scholarly journals Modern view of biliary atresia in children

2020 ◽  
pp. 40-55 ◽  
Author(s):  
G. V. Volynets ◽  
A. I. Khavkin ◽  
A. V. Nikitin
Keyword(s):  
Biliary Atresia ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Biliary Tree ◽  
Common Hepatic Duct ◽  
Type I ◽  
Blood Biochemical ◽  
The Common

Atresia of the biliary tract, or biliary atresia (BA), is a destructive, inflammatory disease in which progressive biliary tree fibrosis in an infant leads to obstruction of the bile ducts and, as a result, to cirrhosis of the liver. If untreated, progressive cirrhosis leads to death by 2 years. Biliary atresia can be divided into 3 types, each of which depends on the level closest to biliary obstruction. Type I (obstruction of the common bile duct), type II (patency of the bile ducts to the level of the common hepatic duct), type III (obstruction at the level of the gates of the liver). It is very important to distinguish between types of BA and conduct differential diagnosis with other cholestatic diseases. There are nonsyndromic, syndromic, and BA, combined with other malformations. In diagnostics, in addition to clinical manifestations and specific changes in blood biochemical parameters characterizing cholestasis, an ultrasound examination of the abdominal cavity organs, gepatobiliscintigraphy, magnetic resonance cholecystopancreatocholangiography, according to indications, a puncture biopsy of the liver and histological examination are performed. The main method of treatment is hepatoportoenterostomy according to Kasai, which must be performed no later than 3 months, and with liver cirrhosis and hepatic insufficiency, liver transplantation. Additional methods of treatment include the use of ursodeoxycholic acid, fat-soluble vitamins.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

Measurement of capacity of biliary tree in rats

1963 ◽  
Vol 205 (6) ◽  
pp. 1122-1126 ◽  
Author(s):  
G. Barber-Riley
Keyword(s):  
Hepatic Duct ◽  
Biliary Tree ◽  
Liver Weight ◽  
Common Hepatic Duct ◽  
Marker Substances ◽  
The Common ◽  
Made In

A method is described for measuring the capacity of the normal and of the distended biliary tree. The method depends on the use of dyes rapidly excreted in the bile, which are used as marker substances, and is here applied to rats. The use of an alternative suitable dye, or large alterations in the quantity injected, produced in most cases only small changes in the measured capacities. The measured capacity of both the normal and of the distended biliary tree was found to be proportional to the liver weight, and was altered by an expected amount when a lobe of the liver was functionally removed. The measured extra capacity produced by obstruction of the common hepatic duct was similar to that found using another method. The reliability of the method and some probable errors are briefly discussed. It is concluded that measurements made in this manner might be used to examine the biliary tree during short periods of obstruction.

scholarly journals Congenital biliary web- a rare cause of obstructive jaundice in an infant: A case report

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Allah Ditta ◽  
Muhammad Bilal Mirza ◽  
Muhammad Waqas-ur-Rehman ◽  
Maria Fahim ◽  
Farrakh Mehmood Satar ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Postoperative Recovery ◽  
Common Hepatic Duct ◽  
Rare Entity ◽  
Case Presentation ◽  
Complete Obstruction ◽  
The Common

Background: Congenital biliary web of the extra-hepatic biliary tree is becoming exceedingly rare cause of obstructive jaundice in children. Case Presentation: We report a case of 5-month-old male baby who presented with acholic stools and persistent jaundice since birth. Magnetic resonance cholangiopancreatography (MRCP) showed contracted gall bladder and focal narrowing at mid portion of the common bile duct (CBD) with proximal dilatation of biliary channels. On exploration, a complete web was found just proximal to the confluence of cystic duct and common hepatic duct causing complete obstruction of biliary tree. A Roux-en-Y hepatico-jejunostomy was done. Postoperative recovery was uneventful. Conclusion: We conclude that congenital biliary web is a rare entity and should be considered in the dif­ferential diagnosis of biliary atresia.

scholarly journals An Unusual Cause of Cholestasis in an Infant: Biliary Atresia Type IIB

2021 ◽  
Author(s):  
Poonam Sherwani ◽  
Rishi Bolia ◽  
Ashish Kaushik ◽  
Sumit Kumar ◽  
Sanjeev Kishore ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Hepatic Duct ◽  
Early Infancy ◽  
Common Hepatic Duct ◽  
Unknown Etiology ◽  
Imaging Features ◽  
Type Ii ◽  
Porta Hepatis ◽  
The West ◽  
The Common

AbstractBiliary atresia (BA) is a progressive destructive cholangiopathy of unknown etiology that presents in early infancy. It has a worldwide frequency of 1:8,000–1:15,000 and is common in Asia than in the west. Based on the level at which the lumen of the extrahepatic duct is obliterated, BA is classified into three types. Type III is the commonest (∼85%) type and has the most proximal level of obstruction in the porta hepatis, while type II in which the atresia is at the level of the common hepatic duct, is the least common (∼2.5%) and has been rarely reported. Here, we report the imaging features of an infant with type IIB biliary atresia.

scholarly journals Presence of Cystic Artery in the Calot’s Triangle and Its Relation with Common Hepatic Duct – a Postmortem Study

2013 ◽  
Vol 10 (2) ◽  
pp. 50-56
Author(s):  
Md Khalilur Rahman ◽  
Selina Anwar
Keyword(s):  
Surgical Intervention ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Common Disease ◽  
Medicine Department ◽  
Medical College ◽  
Iatrogenic Complications ◽  
The Common

Introduction: Most common disease of liver and biliary tree is cholelithiasis which needs surgical intervention. Safe execution of traditional cholecystectomy or laparoscopic surgery needs proper knowledge of the origin, course, branching pattern of the cystic artery and its relation with common hepatic duct. This study was aimed to find the presence of cystic artery in the Calot’s triangle and its relation with common hepatic duct to prevent any iatrogenic complications especially for newer surgeons in this field. Materials and Methods: This study was done on 60 postmortem gallbladder collected from postmortem dead bodies under the guidance of Forensic Medicine department of Rangpur Medical College, Rangpur. After collection of the specimen, the boundary of the Calot’ triangle was identified and course of the cystic artery was observed whether it was passing through the triangle or not. The relation of the cystic artery with the common hepatic duct was also noticed. Results: It was found from the result of the present study that out of 60 cases cystic artery was found as a content of Calot’s triangle in 58 (96.65%) cases. Regarding the relations of the cystic artery, out of 60 specimens, in 54 cases (90%) cystic arteries were observed to pass behind the common hepatic duct. In four cases (6.67%) cystic artery were found crossing over the common hepatic duct and in two cases (3.33%), cystic artery were found crossing below the cystic duct. In one cases, branches of cystic artery (superficial and deep branch) was found. In every specimen a Calot‘s node was found within the Calot‘s triangle. Discussions: The result of the present study was compared with other workers. Though many of the workers found similar results regarding the course of the cystic artery through the Calot’ triangle but some workers found higher number of cystic artery passing outside the triangle. Also higher percentage of cystic artery passing over the common hepatic duct was found by many workers than the present study. DOI: http://dx.doi.org/10.3329/bja.v10i2.17282 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 50-56

scholarly journals Cholangiocellular carcinoma of the common hepatic duct causing obstructive jaundice in a patient with metastatic colonic carcinoma within liver

2010 ◽  
Vol 138 (1-2) ◽  
pp. 88-90
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Vladimir Radak ◽  
Marjan Micev ◽  
Stojan Latincic
Keyword(s):  
Bile Duct ◽  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Postoperative Recovery ◽  
Cholangiocellular Carcinoma ◽  
Colonic Carcinoma ◽  
Common Hepatic Duct ◽  
Histological Findings ◽  
The Common

Introduction. Colorectal carcinoma, one of the most frequent carcinomas, produces liver metastasis very frequently. Surprisingly, those secondaries rarely cause obstructive jaundice. If it appears, it is usually caused by compression or infiltration of the major bile ducts close to the hepatic hilus, less frequently with bile duct obstruction by gelatinous mucus produced by the tumour, much rarer by the tumour growth within the, otherwise intact, common bile duct and very rarely by metastasis into the biliary tree. Case Outline. We present a 67-year-old man who had been submitted to left colectomy for sygmoid colon carcinoma four years earlier, now, admitted with an obstructive jaundice, along with a number of liver and lung secondaries. Obstructive jaundice was caused by the vegetative tumour of the proximal part of the common hepatic duct which was resected and anastomosed with a Roux-en-Y jejunal limb. The postoperative recovery was uneventful. The patient died 7 months later without jaundice due to liver and lung secondaries. Histological findings showed cholangiocellular carcinoma of the common hepatic duct, while the histological findings of the liver tumour specimen confirmed metastatic colonic carcinoma. Conclusion. In case of obstructive jaundice in patients with metastatic colonic carcinoma within liver, other aethiological factors of biliary obstruction can not be excluded and have to be taken into differential diagnosis.

Low Insertion of the Cystic Duct in the Common Hepatic Duct as a Coincidence with an Onset of a Pancreatic Cephalic Carcinoma

2015 ◽  
Vol 69 (2) ◽  
pp. 94-99
Author(s):  
Aleksandar Sumkovski ◽  
Stojan Gjosev ◽  
Ljubomir Ognjenovikj ◽  
Meri Trajkovska ◽  
Goce Spasovski
Keyword(s):  
Cystic Duct ◽  
Surgical Procedure ◽  
Average Length ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Whipple Procedure ◽  
Common Hepatic Duct ◽  
Observation Study ◽  
Long Time ◽  
The Common

AbstractIntroduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mu­­cous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during pre­opera­tive imaging examinations, and particularly to un­­pleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical struc­tures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pan­creatic cephalic carcinoma (PCC).Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in ope­rable stage. The method for estimation of both, the ope­ra­bility and the site of insertion of the CD into CHD cons­isted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopan­cre­a­tectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treat­ment and denervation.Results. Of the total of 21 patients, we revealed low in­sertion of the CD (LICD) in 6 patients (28%). In 4 pa­tients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma.Conclusions. Comparison with other reference radiolo­gical and anatomical studies, our results significantly di­ffer in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed diffe­rences may be caused by the eventually present connec­tion between the LICD and PCC. Therefore, further stu­dies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.

scholarly journals Benign obstruction of the common hepatic duct (Mirizzi syndrome): diagnosis and operative management

2005 ◽  
Vol 42 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Jaques Waisberg ◽  
Adriano Corona ◽  
Isaac Walker de Abreu ◽  
José Francisco de Matos Farah ◽  
Renato Arioni Lupinacci ◽  
...  
Keyword(s):  
Hepatic Duct ◽  
Rare Complication ◽  
Preoperative Evaluation ◽  
Hepatic Abscess ◽  
Individual Characteristics ◽  
Mirizzi Syndrome ◽  
Uneventful Recovery ◽  
Common Hepatic Duct ◽  
Type I ◽  
The Common

BACKGROUND: Mirizzi syndrome is a rare complication of prolonged cholelithiasis, characterized by narrowing of the common hepatic duct due to mechanical compression and/or inflammation due to biliary calculus impacted in the infundibula of the gallbladder or in the cystic duct. OBJECTIVES: To describe a series of eight consecutive patients with Mirizzi syndrome, at a single institution, submitted to surgical treatment and to comment on their aspects with emphasis on the diagnosis and treatment. METHODS: Four women and four men, with a mean age of 61.6 years (42 to 82 years), presenting Mirizzi syndrome were operated between 1997 and 2003. The following items were evaluated: clinical presentation, laboratory results, preoperative evaluation, operative findings, presence of choledocholithiasis, type of Mirizzi syndrome according to the classification by Csendes, choice of operative procedures, and complications. RESULTS: The most frequent symptoms were abdominal pain (87.5%) and jaundice (87.5%). All the patients presented altered hepatic function tests. The diagnosis of Mirizzi syndrome was intra-operative in seven (87.5%) patients, and preoperative in one (12.5%). Cholecystocholedochal fistula associated with choledocholithiasis was observed in three (37.5%) cases. Mirizzi syndrome was classified as Csendes type I in five (62.5%) patients, type II in one (12.5%), type III in one (12,5%) and type IV in another (12.5%). Cholecystectomy, as an isolated surgical procedure, was performed in four (50.0%) patients. One (12.5%) patient was submitted to partial cholecystectomy and closure of the fistulous orifice with the central part of the infundibula. Two (25.0%) patients were submitted to cholecystectomy and side-to-side choledochoduodenostomy and another (12.5%) to side-to-side choledochoduodenostomy remaining the gallbladder in situ. Seven (87.5%) patients had an uneventful recovery and were discharged in good conditions. One (12.5%) patient presented a postoperative sepsis due to a sub-hepatic abscess, and was reoperated. There was no operative mortality. CONCLUSION: The preoperative diagnosis of Mirizzi syndrome is difficult and an awarded suspicion is necessary to avoid lesions of the biliary tree. The problem may only become evident during the operation due to firm adherences around Calot's triangle. The success of the treatment is related to a precocious recognition of the condition, even at the time of surgery, and adapting the management considering to the individual characteristics of each case.

scholarly journals Percutaneous transbiliary biopsy

2017 ◽  
Vol 44 (1) ◽  
pp. 107-108 ◽  
Author(s):  
GUSTAVO VIEIRA ANDRADE ◽  
MIGUEL ARCANJO SANTOS ◽  
MARCONI ROBERTO MEIRA ◽  
MATEUS DUARTE MEIRA
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Percutaneous Drainage ◽  
Biliary Drainage ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Endoscopic Biopsy ◽  
Common Hepatic Duct ◽  
Biopsy Forceps ◽  
The Common

ABSTRACT Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct.

A CADAVERIC STUDY ON VARIATIONS OF THE COMMON HEPATIC DUCT

2021 ◽  
pp. 19-21
Author(s):  
Sabeersha. S
Keyword(s):  
Postoperative Complications ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Descriptive Study ◽  
Common Hepatic Duct ◽  
Clinical Implications ◽  
Normal Anatomy ◽  
Anatomical Knowledge ◽  
The Common ◽  
Extrahepatic Biliary Tree

Variations in the anatomy of extrahepatic biliary apparatus (EHBA) has been a subject of extended research due to its clinical implications. Cholecystectomy is the commonly performed abdominal surgeries and its safety requires the adequate appreciation of anatomical abnormalities of the extrahepatic biliary tree to decrease the morbidity and mortality of the surgery. Abnormalities of the major ducts and presence of accessory ducts give rise to preoperative difculties and postoperative complications. Background & objectives: To study the normal anatomy of common hepatic duct and its variations. With the Methods: aim of the above study, a prospective descriptive study was conducted on 55 specimens with reference to the ducts. Different parameters were used as union of right and left hepatic ducts and common hepatic duct measurements and looked for variations such as accessory hepatic ducts. Results & discussion: Extrahepatic union of right and left hepatic ducts seen in 98% cases and intrahepatic union in 2%. Length of common hepatic duct varied from 1.5 to 4.7 cm with an average of 2.9cm. Accessory hepatic ducts were seen in 7 cases (13%) in which 2 joined the common hepatic duct, 1 joined LHD and 3 were to the cystic duct. All the ndings of the ducts are to enlighte Conclusions: n the anatomical knowledge of the anatomists, general and laparoscopic surgeons, oncosurgeons and to the transplant surgeons which are abundantly useful.

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