Papillary Balloon Dilatation ◽

Duct Cleaning

BACKGROUND Although stenting for the treatment of large and multiple common bile duct stones has been acceptable to everyone, its efficacy and outcome have not been studied in comparison with other endoscopic procedures. The purpose of this study was to compare the consequences of stenting and endoscopic papilla balloon dilatation for the treatment of large and multiple common bile duct stones. METHODS In a double-blind clinical trial, of 431 patients with bile duct stones referred to the treatment center, 64 patients with multiple common bile duct stones ( ≥ 3) and more than 15 cm were selected for the study, then by random allocation rule the participants were allocated in two groups. They were entered into two different endoscopic papillary balloon dilatation (EPBD) and common bile ducts stenting treatments so that both procedures were performed by a person. Both groups were assessed from the point of views therapeutic outcomes such as duct cleaning, pancreatitis, isolated pain, and duct rupture. Data were collected by a self-made questionnaire that was used before and after the procedure to obtain the needed information. Then data were analyzed using SPSS software version 22 and descriptive and analytical tests were used as appropriated. RESULTS Although the duct cleaning and the complete removal of the stones in the stenting treatment procedure was 93.8%, and in EPBD was 78.3%, no significant difference was observed between the two groups (p = 0.14). Pancreatitis significantly increased after the first and second endoscopic retrograde cholangiopancreatography (ERCP) in the stent group compared with EPBD (p = 0.02). Also, the most frequent cases of isolated pain were in the endoscopic group EPBD (p = 0.0). However, the occurrence of perforation after first ERCP and EPBD was zero, but in the second stage of ERCP, 3.3% of the patients had perforations (p = 0.99). The results indicated that the shape of the stone (circular and angled) was not effective in the result of treatment in the two groups. CONCLUSION The results of this study indicated that in case of experience and skill in conducting the ERCP, common bile duct stenting is still the first line of treatment for large and multiple stones of the common bile ducts.

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