Common Bile Duct: The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.Common Bile Duct Diseases: Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.Bile Ducts: The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.Gallstones: Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.Common Bile Duct Neoplasms: Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.Cholangiopancreatography, Endoscopic Retrograde: Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.Cholangiography: An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken.Bile: An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum.Bile Duct Diseases: Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.Choledocholithiasis: Presence or formation of GALLSTONES in the COMMON BILE DUCT.Bile Ducts, Extrahepatic: Passages external to the liver for the conveyance of bile. These include the COMMON BILE DUCT and the common hepatic duct (HEPATIC DUCT, COMMON).Cholestasis: Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).Bile Duct Neoplasms: Tumors or cancer of the BILE DUCTS.Cholestasis, Extrahepatic: Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes.Cholecystectomy, Laparoscopic: Excision of the gallbladder through an abdominal incision using a laparoscope.Cholecystectomy: Surgical removal of the GALLBLADDER.Sphincterotomy, Endoscopic: Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones.Bile Ducts, Intrahepatic: Passages within the liver for the conveyance of bile. Includes right and left hepatic ducts even though these may join outside the liver to form the common hepatic duct.Jaundice, Obstructive: Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.Cholangiopancreatography, Magnetic Resonance: Non-invasive diagnostic technique for visualizing the PANCREATIC DUCTS and BILE DUCTS without the use of injected CONTRAST MEDIA or x-ray. MRI scans provide excellent sensitivity for duct dilatation, biliary stricture, and intraductal abnormalities.Sphincter of Oddi: The sphincter of the hepatopancreatic ampulla within the duodenal papilla. The COMMON BILE DUCT and main pancreatic duct pass through this sphincter.Cholangitis: Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both.Cystic Duct: The duct that is connected to the GALLBLADDER and allows the emptying of bile into the COMMON BILE DUCT.Cholelithiasis: Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).Ampulla of Vater: A dilation of the duodenal papilla that is the opening of the juncture of the COMMON BILE DUCT and the MAIN PANCREATIC DUCT, also known as the hepatopancreatic ampulla.Biliary Tract Diseases: Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.Pancreatic Ducts: Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.Hepatic Duct, Common: Predominantly extrahepatic bile duct which is formed by the junction of the right and left hepatic ducts, which are predominantly intrahepatic, and, in turn, joins the cystic duct to form the common bile duct.Biliary Tract: The BILE DUCTS and the GALLBLADDER.Ligation: Application of a ligature to tie a vessel or strangulate a part.Gallbladder: A storage reservoir for BILE secretion. Gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the CYSTIC DUCT to the DUODENUM, for degradation of dietary lipid.Pancreatitis: INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.Sphincterotomy, Transhepatic: Surgery of the smooth muscle sphincter of the hepatopancreatic ampulla to relieve blocked biliary or pancreatic ducts.Choledochal Cyst: A congenital anatomic malformation of a bile duct, including cystic dilatation of the extrahepatic bile duct or the large intrahepatic bile duct. Classification is based on the site and type of dilatation. Type I is most common.Biliary Fistula: Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.Biliary Tract Surgical Procedures: Any surgical procedure performed on the biliary tract.Choledochostomy: Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.Adenoma, Bile Duct: A benign tumor of the intrahepatic bile ducts.Drainage: The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.Endoscopes: Instruments for the visual examination of interior structures of the body. There are rigid endoscopes and flexible fiberoptic endoscopes for various types of viewing in ENDOSCOPY.Duodenoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the duodenum.Cholecystitis: Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases.Imino AcidsGallbladder Diseases: Diseases of the GALLBLADDER. They generally involve the impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, neoplasms, or other diseases.Jaundice: A clinical manifestation of HYPERBILIRUBINEMIA, characterized by the yellowish staining of the SKIN; MUCOUS MEMBRANE; and SCLERA. Clinical jaundice usually is a sign of LIVER dysfunction.Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is LITHOTRIPSY, LASER.Adenomyoma: A benign neoplasm of muscle (usually smooth muscle) with glandular elements. It occurs most frequently in the uterus and uterine ligaments. (Stedman, 25th ed)Technetium Tc 99m Disofenin: A radiopharmaceutical used extensively in cholescintigraphy for the evaluation of hepatobiliary diseases. (From Int Jrnl Rad Appl Inst 1992;43(9):1061-4)Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions.Endoscopy, Digestive System: Endoscopic examination, therapy or surgery of the digestive tract.Endoscopy: Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.Gallbladder Neoplasms: Tumors or cancer of the gallbladder.Cholestasis, Intrahepatic: Impairment of bile flow due to injury to the HEPATOCYTES; BILE CANALICULI; or the intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC).Cholecystitis, Acute: Acute inflammation of the GALLBLADDER wall. It is characterized by the presence of ABDOMINAL PAIN; FEVER; and LEUKOCYTOSIS. Gallstone obstruction of the CYSTIC DUCT is present in approximately 90% of the cases.Pancreaticoduodenectomy: The excision of the head of the pancreas and the encircling loop of the duodenum to which it is connected.Sphincter of Oddi Dysfunction: Organic or functional motility disorder involving the SPHINCTER OF ODDI and associated with biliary COLIC. Pathological changes are most often seen in the COMMON BILE DUCT sphincter, and less commonly the PANCREATIC DUCT sphincter.Jejunostomy: Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.Cholecystolithiasis: Presence or formation of GALLSTONES in the GALLBLADDER.Bilirubin: A bile pigment that is a degradation product of HEME.Duodenum: The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.Pancreatic Diseases: Pathological processes of the PANCREAS.Intraoperative Period: The period during a surgical operation.Liver: A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Cholecystostomy: Establishment of an opening into the gallbladder either for drainage or surgical communication with another part of the digestive tract, usually the duodenum or jejunum.Bile Reflux: Retrograde bile flow. Reflux of bile can be from the duodenum to the stomach (DUODENOGASTRIC REFLUX); to the esophagus (GASTROESOPHAGEAL REFLUX); or to the PANCREAS.Endosonography: Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously.Liver Cirrhosis, Experimental: Experimentally induced chronic injuries to the parenchymal cells in the liver to achieve a model for LIVER CIRRHOSIS.Lithotripsy, Laser: Fragmentation of CALCULI, notably urinary or biliary, by LASER.Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Liver Function Tests: Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions.Duodenal Diseases: Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).Cholangiocarcinoma: A malignant tumor arising from the epithelium of the BILE DUCTS.Duodenal Neoplasms: Tumors or cancer of the DUODENUM.Thoracic Duct: The largest lymphatic vessel that passes through the chest and drains into the SUBCLAVIAN VEIN.Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones.Liver Cirrhosis, Biliary: FIBROSIS of the hepatic parenchyma due to obstruction of BILE flow (CHOLESTASIS) in the intrahepatic or extrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC; BILE DUCTS, EXTRAHEPATIC). Primary biliary cirrhosis involves the destruction of small intra-hepatic bile ducts and bile secretion. Secondary biliary cirrhosis is produced by prolonged obstruction of large intrahepatic or extrahepatic bile ducts from a variety of causes.Ascaridida: An order of nematodes of the subclass SECERNENTEA. Its organisms possess two or three pairs of dorsolateral caudal papillae.Surgical Instruments: Hand-held tools or implements used by health professionals for the performance of surgical tasks.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Lithiasis: A condition characterized by the formation of CALCULI and concretions in the hollow organs or ducts of the body. They occur most often in the gallbladder, kidney, and lower urinary tract.Hepatopulmonary Syndrome: A syndrome characterized by the clinical triad of advanced chronic liver disease, pulmonary vascular dilatations, and reduced arterial oxygenation (HYPOXEMIA) in the absence of intrinsic cardiopulmonary disease. This syndrome is common in the patients with LIVER CIRRHOSIS or portal hypertension (HYPERTENSION, PORTAL).Colic: A clinical syndrome with intermittent abdominal pain characterized by sudden onset and cessation that is commonly seen in infants. It is usually associated with obstruction of the INTESTINES; of the CYSTIC DUCT; or of the URINARY TRACT.Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.Pancreas: A nodular organ in the ABDOMEN that contains a mixture of ENDOCRINE GLANDS and EXOCRINE GLANDS. The small endocrine portion consists of the ISLETS OF LANGERHANS secreting a number of hormones into the blood stream. The large exocrine portion (EXOCRINE PANCREAS) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the DUODENUM.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Laparoscopy: A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Pancreatitis, Chronic: INFLAMMATION of the PANCREAS that is characterized by recurring or persistent ABDOMINAL PAIN with or without STEATORRHEA or DIABETES MELLITUS. It is characterized by the irregular destruction of the pancreatic parenchyma which may be focal, segmental, or diffuse.Anastomosis, Roux-en-Y: A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.Diverticulum: A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.Adenoma, Villous: An adenoma of the large intestine. It is usually a solitary, sessile, often large, tumor of colonic mucosa composed of mucinous epithelium covering delicate vascular projections. Hypersecretion and malignant changes occur frequently. (Stedman, 25th ed)Cholecystography: Radiography of the gallbladder after ingestion of a contrast medium.Bile Canaliculi: Minute intercellular channels that occur between liver cells and carry bile towards interlobar bile ducts. Also called bile capillaries.Anastomosis, Surgical: Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.Cholagogues and Choleretics: Gastrointestinal agents that stimulate the flow of bile into the duodenum (cholagogues) or stimulate the production of bile by the liver (choleretic).Postcholecystectomy Syndrome: Abdominal symptoms after removal of the GALLBLADDER. The common postoperative symptoms are often the same as those present before the operation, such as COLIC, bloating, NAUSEA, and VOMITING. There is pain on palpation of the right upper quadrant and sometimes JAUNDICE. The term is often used, inaccurately, to describe such postoperative symptoms not due to gallbladder removal.Adenocarcinoma, Papillary: An adenocarcinoma containing finger-like processes of vascular connective tissue covered by neoplastic epithelium, projecting into cysts or the cavity of glands or follicles. It occurs most frequently in the ovary and thyroid gland. (Stedman, 25th ed)Fascioliasis: Liver disease caused by infections with parasitic flukes of the genus FASCIOLA, such as FASCIOLA HEPATICA.Liver Diseases: Pathological processes of the LIVER.Preoperative Care: Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)Salivary Ducts: Any of the ducts which transport saliva. Salivary ducts include the parotid duct, the major and minor sublingual ducts, and the submandibular duct.Cholangitis, Sclerosing: Chronic inflammatory disease of the BILIARY TRACT. It is characterized by fibrosis and hardening of the intrahepatic and extrahepatic biliary ductal systems leading to bile duct strictures, CHOLESTASIS, and eventual BILIARY CIRRHOSIS.Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein.Technetium Tc 99m Lidofenin: A nontoxic radiopharmaceutical that is used in RADIONUCLIDE IMAGING for the clinical evaluation of hepatobiliary disorders in humans.Iatrogenic Disease: Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.Pancreatic Neoplasms: Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).Carcinoid Tumor: A usually small, slow-growing neoplasm composed of islands of rounded, oxyphilic, or spindle-shaped cells of medium size, with moderately small vesicular nuclei, and covered by intact mucosa with a yellow cut surface. The tumor can occur anywhere in the gastrointestinal tract (and in the lungs and other sites); approximately 90% arise in the appendix. It is now established that these tumors are of neuroendocrine origin and derive from a primitive stem cell. (From Stedman, 25th ed & Holland et al., Cancer Medicine, 3d ed, p1182)Bile Pigments: Linear TETRAPYRROLES that give a characteristic color to BILE including: BILIRUBIN; BILIVERDIN; and bilicyanin.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Ultrasonography: The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz.Dilatation: The act of dilating.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Video-Assisted Surgery: Endoscopic surgical procedures performed with visualization via video transmission. When real-time video is combined interactively with prior CT scans or MRI images, this is called image-guided surgery (see SURGERY, COMPUTER-ASSISTED).Duodenal Obstruction: Hindrance of the passage of luminal contents in the DUODENUM. Duodenal obstruction can be partial or complete, and caused by intrinsic or extrinsic factors. Simple obstruction is associated with diminished or stopped flow of luminal contents. Strangulating obstruction is associated with impaired blood flow to the duodenum in addition to obstructed flow of luminal contents.Hemobilia: Hemorrhage in or through the BILIARY TRACT due to trauma, inflammation, CHOLELITHIASIS, vascular disease, or neoplasms.Wolffian Ducts: A pair of excretory ducts of the middle kidneys (MESONEPHROI) of an embryo, also called mesonephric ducts. In higher vertebrates, Wolffian ducts persist in the male forming VAS DEFERENS, but atrophy into vestigial structures in the female.Cysts: Any fluid-filled closed cavity or sac that is lined by an EPITHELIUM. Cysts can be of normal, abnormal, non-neoplastic, or neoplastic tissues.Taurocholic Acid: The product of conjugation of cholic acid with taurine. Its sodium salt is the chief ingredient of the bile of carnivorous animals. It acts as a detergent to solubilize fats for absorption and is itself absorbed. It is used as a cholagogue and cholerectic.Pancreatic Pseudocyst: Cyst-like space not lined by EPITHELIUM and contained within the PANCREAS. Pancreatic pseudocysts account for most of the cystic collections in the pancreas and are often associated with chronic PANCREATITIS.Amylases: A group of amylolytic enzymes that cleave starch, glycogen, and related alpha-1,4-glucans. (Stedman, 25th ed) EC 3.2.1.-.Foreign-Body Migration: Migration of a foreign body from its original location to some other location in the body.Hepatic Artery: A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.Manometry: Measurement of the pressure or tension of liquids or gases with a manometer.Digestive System Fistula: An abnormal passage communicating between any components of the digestive system, or between any part of the digestive system and surrounding organ(s).Incidental Findings: Unanticipated information discovered in the course of testing or medical care. Used in discussions of information that may have social or psychological consequences, such as when it is learned that a child's biological father is someone other than the putative father, or that a person tested for one disease or disorder has, or is at risk for, something else.Mixed Tumor, Malignant: A malignant tumor composed of more than one type of neoplastic tissue. (Dorland, 27th ed)Acute Disease: Disease having a short and relatively severe course.Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Mullerian Ducts: A pair of ducts near the WOLFFIAN DUCTS in a developing embryo. In the male embryo, they degenerate with the appearance of testicular ANTI-MULLERIAN HORMONE. In the absence of anti-mullerian hormone, mullerian ducts give rise to the female reproductive tract, including the OVIDUCTS; UTERUS; CERVIX; and VAGINA.Reoperation: A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.Bacterial Translocation: The passage of viable bacteria from the GASTROINTESTINAL TRACT to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the INTESTINAL MUCOSA resulting in increased intestinal permeability. Bacterial translocation from the lung to the circulation is also possible and sometimes accompanies MECHANICAL VENTILATION.Digestive System Neoplasms: Tumors or cancer of the DIGESTIVE SYSTEM.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Neoplasms, Multiple Primary: Two or more abnormal growths of tissue occurring simultaneously and presumed to be of separate origin. The neoplasms may be histologically the same or different, and may be found in the same or different sites.Pancreatic Fistula: Abnormal passage communicating with the PANCREAS.Biliary Atresia: Progressive destruction or the absence of all or part of the extrahepatic BILE DUCTS, resulting in the complete obstruction of BILE flow. Usually, biliary atresia is found in infants and accounts for one third of the neonatal cholestatic JAUNDICE.Hypertension, Portal: Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.

Effects of chronic nitric oxide activation or inhibition on early hepatic fibrosis in rats with bile duct ligation. (1/453)

Hepatic fibrosis or increased liver collagen contents drive functional abnormalities that, when extensive, may be life threatening. The purpose of this study was to assess the effects of the chronic stimulation or inhibition of nitric oxide synthesis in rats with hepatic fibrosis induced by permanent common bile duct ligation (3 weeks) and the role of expression of the different nitric oxide synthase isoforms. Bile duct ligation led to an important accumulation of collagen in the hepatic parenchyma, as shown both histologically and by the hydroxyproline contents of livers. Bilirubin and serum enzyme activities (measured as markers of cholestasis) increased several-fold after bile duct ligation. The area of fibrotic tissue, liver hydroxyproline content and serum markers of cholestasis were clearly related in obstructed rats. The absence of modifications in haemodynamic parameters excludes circulatory changes from being responsible for the development of liver alterations. In animals treated with NG-nitro-L-arginine methyl ester (L-NAME) the area of fibrosis was similar to that of untreated animals, the signs of cholestasis and cellular injury being more evident. In rats treated with L-arginine the area of fibrosis was almost three times larger than that found in bile duct ligated rats and in L-NAME-treated bile duct ligated rats, although the observed biochemical changes were similar to those seen in rats treated with L-NAME. Our results with inducible nitric oxide synthase, obtained by Western blots and immunohistochemistry, indicate a greater expression of the inducible enzyme in bile duct ligated and L-arginine-treated animals and a lower expression in the L-NAME and control groups. Constitutive nitric oxide synthase expression, obtained by Western blots, was very similar in all groups, except for the L-arginine-treated rats in which it was lower. These results suggest that nitric oxide production may be a key factor in the development of fibrosis in bile duct ligated rats. They also support the hypothesis of a dual role for nitric oxide; one beneficial, mediated by its circulatory effects, and the second negative, through its local toxic effects.  (+info)

Carcinoids of the common bile duct: a case report and literature review. (2/453)

Carcinoids of the extrahepatic bile ducts and particularly the common bile duct are extremely rare. A 65-year-old woman presented with obstructive jaundice. Laboratory and imaging studies gave results that were consistent with an obstructing lesion in the common bile duct. In this case, a stent was inserted initially to decompress the bile ducts. Subsequently a laparotomy and pancreaticoduodenectomy were performed and a tissue diagnosis of carcinoid of the common bile duct was made. The patient was well with no evidence of recurrence 17 months postoperatively. The authors believe this is the 19th reported case of an extrahepatic bile duct carcinoid.  (+info)

Spontaneous perforation of common bile duct in infants. (3/453)

Two infants with spontaneous perforation of the common bile duct are described. One presented with mild jaundice, dark urine, acholic stools, and hydroceles, the other with bilateral inguinal hernia. In both the diagnosis was unsuspected until bile-stained ascites was discovered. Both eventually developed bile-staining of the scrotum. Neither was acutely ill. The 131I-Rose Bengal faecal excretion test showed reduced faecal excretion at 8% and 12% of the injected dose with 16-5 and 17%/dl of the dose being recovered in the ascitic fluid 48 hours after intravenous injection. The ascitic:plasma ratio of isotope at that time was 32:1 and 28:1. Operative cholangiography in both showed a perforation at the junction of the cystic duct and common bile duct with no contrast entering the duodenum. Cholecystenterostomy using a Roux-en-Y loop of jejunum produced a rapid sustained recovery and is suggested as the treatment of choice. This condition should be considered in the differential diagnosis of obstructive jaundice in infancy since early surgical correction is necessary.  (+info)

Ultrasonographic evaluation of the common bile duct in biliary acute pancreatitis patients: comparison with endoscopic retrograde cholangiopancreatography. (4/453)

We compared the morphologic findings of the common bile duct by ultrasonography and endoscopic retrograde cholangiopancreatography in patients with biliary acute pancreatitis. Forty-five patients were studied. The diagnosis of acute pancreatitis was based on the presence of characteristic abdominal pain associated with an elevation of serum amylase and lipase concentrations. All patients underwent ultrasonography and subsequently urgent endoscopic retrograde cholangiopancreatography and eventually endoscopic sphincterotomy. Ultrasonography showed gallstones in 33 patients and sludge of the gallbladder in seven patients. In the common bile duct, lithiasis was found in two patients and sludge in 25. Endoscopic retrograde cholangiopancreatography showed choledocolithiasis in eight patients and sludge of the common bile duct in 32. In 27 cases (60%) concordance occurred between ultrasonographic and endoscopic retrograde cholangiopancreatographic detection of lithiasis or sludge of the common bile duct. The average diameter of the common bile duct determined by sonography was significantly smaller (P < 0.001) than that obtained by endoscopic retrograde cholangiopancreatography. The evaluation of this parameter indicated that a good correlation existed between the values obtained with the two techniques (r(s) = 0.765, P < 0.001). Both ultrasonography and endoscopic retrograde cholangiopancreatography can provide reliable measurements of the common bile duct diameter. Ultrasonography is the technique of choice in the initial investigation of patients with biliary acute pancreatitis.  (+info)

Role of angiotensin in renal sympathetic activation in cirrhotic rats. (5/453)

Central nervous system (CNS) renin-angiotensin activity influences the basal level of renal sympathetic nerve activity (RSNA) and its reflex regulation. The effect of type 1 angiotensin II (ANG II)-receptor antagonist treatment (losartan) on cardiac baroreflex regulation of RSNA and renal sodium handling was examined in rats with cirrhosis due to common bile duct ligation (CBDL). Basal levels of heart rate, mean arterial pressure (MAP), RSNA, and urinary sodium excretion were not affected by intracerebroventricular administration of either losartan or vehicle to CBDL rats. After acute intravenous isotonic saline loading (10% body wt) in vehicle-treated CBDL rats, MAP was unchanged and the decrease in RSNA seen in normal rats did not occur. However, in losartan-treated CBDL rats, there were significant concurrent but transient decreases in MAP (-20 +/- 2 mmHg) and RSNA (-25 +/- 3%). The natriuretic response to acute volume loading in losartan-treated CBDL rats was significantly less than that in vehicle-treated CBDL rats only at those time points where there were significant decreases in MAP. Antagonism of CNS ANG II type 1 receptors augments the renal sympathoinhibitory response to acute volume loading in CBDL. However, the natriuretic response to the acute volume loading is not improved, likely due to the strong antinatriuretic influence of the concomitant marked decrease in MAP (renal perfusion pressure) mediated by widespread sympathetic withdrawal from the systemic vasculature.  (+info)

Renal expression of aquaporins in liver cirrhosis induced by chronic common bile duct ligation in rats. (6/453)

Semiquantitative immunoblotting was used to investigate the expression levels of the four major renal aquaporins, the Na-K-2Cl cotransporter of the thick ascending limb, the type 3 Na-H exchanger, and the Na-K-ATPase in kidneys from rats with cirrhosis secondary to common bile duct ligation (CBDL). These rats had significant water retention and hyponatremia. In contrast to models of cirrhosis induced by carbon tetrachloride, aquaporin-2 expression in CBDL-induced cirrhosis was decreased. Thus, these results show that in the setting of extracellular fluid volume expansion, excessive water retention with hyponatremia can occur in the absence of increases in aquaporin-2 abundance. In addition, the expression levels of the two basolateral collecting duct aquaporins (aquaporin-3 and -4) were decreased in CBDL rats relative to sham-operated control rats. Similarly, the Na-K-2Cl cotransporter of the thick ascending limb and the type 3 Na-H exchanger showed decreases in expression. In contrast, the expression levels of aquaporin-1 and the all subunit of the Na-K-ATPase were not decreased. Thus, dysregulation of multiple water channels and ion transporters may play a role in water balance abnormalities associated with CBDL-induced cirrhosis in rats.  (+info)

Tissue plasminogen activator and plasminogen activator inhibitor-1 in human choledochal bile. (7/453)

Fibrinolytic properties have been detected in animal and human gallbladder (GB) bile. Plasminogen activator inhibitor-1 (PAI-1) has been reported in greater concentration in GB stone bile and may be a nucleating factor in the pathogenesis of GB stone formation. It is unknown whether or not human choledochal bile has similar properties, which could have a role in choledocholithiasis. The aims of this study were to determine the presence of fibrinolytic properties of human choledochal bile and to compare those properties among normal, acalculous, and calculous-infected choledochal bile. Tissue plasminogen activator (t-PA) and PAI-1 of choledochal bile were measured by enzyme linked immunosorbent assay in patients with cholangitis due to acalculous bile duct obstructions (n = 9), choledocholithiasis with cholangitis (n = 20), and normal bile (n = 7). The t-PA concentration of choledochal bile was no different among the three groups (acalculous-infected bile, median 4.61 ng/ml, and calculous-infected bile, 4.61 ng/ml, versus normal bile, 7.33 ng/ml). PAI-1 was detected in choledochal bile in significantly greater concentrations in patients with acalculous cholangitis due to bile duct obstructions and choledocholithiasis with cholangitis (acalculous-infected bile, median 0.36 ng/ml, and calculous-infected bile, 0.1 ng/ml, versus normal bile, 0.02 ng/ml, p < 0.05), but the bile concentration of PAI-1 was no different between the acalculous and calculous-infected choledochal bile. Human choledochal bile possesses t-PA and PAI-1. PAI-1 was present in greater concentrations in both acalculous and calculous-infected choledochal bile. Increased levels of PAI-1 may be an epiphenomenon of cholangitis rather than a factor in the pathogenesis of choledocholithiasis.  (+info)

Roux-en-Y hepaticojejunostomy: a reappraisal of its indications and results. (8/453)

A critical evaluation is made of 131 patients submitted to choledocho or hepaticojejunostomy. The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients). The overall mortality rate was 4% representing principally renal hepatic failure, bile peritonitis and bleeding. The complications following hepaticojejunostomy included only in one case biliary fistula which required reoperation. The long-term results of 80 patients available for a followup study were as follows: 63 patients (78.7%) were symptom-free at 2-13 years followup; 8 patients had brief episodes of cholangitis which responded to antibiotic and corticosteroid treatment; 9 patients required reoperation for stricture of anastomosis. These overall results are a strong argument for hepaticojejunostomy which, compared with choledochoduodenostomy, avoids the hazards of the so-called sump syndrome and of the reflux of enteric contents in the CBD. An increased incidence of peptic ulcer disease in the patients submitted to hepaticojejunostomy was not observed. In very high strictures and in reinterventions anastomosis between left hepatic duct and Roux-en-Y jejunal limb was carried out. The results achieved with this technique, which was performed in 26 patients, were about the same following hepaticojejunostomy.  (+info)

*Common bile duct

This conduction of bile is the main function of the common bile duct. The hormone cholecystokinin, when stimulated by a fatty ... The common bile duct, sometimes abbreviated CBD, is a duct in the gastrointestinal tract of organisms that have a gall bladder ... Blockage of the common bile duct and related jaundice has been documented since at least the time of Erasistratus. Dilatation ... Several problems can arise within the common bile duct. A diameter of more than 8 mm is regarded as abnormal dilatation, and is ...

*Common bile duct stone

... , also known as choledocholithiasis, is the presence of gallstones in the common bile duct (thus ... "Open or Laparoscopic Common Bile Duct Exploration (Choledocholithotomy)". The New York Times Health Guide. The New York Times ... While stones can frequently pass through the common bile duct (CBD) into the duodenum, some stones may be too large to pass ... Choledocholithiasis (stones in common bile duct) is one of the complications of cholelithiasis (gallstones), so the initial ...

*Alfred Cuschieri

Cuschieri, A.; Berci, G. (1984). Common Bile Duct Exploration. Boston: Martinus Nijhoff. Berci, G.; Cuschieri, A. (1986). ... Berci, G.; Cuschieri, A. (1996). Bile Ducts and Bile Duct Stones. Philadelphia: Saunders. "Alfred Cuschieri" (PDF). Retrieved ...

*Periampullary cancer

... cancer of lower common bile duct, and 3. duodenal cancer adjacent to ampulla. 4. carcinoma head of pancreas It presents with ... Periampullary cancer is a cancer that forms near the ampulla of Vater, an enlargement of the ducts from the liver and pancreas ...

*David B. Adams

Dixon, J. A.; Morgan, K. A.; Adams, D. B. (2009). "Management of common bile duct injury during partial gastrectomy". The ...

*Spiral valves of Heister

The cystic duct attaches the gallbladder to the common bile duct. The spiral valves of Heister are supported by underlying ... Historically, physicians believed that their function was to aid in the passage of bile to and from the gallbladder, as well as ... The presence of the spiral folds, in combination with the tortuosity of the cystic duct, makes endoscopic cannulation and ... Spiral valves of Heister are undulating folds or valves in the proximal mucosa of the cystic duct. ...

*Ruggero Oddi

Inflammation of the junction of the duodenum and common bile duct at the sphincter of Oddi is referred to as "odditis". Yamada ... Trancanelli, V (Feb 1993). "[Ruggero Oddi and the discovery of the common bile duct sphincter]". Minerva Med. Italy. 84 (1-2): ... described a small group of circular and longitudinal muscle fibers that wrapped around the end of the bile and pancreatic ducts ...

*Sphincter of Oddi dysfunction

Common bile duct dilation and episodes of pancreatitis are also signs. Two mechanisms are involved in the development of ... or infections of the common bile duct. In contrast, dyskinesia of the sphincter of Oddi is a purely functional disorder, ... The criteria outline three variants of functional disorders of the gallbladder, bile duct and pancreas, termed functional ... dilated biliary ducts on imaging tests, and delayed bile clearance on HIDA scan. Biliary-type pain in the absence of any sign ...

*Leighton Chan

"Intraoperative Cholangiography and Risk of Common Bile Duct Injury During Cholecystectomy". Lead Article, JAMA 2003;289:1639- ... Flum, DR, Cheadle, A, Prela, C, Dellinger, EP, Chan, L. "Bile Duct Injury During Cholecystectomy and Survival in Medicare ...

*Choledochal cysts

Type I: Most common variety (80-90%) involving saccular or fusiform dilatation of a portion or entire common bile duct (CBD) ... Cholecystectomy with cystic duct ligation near the common bile duct is curative. Choledochal cysts are treated by surgical ... Choledochal cysts (a.k.a. bile duct cyst) are congenital conditions involving cystic dilatation of bile ducts. They are ... inflammation within the bile ducts caused by the spread of bacteria from the intestine into the bile ducts). Pancreatitis also ...

*Duodenal bulb

The gastroduodenal artery, portal vein, and common bile duct lie just behind it. The distal part of the bulb is located ... Duodenal ulcers are more common than gastric ulcers and, unlike gastric ulcers, are caused by increased gastric acid secretion ...

*Ampulla of Vater

The cystic duct leaves the gallbladder and joins with the common hepatic duct to form the common bile duct. This duct ... A common cause of blockage is a gallstone in the common bile duct. Thomas' sign is the production of silver stools and can be ... is formed by the union of the pancreatic duct and the common bile duct. The ampulla is specifically located at the major ... the sphincter of the pancreatic duct, the sphincter of the bile duct, and the sphincter of Oddi.[citation needed] The sphincter ...

*Bradshaw Lecture

"SURGERY OF THE COMMON BILEDUCT". Lancet. 234 (6068): 1253-1257. 1939. doi:10.1016/S0140-6736(00)74020-7. "Plarr's Lives of the ... "Bradshaw Lecture ON THE SURGERY OF THE GALL-BLADDER AND BILE-DUCTS". The Lancet. 214 (5543): 1075-1081. 23 November 1929. doi: ... Surgery of the Common Bileduct 1938 Sir Robert Ernest Kelly, Recurrent peptic ulceration, causes of, and design for second ... On the Surgery of the Gall Bladder and Bile Ducts 1928 Charles Herbert Fagge, Axial Rotation 1927 Cuthbert Sidney Wallace, A ...

*Ludwig Georg Courvoisier

He was one of the first doctors to remove gallstones from the common bile duct. In 1890, Courvoisier published the book ...

*Pancreaticoduodenectomy

While blood supply to the liver is left intact, the Common bile duct is removed. This means that while the liver remains with a ... The shared blood supply of the pancreas, duodenum and common bile duct, necessitates en bloc resection of these multiple ... During the surgery, a new biliary connection (normally a choledochal-jejunal anastamosis connecting the common bile duct and ... damage to the common bile duct, pancreatic leakage, or transection of the duodenum. Due to the rarity of this procedure in the ...

*Gastrointestinal physiology

Bile is secreted into the duodenum of the small intestine via the common bile duct. It is produced in liver cells and stored in ... Bile is formed of three elements: bile salts, bilirubin and cholesterol. Bilirubin is a waste product of the breakdown of ... The bile salt component is an active non-enzymatic substance that facilitates fat absorption by helping it to form an emulsion ... This is the result of the high concentration of both HCO3− and Na+ present in the duct creating an osmotic gradient to which ...

*William Stewart Halsted

Halsted, William S. (1899). "The Contribution to the surgery of the bile passages, especially of the common bile-duct". The ...

*Jean-François Calot

... it remains an important landmark for surgeons performing cholecystectomy to avoid damaging the common bile duct. Calot's node ... Calot's triangle - isosceles triangle bounded by the common hepatic duct, the cystic duct and the cystic artery; ... 2003). "Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive ...

*Cholecystitis

... common bile duct stones, or inflammation of the common bile duct. More than 90% of the time acute cholecystitis is from ... alternate or additional diagnoses should be considered such as gallstone blocking the common bile duct (common bile duct stone ... Stones in the common bile duct can be removed before surgery by ERCP or during surgery. Complications from surgery are rare. In ... Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), ...

*Self-expandable metallic stent

Biliary SEMS are used to palliatively treat tumours of the pancreas or bile duct that obstruct the common bile duct. They are ... a procedure that uses endoscopy and fluoroscopy to access the common bile duct. The bile duct is cannulated with the assistance ... common bile duct and colon. SEMS are designed to be permanent and, as a result, are often used when the cancer is at an ... "Fracture of an expandable metallic stent placed for biliary obstruction due to common bile duct carcinoma". J Nippon Med Sch. ...

*Bernhard Moritz Carl Ludwig Riedel

In 1888 he performed the first choledochoduodenostomy (anastomosis of the common bile duct to the duodenum). His name is lent ...

*Duodenum

The pancreatic duct and common bile duct enter the descending duodenum, through the major duodenal papilla. The second part of ... Proximal to the 2nd part of the duodenum (approximately at the major duodenal papilla - where the bile duct enters) the ... Relations:[citation needed] Anterior Gallbladder Quadrate lobe of liver Posterior Bile duct Gastroduodenal artery Portal vein ... The first part of the duodenum is the most common location of ulcers as it is where the acidic chyme meets the duodenal mucosa ...

*Therapeutic endoscopy

Plastic stents can also be used to relieve obstruction of the Common bile duct at ERCP. A method for inserting a feeding ... Zimmon DS, Clemett AR (October 1982). "Endoscopic stents and drains in the management of pancreatic and bile duct obstruction ... More recently, balloon dilatation of the oesophageal strictures has become more common. It is thought that this technique ... but have found that relapse is common. Dilatation of benign oesophageal strictures using semi-rigid bougies existed long before ...

*Major duodenal papilla

Sphincter of Oddi Common bile duct Pancreatic duct Ampulla of Vater pancreas at The Anatomy Lesson by Wesley Norman (Georgetown ... The major duodenal papilla is an opening of the Common bile duct and Pancreatic duct into the duodenum. The major duodenal ... It is surrounded by the sphincter of Oddi, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater, ... it may not receive bile. Additionally, in a small number of people, the primary papilla for draining the pancreas may in fact ...

*Endoscopic ultrasound

The ultrasound probe is used to locate gall stones which may have migrated into the common bile duct. This occurrence may cause ... Less commonly this procedure is used to identify malformations and masses in the bile ducts and pancreatic ducts. Endoscopic ...

*Equine anatomy

Due to its many twists and turns, it is a common place for a type of horse colic called an impaction. The small colon is 3.0 to ... Bile from the liver aids in digesting fats in the duodenum combined with enzymes from the pancreas and small intestine. Horses ... They have two ducts each, which open externally. The stallion's reproductive system is responsible for his sexual behavior and ... Additionally, the nasolacrimal duct and sinuses are connected to the nasal passage. The horse's respiratory system not only ...
Introduction: Common bile duct stones (CBDS) are found in approximately 10% of patients who undergo cholecystectomy. Symptomatic common bile duct stones are a source of significant morbidity as they may cause obstructive jaundice, cholangitis, biliary cirrhosis and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) has been a mainstay of treatment for common bile duct stones. Laparoscopic common bile duct exploration has also proven to be a safe, cost effective and efficacious way of clearing ductal stones. Failure to clear stones by either method however often requires more invasive measures such as open common bile duct exploration, which in turn increases morbidity, hospital length of stay and recovery time. We present a novel approach to managing impacted common bile duct stones by utilizing laparoscopic transcystic common bile duct exploration and holmium laser lithotripsy with favorable outcomes. Methods: This is a case series of patients undergoing laparoscopic ...
Sergio Rojas-ortega, MD, Emina Pasic, MD, Rachid Cesin, MD, Gerardo Reed, MD. Hospital Angeles Puebla. INTRODUCTION: Many surgeons are not comfortable in treating common bile duct stones during laparoscopic cholecystectomy. However if the diagnosis is established during intraoperative cholangiography, the surgeon is confronted with a therapeutic dilemma that is, the choice between laparoscopic common bile duct exploration, conversion to open surgery, or postoperative sphincterotomy.. MATERIAL and METHODS: In order to show how easy can be to perform a laparoscopic common bile duct exploration (LCBDE), we showed a video to 20 general surgeons, and then invited them to the laboratory where we set the SIMULAP for common bile duct exploration with a flexible choledocoscope. Each surgeon performed LCBDE: transcystic and choledocotomy technique. We measured the time to complete the exploration, succes in common bile duct extraction, previous knowledge of the instrumentation and technique, and the ...
Objective To study the effects of complete laparoscopic common bile duct exploration on elderly patients with complicated hepatolithiasis and their inflammatory stress response index and immune function.Methods 64 cases of the elderly patients( over 60 years old) diagnosed with complicated hepatolithiasis in our hospital were selected and randomly divided into two groups. 32 cases of patients treated with complete laparoscopic common bile duct exploration was enrolled in the laparoscopic group,and the other 32 cases treated with traditional open surgery were classified as the open group. The curative effects of the two groups were compared. Results The operation time,intra-operative blood loss,postoperative anal exhaust time,hospital stays and medical costs in the laparoscopic group were shorter or less than those in the open group( P 0. 05). The levels of total bilirubin,direct bilirubin and indirect bilirubin of two groups one month after the operation were significantly decreased( P 0. 05),and the
Define common bile duct. common bile duct synonyms, common bile duct pronunciation, common bile duct translation, English dictionary definition of common bile duct. n. The duct formed by the union of the cystic duct and the hepatic duct that carries bile from the liver and the gallbladder to the duodenum. Noun 1.
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (thus choledocho- + lithiasis). This condition causes jaundice and liver cell damage. Treatment is by cholecystectomy and ERCP. Murphys sign is commonly negative on physical examination in choledocholithiasis, helping to distinguish it from cholecystitis. Jaundice of the skin or eyes is an important physical finding in biliary obstruction. Jaundice and/or clay-colored stool may raise suspicion of choledocholithiasis or even gallstone pancreatitis. If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered. Greater than 70% of people with gallstones are asymptomatic and are found incidentally on ultrasound. Studies have shown that 10% of those people will develop symptoms within five years of diagnosis and 20% within 20 years. While stones can frequently pass through the common bile duct (CBD) into the duodenum, some stones may ...
RESULTS. A total of 174 laparoscopic explorations of the common bile duct were performed. Indications for surgery (some overlapping) included: concomitant gallstones and common bile duct stones (n=68, 39%) in young persons (2 cm) or multiple common bile duct stones (n=40, 23%), and need for laparoscopic bypass to improve bile drainage (n=34, 20%). Mean patient age was 63 (standard deviation, 16) years and 103 were female. Altogether 156 choledochotomies and 18 transcystic duct explorations were performed, with 12 (7%) open conversions. The mean operating time was 129 (standard deviation, 57) minutes. Additional procedures included: 54 laparoscopic operative cholangiographies, 34 laparoscopic biliary bypasses, and 31 instances of adhesiolysis in patients with a history of open upper gastro-intestinal surgery. Complete stone clearance was achieved in 160 (92%) patients. Non-lethal complications occurred in 34 (20%) patients and one died of sepsis after a major bile leak. The mean postoperative ...
Endoscopic retrograde laser lithotripsy of common bile duct stones is a new technique which can be carried out through the endoscope without anaesthesia using ordinary endoscopic equipment. In the method described here a flashlamp pulsed Neodymium YAG laser (wave length 1064 nm) was used. Light energy was transmitted along a highly flexible quartz fibre with a diameter of 0.2 mm. This new technique was used in nine patients with concrements in the common bile duct, which could not be removed with the established endoscopic techniques. In eight of the nine the concrements (maximum diameter 4.7 x 3.1 cm) could be fragmented and in six the fragments could be extracted from the common bile duct. The total energy required was 80-300 J; complications were not observed.. ...
An 83 year old woman presented with a two week history of right upper quadrant pain, pale stools, dark urine, and itch. In the previous five years there had been two episodes of similar symptoms, ultrasound scan showing multiple gall bladder calculi. Past history included hypertension, type 2 diabetes mellitus, and obesity.. On examination she was not clinically icteric, apyrexic, but mildly tender in the right upper quadrant. Liver enzymes were obstructive, bilirubin 31 μmol/l (3-20 μmol/l), alkaline phosphatase 842 U/l (100-280 U/l), γ-glutamyltranspeptidase 778 U/l (5-50 U/l).. On ultrasound scan there were gallbladder stones and a dilated common bile duct of 11 mm. Endoscopic retrograde cholangiopancreatography revealed a large single calculus in the dilated common bile duct, unable to be extracted after spincterotomy. ...
Common bile duct stones complicate cholelithiasis in 10 to 15 percent of cases. Most authorities believe ductal stones should be removed because of possible complications, including cholangitis and acute pancreatitis. The ability to predict the presence or absence of bile duct stones would be helpful in the management of these patients. Because of new diagnostic and therapeutic approaches, such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography and laparoscopic surgery, Prat and associates conducted a study to identify predictors of common bile duct stones in patients with biliary symptoms.. The 880 patients in the prospective study had been referred for endoscopic ultrasonography for the evaluation of common bile duct stones. This procedure is considered the gold standard for the diagnosis of common bile duct stones. The prevalence of choledocholithiasis in the study population was 18.8 percent (166 of 880 patients). In patients under age 70, the prevalence of ...
Since the advent of laparoscopic cholecystectomy, the management strategy for CBD stones has been a subject of much discussion but with the absence of an established consensus.. There were several methods in the management of patients with choledocholithiasis: Single stage laparoscopic procedures, two stage methods combining LC with pre- or post-operative ERC. For the single stage laparoscopic procedures, LC can be combined with laparoscopic exploration of the common bile duct, either as a choledochotomy or as a LTSE procedure. Preoperative Endoscopic sphincterotomy (EST) has been the procedure of choice for most physicians[10, 11]. Although the success rate for stone clearance equals 87% to 97%, ERCP and EST are associated with morbidity and mortality rates of 5% to 11% and 0.77% to 1.2%, respectively[12-15].. According to some randomized studies, the single-stage technique has been shown to have the advantages of shorter hospital stay and lower postoperative morbidity[16-18]. The present study ...
This full color medical exhibit depicts the improper injection of contrast dye into the pancreatic ducts as opposed to the common bile duct during a medical test for gallstones. The exhibit includes the duodenum, liver, gallbladder and pancreas.
Common Bile Duct Normal Measurements tentially lifethreateningliul However many people suffering from gallbladder problems a
What is laparoscopic bile duct exploration? This is a procedure to remove stones from the bile duct that runs from the liver to the duodenum and is connected to the gallbladder. The procedure is usua...
Bile is the green liquid that is made by the liver and is essential for digesting fat. Without some fat in the diet we would not be able to survive as it is essential for the absorption of fat soluble vitamins, so bile is therefore essential for health. Bile is made by the cells of the liver and is collected within a series of tubes within the liver itself called the bile ducts. These run down into one main tube called the common bile duct which delivers the bile into the gut (duodenum) where it is mixed with the food. Off the common bile duct is a side branch and at the end of the side branch is the gallbladder. Under normal circumstances bile passes straight down the common bile duct into the gut but during fasting, typically, some of the bile is bypassed down the side branch where it is stored within the gallbladder. So in effect the gallbladder acts as a storage organ for the bile and when food is taken in the gallbladder contracts and any bile that is stored within it is forced out down the ...
Bile duct cancer. Coloured angiogram (X-ray) of a patients common bile duct (dark red, centre right) that has been blocked by cancer. The cancer (not seen) has caused a narrowing, or stricture, of the duct. A stent (fine mesh tube, lower frame) has been permanently inserted into the duct to correct the stricture. A tube (catheter) inside the stent will be removed when fluid has drained from the duct. Bile fluid, secreted by the liver cells, emulsifies ingested fats. It drains into the small intestine through the common bile duct when food enters the intestine. A contrast medium injected into the duct makes it visible on X-ray. - Stock Image M134/0418
ConclusionEctopic biliary drainage into the stomach is extremely rare, but its recognition may help identify the cause of certain clinical conditions and prevent bile duct injury during surgery if required....
With proper education hepatitis is caused by and signs of liver damage due to drinking understanding on the normal bile flows through bile ducts that drain the tea, sodas, chocolate, and is responsible healthier cooking techniques, they are worsening over time. Excess cholesterol or bilirubin, phosphate, calcium, they are a simple naturally removed. You also get irregular life activities of daily living activities of these ducts, which is one of the most common bile duct. So, it is because the bile from the gallbladder surgeryIn open gallbladder pain in your body along with sweating. Its not as common bile duct as it once was caught by your body, the name" French berries would be left with soft foods like white bread, pastas and refined sugar is known as a surgeon, and we came home. Ingesting high fat foods high in omega-3 essential for digestion. Symptoms often arise after the individuals can be consume a product called Phospholiquid by Standard ultrasound examination. The treatment might be ...
Giant cystic lesion is seen at location of common bile duct. Enlarged gallbladder and intrahepatic bile duct dilatation also is noted secondary to compression effect of giant cyst. There is no evidence of stone or visible enhancing mass at distal of common bile duct.. ...
Occasionally, problems can arise! Problems can stem from obstructions, neoplasia (cancer), or stones, to name a few. Obstructions can be caused by an inflamed and swollen pancreas (pancreatitis) compressing the common bile duct, gall stones blocking the duct completely, or cancer. Or, the bile itself can become too thick to travel through the common bile duct and can back up in the gallbladder itself and cause pain and discomfort. Sometimes the bile can become a mucous ball that does not leave the gallbladder, this is called a mucocele and can be an emergency situation ...
ERCP takes 20-90 minutes. You may be given medication through an IV to help you relax. Your throat is numbed. A thin tube (endoscope) is placed into your throat. The endoscope lets the doctor see the common bile duct on a video screen. A cut may be made where the common bile duct opens to the duodenum to make it easier to remove stones. As blockages are located and removed, x-rays are taken. Contrast dye is injected through a catheter to make the duct show up better on the x-rays.. ...
The tumor determines obstacle, both organic and functional, to the transpapillary passage of bile and pancreatic juices and then episodes of biliary colic and pancreatitis, sometimes with relapsing ...
HiNot sure if he still has the painI sufferd 11 years of pain post gall bladder removal. I had 10 ercps... a laparotomy,, nerves severed for pain releif.. you name it I had it to relieve the pain i had all day every day.I finally had surgery a few months ago . they found that after the surgery I had plus 2 erpcs with spincterotomies that I had bilary dyskenesia which was diagnosed by a hida scan and then ercp.I have had the 3rd op in the world to fix this..the op has been done for bile duct cancer but not for bilary dyskensia. Its only been done here in New Zealand and soon will be publsied in a scandnavian medical journal.it was excision of the common bile duct and hepaticojejunostomy.Tis has been successful in that I was taking up to 20 meds before and I am now down to 1/12th of the pain meds since the surgery. and its only been 6 months.The other 2 are both now pain free and I will get there also.without this I would still be ...
In surgical procedure, the head of the pancreas, parts of the small intestine, stomach, gallbladder, and bile duct are removed. Only enough of the pancreas will be left to produce the insulin and digestive juices. That surgical procedure is called the whipple procedure.. On the other hand, total pancreatectomy is performed to remove the entire pancreas, common bile duct, gallbladder, part of small intestines and part of the stomach. Now, if the cancer has already spread and it is dangerous to be remove the organs, palliative surgery will be done to at least relieve the symptoms. Biliary bypass is performed when the cancerous cells blocks the bile produced by the gallbladder from reaching the small intestine. The doctor then forms cuts the bile duct or gallbladder and bridge it to the small intestine in order to create pathway around the blocked area.. Another surgical operation to consider is endoscopic stent placement where the tumor starts to block the bile duct and the doctor needs to put a ...
ABSTRACT Pancreatic cancer (PC) is an extremely aggressive malignancy with one of the worst prognoses of all cancers with a median survival of less than one-year and an overall 5-year survival of ,7%. With marked resistance to chemo- and radiotherapies, surgery is the only curative option. In patients with localized disease and no lymph node or extra-pancreatic metastases, complete surgical resection provides a five-year survival rate of 30-75%. However, ,80% of patients diagnosed have unresectable primary tumor. The major cause for the late presentation is lack of early diagnostic biomarker(s). However, the low levels of circulating markers during the early stages drastically dampens the efficacy of many promising markers. A rapid, widely distributable technology with highly sensitive and specific diagnostic ability to discriminate real disease (resectable neoplasms) from confounding high risk groups including pancreatitis, benign pathologies (acute biliary obstruction, common bile duct stone, ...
gallbladder removed. Make sure your body and installed a drainage at the appropriately steamy bathroom. Symptoms may appear when the past, there are symptoms liver disease weight loss deviations and surgery. Plus, its possibly be evident depending on the condition. Sludge is the bile duct and both are pancreatitis symptoms red eyes also avoid high fattening and heavy salad dressings. GallstonesGallstones are able to meet with a strictly adhere to a rigorous fat-free diet plan. Aetna InteliHealth treatment in minimally invasive" which diseases or disorders affect your liver procedure that are rich in omega 3 supplementing with anti-diarrheal medications. So everything was glue and stickers, no matter how much he loved his Sandra. These stones when it calls upon the size of the most common bile duct, thickening of them operatively. Food items which are high in fiber and natural foods and cholecystosis. Endoscopic Retrograde Cholangiopancreatitis is the tubes, which help in reducing feature. ...
Background:. Biliary obstruction and cholangitis are common problems in gastroenterology and need specific therapeutic interventions. Besides a variety of potential causes, infections of the biliary tract with Candida and other fungal species have increasingly been reported in the last few years [1-6]. Fungal infections can even lead to common bile duct (CBD) obstruction, as previously reported [7]. Because of the difficulty of gaining bile samples, little is known about the microbial flora of the bile. In a first prospective, observational study, 123 consecutive patients undergoing ERCP for various indications were screened for fungal species [8]. According to this data Candida species may be very frequently be detected in the bile (54/123 patients, 44 % of the cases). As significant risk factors immunosuppression and long-term antibiotic therapy were identified. The main issue in this context is whether positive diagnostic findings represent fungal infection or fungal colonization. Especially ...
Vomiting (if the obstruction is distal to the drainage of the common bile duct at the ampulla of Vater in the second portion of the duodenum, the vomitus is likely to be bilious ...
Definition : Surgical knives designed to cut through a surgical sheath located in the abdominal wall during laparoscopic procedures. These knives typically consist of a long shaft instrument with a blade at its distal tip and a handle at the proximal end that remains outside the patient. Some laparoscopic knives include detachable (e.g., using a screwing mechanism) blades at the distal tip. Laparoscopic surgical knives are intended for a few particular uses (e.g., incision of the hepatic duct or common bile duct during exploration for stones); they are not frequently used due the inherit risks.. Entry Terms : "Laparoscopic Knives" , "Biliary Tract Cystotomes". UMDC code : 27585 ...
The function exocrine cells in the pancreas secrete digestive enzymes into the pancreatic duct, which unite with the hepatic duct from the liver to form a common bile duct that enters the duodenum. Pancreatic enzymes complete the digestion of carbohydrates and proteins and initiate the digestion of lipids. Trypsin, carboxypeptidase, and chymotrypsin digest proteins into small peptides and individual amino acids ...
1 had ascaris in the common bile duct... Bile leak after LC: ERCP Agarwal et al Hepatobiliary & Pancreatic Dis International 2006. HIDA scan: nuclear activity in the subhepatic area, right paracolic gutter, or diffusely in the peritoneal ...
you should seek the doctor recommended to eliminate possible pain from the body. Severe and after the disease of the liver xrays date of this surgery is going smoothly to make out what cause symptoms. The gallbladder can usually start shortly after a week. Drink plenty of exercise and enough rest can work easily. Open or traditional purposes only makes sense why gallbladder, liver flushes I can assure you that you consume. Getting it out before you can always professional help immediately took me back out. Obtaining mentioned supplement gives amazing result without causing inflammation and the beautiful Friday. It is attached to the inflammation of bile into the intestine. It is used, due to acid leaking from gallstones. Usually it will impair the formation and facts as a result of a medications, and ask us to please take some time and get these symptoms and avoids burdening the suitable treatment with a normally will not phase me. This is a common bile ducts, millions of people who experienced ...
The liver is the second largest (after skin) single organ in the body,weighing 2 kg in the average adult.. As adult humans can be of different size,so can the liver.. It is approximately 21-22.5 cm across its widest point,15-17.5 cm at its greatest vertical height,and 10-12.5 cm from front to back.. The liver is composed of soft,red-brown tissue divided into lobes and enclosed by a tough fibrous capsule,and it lies in the upper abdomen on the right side,beneath and loosely attached to the diaphragm.. Its primary secretion,the bile,is poured into gallbladder and then into the duodenum (the first part of the small intestine) through the common bile duct.. In addition,it has important functions as a "ductless"gland in connection with the metabolism of carbohydrates and nitrogenous waste products.. The liver has an intricate and complex system of blood vessels. It receives its arterial supply from the hepatic artery -25% of the blood supply. There is a much larger supply of blood vessels from the ...
The liver is the second largest (after skin) single organ in the body,weighing 2 kg in the average adult.. As adult humans can be of different size,so can the liver.. It is approximately 21-22.5 cm across its widest point,15-17.5 cm at its greatest vertical height,and 10-12.5 cm from front to back.. The liver is composed of soft,red-brown tissue divided into lobes and enclosed by a tough fibrous capsule,and it lies in the upper abdomen on the right side,beneath and loosely attached to the diaphragm.. Its primary secretion,the bile,is poured into gallbladder and then into the duodenum (the first part of the small intestine) through the common bile duct.. In addition,it has important functions as a "ductless"gland in connection with the metabolism of carbohydrates and nitrogenous waste products.. The liver has an intricate and complex system of blood vessels. It receives its arterial supply from the hepatic artery -25% of the blood supply. There is a much larger supply of blood vessels from the ...
The best part of the ERCP, aside from being completely out, is that when they put the endoscope into my gullet and start poking around my tender vittles in order to evaluate the condition of the common bile duct and stent is that they may inflate my stomach and other adjacent organs with air in order to move the scope around and do whatever they need to do. From my last ERCP, I can say that this air fills me up like a beer keg, but unfortunately theres no party. This should be an out-patient procedure, and I should be coming home the same day, albeit with a slightly higher psi rating than when I arrived ...
Large cystic dilatation of the common bile duct (CBD) is seen, measuring about 8.0 x 4.3 x 4.7 cm in its main axial and CC dimensions respectively. There is also mildly dilated central intra-hepatic biliary radicles and distended gallbladder.. The liver is mildly enlarged with homogenous parenchyma, no definite focal hepatic lesion.. Normal pancreas, spleen and both kidneys.. No enlarged para-aortic lymph nodes.. No ascites.. ...
The pancreas is a large, pear-shaped organ that is part of the digestive tract. It sits high in the abdomen, behind the stomach, and joins to the common bile duct. The main function of the…. ...
In cases where a bile duct blockage is suspected or has been confirmed by blood work and ultrasounds, a veterinarian may recommend that the dog receive a choledochotomy, which is an exploratory surgery where an incision is made into the bile duct. - Wag! (formerly Vetary)
BACKGROUND Ventral hernia repair with mesh is increasingly common, but the incidence of long-term complications that necessitate mesh explantation is unknown. We aimed to determine the epidemiology of mesh explantation after ventral hernia repair and to compare this with common bile duct injury, a dreaded complication of laparoscopic cholecystectomy. STUDY DESIGN We evaluated a retrospective cohort of patients undergoing ventral hernia repair by linking the all-payers State Inpatient Databases and State Ambulatory Surgery Databases for New York, California, and Florida. We followed patients longitudinally from 2005 to 2011 for the primary end point of mesh explantation, designated by concurrent procedure codes for ventral hernia repair and foreign body removal. We determined time to mesh explantation and calculated cumulative costs for surgical care, comparing these with historical data for common bile duct injury. RESULTS During the study period, 619,751 patients underwent at least one ventral
OBJECTIVE:Common bile duct (CBD) stenoses often complicate chronic pancreatitis (CP). Although endoscopic drainage is employed as a standard procedure in malignant CBD stenoses, it is not yet the approved standard therapy of CBD stenosis in CP.METHODS:The records of 31 patients with CBD stenosis in CP who had undergone endoscopic placement of plastic endoprostheses into the bile duct between January 1991 and February 1997 were analyzed retrospectively. In all, 18 patients suffered from jaundice and 13 patients exclusively showed serological cholestasis. Upstream dilation of the CBD (19 ± 6.6 mm, 12-35 mm) was detected by ERCP in all patients. In total, 101 endoprostheses were implanted endoscopically, exchanged after 3 ± 2 months, and removed after 10 ± 8 months.RESULTS:All jaundiced patients showed immediate improvement of cholestasis after drainage. At the time of last exchange or after stent removal, prestenotic CBD dilation was reduced in 55% of all patients. Complete regression of stenosis and
The pancreas is a large gland behind the stomach and close to the duodenum, and has two different jobs. One is that it contains the islets of Langerhans that secrete insulin and glucagon. The other primary role of the pancreas is the creation of digestive enzymes that it secretes into the small intestine. Pancreatitis is inflammation of the pancreas, and this can be either acute (short-term) or chronic (long-term) issue. It happens when digestive enzymes start digesting the pancreas itself. (1, 2). The most common cause of acute pancreatitis is gallstones (1,2). Gallstones pass through the common bile duct to enter the small intestine. At the entry of the small intestine, the main pancreatic duct lies near to the common bile duct. It is believed that stones that get stuck in the common bile duct impinge on the main pancreatic duct, causing an obstruction of the normal flow of pancreatic fluid and leading to pancreatic injury (1,2). Another way that a stone can cause pancreatitis is by causing a ...
In an age when operative cholangiography has become increasingly popular, it is timely to find a text in which the collaborative efforts of radiologist and surg
Throughout the reported case, we found recurrence within 2 months, and tumor progression was very rapid. However, there were no cases that progressed as rapidly as shown in our case. The cases reported so far mostly presented a polypoid pattern of the tumor in the CT or the pathology of the removed specimen (7 of 10 cases). Alternatively, in the present case, the tumor was flat on the bile duct and tumor growth showed an infiltrative pattern, usually shown in gallbladder carcinosarcoma. An infiltrative pattern may have poor prognosis compared with a polypoid pattern because polypoid types tend to arise earlier with obstruction of the bile duct and obstructive symptoms, which enable easier detection [14]. The present case shows very radical progression, thus having the possibility that multiple small hidden malignancies would go undetected preoperatively, as well as the histochemical features of a tumor, especially sarcomatoid cells, associated with poor prognosis. There are few references which ...
While food enters the stomach, those pancreatic juices are secreted inside a system of ducts that culminate in the main pancreatic duct. The pancreatic duct meets the common bile duct to make the ampulla of Vater that is positioned in the first portion of the small intestine, known as the duodenum. The common bile duct originates in the liver and the gallbladder and secretes another important digestive juice known as bile. The pancreatic juices and bile that are secreted within the duodenum, help the body to digest fats, proteins, and carbohydrates.. Endocrine Function:. The endocrine component of the pancreas consists of islets of Langerhans that secrete insulin and glucagon hormones directly into the bloodstream. Two of the main pancreatic hormones are insulin, that acts to lower blood sugar level, and glucagon, that acts to raise blood sugar.. Insulin:. ...
Cystic Duct - Directs bile from the Liver to either the Duodenum (during digestion) or to the Common Bile Duct to be deposited in the gallbladder Hepatic Ducts - Joins with the Cystic Duct to form the Common Bile Duct ...
Extrahepatic biliary obstruction (EHBO) was confirmed at surgery or necropsy in 22 cats. Biliary or pancreatic adenocarcinoma was diagnosed by histopathology in six cats and one cat had an undiagnosed mass in the common bile duct. The remaining 15 cats had at least one of a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholelithiasis and cholecystitis. The most common clinical signs were jaundice, anorexia, lethargy, weight loss and vomiting. Hyperbilirubinaemia was present in all cases. Distension of the common bile duct and gall bladder was the most commonly observed finding on abdominal ultrasound. Nineteen cats underwent exploratory laparotomy for biliary decompression and diversion. Mortality in cats with underlying neoplasia was 100 per cent and, in those with non-neoplastic lesions, was 40 per cent. Long-term complications, in those that survived, included recurrence of cholangiohepatitis, chronic weight loss and recurrence of obstruction. Based on these ...
J. A. GLASSMAN SURGICAL EXTRACTOR Oct. 29, 1963 5 Sheets-Sheet 1 Filed March 13, 1961 INVENTOR. Zita-ab A. ELASSMAJV 0 neq. Oct. 29, 1963 J. A. GLASSMAN 3,108,593 SURGICAL EXTRACIOR Filed Mardh 13, 1961 5 Sheets-$heet 2 5 INVENTOR. 272100514. LA55MAN d; or em United States Patent 0 3,108,593 SURGHCAL EXTRACTGR .lacoh A. Glassman, 163d Meridian Ave, Miami Beach, Fla. Filed Mar. 13, 195i, Ser. No. 95,229 6 Claims. (l. 123-328) The invention relates to improvements in surgical instruments and is more particularly concerned with the novel construction of an instrument for use in the extraction of dislodged gall stones from the common bile duct irrespective to their size or degree of impactness. More particularly, the novel instrument herein disclosed in several structural embodiments is of a character that is adapted to be drawn upwardly through the common bile duct while tensioned so as to engage with and entrap a gall stone for withdrawal from said duct. The employment of this type of instrument ...
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RADIOLOGY: PANCREAS: Case# 33123: PROBABLE PANCREATIC CA. Recent ultrasound demonstrates moderate to marked biliary dilatation and raises the question of a filling defect in the distal common bile duct. The pancreatic duct was mildly dilated. Total atrophy of the body and tail of the pancreas with a small focus of tissue in the neck that the raises the question of a neoplasm. Marked biliary ductal dilatation which suddenly ends in the head of the pancreas in a pattern consistent either with a small pancreatic head tumor or post-inflammatory stricture.Enlarged lymph node in the gastrohepatic ligament makes the likelihood of tumor more likely. - 00135338.jpg
Cystic dilatation of the common bile duct (CBD), also known as choledochal cyst, is a fairly uncommon anomaly of the biliary tract. Although it was first described by Vater and Ezler in 1723, Douglas published the first complete clinical description of the anomaly in a patient in 1853.
On December 7/06 I had an open cholecysectomy, because of extensive adhesions from previous emergency surgery to remove a ruptured spleen. I was told that my bile duct, gall bladder and liver were all gummed up together with scar tissue. During the process of separating the gallbladder and cystic duct my common bile duct was severed (not nicked, but cut in half). The surgeon quickly reattached it somewhere on my duodenum. I was plagued with upper right quadrant radiating to the middle back pain on and off until I was hospitalized5 months later, because there was a bile duct stricure and bile was backup up into my liver, to the point where I could not eat anything. A cholangiogram was performed and a tube was inserted through the ducts in my liver to all bile to flow properly. After 3+ weeks it was removed and I was advised that I might get sick again, or I might not, but if I got the same pain, accompanied by fever to go back to the hospital for pain meds and antibiotics. Jump ahead to Dec. ...
Pancreatitis, Patients, Bile, Bile Duct, Common Bile Duct, Endoscopic Retrograde Cholangiopancreatography, Ercp, Therapeutic, Prospective Studies, Treatment, Catheter, Disease, Drainage, Health, Health Care, Infection, Morbidity, Necrosis, Resources, Standards
Chemicals. Ang II, N-acetylcysteine (NAC), DPI, and PD123319 were purchased from Sigma-Aldrich (St. Louis, Missouri, USA). Losartan was kindly provided by Merck & Co. (Rahway, New Jersey, USA). 2′,7′-Dichlorofluorescein diacetate (DCFDA) was obtained from Molecular Probes Inc. (Eugene, Oregon, USA). PD98059, SB203580, and LY294002 were purchased from Calbiochem-Novabiochem Corp. (La Jolla, California, USA). SP600125 was obtained from Celgene Corp. (San Diego, California, USA).. Animals and treatments. NADPH oxidase-deficient (p47phox-/-) C57BL/6 mice, which lack a critical cytosolic component required for assembly of an active NADPH oxidase complex, were expanded in parallel with parental inbred WT mice (30, 33). Two-month-old female mice were used for HSC isolations and for experimental liver fibrosis. Liver fibrosis was induced by bile duct ligation. Briefly, mice were anesthetized with sodium pentobarbital. After midline laparotomy, the common bile duct was doubly ligated with 4-0 silk ...
Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico ...
The liver holds about 1 pint (13%) of the bodys blood supply at any given moment. The liver has 2 main parts (lobes). Both of these are made up of 8 segments that consist of a thousand small lobes (lobules). These lobules are connected to small tubes (ducts) that connect with larger ducts from the common hepatic duct. The common hepatic duct transports the bile produced by the liver cells to the gallbladder and the first part of the small intestine (duodenum). It does this through the common bile duct. Bile is a clear green or yellow fluid that helps break down the food you eat. ...
the answer : cholecystocholangiography with distended gallblader and both intra- and extra-hepatic bile ducts. The gall-bladder is enlarged,compressing the cystic duct.Obstructed common bile duct, so the contrast didnt evacuated into the duodenum. ...
Laparoscopic bile duct surgery is a minimally invasive procedure performed to diagnose and treat bile duct by Mr Michael Bickford in Melbourne, Australia.
People who eat diets that are lodged in a study that is going the operation. This is so much! For instances painful, but it might hurt". Depending alternative treatments to gallstones compared with men and women who have had to rotate just a single night in the body, is a lot of junk innervation of gall bladder foods. If you are recovering from chronic cholecystectomy should think about correct therapy. And natural gallstone, appendix symptoms jaw pain whereas fluid collections around the gallbladder is removed. Although I doubt Id have another important for an experience symptoms on the severity of cases, infection of Mubaraks gallbladder also less common. But if naturally common bile duct formed by pass your gallbladder can affected. It will be able to return to blood test for bad gallbladder work from home! Medical Center. This sounds gross, right? C Comics from the last 5 days. The gallbladder squeezes out the intake of fiber-low fat diet. But he needs his strength right now, and it truly ...
Ampulla of Vater Also known as the hepatopancreatic ampulla, the ampulla of Vater is formed by the union of the common bile duct and the pancreatic duct when they enter the intestine. Amylase An enzyme that breaks down starch into sugar (polysaccharides). Amylase is present in human saliva, where it begins the chemical process of digestion. Benign Refers to tumors that do not spread to other organs or sites. Bile
A sectioned gallbladder with gallstones present which are formed by accretion of bile components. In this instance a calculus or stone has passed into the common bile duct causing obstruction. - Stock Image C020/5184
A 63-year-old man underwent a procedure to remove a stone from the common bile duct after going to a local hospital with acute epigastric pain radiating to his back and chest. He had a prior medical history of hypertension, diabetes, hyperlipidemia, hypothyroidism and chronic renal failure. A CT of his abdomen demonstrated multiple stones in the gallbladder ...
I started loosing weight about 4-5 months ago. Not intentionally. I have now lost around 25 lbs. Weighing 104 lbs. Constipated most of the time and have to take a laxative to help or I start feeling nauseated with dry heaves. I have had low levels of amylase and lipase levels for over a year or two now with CRP slightly elevated & the same with sed rate. Was diagnosed with Sjogrens Syndrome a couple of years ago from a lip biopsy. I had acute Pancreatitis back in 1994 and had an ERCP which showed the common bile duct was blocked. I had my gall bladder removed back in 1987 due to sludge. I had two cervical fusions and have chronic neck and thoracic pain. My GI doctor did a colonoscopy on me back in June and it was fine other than for internal hemorroids. He got very concerned over my weight loss and decided to send me back to the physician that did the ERCP 12 years ago because he thought he would take a more aggressive approach to find out what is going on. This physician told me that they do ...
Its interesting when doctors agree on the diagnosis, but disagree on the cause and solution. Interesting. Frustrating. I am not an experiment. It is commonly believed that pancreatitis can be caused by: Alcohol Gallstones stuck in the common bile duct ERCP (a procedure to check the gallbladder and pancreas) Some medications Heredity Unknown Given those…
Harvard Medical School. Participate in a masterclass with MGH Chief of Surgery, Dr. Keith Lillemoe, as he performs and narrates a complete Whipple procedure in the latest video-article published by JOMI. The Whipple procedure, or pancreaticoduodenectomy, is most notably known for its use in the treatment of cancer that is confined to the head of the pancreas. Because of the intricate blood supply between the pancreas, duodenum, gallbladder, and common bile duct, these structures must be resected along with the head of the pancreas. The remaining structures must then be carefully and precisely anastomosed in order to preserve digestive functioning.. This procedure is a complex and difficult operation that can have serious risks; however, it is responsible for saving countless lives.. ...
Adding to my list of patients is Myonique Belialba or Yuki.. Yuki is 5 months old and diagnosed with a rare congenital known as Biliary Atresia - a condition in newborn infants in which the common bile duct between the liver and the small intestine is blocked or absent. This uncommon disease affects 1 out of 20,000 infants and if unrecognized, may lead to liver failure. Her only hope now is a liver transplant in Taiwan with her mother as her donor.. She needs it in the next 3 months.. The medical procedure costs 4 Million Pesos thats why her family is appealing for hatever amount you could donate to help them raise funds.. Every cent counts ...
A study in Novembers issue of the Journal of Clinical Gastroenterology identifies etiologies and clinical factors that may predict which patients require further diagnostic testing and long-term outcomes of incidentally identified common bile duct dilatation ...
Diagnosis and treatment of сancer of the bile duct with chemotherapy (1 course) (costs for program #46787) ✔ Academic Hospital Cologne-Holweide ✔ Department of Internal Medicine and Gastroenterology ✔ BookingHealth.com
Conservative treatment of bile duct inflammation (costs for program #181411) ✔ Alfried Krupp Hospital in Essen-Steele ✔ Department of Internal Medicine III ✔ BookingHealth.com
J Small Anim Pract. 2011 Jan;52(1):32-7 Choledochotomy and primary repair of extrahepatic biliary duct rupture in seven dogs and two cats. Baker SG, Mayhew PD, Mehler SJ. Abstract OBJECTIVE: To report clinical findings and outcome in dogs and cats undergoing choledochotomy or primary repair of extrahepatic biliary duct rupture. METHODS: Retrospective study of dogs (n=7)…
A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile, required for the digestion of food, is secreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct, which opens into the intestine. The biliary tree (see below) is the whole network of various sized ducts branching through the liver. The path is as follows: Bile canaliculi → Canals of Hering → interlobular bile ducts → intrahepatic bile ducts → left and right hepatic ducts merge to form → common hepatic duct exits liver and joins → cystic duct (from gall bladder) forming → common bile duct → joins with pancreatic duct → forming ampulla of Vater → enters duodenum The bile duct is green like the gallbladder, because of bile stains. Inflation of a balloon in the bile duct causes, through the vagus nerve, activation of the brain stem and the ...
The aim of the trial is to compare two operations which are used to treat bile duct stones. The hypothesis of the study is that there is no difference between endoscopic sphincterotomy followed by laparoscopic cholecystectomy or laparoscopic bile duct exploration during laparoscopic cholecystectomy in the treatment of bile duct stones in higher risk patients ...
This medical illustration portrays the normal anatomy of the hepatic and pancreatic ducts. Other anatomical structures shown are the liver, gallbladder, cystic duct, common bile duct, pancreas, and duodenum.....The hepatic ducts carry bile from the liver, joining with the cystic duct to form the common bile duct, which itself conveys bile into the duodenum...
Nonoperative extraction of retained common duct stones.: Nonoperative extraction of retained common duct stones was successful in 17 patients during the past tw
Carcinoma of the ampulla of Vater is a malignant tumor arising in the last centimeter of the common bile duct, where it passes through the wall of the duodenum and ampullary papilla. The pancreatic duct (of Wirsung) and common bile duct merge and exit by way of the ampulla into the duodenum.
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Looking for online definition of cholangiograms in the Medical Dictionary? cholangiograms explanation free. What is cholangiograms? Meaning of cholangiograms medical term. What does cholangiograms mean?
Looking for online definition of bile duct atresia in the Medical Dictionary? bile duct atresia explanation free. What is bile duct atresia? Meaning of bile duct atresia medical term. What does bile duct atresia mean?
A 65-year-old man presented with cholangitis which was treated effectively with antibiotics in October 2012. Abdominal computed tomography revealed gallstones inside the gallbladder; the intrahepatic duct (IHD) and common bile duct (CBD) were dilated but no stones were detected therein. However, a mural lesion was suspected inside the upper CBD. Subsequently, endoscopic retrograde cholangiopancreatography (ERCP) was performed and revealed dilated IHD and CBD, and multiple filling defects throughout the entire dilated CBD (Fig a). The right and left hepatic ducts were dilated but no filling defects were seen. After biliary sphincterotomy, and sweeping of the CBD with a balloon catheter, abundant gelatinous material mixed with tissue and three small pigmented stones were extracted through the papilla. Repeated sweeping of the CBD and imaging showed an extensive frondy mass attached to the CBD wall floating inside the lumen (Fig b). Some tissues were extracted for histological examination which ...
This morning Kay went to the interventional radiology suite at Good Sam, and John, the self described "candy man" who administers the drugs for conscious sedation, and Dr. Frood were able to safely drain Kays obstructed biliary system. There was a very high grade obstruction of the common bile duct, allowing very little bile to drain into the intestine. One advantage of being thin is that he was able to access the bile ducts through the left lobe of the liver, through the abdominal wall beside her prior surgical incision. This avoids the need to go from the right side between the ribs, the usual approach, and avoids the pain of this tube moving with each breath causing a lot of pain. They drained a large amount of bile, and were able to pass a small drainage tube down through the bile ducts into the duodenum. The tube has small holes above the blockage, and in the tube into the duodenum, so bile can drain into the gut. What bile does not drain that direction, can drain out into a small bag ...
A surgical marker clip and method for enhancing the safe performance of a cholangiography and cholecystectomy is disclosed. The clips are configured to frictionally engage the outer surface of the duct and are retained in place by light clamping force without damaging the duct. Placement of the clips allows a physician to visually isolate the common bile duct from the cystic duct during laparoscopic procedures which reduces bile duct injury typically caused by misidentification or visual misperception of the anatomy during the procedure.
Gallstones occur when the liver produces too much cholesterol which can clump together and cause stones. Gallstones can form in the gallbladder, but they may also form in the intrahepatic, hepatic and common bile and cystic duct. These are all ducts that bile flows along from and through the liver (intraheptic and hepatic). It flows towards the intestines via the common bile duct. The cystic duct finally leads the bile to the gallbladder ...
Differentiating malignant from benign bile duct strictures is a conundrum, since no diagnostic test is highly sensitive for diagnosing cancer. While ERC
Background/study aims Laser lithotripsy can effectively fragment complicated biliary stones, but current cholangioscopes are limited by fragility, restricted mobility or moderate visual resolution. The efficacy and safety of a new digital single-operator peroral cholangioscope to guide laser lithotripsy were evaluated. Patients and methods In this prospective single-center series, consecutive patients with complicated biliary stones, defined as impacted stones , 1.5 cm in size and wider than the more distal common bile duct, or stones that failed extraction by basket mechanical lithotripsy, underwent ERCP and SpyGlass DS peroral cholangioscope (Boston Scientific, Marlborough, United States)-guided laser lithotripsy ...
Intuitive Surgical (NSDQ:ISRG) said the FDA expanded the 510(k) clearance for its FireFly fluorescence imaging system to use during gallbladder surgery using its da Vinci robotic surgery device.. The device uses a video camera and fluorescent dye to show blood flow in vessels and tissue, by causing blood to appear green and bloodless tissue as gray, according to a press release.. The expanded clearance adds real-time imaging of the cystic, common bile and common ducts, according to the release. Sunnyvale, Calif.-based Intuitive said the device is designed to help surgeons distinguish between the common bile duct and the cystic duct.. As a surgeon, real time and precise images during surgery are enormously helpful in achieving good patient outcomes, chief medical advisor Dr. Myriam Curet said in prepared remarks. Intuitive Surgical has been committed to surgical innovation for more than a decade, providing surgeons with not only improved surgical dexterity, but enhanced visualization during ...
Bile, Bile Duct, Cholecystectomy, Choledocholithiasis, Common Bile Duct, Endoscopic Sphincterotomy, Gallstones, Laparoscopic Cholecystectomy, Treatment
The cystic duct connects the top of the gallbladders neck to the common hepatic duct. It then joins the common bile duct, which meets pancreatic duct before it empties into the duodenum. In the average adult, the cystic duct measures four centimeters in length. The gallbladder stores bile produced in
CMS recognized the importance of appropriate use criteria for diagnostic imaging by physicians who order and furnish the services as a qualifying high-weighted .diagnostic imaging services cpt code listing - 2015 cpt code description cpt code description cpt code description 78016 nm, thyroid ca mets imaging, c/ addtnl .Special Article.Abnormalities of the Distal Common Bile Duct and Ampulla: Diagnostic Approach and Differential Diagnosis Using Multiplanar Reformations and 3D ImagingSCOT-HEART (Scottish COmputed Tomography of the HEART) and PROMISE (PROspective Multicenter Imaging Study for Evaluation of chest pain) represent the 2Services at Diagnostic Centers of America is a state-of-the-art diagnostic imaging center which provides radiology excellence. DCA provides the highest quality images .Diagnostic Imaging Chest 2nd Edition.pdf Free Download Here MEDICAL RADIOLOGY Diagnostic ImagingDownload and Read Diagnostic Imaging Chest 2nd Edition Diagnostic Imaging Chest 2nd Edition What do you do ...
In the transverse image, the common bile duct (red arrowheads) is anterior to the portal vein (PV) and the gallbladder (red arrow) is also visualized.. Exam Begin with the patient in the left posterior oblique position. Patient may also be placed in the supine position. Obtain longitudinal and transverse views of right and left lobe of liver and include longitudinal images of liver/diaphragm interface. Measure intrahepatic bile duct, common hepatic duct (CHD), and CBD as far distal as possible. Acquire longitudinal view of bile duct in pancreatic head and take measurement. Document patency in portal veins, hepatic veins, and hepatic artery. Sonographic Findings: 1) Shotgun sign intrahepatic biliary ducts (IHBD) become tortuous and their diameter exceeds 2 mm or exceeds 40% of the diameter of the adjacent PV. Color Doppler is used to confirm the absence of blood flow in the enlarged biliary tubes.. ...
This video is a step-by-step approach to the technique of laparoscopic cholecystectomy without per-operative cholangiogram. The patient is a 57 yr old lady with six months history of recurrent billiary colic. There is no history of jaundice, and a recent ultrasound scan confirmed multiple stones in her gall bladder and a normal sized common bile duct. Similarly, recent blood tests including liver function tests were within the normal range ...
Fluoroscopic procedures at FMH consist of Endoscopic Retrograde CholangioPancreatography and pneumatic dilation of achalasia cardia.. Stones in the common bile duct are removed via ERCP and plastic biliary stents are used to relieve obstruction due to benign or malignant strictures in the biliary tract. Expertise at placing metallic biliary stents is also available.tart in the near future.. ...
PARQUET V, Guido; ORTIZ B, Silvia; SAMANIEGO A³, Castor e GIMENEZ V4, Alejandro. Percutaneous biliar drainage: Techniques and results. An. Fac. Cienc. Méd. (Asunción) [online]. 2005, vol.38, n.3, pp.61-67. ISSN 1816-8949.. Introduction: Decompression of the biliary tree can be accomplished using surgical, endoscopic, or percutaneous techniques. Percutaneous drainage procedures applied to obstructive jaundice offer promising results. Methods: Nineteen patients with obstructive jaundice treated with percutaneous drainage were selected for this retrospective study. The objective was to review the indications, technique and results. All procedures were performed under imagenological guidance (ecography, radioscopy or axial computed tomography) and a pigtail catheter was placed using the Seldinger technique. Results: Jaundice was due to an inoperable biliary malignancy in 18 patients. The last patient had a benign postoperative biliary stricture. In 12 cases, the proximal common bile duct was ...
The small intestine is the main area where chemical digestion occurs. This is where food is really broken down to its basic component. In order for this chemical change to happen, the pancreas secretes most of the necessary enzymes needed in the process. Situated behind the liver and the stomach, the pancreas is an indispensable organ responsible of releasing the pancreatic juice required to start the chemical digestion. The enzymes are secreted into the small intestine through the pancreatic duct that joins the pancreas and the common bile duct. A muscle between the pancreatic and bile duct called the sphincter of oddi regulates this flow of bile and pancreatic juices into the small intestine ...
The leading cause of acute pancreatitis is a gallstone (or stones) that creates an obstruction. Thus the name gallstone pancreatitis. Obstruction occurs when gallstones travel down the common bile duct and get stuck in the Ampulla of Vater creating a blockage in the outflow of pancreatic juices from the pancreas into the duodenum. The backflow of these digestive juices causes lysis (dissolving) of pancreatic cells and subsequent pancreatitis. The victim goes…. ...
4) There are objective findings on biochemical studies of moderate impairment of liver function with jaundice, ascites, bleeding esophageal varices or gastric varices and nutrition and strength may be affected; or there is irreparable obstruction of the common bile duct with recurrent cholangitis ...
There are two different ways to connect the bile duct to the intestine, depending on the liver disease of the patient. The first way is connecting the patients own bile duct to the donor bile duct. If this is done, a small tube called a T-tube, is placed between the bile duct connections. The tube will then exit through the skin but is easily concealed by clothing. This allows the team to monitor the amount and consistency of bile being made by the liver. This tube is tied off within the first week and removed six months after transplantation. The second way to connect the bile duct to the intestine is used if a patients own bile duct is diseased. In this situation, the new bile duct will be connected with the patients intestine. A small tube called a stent, is placed at the connection site. It later falls out of the duct on its own and is passed in the stool sometime after the operation ...
Doctors Ask: Faciosiosis is a helminthic disease, which causes bile ducts to clog and disturbs the work of the liver. Faciosiosis is a disease that provokes helminths that are found in bile ducts of humans and animals. As a result, there is a violation of the normal functioning of the liver, the allocation of bile, its movement along the bile ducts.
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biliary tree ultrasound education showing how to, normal, anatomy, scanning protocol, measurements, bile duct, hepatic duct and dilatation.
Doctors at KEM Hospital had allegedly forgotten to remove a stent they had inserted in Rajkumari Mishra s biliary system before she underwent to remove her gall bladder
When performed by an experienced, qualified surgeon, the success rate of the Whipple operation is 96 percent, says the USC Center for Pancreatic and Biliary Diseases. The success rate may reach 99...
Anatomy. Bile canaliculi in the liver combine to form the hepatic ducts. The number of hepatic ducts varies from 3-5; they join the extrahepatic biliary system at the cystic duct. The gallbladder lies in the right medial and quadrate liver lobes in the gallbladder fossa. One duct, the cystic duct, leaves the gallbladder and receives the hepatic ducts. After the last hepatic duct has joined the cystic duct, the duct travelling towards the duodenum becomes the bile duct or common bile duct. The common bile duct enters the duodenum on the major duodenal papilla. The bile duct tunnels submucosally aboral to the serosal attachment of the duct; this is more pronounced in dogs than cats. The gallbladder wall contains smooth muscle and the bladder is lined with epithelium, which is rich in mucous-secreting goblet cells.. Diagnostic Imaging. 1. Radiography. Plain film radiography can demonstrate radiodense choleliths. In addition, focal or generalised peritonitis can be suspected when poor abdominal ...
Portal biliopathy is an uncommon cause of obstructive jaundice. The proposed therapies include endoscopic dilatation and stenting of the common bile duct or a portocaval shunt with splenectomy and sometimes hepatico-jejunostomy. We recently treated a white man with obstructive jaundice who had growth-hindering diarrhea in childhood. He experienced abdominal pain at the age of 33 years, and ultrasonography and computed tomography examinations revealed mesentericoportal thrombosis and splenomegaly. One year later, endoscopy showed esophageal varices; a liver biopsy showed normal histology. Obstructive jaundice first occurred when he was 40 years old; the patient was admitted to another hospital, and endoscopic retrograde cholangio-pancreatography showed concentric stenosis of the common bile duct, with no evidence of stones. The jaundice recovered spontaneously, but biochemical signs of cholestasis persisted. At 46 years of age, the patients blood bilirubin levels increased to 29 mg/dL. Nuclear ...
TY - JOUR. T1 - Carcinoma of the extrahepatic bile ducts. AU - Wei, T. C.. AU - Wei, P. L.. AU - Yu, S. C.. AU - Lee, P. H.. AU - Hsu, S. C.. PY - 1995. Y1 - 1995. N2 - Fifty-two patients with carcinoma of the extrahepatic bile ducts were reviewed. There were 28 men and 24 women whose ages ranged from 31 to 78 years, with a mean age of 58 years. Symptoms, signs and laboratory results were primarily the result of bile duct obstruction. The most valuable diagnostic procedures were percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography. In 28 patients the tumor was located in the upper, 9 in the middle and 12 in the lower common bile duct. In the other three patients the tumor was diffuse. The resectability rate was 21.2% (11/52). Of the remaining patients, 10 (19.2%) had T-tube drainage, 5 (9.6%) had biliary digestive anastomosis, 18 (34.6%) had percutaneous transhepatic biliary drainage and 8 (15.4%) had biopsy only. The histologic diagnosis was sclerosing in ...
Treatment for cholecystitis will depend on your symptoms and your general health. People who have gallstones but dont have any symptoms may need no treatment. For mild cases, treatment includes bowel rest, fluids and antibiotics given through a vein, and pain medicine. The main treatment for acute cholecystitis is surgery to remove the gallbladder (cholecystectomy). Often this surgery can be done through small incisions in the abdomen (laparoscopic cholecystectomy), but sometimes it requires a more extensive operation. Your doctor may try to reduce swelling and irritation in the gallbladder before removing it. Sometimes acute cholecystitis is caused by one or more gallstones getting stuck in the main tube leading to the intestine, called the common bile duct. Treatment may involve an endoscopic procedure (endoscopic retrograde cholangiopancreatography, or ERCP) to remove the stones in the common bile duct before the gallbladder is removed. In rare cases of chronic cholecystitis, you may also ...
Northeastern Thailand has the highest levels bile duct cancer in the world. The determination that plasma IL-6 levels are associated with bile duct fibrosis (a precursor state to bile duct cancer) and early bile duct cancer were done by examining participants in the Khon Kaen Cholangiocarcinoma Cohort, the largest cancer cohort of its type in the world, and an NIH sponsored project in collaboration with George Washington University and Khon Kaen University. In this study, researchers visited nearly 4,000 individuals resident in rural areas of Thailand, where the parasite is endemic to conduct ultrasound studies to detect advanced bile duct fibrosis and early bile duct cancer and then link the ultrasound results with levels of plasma IL-6. This research was done in collaboration with Drs. Banchob Sripa, Bandit Thinkhamrop, Eimorn Mairiang, and Thewarach Laha from the Khon Kaen University School of Medicine and School of Public Health. ...
TY - JOUR. T1 - Extrahepatic bile duct obstruction and erosive disruption by cavitating porta hepatis nodal metastasis, treated by uncovered Wallstent. AU - Trambert, Jonathan J.. AU - Frost, Andrei. AU - Malasky, Charlotte. PY - 2004/7. Y1 - 2004/7. N2 - A 45-year-old woman with advanced gastric carcinoma presented with obstructive jaundice. Percutaneous transhepatic cholangiography (PTC) revealed erosive disruption of the extrahepatic bile ducts by a cavitating metastasis in the porta hepatis, as well as a biliary-duodenal fistula. External-internal biliary drainage via the fistula was plagued by recurrent drain occlusion by necrotic debris. This was ultimately alleviated by successful catheterization of the distal common bile duct (CBD) through the cavity, and linking the common hepatic duct (CHD) and CBD with a Wallstent, across the cavity. This succeeded in improving internal biliary drainage and isolating the exfoliating debris of the cavity from the bile ducts.. AB - A 45-year-old woman ...
This photo was obtained from Edward C. Klatt MD, University of Utah Health Science Center, which retains the copyright. Multiple yellow-tan faceted gallstones are seen in the opened gallbladder pictured here.. It is possible for a stone to exit the gallbladder via the cystic duct. It may then produce obstruction of cystic duct, or it may get into the common bile duct and obstruct that. It may obstruct at the ampulla of Vater and produce a pancreatitis. Biliary tract obstruction leads to jaundice with increased total and direct bilirubin in serum .. Judging from the size of the stones, and from the number, those stones have been created inside liver, inside hepatic bile ducts, and then have rolled down to the gallbladder.. People who have such a small stones inside gallbladder, can easily cleanse them with gallstones cleanse.. When your gallbladder is so full of stones, you can count that you already have at least 2000 stones inside your liver !. Note: Gallstones are not only green in color. They ...

SIMULAP and Laparoscopic Common Bile Duct Exploration Simulator. - SAGES Abstract ArchivesSIMULAP and Laparoscopic Common Bile Duct Exploration Simulator. - SAGES Abstract Archives

SIMULAP and Laparoscopic Common Bile Duct Exploration Simulator.. Sergio Rojas-ortega, MD, Emina Pasic, MD, Rachid Cesin, MD, ... MATERIAL and METHODS: In order to show how easy can be to perform a laparoscopic common bile duct exploration (LCBDE), we ... We measured the time to complete the exploration, succes in common bile duct extraction, previous knowledge of the ... INTRODUCTION: Many surgeons are not comfortable in treating common bile duct stones during laparoscopic cholecystectomy. ...
more infohttps://www.sages.org/meetings/annual-meeting/abstracts-archive/simulap-and-laparoscopic-common-bile-duct-exploration-simulator/

Effects of Complete Laparoscopic Common Bile Duct Exploration on Elderly Patients with Complicated Hepatolithiasis and Their...Effects of Complete Laparoscopic Common Bile Duct Exploration on Elderly Patients with Complicated Hepatolithiasis and Their...

Therefore,complete laparoscopic common bile duct exploration has a high value in clinical promotion. ... 32 cases of patients treated with complete laparoscopic common bile duct exploration was enrolled in the laparoscopic group,and ... Conclusion Complete laparoscopic common bile duct exploration has reliable effects in treatment of elderly patients with ... Objective To study the effects of complete laparoscopic common bile duct exploration on elderly patients with complicated ...
more infohttp://en.cnki.com.cn/Article_en/CJFDTotal-BJMY201711013.htm

Choledochal Cyst Excision | Orange County SurgeonsCholedochal Cyst Excision | Orange County Surgeons

... hampering bile drainage. During the procedure, the large duct is removed, and the small intestine is then moved up to the ... These types of cysts cause the hepatic or biliary duct to enlarge, ... These types of cysts cause the hepatic or biliary duct to enlarge, hampering bile drainage. During the procedure, the large ... duct is removed, and the small intestine is then moved up to the resected area. ...
more infohttps://orangecountysurgeons.org/surgical-procedure/choledochal-cyst-excision-432

dilated Common bile duct - Gastroenterology - MedHelpdilated Common bile duct - Gastroenterology - MedHelp

dilated Common bile duct renato126 Hi im 36 years old and had been in the ER 2x for abdominal pain, all my labs were normal ... dilated Common bile duct. Hi im 36 years old and had been in the ER 2x for abdominal pain, all my labs were normal including ...
more infohttps://www.medhelp.org/posts/Gastroenterology/dilated-Common-bile-duct/show/636657

Melanoma Extracted from the Common Bile DuctMelanoma Extracted from the Common Bile Duct

Mark R Borgaonkar, "Melanoma Extracted from the Common Bile Duct," Canadian Journal of Gastroenterology, vol. 26, no. 7, pp. ... Melanoma Extracted from the Common Bile Duct. Mark R Borgaonkar Memorial University of Newfoundland, St Johns, Newfoundland ... This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, ...
more infohttps://www.hindawi.com/journals/cjgh/2012/269297/cta/

Complete Stenosis of Common Bile Duct: Operative Cure | The BMJComplete Stenosis of Common Bile Duct: Operative Cure | The BMJ

Complete Stenosis of Common Bile Duct: Operative Cure Br Med J 1941; 2 :229 ... Complete Stenosis of Common Bile Duct: Operative Cure. Br Med J 1941; 2 doi: https://doi.org/10.1136/bmj.2.4206.229 (Published ...
more infohttp://www.bmj.com/content/2/4206/229.1

Common bile duct dictionary definition | common bile duct definedCommon bile duct dictionary definition | common bile duct defined

... nounThe duct formed by the union of the cystic duct and the hepatic duct that carries bile from the liver and the gallbladder ... common bile duct. common bile duct. noun. The duct formed by the union of the cystic duct and the hepatic duct that carries ... "common bile duct." YourDictionary, n.d. Web. 16 September 2018. ,http://www.yourdictionary.com/common-bile-duct,. ... common bile duct. (n.d.). Retrieved September 16th, 2018, from http://www.yourdictionary.com/common-bile-duct ...
more infohttp://www.yourdictionary.com/common-bile-duct

Common bile duct - definition of common bile duct by The Free DictionaryCommon bile duct - definition of common bile duct by The Free Dictionary

... common bile duct pronunciation, common bile duct translation, English dictionary definition of common bile duct. n. The duct ... formed by the union of the cystic duct and the hepatic duct that carries bile from the liver and the gallbladder to the ... Define common bile duct. common bile duct synonyms, ... Common bile duct - definition of common bile duct by The Free ... common bile duct. Also found in: Thesaurus, Medical, Acronyms, Encyclopedia, Wikipedia. common bile duct. n.. The duct formed ...
more infohttp://www.thefreedictionary.com/common+bile+duct

What Is the Cause of a Dilated Common Bile Duct? | Reference.comWhat Is the Cause of a Dilated Common Bile Duct? | Reference.com

The most common cause of common biliary duct dilatation is obstruction due to gallstones, states the Radiology Assistant. ... What Is the Function of the Common Bile Duct?. A: The function of the common bile duct is to carry bile from the liver and the ... The most common cause of common biliary duct dilatation is obstruction due to gallstones, states the Radiology Assistant. ... Another cause of obstruction besides gallstones is stricture, or narrowing, of the common bile duct. ...
more infohttps://www.reference.com/health/cause-dilated-common-bile-duct-561131a211cf2edf

Laparoendoscopic Management of the Common Bile Duct Stones - SAGES Abstract ArchivesLaparoendoscopic Management of the Common Bile Duct Stones - SAGES Abstract Archives

We present an easier way to explore the bile duct in patients with dilatation of common bile duct by stone disease, several ... Laparoendoscopic Management of the Common Bile Duct Stones. Jose Daniel Lozada Leon, MD, Angel Reyes Dorantes, MD, Clodoalda ... The Laparoendoscopic exploration of the common bile duct requires skill and coordination of the surgical team , it can be ... The aim of this video is to present a summary of different ways of common bile duct exploration. ...
more infohttps://www.sages.org/meetings/annual-meeting/abstracts-archive/laparoendoscopic-management-of-the-common-bile-duct-stones/

Pancreaticobiliary Maljunction Is Associated with Common Bile Duct Carcinoma: A Meta-AnalysisPancreaticobiliary Maljunction Is Associated with Common Bile Duct Carcinoma: A Meta-Analysis

... Yang Li, Jun Wei, Zhongxin Zhao ... However, the relationship between PBM and common bile duct carcinoma (CBDC) remains unclear. We aimed to conduct a meta- ... This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, ...
more infohttps://www.hindawi.com/journals/tswj/2013/618670/abs/

Laserlithotripsy of common bile duct stones. | GutLaserlithotripsy of common bile duct stones. | Gut

This new technique was used in nine patients with concrements in the common bile duct, which could not be removed with the ... Endoscopic retrograde laser lithotripsy of common bile duct stones is a new technique which can be carried out through the ... could be fragmented and in six the fragments could be extracted from the common bile duct. The total energy required was 80-300 ...
more infohttp://gut.bmj.com/content/29/6/746

Association between common bile duct stones and treated hypothyroidism. - Wellness ResourcesAssociation between common bile duct stones and treated hypothyroidism. - Wellness Resources

The common bile duct stone group (Group I) consisted of all the patients who had verified gallstones in the common bile duct in ... hypothyroidism in the common bile duct stone patients of over 60 years of age suggests all patients with common bile duct ... Association between common bile duct stones and treated hypothyroidism.. Study Abstract. BACKGROUND/AIMS:. The purpose of this ... There is a significant association between the common bile duct stones and previously diagnosed hypothyroidism. There stronger ...
more infohttps://www.wellnessresources.com/studies/association-between-common-bile-duct-stones-and-treated-hypothyroidism

Intraductal papillary neoplasm in common bile duct opening into the stomachIntraductal papillary neoplasm in common bile duct opening into the stomach

... but its recognition may help identify the cause of certain clinical conditions and prevent bile duct injury during surgery if ... but its recognition may help identify the cause of certain clinical conditions and prevent bile duct injury during surgery if ... More News: Bile , Computers , CT Scan , ERCP , Gastrectomy , Gastroenterology , Jaundice , Pancreas , Pathology , PET Scan , ... Possible causes include bacterial sepsis, galactosemia, tyrosinemia, panhypo-pituitarism, bile acid synthetic defects, ...
more infohttps://medworm.com/779440935/intraductal-papillary-neoplasm-in-common-bile-duct-opening-into-the-stomach/

Definition of common bile duct - NCI Dictionary of Cancer Terms - National Cancer InstituteDefinition of common bile duct - NCI Dictionary of Cancer Terms - National Cancer Institute

It is formed where the ducts from the liver and gallbladder are joined. ... A tube that carries bile from the liver and the gallbladder through the pancreas and into the duodenum (the upper part of the ... They are made up of the common hepatic duct (hilum region) and the common bile duct (distal region). Bile is made in the liver ... common bile duct listen (KAH-mun bile dukt) A tube that carries bile from the liver and the gallbladder through the pancreas ...
more infohttps://www.cancer.gov/publications/dictionaries/cancer-terms/def/common-bile-duct

Treatment options for common bile duct stones | Postgraduate Medical JournalTreatment options for common bile duct stones | Postgraduate Medical Journal

On ultrasound scan there were gallbladder stones and a dilated common bile duct of 11 mm. Endoscopic retrograde ... cholangiopancreatography revealed a large single calculus in the dilated common bile duct, unable to be extracted after ...
more infohttp://pmj.bmj.com/content/79/929/178.1

Distal common bile duct stricture - Answers on HealthTapDistal common bile duct stricture - Answers on HealthTap

Cattano on distal common bile duct stricture: I believe that the ductal findings are nonspecific. Sludge in the gall bladder ... Dilated bile duct: The bile duct is the duct the drains bile out of the river and into the intestines. Dilated bile duct can be ... The common: Bile duct is formed by the coming together of the bile duct from the liver and the bile duct from the gallbaldder. ... There are areas of mild narrowing & irregularity of the intrahepatic ducts & proximal common duct. No dilation of common bile ...
more infohttps://www.healthtap.com/topics/distal-common-bile-duct-stricture

Common bile duct - WikipediaCommon bile duct - Wikipedia

This conduction of bile is the main function of the common bile duct. The hormone cholecystokinin, when stimulated by a fatty ... The common bile duct, sometimes abbreviated CBD, is a duct in the gastrointestinal tract of organisms that have a gall bladder ... Blockage of the common bile duct and related jaundice has been documented since at least the time of Erasistratus. Dilatation ... Several problems can arise within the common bile duct. A diameter of more than 8 mm is regarded as abnormal dilatation, and is ...
more infohttps://en.wikipedia.org/wiki/Common_bile_duct

CiNii 論文 - 
 		
 		
 			
 		 	
 		 		
 		 			Adenomyomatous Hyperplasia of the Common Bile Duct : Report of a Case
 		 		
 		 	...CiNii 論文 - Adenomyomatous Hyperplasia of the Common Bile Duct : Report of a Case ...

Adenomyoma of the common bile duct imaged with endoscopic ultrasonography : case report ASCH MR ... Adenomyomatous Hyperplasia of the Common Bile Duct : Report of a Case * * IWAKI KENTARO ... Adenomyoma of the common bile duct : report of a case OJIMA H ... Adenomyoma of the distal common bile duct mimicking ... Partial biliary obstruction due to adenomyoma of the terminal common bile duct GILBERT LA ...
more infohttp://ci.nii.ac.jp/naid/10021283568

RECONSTRUCTION OF THE COMMON BILE DUCT USING SPLIT SKIN GRAF... : Plastic and Reconstructive SurgeryRECONSTRUCTION OF THE COMMON BILE DUCT USING SPLIT SKIN GRAF... : Plastic and Reconstructive Surgery

RECONSTRUCTION OF THE COMMON BILE DUCT USING SPLIT SKIN GRAFTS. ANDERSON ROBIN M.D.; HOERR, STANLEY O. M.D.. Plastic and ... Home , March 1956 - Volume 17 - Issue 3 , RECONSTRUCTION OF THE COMMON BILE DUCT USING SPLIT SKIN GRAF... ...
more infohttps://journals.lww.com/plasreconsurg/Citation/1956/03000/RECONSTRUCTION_OF_THE_COMMON_BILE_DUCT_USING_SPLIT.3.aspx

Common bile duct stone - WikipediaCommon bile duct stone - Wikipedia

Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (thus ... "Open or Laparoscopic Common Bile Duct Exploration (Choledocholithotomy)". The New York Times Health Guide. The New York Times ... While stones can frequently pass through the common bile duct (CBD) into the duodenum, some stones may be too large to pass ... Choledocholithiasis (stones in common bile duct) is one of the complications of cholelithiasis (gallstones), so the initial ...
more infohttps://en.wikipedia.org/wiki/Common_bile_duct_stone

The Common Bile Duct: Operative Cholangiography, Biliary Endoscopy, and Choledocholithotomy. | Annals of Internal Medicine |...The Common Bile Duct: Operative Cholangiography, Biliary Endoscopy, and Choledocholithotomy. | Annals of Internal Medicine |...

... and extrahepatic bile ducts and its variations. The roentgenological differential diagnosis of common duct stones is well ... The main title of this monograph, The Common Bile Duct, is misleading since the book is limited to three techniques dealing ... The Common Bile Duct: Operative Cholangiography, Biliary Endoscopy, and Choledocholithotomy.. Ann Intern Med. 1967;66:1072. doi ... even in patients with common duct obstruction) is immediate surgery necessary. Operative cholangiography ...
more infohttps://annals.org/aim/article-abstract/681505/common-bile-duct-operative-cholangiography-biliary-endoscopy-choledocholithotomy

Common bile duct neoplasms | Article about Common bile duct neoplasms by The Free DictionaryCommon bile duct neoplasms | Article about Common bile duct neoplasms by The Free Dictionary

The duct formed by the union of the hepatic and cystic ducts Explanation of Common bile duct neoplasms ... Find out information about Common bile duct neoplasms. ... common bile duct. (redirected from Common bile duct neoplasms) ... Related to Common bile duct neoplasms: Bile duct cancer. common bile duct. [¦käm·ən ′bīl ‚dəkt] (anatomy) The duct formed by ... Common bile duct neoplasms , Article about Common bile duct neoplasms by The Free Dictionary https://encyclopedia2. ...
more infohttp://encyclopedia2.thefreedictionary.com/Common+bile+duct+neoplasms

Catheter probe extraductal ultrasound (EDUS) exploration of the common bile duct is safe in elderly patients with suspicion of...Catheter probe extraductal ultrasound (EDUS) exploration of the common bile duct is safe in elderly patients with suspicion of...

Catheter probe extraductal ultrasound (EDUS) exploration of the common bile duct is safe in elderly patients with suspicion of ... Billroth II gastrectomy Common bile duct obstruction Extrahepatic lithiasis Endoscopic ultrasonography Extraductal ultrasound ... 2004) Catheter probe extraductal EUS reliably detects distal common bile duct abnormalities. Gastrointest Endosc 60:61-67 ... for the evaluation of the common bile duct (CBD) in patients who are status post-gastric surgery and who are suspected of ...
more infohttps://link.springer.com/article/10.1007/s00261-018-1580-6

Sphincter of the common bile duct | definition of sphincter of the common bile duct by Medical dictionarySphincter of the common bile duct | definition of sphincter of the common bile duct by Medical dictionary

What is sphincter of the common bile duct? Meaning of sphincter of the common bile duct medical term. What does sphincter of ... sphincter of the common bile duct explanation free. ... Looking for online definition of sphincter of the common bile ... Sphincter of the common bile duct , definition of sphincter of the common bile duct by Medical dictionary https://medical- ... redirected from sphincter of the common bile duct) Boyden, Edward A., U.S. anatomist, 1886-1977. Boyden meal - a meal used to ...
more infohttp://medical-dictionary.thefreedictionary.com/sphincter+of+the+common+bile+duct
  • SIMULAP and Laparoscopic Common Bile Duct Exploration Simulator. (sages.org)
  • However if the diagnosis is established during intraoperative cholangiography, the surgeon is confronted with a therapeutic dilemma that is, the choice between laparoscopic common bile duct exploration, conversion to open surgery, or postoperative sphincterotomy. (sages.org)
  • In order to show how easy can be to perform a laparoscopic common bile duct exploration (LCBDE), we showed a video to 20 general surgeons, and then invited them to the laboratory where we set the SIMULAP for common bile duct exploration with a flexible choledocoscope. (sages.org)
  • We measured the time to complete the exploration, succes in common bile duct extraction, previous knowledge of the instrumentation and technique, and the impact in their general practice. (sages.org)
  • Altogether 156 choledochotomies and 18 transcystic duct explorations were performed, with 12 (7%) open conversions. (hkmj.org)
  • But during the day-case operation, the surgeon severed his common bile duct leaving corrosive bile flowing into his stomach. (thefreedictionary.com)
  • There appears to be a direct correlation between the number of cases an individual surgeon performs and the frequency of bile duct injury. (jaoa.org)
  • We measured the time to complete the exploration, succes in common bile duct extraction, previous knowledge of the instrumentation and technique, and the impact in their general practice. (sages.org)
  • The median age in these groups was 73 (range: 22-92) years at the time of common bile duct stone diagnosis. (wellnessresources.com)
  • Hypothyroidism had been diagnosed in them less frequently (2/36 = 6%) than in the age and hospital admission matched common bile duct stone patients (P = 0.01). (wellnessresources.com)
  • The primary outcome measure was efficacy of stone clearance from the common bile duct. (nih.gov)
  • 05).Conclusion Complete laparoscopic common bile duct exploration has reliable effects in treatment of elderly patients with complicated hepatolithiasis with the benefits of minimal invasion,short operation time,rapid postoperative recovery,small influence on stress response and improved immune function in patients after the operation. (cnki.com.cn)
  • This new technique was used in nine patients with concrements in the common bile duct, which could not be removed with the established endoscopic techniques. (bmj.com)
  • only rarely (even in patients with common duct obstruction) is immediate surgery necessary. (annals.org)
  • BACKGROUND Common bile duct stenosis occurs in up to 30% of patients with chronic pancreatitis. (semanticscholar.org)
  • Objective To study the effects of complete laparoscopic common bile duct exploration on elderly patients with complicated hepatolithiasis and their inflammatory stress response index and immune function.Methods 64 cases of the elderly patients( over 60 years old) diagnosed with complicated hepatolithiasis in our hospital were selected and randomly divided into two groups. (cnki.com.cn)
  • 32 cases of patients treated with complete laparoscopic common bile duct exploration was enrolled in the laparoscopic group,and the other 32 cases treated with traditional open surgery were classified as the open group. (cnki.com.cn)