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Bile duct embryology

Libby R Copeland-Halperin, Kunal Kapoor, James B Piper
We report a patient with previous biliary symptoms and endoscopic interventions who presented with clinical features suggestive of choledocholithiasis. Open surgical exploration disclosed three gallbladders with copious stones and varying degrees of acute and chronic inflammation. Literature review revealed only 16 previously reported cases. We review the aetiology of triple gallbladder as being due to failure of rudimentary bile ducts to regress during embryological development, as well as the classification scheme of triple gallbladder based on size, location and number...
2016: BMJ Case Reports
Soichi Narumoto, Ken Hayashi, Hitoshi Seki, Yasuhiro Munakata
BACKGROUND/AIMS: Pancreas-preserving resection of the bile duct has been attempted as an organ preserving procedures for the treatment of low-grade malignant neoplasms of the bile duct. The fact that the lower bile duct penetrates pancreas head to join the duodenum, makes those attempts one of the challenging procedures in biliary tract surgery. Here we present a novel and unique surgical technique for anatomically resecting lower bile duct, focusing on the anatomy of the pancreas head...
May 2015: Hepato-gastroenterology
Rosa B Schmuck, Cynthia V de Carvalho-Fischer, Christopher Neumann, Johann Pratschke, Marcus Bahra
The set definition of distal cholangiocarcinomas and adenocarcinomas of the pancreatic head is challenged by their close anatomical relation, similar growth pattern, and corresponding therapeutic outcome. They show a mutual development during embryologic organ formation and share phenotypic characteristics. This review will highlight the similarities with regard to the common origin of their primary organs, histopathological similarities, and modern clinical management. Thus, we propose to subsume those entities under a common superfamily...
January 2016: Cancer Medicine
Shigenori Yamada, Takashi Muraki, Shuichi Yokosawa, Norikazu Arakura, Shigeyuki Kawa, Katsuhiko Ishizaka, Manabu Nakamura
A 52-year-old man was admitted to our hospital complaining of abdominal pain. A blood test showed high serum levels of biliary enzymes and amylase. Surprisingly, a computed tomography scan revealed complete separation of the ventral and dorsal pancreas and swelling of the ventral pancreas with choledocholithiasis. Surgical cholecystectomy was performed to remove the bile duct stones after endoscopic removal was unsuccessful. The complete separation of the pancreatic parenchyma caused by ventral pancreas malrotation seen in this case is extremely rare, and may provide important information regarding embryologic development, deformity, and malfunction of the pancreas...
February 2012: Clinical Journal of Gastroenterology
Shivi Goel, Shaifaly Madan Rustagi, Susmita Saha, Vandana Mehta, Rajesh Kumar Suri, Gayatri Rath
Anomalous pancreatic ductal system has always enthralled the anatomists, surgeons, gastroenterologists and radiologists alike. With the growing use of MRCP, ERCP and endoscopic and surgical procedures, the knowledge of anatomical aberrations of pancreaticobiliary tract becomes extremely important. Moreover, the anomalous pancreatic duct morphology may be responsible for atypical gastrointestinal complains. We report an exceptionally rare case of two accessory ventral pancreatic ducts opening separately into the common bile duct proximal to the hepato pancreatic ampulla...
July 2015: Surgical and Radiologic Anatomy: SRA
Ankur Arora, Binit Sureka, Vivek Kasana, Yashwant Patidar, Kalpana Bansal
Congenital duplication of the common bile duct is an extremely rare anomaly of the biliary tract, which putatively represents failure of regression of the embryological double biliary system. Depending on the morphology of the duplicated bile duct, the anomaly can be classified into five distinct subtypes as per the modified classification (proposed by Choi et al). Among the five subtypes of bile duct duplication, type V duplication is considered to be the least common with only two previous cases of type Va variant reported in medical literature prior to the current report...
January 2015: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Sumanta Kumar Ghosh
Double gallbladder is a rare embryological anomaly of clinical significance. Despite availability of modern imaging, only 50% of recently reported cases had preoperative diagnosis, which is desirable in every case to avoid serious operative complications. Double pathology in double gallbladder is extremely rare with only 3 reporting's available till date to the best of author's knowledge. With a preoperative diagnosis of double gallbladder, laparoscopic cholecystectomy can be safely and successfully performed with meticulous dissection, aided by operative cholangiogram...
April 2014: Journal of Minimal Access Surgery
Disaya Chavalitdhamrong, Peter V Draganov
Variations in the bile duct and pancreatic duct opening are related to the process of rotation and recanalization during embryologic development. Complete non-union of distal common bile duct and pancreatic duct gives rise to double papillae of Vater. The separation of the drainage of the main pancreatic duct and bile duct can be appreciated by careful assessment at the time of endoscopic retrograde cholangiopancreatograpy. The cranial orifice is a bile duct opening, whereas the caudal orifice is a pancreatic duct opening...
February 16, 2014: World Journal of Clinical Cases
Jung Hyeok Kwon, Mi Jeong Kim, Young Hwan Kim, Koo Jeong Kang, Yu Na Kang, Sun Young Kwon
Hepatobiliary fibropolycystic diseases are a unique group of entities involving the liver and biliary tract, which are caused by abnormal embryologic development of the ductal plates at various stages. We experienced strange hepatobiliary fibropolycystic diseases with a complex mass composed of malformed ducts and biliary cysts, which did not belong to, and were different from, previously known malformations. They were unique in imaging and histologic features. We herein report three cases of monosegmental hepatobiliary fibropolycystic disease mimicking a mass...
January 2014: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Yasuni Nakanuma, Yasunori Sato
Routine experiences suggest that cholangiocarcinomas (CCAs) show different clinicopathological behaviors along the biliary tree, and hilar CCA apparently resembles pancreatic duct adenocarcinoma (PDAC). Herein, the backgrounds for these similarities were reviewed. While all cases of PDAC, hilar CCA, intrahepatic CCA (ICCA) and CCA components of combined hepatocellular-cholangiocarcinoma (cHC-CCA) were adenocarcinomas, micropapillary patterns and columnar carcinoma cells were common in PDAC and hilar CCA, and trabecular components and cuboidal carcinoma cells were common in ICCA and CCA components of cHC-CCA...
July 2014: Journal of Hepato-biliary-pancreatic Sciences
Peter Bronsert, Ilona Kohler, Martin Werner, Frank Makowiec, Simon Kuesters, Jens Hoeppner, Ulrich Theodor Hopt, Tobias Keck, Dirk Bausch, Ulrich Friedrich Wellner
BACKGROUND: Periampullary adenocarcinomas comprise pancreatic, distal bile duct, ampullary and duodenal adenocarcinoma. The epithelia of these anatomical structures share a common embryologic origin from the foregut. With steadily increasing numbers of pancreatoduodenectomies over the last decades, pathologists, surgeons and oncologists are more often confronted with the diagnosis of "other than pancreatic" periampullary cancers. The intestinal subtype of ampullary cancer has been shown to correlate with better prognosis...
2013: BMC Cancer
Seiichi Hara, Terumi Kamisawa, Taku Tabata, Sawako Kuruma, Kazuro Chiba, Go Kuwata, Takashi Fujiwara, Hideto Egashira, Koichi Koizumi, Junko Fujiwara, Takeo Arakawa, Kumiko Momma, Shin-ichiro Horiguchi, Yoshinori Igarashi
OBJECTIVE: We examined the anatomy of the pancreatic duct system in patients with autoimmune pancreatitis (AIP) from the standpoint of embryological pancreatic primordial. MATERIAL AND METHODS: The pancreatic duct system involved in 83 AIP patients was embryologically divided into both ventral and dorsal pancreatic ducts (VD type), only the dorsal pancreatic duct (D type), or only the ventral pancreatic duct (V type). RESULTS: The 83 AIP patients were divided into 62 VD type, 20 D type, and 1 V type...
July 2013: Scandinavian Journal of Gastroenterology
Chihiro Gandou, Kenichi Harada, Yasunori Sato, Saya Igarashi, Motoko Sasaki, Hiroko Ikeda, Yasuni Nakanuma
Embryologically, intrahepatic small bile ducts arise from hepatic progenitor cells via ductal plates, whereas the pancreato-extrahepatic biliary progenitor cells expressing the transcription factors PDX1 and HES1 are reportedly involved in the development of the extrahepatic biliary tract and ventral pancreas. The expression of cellular markers characteristic of the different anatomical levels of the biliary tree and pancreas, as well as PDX1 and HES1, was examined in cholangiocarcinoma components of combined hepatocellular cholangiocarcinoma (12 cases), intrahepatic cholangiocarcinoma (21 cases), hilar cholangiocarcinoma (25 cases), and pancreatic ductal adenocarcinoma (18 cases)...
May 2013: Human Pathology
Rossella Semeraro, Guido Carpino, Vincenzo Cardinale, Paolo Onori, Raffaele Gentile, Alfredo Cantafora, Antonio Franchitto, Cristina Napoli, Maurizio Anceschi, Roberto Brunelli, Daniela Bosco, Alessia Torrice, Lola Reid, Eugenio Gaudio, Domenico Alvaro
BACKGROUND & AIMS: Biliary tree, liver, and pancreas share a common embryological origin. We previously demonstrated the presence of stem/progenitor cells of endodermal origin in the adult human extrahepatic biliary tree. This study evaluated the human foetal biliary trees as sources of stem/progenitor cells of multiple endodermal-derived mature fates. METHODS: Human foetal intrahepatic and extrahepatic biliary tree tissues and isolated cells were tested for cytoplasmic and surface markers of stem cells and committed progenitors, as well as endodermal transcription factors requisite for a liver versus pancreatic fate...
November 2012: Journal of Hepatology
Jasmin Delić, Admedina Savković, Eldar Isaković, Sergije Marković, Alma Bajtarevic, Amir Denjalić
Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988...
2012: ISRN Surgery
Vincenzo Cardinale, Yunfang Wang, Guido Carpino, Gemma Mendel, Gianfranco Alpini, Eugenio Gaudio, Lola M Reid, Domenico Alvaro
The biliary tree is composed of intrahepatic and extrahepatic bile ducts, lined by mature epithelial cells called cholangiocytes, and contains peribiliary glands deep within the duct walls. Branch points, such as the cystic duct, perihilar and periampullar regions, contain high numbers of these glands. Peribiliary glands contain multipotent stem cells, which self-replicate and can differentiate into hepatocytes, cholangiocytes or pancreatic islets, depending on the microenvironment. Similar cells-presumably committed progenitor cells-are found in the gallbladder (which lacks peribiliary glands)...
April 2012: Nature Reviews. Gastroenterology & Hepatology
J P Low, D Williams, J R Chaganti
Polysplenia, as part of the heterotaxy syndrome, is a rare embryological disorder which results from failure of development of the usual left-right asymmetry of organs. It is often associated with cardiac and biliary abnormalities, which are the usual causes of death in early neonatal life. A congenitally short pancreas and abnormalities with portal vein formation, gut malrotations and inferior vena cava anomalies are known to be associated with this rare syndrome. We report a case of polysplenia in an adult female presenting with obstructive jaundice owing to choledocholithiasis, possibly formed by biliary stasis as a result of compression of the common bile duct by the preduodenal portal vein, and review the literature...
November 2011: British Journal of Radiology
N Venkatanarasimha, R Thomas, E M Armstrong, J F Shirley, B M Fox, S A Jackson
Ductal plate malformations, also known as fibrocystic liver diseases, are a group of congenital disorders resulting from abnormal embryogenesis of the biliary ductal system. The abnormalities include choledochal cyst, Caroli's disease and Caroli's syndrome, adult autosomal dominant polycystic liver disease, and biliary hamartoma. The hepatic lesions can be associated with renal anomalies such as autosomal recessive polycystic kidney disease (ARPKD), medullary sponge kidney, and nephronophthisis. A clear knowledge of the embryology and pathogenesis of the ductal plate is central to the understanding of the characteristic imaging appearances of these complex disorders...
November 2011: Clinical Radiology
Alessandro Cucchetti, Eugenia Peri, Matteo Cescon, Matteo Zanello, Giorgio Ercolani, Chiara Zanfi, Valentina Bertuzzo, Paolo Di Gioia, Antonio Daniele Pinna
BACKGROUND: Accurate knowledge of biliary anatomy and its variants is essential to ensure successful hepatic surgery; however, data from European countries are lacking. METHODS: Two hundred cholangiograms obtained from patients submitted to whole liver transplantation were reviewed; donors' characteristics were related to the prevalence of typical biliary anatomy and its variants. A comprehensive literature search was performed with MEDLINE and EMBASE from 1980 to 2010 to investigate whether geographical origin could be related to biliary abnormalities...
April 2011: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Hisami Ando
A hepatic diverticulum appears in the ventral wall of the primitive midgut early in the 4th week of intrauterine life in the development of the human embryo. This small diverticulum is the anlage for the development of the liver, extrahepatic biliary ducts, gallbladder, and ventral pancreas. By the 5th week, all elements of the biliary tree are recognizable. Marked elongation of the common duct occurs with plugging of the lumen by epithelial cells. Recanalization of the lumen of the common duct starts at the end of the 5th week and moves slowly distally...
2010: Digestive Surgery
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