Complications of laparoscopic choledochotomy and lithotomy for primary suture

Objective: To explore the non-placement of "T" tube" after laparoscopic choledochotomy. feasibility and complication analysis of primary suture bile duct. Methods: Retrospective analysis of January 2013~ December 2016, Laparoscopic choledocholithotomy for primary bile duct suture in 87 cases, Combined with literature, the indications, methods and complications of the operation were summarized and analyzed. Results: There was no operative death in the whole group, Postoperative complications occurred in 5 cases (5.7%), 1 case with jaundice, gradually subsided after 4 days of conservative treatment. Two cases had postoperative bile leakage, to prolong the drainage time of the peritoneal drainage tube and stop by itself. In 1 case, bile duct stenosis occurred. 1 case of residual common bile duct stones. The average postoperative hospitalization was 9 days. Conclusion: Select the right case strictly, Patient and delicate operation, Laparoscopic choledochotomy is safe and feasible.

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PRELIMINARY RESULTS OF APPLICATION OF ERCP IN THE TREATMENT OF SOME PANCREATOBILINARY DISEASES

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.1.15 ◽

2016 ◽

pp. 116-124

Author(s):

Trong Long Than ◽

Viet Nho Le ◽

Tan Toan Le ◽

Quang Huy Truong

Keyword(s):

Acute Pancreatitis ◽

Bile Duct ◽

Common Bile Duct ◽

Hepatic Duct ◽

Common Bile Duct Stones ◽

Pancreatic Tumors ◽

Bile Duct Stones ◽

Bile Duct Stenosis ◽

Duct Stenosis ◽

Oddi Sphincter

Background and objectives: ERCP is helpful technique in the diagnosis and treatment of some pancreatobilinary diseases. Purposes of this study are studying clinical characteristics, imaging of patients pancreatobilinary diseases indicated for ERCP as well as treatment results and safety of ERCP in the treatment of some pancreatobilinary diseases. Materials and methods: a observational study of results of ERCP application in the patients with bilinary stones and Oddi sphincter stenosis, pancreatic tumors at Quangnam Central General Hospital from 6/2013 till 5/2015. Results: Among 30 patients selected for study, there are 26 patients with bile duct stones (86.6%), 1 patients with Oddi sphincter stenosis and 1 bile duct stenosis (6.7%) and 2 patients with pancreatic tumors (6.7%). In patients with bile duct stones, 12 patients were complicated by obstructive jaundice. Among them, 11 patients were complicated by bilinary infection (42.3%), 5 patients had hyperamylasemia (19.2%), 2 patients were complicated by acute pancreatitis (7.7%); in patients with Oddi sphincter stenosis and 1 bile duct stenosis, in patients with pancreatic tumors. The complete success rate of stone removing is 81.3% in common bile duct stones. The complete success rate of stone removing is 42.9% in common bile duct stones combined with hepatic duct stones. We can not remove stones in all 3 patients with only hepatic duct stones. The complication rate of ERCP is 13.3%, including 2 acute pancreatitis (6.7%), 2 bleeding (6.7%). Conclusions: Bile duct stones are the commonest pancreatobilinary diseases which were selected for ERCP. ERCP is the safe, effective technique in the treatment of pancreatobilinary diseases. Key words: (Endoscopic Retrograde Cholangio-Pancreatography: ERCP);

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ENDOSCOPIC ULTRASOUND-GUIDED BILIARY DRAINAGE PERFORMED FOR REFRACTORY BILE DUCT STENOSIS DUE TO CHRONIC PANCREATITIS: A CASE REPORT

Digestive Endoscopy ◽

10.1111/j.1443-1661.2012.01256.x ◽

2012 ◽

Vol 24 ◽

pp. 34-37 ◽

Cited By ~ 9

Author(s):

AKIO KATANUMA ◽

HIROYUKI MAGUCHI ◽

MANABU OSANAI ◽

KUNIYUKI TAKAHASHI

Keyword(s):

Case Report ◽

Chronic Pancreatitis ◽

Bile Duct ◽

Endoscopic Ultrasound ◽

Biliary Drainage ◽

Ultrasound Guided ◽

Bile Duct Stenosis ◽

Duct Stenosis

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Difficulty Achieving a Preoperative Diagnosis of IgG4-Related Sclerosing Cholangitis

Case Reports in Gastroenterology ◽

10.1159/000490523 ◽

2018 ◽

Vol 12 (2) ◽

pp. 425-431

Author(s):

Kazuhiro Suzumura ◽

Etsuro Hatano ◽

Masaharu Tada ◽

Hideaki Sueoka ◽

Hiroshi Nishida ◽

...

Keyword(s):

Bile Duct ◽

Preoperative Diagnosis ◽

Sclerosing Cholangitis ◽

Wall Thickening ◽

Distal Bile Duct ◽

Obliterative Phlebitis ◽

Bile Duct Stenosis ◽

Storiform Fibrosis ◽

Lymphoplasmacytic Infiltration ◽

Duct Stenosis

A 75-year-old male was admitted to our hospital because of bile duct stenosis. He had no medical history of autoimmune disease. The level of tumor markers, serum IgG, and IgG4 were within normal ranges. Computed tomography showed perihilar and distal bile duct stenosis and wall thickening without swelling or abnormal enhancement of the pancreas. Endoscopic retrograde cholangiopancreatography showed perihilar and distal bile duct stenosis. A biopsy and cytology from the distal bile duct stenosis suggested adenocarcinoma, and cytology from the perihilar bile duct also suggested adenocarcinoma. A preoperative diagnosis of perihilar and distal bile duct cancer was made, and the patient underwent left hepatectomy and pancreaticoduodenectomy. Resected specimens showed wall thickening in the perihilar and distal bile duct; however, tumors were unclear. A histopathological examination revealed lymphoplasmacytic infiltration, storiform fibrosis, and obliterative phlebitis in the perihilar and distal bile ducts. Immunohistochemistry revealed diffuse infiltration of IgG4-positive plasma cells in the perihilar and distal bile ducts. Lymphoplasmacytic infiltration, inflammatory change, storiform fibrosis, and obliterative phlebitis were shown in the pancreas. A final diagnosis of IgG4-related sclerosing cholangitis (IgG4-SC) with autoimmune pancreatitis was made. We herein report a case in which a preoperative diagnosis of IgG4-SC was difficult due to normal serum IgG4 levels and no obvious pancreatic lesion.

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