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Bile duct calculi

Qingfeng Sheng, Zhibao Lv, Weijue Xu, Xianmin Xiao, Jiangbin Liu, Yibo Wu
BACKGROUND Complete cyst excision with biliary reconstruction is the treatment of choice for choledochal cyst (CC). The aim of this article is to review our experience in patients who underwent reoperation between January 1995 and December 2014. MATERIAL AND METHODS The records of 18 patients (female/male, 15/3) were retrospectively analyzed including age, sex, cyst type, initial procedure, lab and imaging findings, indications for reoperation, intraoperative findings, and results of reoperation. The median follow-up period was 6 years...
March 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jeffrey M Adler, Timothy B Gardner
Chronic pancreatitis is a fibroinflammatory disease of the pancreas leading to varying degrees of endocrine and exocrine dysfunction. Treatment options are generally designed to control the pain of chronic pancreatitis, and endoscopic therapy is one of the main treatment modalities. Herein, we describe the endoscopic management of pancreatic duct calculi and strictures, entrapment of the intrapancreatic bile duct, celiac plexus interventions, and drainage of pancreatic pseudocysts.
March 3, 2017: Digestive Diseases and Sciences
Mohamed Salah Jarrar, Mohamed Habib Ben Hadj Khalifa, Rafik Ghrissi, Imed Ben Mansour, Fehmi Hamila, Amine Elghali, Rached Letaief
Background - Stones in common bile duct are defined as 'large' if they are more than 15 mm in size. There are very few reports which describe a giant stone measuring 5 cm or more and exceptionally a staghorn calculus in the common bile duct. Purpose - The purpose is to report a new rare case of giant staghorn gallstone and discuss the diagnostic approach and therapeutic possibilities. Case report - We report a case of a giant staghorn common bile duct calculus in a 65-year-old patient. Its removal required 2 operations and an endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy...
July 2016: La Tunisie Médicale
J Ma, S C Lü, J T Kou, X L Li, J Q Zhu, H M Dong, Q He
Objective: To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage. Methods: The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed...
December 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
K E Verweij, H van Buuren
Oriental cholangiohepatitis is a condition occurring in the Asian population, characterised by recurrent bacterial cholangitis and presence of calculi within the intrahepatic bile ducts, biliary strictures and an increased risk for cholangiocarcinoma. It is an uncommon disease in the West that may not always be considered. The therapeutic approach is multidisciplinary and highly individual, and includes antibiotic therapy, endoscopic and percutaneous biliary drainage with stone removal and dilation of strictures, and in selected cases surgical resection of affected liver segments...
November 2016: Netherlands Journal of Medicine
Jun Liu, Lan Jin, Zhongtao Zhang
BACKGROUND AND OBJECTIVES: Laparoscopic transcystic common bile duct exploration (LTCBDE) is a complex procedure requiring expertise in laparoscopic and choledochoscopic skills. The purpose of this study was to investigate the safety and feasibility of treating biliary calculi through laparoscopic transcystic exploration of the CBD via an ultrathin choledochoscope combined with dual-frequency laser lithotripsy. METHODS: From August 2011 through September 2014, 89 patients at our hospital were treated for cholecystolithiasis with biliary calculi...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
H Jiang, S Y Wang, X L Jin, J C Jin, H B Gu, F M Zhang
The present study aimed to investigate the practicability and clinical value of applying laparotomy biliary lithotomy forceps to laparoscopic bile duct exploration (LCBDE) for the surgical treatment of incarcerated calculi. A total of 63 patients were diagnosed with cholecystolithiasis and choledocholithiasis. The present study performed a retrospective analysis of clinical samples from 16 of these patients who had incarcerated calculi at the terminus of the common bile duct, and who had been treated with laparoscopic cholecystectomy and LCBDE...
October 2016: Experimental and Therapeutic Medicine
Mohammad S Khuroo, Ajaz A Rather, Naira S Khuroo, Mehnaaz S Khuroo
Portal biliopathy refers to cholangiographic abnormalities which occur in patients with portal cavernoma. These changes occur as a result of pressure on bile ducts from bridging tortuous paracholedochal, epicholedochal and cholecystic veins. Bile duct ischemia may occur due prolonged venous pressure effect or result from insufficient blood supply. In addition, encasement of ducts may occur due fibrotic cavernoma. Majority of patients are asymptomatic. Portal biliopathy is a progressive disease and patients who have long standing disease and more severe bile duct abnormalities present with recurrent episodes of biliary pain, cholangitis and cholestasis...
September 21, 2016: World Journal of Gastroenterology: WJG
E I Shapovalova, V V Grubnik, A I Tkachenko, D V Gerasimov, R P Romak
Results of treatment was studied in 2008 - 2015 yrs in 57 patients, suffering "difficult stones" (choledocholithiasis), in whom a dosed papillotomy in combination with the balloon dilatation. The advantages of application of combined dosed endoscopic papillosphincterotomy and balloon dilatation, comparing with complete endoscopic papillosphincterotomy, while treating "difficult stones" of common biliary duct, were established. Application of the procedure have guaranteed a good access through the duodenal papilla magna and have permitted to perform the calculi extraction in a less traumatic way, what have promoted its function preservation, and reduction of a postoperative complications rate, the patients' stationary treatment duration, and the remote complications rate...
April 2016: Klinichna Khirurhiia
E M Strehle, Y De Alwis, M Saleem
A 14-year-old girl was admitted to hospital with fever, headache, sore throat and abdominal pain. Her blood lymphocyte count and inflammatory markers were raised. Acute Epstein-Barr virus (EBV) infection was suspected and confirmed serologically and by measuring the viral load. On day 7, she developed jaundice with abnormal liver function tests. An abdominal ultrasound scan revealed thickening of the gallbladder and bile duct walls without calculi suggesting acute acalculous cholecystitis. The patient improved slowly with symptomatic treatment, and a repeat ultrasound scan six months later was normal...
May 2014: Ultrasound: Journal of the British Medical Ultrasound Society
Sheshang U Kamath, Satish B Dharap, Vineet Kumar
BACKGROUND: The incidence of common bile duct (CBD) calculi has been reported to be 8 % to 20 % among the patients with cholelithiasis. Failure to detect CBD stones on the part of the surgeon not only fails to relieve symptoms but also subjects them to potentially life-threatening complications such as cholangitis, pancreatitis or obstructive jaundice. Modalities for detection of CBD stones have evolved over time from CBD exploration based on clinical and operative findings to intraoperative cholangiography (IOC), to endoscopic retrograde cholangiopancreaticography (ERCP) and, recently, to magnetic resonance cholangiopancreaticography (MRCP) and endoscopic ultrasonography (EUS)...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Biswajit Dey, Gourav Kaushal, Sajini Elizabeth Jacob, Adarsh Barwad, Biju Pottakkat
Hepatolithiasis or primary intrahepatic stones are prevalent in the Far-East countries such as Korea, Japan and Taiwan. It has been associated with helminthiasis, bacterial infections, environmental and dietary factors. Despite high prevalence of helminthiasis like ascariasis, poor environmental condition and low protein diet, India and Middle-East countries have a low incidence of hepatolithiasis. We report two cases of hepatolithiasis associated with bacterial infections and were surgically managed. The first case is a 45-year-old female presenting with upper abdominal pain and fever...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Arpit Amin, Yuriy Zhurov, George Ibrahim, Anthony Maffei, Jonathan Giannone, Thomas Cerabona, Ashutosh Kaul
Mirizzi syndrome has been defined in the literature as common bile duct obstruction resulting from calculi within Hartmann's pouch or cystic duct. We present a case of a 78-year-old female, who developed postcholecystectomy Mirizzi syndrome from a remnant cystic duct stone. Diagnosis of postcholecystectomy Mirizzi syndrome was made on endoscopic retrograde cholangiography (ERCP) performed postoperatively. The patient was treated with a novel strategy by combining advanced endoscopic and laparoscopic techniques in three stages as follows: Stage 1 (initial presentation): endoscopic sphincterotomy with common bile duct stent placement; Stage 2 (6 weeks after Stage 1): laparoscopic ultrasonography to locate the remnant cystic duct calculi followed by laparoscopic retrieval of the calculi and intracorporeal closure of cystic duct stump; Stage 3 (6 weeks after Stage 2): endoscopic removal of common bile duct stent along with performance of completion endoscopic retrograde cholangiogram...
2016: Case Reports in Surgery
Pankaj Prasson, Xueli Bai, Qi Zhang, Tingbo Liang
BACKGROUND: Laparoscopic common bile duct exploration and endoscopic retrograde cholangiopancreatography (ERCP) are secure and effective techniques that recently been used to treat bile duct stones. The purpose of this research was to assess the intra-procedural efficacy and postprocedural upshots of the laparoscopic common bile duct exploration plus laparoscopic cholecystectomy (LCBDE) and ERCP plus laparoscopic cholecystectomy (ERCP + LC). METHODS: All studies contrasting one-stage (LCBDE) with two-stage (ERCP/EST + LC) managements in patients with concomitant gallstones and common bile duct (CBD) stones were included...
August 2016: Surgical Endoscopy
O L Madge, Cl Daha, C Cirimbei, E Brătucu, N D Straja
INTRODUCTION: The introduction of laparoscopic techniques has caused the dispute between supporters of routine or elective intraoperative cholangiography to continue, but at present most authors recommend its elective practice on the basis of well-established preoperative and / or intraoperative indications, thus avoiding to carry out a large number of unnecessary procedures, with their inherent disadvantages and risks. METHOD: A retrospective study was conducted over 20 years, comprising 100 elective laparoscopic cholangiographies...
November 2015: Chirurgia
Hong Liang, Chao Zhang, Hui Zhang
This study was to discuss the safety, feasibility and application scope of choledocholithotomy 1st stage suture surgery under laparoscopic choledochoscope on treatment of extra hepatic bile duct stones. There were 68 patients with abdominal surgery admitted to hospital from 2009 to 2013. Among 68 patients, 3 cases had surgical laparotomy, while rest of the 65 patients were completely finished the operation of laparoscopy without complication or calculi recurrence in the next 2 year follow-up. If the surgical indications could be properly handled under the mastery of skilled laparoscopy and laparotomy, suture of the patients with the laparoscopic choledocholithotomy method still is a safe, effective and feasible treatment method and it can achieve small trauma, rapid recovery, few complication of minimally invasive purpose even though these patients have history of abdominal surgery...
November 2015: Pakistan Journal of Pharmaceutical Sciences
Pradeep Chowbey, Anil Sharma, Amit Goswami, Yusuf Afaque, Khoobsurat Najma, Manish Baijal, Vandana Soni, Rajesh Khullar
BACKGROUND: Incomplete gallbladder removal following open and laparoscopic techniques leads to residual gallbladder stones. The commonest presentation is abdominal pain, dyspepsia and jaundice. We reviewed the literature to report diagnostic modalities, management options and outcomes in patients with residual gallbladder stones after cholecystectomy. MATERIALS AND METHODS: Medline, Google and Cochrane library between 1993 and 2013 were reviewed using search terms residual gallstones, post-cholecystectomy syndrome, retained gallbladder stones, gallbladder remnant, cystic duct remnant and subtotal cholecystectomy...
October 2015: Journal of Minimal Access Surgery
Kyudon Chung, Seunguk Bang, Yoona Kim, Hyuntae Chang
We present the first reported case of a patient with intraoperative hypoglycemia, with no predisposing factors, that was indicative of post-hepatectomy liver failure due to liver injury. A 56-year-old man was hospitalized to undergo left lateral segmentectomy, cholecystectomy and T-tube choledocholithotripsy due to calculi in the intrahepatic and common bile ducts. His medical history was unremarkable. Three hours after surgery initiation, his glucose level decreased from 84 mg/dL to below detectable levels...
February 2016: Journal of Anesthesia
Lionel Arrivé, Marianne Hodoul, Antoune Arbache, Lucie Slavikova-Boucher, Yves Menu, Sanaâ El Mouhadi
Magnetic resonance cholangiography (MRC) has become the standard of reference for imaging of the biliary ducts. The use of three-dimensional (3D) sequences has resulted in improved spatial resolution with virtually isotropic voxel and improved signal/noise ratio. In addition to MRC images, 3D fat suppressed T1-weighted MR images should be systematically obtained to search for intrahepatic calculi. MRC plays a major role in the diagnosis of cholangiocarcinoma and assessment of its resectability. With modern MR systems the performance of MR is basically the same that of CT for evaluation of arterial and portal vein extent...
December 2015: Clinics and Research in Hepatology and Gastroenterology
Bryant Furlow
Pancreatic disease often is asymptomatic until tissue damage and complications occur or until malignancies have reached advanced stages and have metastasized. Contrast-enhanced multidetector computed tomography plays a central role in diagnosing, staging, and treatment planning for pancreatitis and pancreatic cancer. This article introduces the functional anatomy of the pancreas and common bile duct and the epidemiology, pathobiology, and computed tomography imaging of pancreatitis, calculi, and pancreatic cancer...
July 2015: Radiologic Technology
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