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Bile duct anatomy

Yuichi Nakaseko, Takeaki Ishizawa, Akio Saiura
In hepatobiliary surgery, fluorescence imaging enables identification of subcapsular liver tumors through accumulation of indocyanine green after preoperative intravenous injection in cancerous tissues of hepatocellular carcinoma and in noncancerous hepatic parenchyma around intrahepatic cholangiocarcinoma and liver metastases. Indocyanine green-fluorescence imaging can also be used for visualizing extrahepatic bile duct anatomy and hepatic segmental boundaries, enhancing the accuracy of open and laparoscopic hepatectomy...
August 11, 2018: Journal of Surgical Oncology
Mamoru Takenaka, Kentaro Yamao, Masatoshi Kudo
The efficacy of balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) for patients with surgically altered gastrointestinal anatomy has been previously reported. However, although this method allows the endoscope to reach the papilla, successful biliary cannulation is difficult. Unlike normal ERCP, directions in these patients are reversed, and it is difficult to adjust the catheter in the direction of the bile duct. Intubating the cannula to the papilla is therefore time-consuming...
August 7, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Shuntaro Mukai, Takao Itoi, Atsushi Sofuni, Takayoshi Tsuchiya, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Mitsuru Fujita, Kenjiro Yamamoto, Yuichi Nagakawa
BACKGROUND AND AIMS: Although balloon enteroscopy-assisted ERCP (BE-ERCP) is effective and safe for benign biliary diseases in patients with surgically altered anatomy (SAA), BE-ERCP is not always successful. Recently, EUS-guided antegrade intervention (EUS-AI) including a 1-stage or 2-stage procedure has been developed for BE-ERCP failure cases. The aim of the present study was to evaluate the outcome of EUS-AI for benign biliary diseases with SAA. METHODS: Of 48 patients in whom BE-ERCP failed, percutaneous transhepatic intervention was performed in 11 patients...
August 1, 2018: Gastrointestinal Endoscopy
Kiyokazu Hiwatashi, Hiroshi Okumura, Tetsuro Setoyama, Kei Ando, Yoshito Ogura, Kuniaki Aridome, Shigeho Maenohara, Shoji Natsugoe
Intraoperative cholangiography involving the excretion of fluorescent indocyanine green (ICG) into the bile is used to determine biliary anatomy in laparoscopic cholecystectomy (LC). This study aimed to evaluate the features of intraoperative ICG cholangiography, in LC with cholecystitis, and compared the delineation of the cystic duct (CD) between ICG cholangiography and magnetic resonance cholangiopancreatography (MRCP).Participants comprised 65 patients undergoing LC using ICG cholangiography.Fifty-eight patients (89...
July 2018: Medicine (Baltimore)
Kei Yane, Tsuyoshi Hayashi, Akio Katanuma
Afferent limb syndrome (ALS) is a postoperative complication following various gastrointestinal surgeries [1-3]. The traditional definitive treatment for ALS is surgical bypass [4]. However, in patients with poor medical condition, less invasive treatments are strongly desired. Percutaneous transhepatic biliary drainage (PTBD) is an alternative; however, it is difficult to perform for patients with bleeding tendency or without intrahepatic bile duct dilation. Herein, we describe a case of ALS-induced severe acute cholangitis in a patient with altered Roux-en Y anatomy successfully treated by emergency endoscopic drainage...
July 24, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Irene Andaluz García, Irene González Partida, Javier Lucas Ramos, Jorge Yebra Carmona
Malignant bile duct obstruction is a common entity in clinical practice and is infrequently caused by non-biliopancreatic neoplasms. We report the case of a male admitted with malignant obstruction of the biliary tract, showing after numerous studies that this obstruction was the initial presentation of a stage IV adenocarcinoma of the lung. Pulmonary neoplasms have variable behaviors being often spread at time of diagnosis, especially in the more aggressive subtypes. However, it is uncommon its manifestation as obstructive jaundice and when this happens it is usually due to liver damage and not to metastases to periampullary region that are extremely infrequent...
August 2018: Revista Española de Enfermedades Digestivas
Roman O Kowalchuk, Roman M Kowalchuk, Katia Kaplan-List, Theodore K Oates, Sean C Smith
Gallbladder duplication is a rare anatomic variant of biliary anatomy, which can present diagnostic and treatment challenges. In this case, a 49-year-old male presented with classic symptoms of biliary colic to his primary care physician, and while computed tomography (CT) noted the presence of gallstones, neither CT nor ultrasound was able to locate a gallbladder within the gallbladder fossa. Initial surgery found and cauterized a rudimentary gallbladder, but symptoms persisted, requiring a second surgery and secondary analysis of CT, ultrasound, and magnetic resonance imaging with magnetic resonance cholangiopancreatography...
August 2018: Radiology Case Reports
Harshit S Khara, Truptesh H Kothari, Amitpal S Johal, Shivangi T Kothari, Nina Ahuja, Ashok Bhanushali, Anil Kotru, Andrea Berger, Vivek Kaul, Seth A Gross, Christopher J DiMaio, William B Hale, Rami Abbass, Marvin Ryou, Amrita Sethi, Brian G Turner, Paul Fockens, David L Diehl
Background and study aims : The anatomical meaning of the terms "proximal" and "distal" in relation to the pancreaticobiliary anatomy can be confusing. We aimed to investigate practice patterns of use of the terms "proximal" and "distal" for pancreaticobiliary anatomy amongst various medical specialties. Materials and methods : An online survey link to a normal pancreaticobiliary diagram was emailed to a multispecialty physician pool...
July 2018: Endoscopy International Open
Ahmed Taki-Eldin, Abd-Elnaser Badawy
BACKGROUND: Laparoscopic cholecystectomy is the most commonly performed operation of the digestive tract. )It is considered as the gold standard treatment for cholelithiasis. AIM: To evaluate the outcome of it regarding length of hospital stay, complications, morbidity and mortality at a secondary hospital. METHODS: Data of 492 patients who underwent laparoscopic cholecystectomy were retrospectively reviewed. Patients' demographics, co-morbid diseases, previous abdominal surgery, conversion to open cholecystectomy, operative time, intra and postoperative complications, and hospital stay were collected and analyzed from patients' files...
June 21, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Juliana Yang, Payal Saxena, Lea Fayad, Omid Sanaei, Robert Moran, Olaya Brewer-Gutierrez, Christopher Paiji, Mouen A Khashab
No abstract text is available yet for this article.
June 21, 2018: American Journal of Gastroenterology
Liwei Pang, Jindong Yuan, Yan Zhang, Yuwen Wang, Jing Kong
Introduction: With the development of laparoscopic skills, the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) has become the standard surgical procedure for choledocholithiasis. We usually use Hem-o-lok clips to control cystic duct and vessels, which is safe on most occasions and has few perioperative complications such as major bleeding, wound infection, bile leakage, and biliary and bowel injury. However, a rare complication of post-cholecystectomy clip migration (PCCM) increases year by year due to the advancement and development of LC, CBD exploration as well as the wide use of surgical ligation clips...
May 24, 2018: Journal of Minimal Access Surgery
Arecio Peñaloza-Ramírez, Andrés Murillo-Arias, Jaison Rodríguez-Mongui, Ricardo Carvajal-Flechas, Pedro Aponte-Ordoñez
INTRODUCTION: Despite the advances of bile duct catheterization, its success is still not guaranteed. Few studies have been published regarding a second ERCP attempt, however those reports enhance the catheterization success Objective: To determine whether an ERCP performed 72 hours after a first precut papillotomy enhances the bile duct catheterization. MATERIAL AND METHODS: A cohort study was performed including all patients that had ERCP with precut papilotomy without catheterization of the bile duct and 72 hours later were programmed to a new ERCP between September 2015 and September 2016...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich
BACKGROUND: The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed...
May 16, 2018: BMC Surgery
Theodore W James, Y Claire Fan, Todd H Baron
BACKGROUND AND AIMS: EUS-guided hepaticoenterostomy (EUS-HE) usually is reserved for palliation of malignant biliary obstruction after failed endoscopic retrograde cholangiography (ERC) or inaccessible biliary tree in surgically altered anatomy (SAA). We describe the outcome of EUS-HE and antegrade therapy for benign biliary disease in patients with SAA. METHODS: Retrospective review of 20 consecutive patients with surgically altered anatomy and benign biliary obstruction who underwent EUS-HE performed by 1 endoscopist at a tertiary-care center over a 3-year period...
May 3, 2018: Gastrointestinal Endoscopy
Kausar Makki, Vishal Chorasiya, Ajitabh Srivastava, Ashish Singhal, Arif Ali Khan, Vivek Vij
Biliary complications are a significant cause of morbidity after living donor liver transplant (LDLT). Bile leak may occur from bile duct (anastomotic site in recipient and repaired bile duct stump in donor), cystic duct stump, cut surface pedicles or from divided caudate ducts. The first three sites are amenable to post-operative endoscopic stenting as they are in continuation with biliary ductal system. However, leaks from divided isolated caudate ducts can be stubborn. To minimize caudate duct bile leaks, it is important to understand the anatomy of hilum with attention to the caudate lobe biliary drainage...
May 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Takeshi Ogura, Nobu Nishioka, Kazuhide Higuchi
BACKGROUND: Endoscopic ultrasound-guided hepaticojejunostomy (EUS-HJS) combined with antegrade stenting (AS) can proceed if patients are complicated with duodenal obstruction or surgical anatomy such as Roux-en-Y esophagojejunostomy. A novel plastic stent (Gadelius Medical Co. Ltd., Tokyo, Japan) that is designed to prevent stent migration into the abdominal cavity was made available in Japan. Here, we describe technical tips for EUS-HJS combined with EUS-AS using this plastic stent. TECHNICAL PRESENTATION: After the intrahepatic bile duct is punctured, the guidewire is inserted into the intestine across the bile duct obstruction site...
July 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masahiro Itonaga, Keiichi Hatamaru, Masayuki Kitano
No abstract text is available yet for this article.
July 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Yousuke Nakai, Hirofumi Kogure, Atsuo Yamada, Hiroyuki Isayama, Kazuhiko Koike
Bile duct stones in patients with surgically altered anatomy still pose a challenge to endoscopists. For successful endoscopic management of bile duct stones, there are multiple hurdles: Intubation to the afferent limb, biliary cannulation, ampullary intervention and stone extraction. The major advancement in this area is the development of dedicated device-assisted endoscopes for endoscopic retrograde cholangiopancreatography (ERCP). In patients with Billroth II reconstruction, a high technical success rate is reported using a duodenoscope but can be complicated by a potentially high perforation rate...
April 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Thomas Togliani, Stefano Pilati, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
PURPOSE: Post-surgical upper gastrointestinal anatomy may hamper a complete bilio-pancreatic evaluation with a standard echoendoscope. The aim of this study was to assess the role of catheter probe extraductal ultrasound (EDUS) for the evaluation of the common bile duct (CBD) in patients who are status post-gastric surgery and who are suspected of having choledocholithiasis. METHODS: We retrospectively analyzed patients with a prior history of gastric surgery, who underwent EDUS for a suspicion of CBD obstruction...
March 29, 2018: Abdominal Radiology
Petros C Benias, Rebecca G Wells, Bridget Sackey-Aboagye, Heather Klavan, Jason Reidy, Darren Buonocore, Markus Miranda, Susan Kornacki, Michael Wayne, David L Carr-Locke, Neil D Theise
Confocal laser endomicroscopy (pCLE) provides real-time histologic imaging of human tissues at a depth of 60-70 μm during endoscopy. pCLE of the extrahepatic bile duct after fluorescein injection demonstrated a reticular pattern within fluorescein-filled sinuses that had no known anatomical correlate. Freezing biopsy tissue before fixation preserved the anatomy of this structure, demonstrating that it is part of the submucosa and a previously unappreciated fluid-filled interstitial space, draining to lymph nodes and supported by a complex network of thick collagen bundles...
March 27, 2018: Scientific Reports
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