Laparoscopic surgery for lithiasis local choledochal dilatation diagnosed a cyst: Case report and literature reviews

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Tuấn Anh Đỗ ◽  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Proper Diagnosis ◽  
The Common

Abstract Biliary dilation is common in clinical practice and originates from many pathologies; among them, choledocholithiasis, chronic pancreatitis and periampullary diverticula (PAD) are the most common. Popular signs of cholelithiasis is diffuse dilatation of the intra- and extrahepatic bile duct, however, in some cases, it might be local dilatation of the common bile duct without intrahepatic bile duct dilatation. The long-term outcome is favorable, however, it is necessary to rule out other causes such as choledochal cyst, pancreatitis by frozen section in order to have a proper diagnosis and treatment. We describe a 19-year-old female patient with local dilation of the common bile duct due to choledocholithiasis that was operated laparoscopically with success. Key word: Local common bile duct dilation, gallstones, choledochal cyst, laparoscopy. Tóm tắt Giãn đường mật là một hình thái tổn thương hay gặp trên lâm sàng, do nhiều bệnh lý khác nhau, hay gặp nhất là sỏi ống mật chủ (OMC), viêm tụy mạn và túi thừa Vater 1. Dấu hiệu phổ biến của sỏi mật là giãn đường mật trong và ngoài gan lan tỏa, tuy nhiên có trường hợp OMC giãn đơn thuần không kèm theo giãn đường mật trong gan. Tiên lượng của bệnh này là tốt, tuy nhiên cần loại trừ các nguyên nhân như nang OMC, viêm tụy bằng sinh thiết tức thì để có chẩn đoán và điều trị phù hợp nhất. Chúng tôi xin báo cáo một trường hợp người bệnh (NB) nữ, 19 tuổi mắc sỏi mật gây giãn OMC khu trú dạng nang được phẫu thuật nội soi thành công. Từ khóa: Giãn đường mật khu trú, sỏi mật, nang ống mật chủ, phẫu thuật nội soi.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

scholarly journals Neurofibroma of the bile duct: a rare cause of obstructive jaundice

2013 ◽  
Vol 95 (2) ◽  
pp. e14-e16 ◽  
Author(s):  
A De Rosa ◽  
D Gomez ◽  
AM Zaitoun ◽  
IC Cameron
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Benign Lesion ◽  
Exploratory Laparotomy ◽  
Radiological Features ◽  
The Common ◽  
Duct Stricture

Neurofibromas of the common bile duct are extremely rare. The lack of specific clinical or radiological features makes preoperative diagnosis in the absence of histology difficult. We report the case of a female patient who presented with obstructive jaundice and evidence of a common bile duct stricture on imaging. She underwent an exploratory laparotomy, and intraoperative frozen section confirmed clear margins and a benign lesion. Excision of the extrahepatic bile duct and A Roux-en-Y hepaticojejunostomy was performed. We discuss the clinical features and management of neurofibromas of the bile duct in light of the literature.

scholarly journals A Resected Case of Mucinous Adenocarcinoma of the Duodenum, Mimicking Intraductal Papillary Neoplasm of the Bile Duct

2015 ◽  
Vol 100 (11-12) ◽  
pp. 1443-1448
Author(s):  
Norio Kubo ◽  
Hideki Suzuki ◽  
Norihiro Ishii ◽  
Mariko Tsukagoshi ◽  
Akira Watanabe ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Transverse Colon ◽  
Extrahepatic Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Mucinous Carcinoma ◽  
Villous Tumor ◽  
Intraductal Papillary Neoplasm ◽  
The Common ◽  
Papillary Neoplasm

Duodenum mucinous carcinoma is very rare, and the prognosis of the patient is very bad, especially when the tumor is invasive to other organs. In this case, duodenum carcinoma was invasive to common bile duct and transverse colon. Mucinous fluid, which was secreted from a duodenum tumor, was found in the dilatated bile duct. The intraductal papillary neoplasm of the bile duct was considered a differential diagnosis. We performed aggressive resection and had a good prognosis. A 74-year-old woman received a diagnosis of cholangitis and was treated with antibiotic drugs. Endoscopic retrograde cholangiopancreatography revealed a defect in the lower common bile duct with the mucoid fluid. We suspected intraductal papillary neoplasm of the bile duct, but no malignant cells were detected. One year later, gastrointestinal fiberscopy revealed a villous tumor in the postbulbar portion of the duodenum; adenocarcinoma was detected in biopsy specimens. Computed tomography revealed dilatation of the duodenum with an enhanced tumor, and dilatation of both the common and intrahepatic bile ducts. Magnetic resonance cholangiopancreatography revealed that the duodenum was connected with the common bile duct and ascending colon. We resected the segmental duodenum, extrahepatic bile duct, left lobe of liver, a partial of the transverse colon, and associated lymph nodes. Although the advanced duodenal carcinoma had poor prognosis, the patient was alive, without recurrence, 5 years after the operation.

scholarly journals Biliary Peritonitis Due to Spontaneous Perforation of the Left Intrahepatic Bile Duct in an Adult: A Case Report and Review of Literature

2018 ◽  
Vol 103 (7-8) ◽  
pp. 339-343
Author(s):  
Wenwu Cai ◽  
Ke Pan ◽  
Qinglong Li ◽  
Xiongying Miao ◽  
Chang Shu
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Bile Leakage ◽  
Common Bile Duct Exploration ◽  
Good Prognosis ◽  
Spontaneous Perforation ◽  
Repair Operation

Spontaneous perforation of the left intrahepatic bile duct is extremely rare, especially in adults. Here, we report on a case of a 64-year-old woman who had a complaint of right upper abdominal pain for 10 days, which gradually progressed to entire abdominal pain for 3 days, and was admitted to our hospital. Relevant examinations revealed she had a normal cardiac and lung workup, but an obvious abnormal abdominal computed tomography examination, which revealed an enlarged gallbladder, choledocholithiasis with dilatation of the common bile duct (1.8 cm) and intrahepatic bile duct, and a lot of encapsulated ascites. After being given adequate fluid resuscitation and active preoperative preparation, cholecystectomy and common bile duct exploration and perforation repair operation were then performed. The postoperative course was uneventful, and she was discharged with the T-tube in situ. A choledochoscopy examination at week 6 showed the conditions of the intrahepatic and extrahepatic bile duct were good. For these patients, early diagnosis and surgical treatment are essential for good prognosis. The goal of our surgery is to stop bile leakage, resolve choledocholithiasis and cholangitis, and reconstruct the bile duct.

scholarly journals Common Bile Duct Obstruction by Free Floating Tumor

HPB Surgery ◽  
1993 ◽  
Vol 6 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Richard A. Prinz ◽  
Tien C. Ko ◽  
Sheldon B. Maltz ◽  
Carlos J. Reynes ◽  
Richard E. Marsan ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Frozen Section ◽  
Total Serum ◽  
Metastatic Colon Cancer ◽  
Tumor Spread ◽  
Multiple Defects ◽  
Tissue Fragment ◽  
The Common

Tumors usually spread by local invasion or by vascular or lymphatic metastases. We report six patients in whom tumor cells were shed into the common bile duct with resulting obstruction. The three men and three women had jaundice and upper abdominal discomfort. Jaundice was intermittent in four patients. Preoperative total serum bilirubin ranged from 2.5 to 16.1 mg/dl; alkaline phosphatase ranged from 221 to 605 IU/1. Ultrsasound showed a dilated gallbladder [GB] in five patients with dilated intrahepatic ducts in three and stones in only one. ERCP showed a single filling defect in two of three patients and multiple defects in one. PTC showed multiple defects in one patient. At operation a thick gelatinous tissue fragment or clot was seen in the common bile duct of each patient. Frozen section identified tumor tissue in all. The source was GB carcinoma [2], GB adenomyoma [1], hepatic metastases of colon cancer [2] and common bile duct cancer [1]. Treatment consisted of pancreaticoduodenectomy [2], including one for GB cancer, left hepatic lobectomy [1], choledochoduodenostomy [1], common duct exploration with T-tube insertion and cholecystectomy [1]. One patient with metastatic colon cancer and another with gallbladder cancer died within one year of operation. The other four are alive from 2 to 4 years later. Conclusion: Benign or malignant tumors within the hepatobiliary tree can shed tissue into the common bile duct which can cause biliary obstruction. Any tissue fragment found in the common bile duct should be evaluated by frozen section. Recognition of this mode of tumor spread is needed for appropriate therapy of the underlying benign or malignant tumor.

scholarly journals Actual Long-term Outcome of Extrahepatic Bile Duct Cancer After Surgical Resection

2005 ◽  
Vol 241 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Jin-Young Jang ◽  
Sun-Whe Kim ◽  
Do Joong Park ◽  
Young Joon Ahn ◽  
Yoo-Seok Yoon ◽  
...  
Keyword(s):  
Bile Duct ◽  
Surgical Resection ◽  
Bile Duct Cancer ◽  
Extrahepatic Bile Duct ◽  
Term Outcome ◽  
Extrahepatic Bile Duct Cancer ◽  
Long Term Outcome ◽  
Duct Cancer

Surgical treatment of idiopathic dilatation of the common bile duct (choledochal cyst) in 14 children

1971 ◽  
Vol 6 (4) ◽  
pp. 421-426 ◽  
Author(s):  
John Duckett ◽  
Angelo J. Eraklis ◽  
Luther Longino
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
The Common
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