Systematic review: Should routine resection of the extra-hepatic bile duct be performed in gallbladder cancer?

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.

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Evaluation of extra capsular lymph node involvement in patients with extra-hepatic bile duct cancer

World Journal of Surgical Oncology ◽

10.1186/1477-7819-10-106 ◽

2012 ◽

Vol 10 (1) ◽

Cited By ~ 13

Author(s):

Takehiro Noji ◽

Masaki Miyamoto ◽

Kanako C Kubota ◽

Toshiya Shinohara ◽

Yoshiyasu Ambo ◽

...

Keyword(s):

Lymph Node ◽

Bile Duct ◽

Bile Duct Cancer ◽

Lymph Node Involvement ◽

Hepatic Bile ◽

Hepatic Bile Duct ◽

Node Involvement ◽

Duct Cancer

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A small solitary non-parasitic hepatic cyst causing an intra-hepatic bile duct stricture: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-4-254 ◽

2010 ◽

Vol 4 (1) ◽

Cited By ~ 1

Author(s):

Keunho Lee ◽

Taeho Hong

Keyword(s):

Case Report ◽

Bile Duct ◽

Hepatic Cyst ◽

Bile Duct Stricture ◽

Hepatic Bile ◽

Hepatic Bile Duct ◽

Duct Stricture

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Effect of phospholipase A2 on proliferation of the primary cultured biliary epithelial cells from the extra-hepatic bile duct of rats using D-valine containing medium

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) ◽

10.4044/joma1947.114.3_289 ◽

2003 ◽

Vol 114 (3) ◽

pp. 289-296

Author(s):

Kaoru OGURA ◽

Yasuhiro WATANABE ◽

Chiharu HIRAMINE ◽

Toshitaka NAKAGAWA ◽

Akira TOKI ◽

...

Keyword(s):

Bile Duct ◽

Epithelial Cells ◽

Phospholipase A ◽

Hepatic Bile ◽

Hepatic Bile Duct ◽

Biliary Epithelial Cells

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Robotic Resection of Type IV-A Choledochal Malformation with Complete Extra-hepatic Bile Duct Resection and En Bloc Left Hepatectomy, with Roux-en-Y Right Hepaticojejunostomy

Videoscopy ◽

10.1089/vor.2019.0589 ◽

2019 ◽

Vol 29 (5) ◽

Author(s):

Edwin Onkendi ◽

Adel Alhaj Saleh

Keyword(s):

Bile Duct ◽

Left Hepatectomy ◽

Bile Duct Resection ◽

Hepatic Bile ◽

En Bloc ◽

Hepatic Bile Duct ◽

Type Iv ◽

Robotic Resection ◽

Choledochal Malformation

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Hepatolitiasis: Kasus Serial di RSUD Dr. Soetomo

JBN (Jurnal Bedah Nasional) ◽

10.24843/jbn.2018.v02.i01.p02 ◽

2018 ◽

Vol 2 (1) ◽

pp. 5 ◽

Cited By ~ 1

Author(s):

Made Mahayasa ◽

Tommy Lesmana

Keyword(s):

Bile Duct ◽

Magnetic Resonance ◽

Common Bile Duct ◽

Gall Bladder ◽

Hepatic Duct ◽

Magnetic Resonance Cholangiopancreatography ◽

Common Hepatic Duct ◽

Hepatic Bile ◽

Hepatic Bile Duct

Latar Belakang: hepatolitiasis adalah batu empedu pada saluran empedu liver dengan insidensi 20-30% dari semua pasien yang menjalani operasi untuk penyakit batu empedu. Ada beberapa pilihan operasi hepatolitiasis, seperti hepatektomi, eksplorasi common bile duct (CBD), dan drainase saluran intrahepatik atau cholangioenterostomy (access loop procedures), dan teknik perkutaneus. Pada laporan kasus serial ini, akan dibahas aspek pemilihan operasi pada pasien dengan hepatolitiasis. Kasus: kasus pertama adalah laki-laki, 60 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan nyeri abdomen kuadran kanan atas sejak 2 minggu. Diagnosis dengan USG (ultrasonografi) abdomen dan MRCP (magnetic resonance cholangiopancreatography) menunjukkan terdapat beberapa batu di IHBD (intra hepatic bile duct), CHD (common hepatic duct), CBD, GB (gall bladder), dan sistem bilier yang melebar. Pada pasien dilakukan tindakan kolesistektomi, eksplorasi duktus, dan by pass bilio-digestive Roux en Y (access loop procedures). Kasus kedua adalah perempuan, 45 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan didiagnosis batu IHBD dan CBD. Penderita telah dilakukan kolesistektomi sejak 12 tahun yang lalu. Durante operasi ditemukan atrofi lobus kiri hati. Pada pasien, dilakukan operasi dengan eksplorasi duktus, by pass bilio-digestive Roux en Y (access loop procedures), dan hepatektomi lobus kiri. Simpulan: kasus hepatolitiasis jarang terjadi di Rumah Sakit Dr. Soetomo Surabaya. Diagnosis lengkap memerlukan kombinasi modalitas pencitraan. Pembedahan tetap menjadi pilihan utama pengobatan definitif. Menurut strategi terapeutik saat ini untuk hepatolitiasis, hepatektomi tampaknya merupakan pengobatan yang paling efektif untuk pasien dengan hepatolitiasis kiri yang terisolasi jika prosedur pembedahan lain tidak dapat mengatasi semua lesi terkait. Perawatan yang baik dapat memberikan luaran yang baik.

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