scholarly journals CONDUCTO BILIAR SUBVESICULAR: HALLAZGO QUIRÚRGICO Y COLANGIOGRÁFICO. Sub-gallbladder bile duct: Surgical and colangiographic findings

2016 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Alejandro M Russo ◽  
Pablo M Sciuto
Keyword(s):  
Bile Duct ◽  
Biliary Tract ◽  
Hepatic Duct ◽  
Gallbladder Bile ◽  
Deep Knowledge ◽  
The Right

Las variaciones de la vía biliar son frecuentes y pueden provocar complicaciones en el curso de una colecistectomía. Por esta razón el cirujano debe estar interiorizado en la anatomía habitual así como en las posibles variantes. Presentamos un caso de un conducto biliar subvesicular encontrando durante una colecistectomía. Se trató de un conducto que se originaba en el conducto hepático derecho y terminaba en la vesícula biliar. Se procedió a la ligadura del mismo y su posterior sección. El paciente tuvo una buena evolución y fue dado de alta a las 48 horas del posoperatorio. En vistas a este hallazgo se discuten la anatomía y las implicancias quirúrgicas de esta variante. Variations in the biliary tract are frequent and may cause complications during a cholecyst-ectomy. Thus, the surgeon must have a deep knowledge of the usual configuration of the biliary tract as well as its variations. We report a case of a subvesical bile duct found during a cholec-ystectomy. It consisted of a bile duct which originated from the right hepatic duct and ended in the gallbladder. The duct was clipped and cut, the patient had good evolution and was discharged 48 hours after surgery. The anatomy and surgical implications of this variation are discussed.

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

scholarly journals Right Hepatic Artery: A Cadaver Investigation and Its Clinical Significance

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Usha Dandekar ◽  
Kundankumar Dandekar ◽  
Sushama Chavan
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Artery ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Normal Anatomy ◽  
Surgical Safety ◽  
Right Hepatic Artery ◽  
The Common ◽  
The Right

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.

scholarly journals Leakage Via Aberrant Bile Duct Due to Cholangiocarcinoma

HPB Surgery ◽  
1998 ◽  
Vol 11 (2) ◽  
pp. 125-128 ◽  
Author(s):  
R. Stanton ◽  
P. I. Craig ◽  
J. O. Jorgensen ◽  
D. L. Morris
Keyword(s):  
Bile Duct ◽  
Hepatic Duct ◽  
Open Cholecystectomy ◽  
Bile Leak ◽  
Biliary Tree ◽  
Unusual Presentation ◽  
Subsequent Investigation ◽  
The Right ◽  
Aberrant Bile Duct

The case of a male who had an open cholecystectomy complicated by presistent bile leak from an aberrant bile duct is presented. The persistence and volume of bile leak resulted in subsequent investigation of the biliary tree which demonstrated a cholangiocarcinoma of the right hepatic duct. This case is presented as an unusual presentation of cholangiocarcinoma and to highlight the value of modern techniques in imaging the biliary tree.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals The segment IV approach: a useful method for achieving the critical view of safety during laparoscopic cholecystectomy in patients with anomalous bile duct

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuichi Fujioka ◽  
Keigo Nakashima ◽  
Hiroaki Kitamura ◽  
Yuki Takano ◽  
Takeyuki Misawa ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Hepatic Duct ◽  
Left Hepatic Duct ◽  
Critical View ◽  
Critical View Of Safety ◽  
Right Border ◽  
Imaginary Line ◽  
Branching Point ◽  
The Right

Abstract Background The critical view of safety (CVS) method can be achieved by avoiding vasculo-biliary injury resulting from misidentification during laparoscopic cholecystectomy (LC). Although achieving the CVS has become popular worldwide, there is no established standardized technique to achieve the CVS in patients with an anomalous bile duct (ABD). We recently reported our original approach for securing the CVS using a new landmark, the diagonal line of the segment IV of the liver (D-line). The D-line is an imaginary line that lies on the right border of the hilar plate. The cystic structure can be securely isolated along the D-line without any misidentification, regardless of the existence of an ABD. We named this approach the segment IV approach in LC. Methods In this study, we adopted the segment IV approach in patients with an ABD. Results From October 2015 to June 2020, 209 patients underwent LC using the segment IV approach. Among them, three (1.4%) were preoperatively diagnosed with an ABD. The branching point of the cystic duct was the posterior sectional duct, anterior sectional duct, or left hepatic duct in each patient. The CVS was achieved in all cases without any complications. Conclusion It is a promising technique, especially even for patients with an ABD during LC.

Aberrant Right Hepatic Duct Originating from the Right Posterior Duct with Low Insertion into the Common Bile Duct

2006 ◽  
Vol 203 (6) ◽  
pp. 972 ◽  
Author(s):  
Gonzalo Pérez ◽  
Ricardo O. Escárcega ◽  
Julio Gargantua ◽  
Salvador Fuentes-Alexandro
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Duct ◽  
The Common ◽  
The Right

scholarly journals Mucinous cystic neoplasm of the liver with biliary communication: case report and surgical therapeutic option

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Raphaella Ferreira ◽  
Phillipe Abreu ◽  
Vagner Birk Jeismann ◽  
Vanderlei Segatelli ◽  
Fabricio Ferreira Coelho ◽  
...  
Keyword(s):  
Bile Duct ◽  
Hepatic Duct ◽  
Therapeutic Option ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Low Grade ◽  
Mucinous Epithelium ◽  
Biliary Communication ◽  
Cystic Liver ◽  
The Right

Abstract Background Mucinous cyst neoplasm of the liver (MCN-L) comprise less than 5% of all cystic liver lesions and is characterized by the presence of ovarian stroma and absence of bile duct communication. Case presentation Here, we discuss a 45-year-old woman who presented with symptomatic liver mass. Diagnostic workup detected a 4.2 × 3.6 cm septate cyst located in segments I, V, and VIII of the liver in communication with the right hepatic duct. An open right liver resection with total bile duct excision and hilar lymphadenectomy was performed. Pathology revealed a multiloculated cyst with lined mucinous epithelium and ovarian-like stroma, consistent with low-grade MCN-L. Conclusions This case shows that unusual location and bile duct communication can be present in MCN-L.

scholarly journals Challenges in treatment of a patient suffering from neuroendocrine tumor G1 of the hilar bile duct: a case report

2021 ◽  
Author(s):  
Biao Zhang ◽  
Zhen Sun ◽  
Xu Chen ◽  
Bing Qi ◽  
Qingkai Zhang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Adjuvant Chemotherapy ◽  
Biliary Tract ◽  
Time Management ◽  
Proper Time ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Neuroendocrine Cells ◽  
R1 Resection ◽  
Hilar Bile Duct

Abstract Background Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are extremely rare located in the biliary tract. Currently, there are no guidelines for the diagnosis and treatment of biliary NETs. We present a case with NETs G1 of the hilar bile duct and the challenges for her treatment.Case presentation A 24-year-old woman was presented to our department with painless jaundice and pruritus, and the preoperative diagnosis was the perihilar bile duct cholangiocarcinoma. She underwent Roux-en-Y hepaticojejunostomy with excision of the extrahepatic biliary tree and radical lymphadenectomy. Unexpectedly, postoperative pathology showed a perihilar bile duct NETs G1 and microscopic invasion of the resected right hepatic duct. Then the patient received 3 cycles of adjuvant chemotherapy (Gemcitabine and tegafur-gimeracil-oteracil potassium capsule). At present, this patient has been following up for 20 months without recurrence or disease progression.Conclusions NETs of the biliary tract are difficult to diagnose preoperatively. The treatment for NETs G1 with R1 resection is still controversial yet may offer potential positive adjuvant chemotherapy. The diagnosis of NETs should be kept in mind by the surgeon for proper time management and more information about biliary NETs should be registered.

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