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.
Surgery of the smooth muscle sphincter of the hepatopancreatic ampulla to relieve blocked biliary or pancreatic ducts.
The sphincter of the hepatopancreatic ampulla within the duodenal papilla. The COMMON BILE DUCT and main pancreatic duct pass through this sphincter.
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.
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.
A painful linear ulcer at the margin of the anus. It appears as a crack or slit in the mucous membrane of the anus and is very painful and difficult to heal. (Dorland, 27th ed & Stedman, 25th ed)
Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
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.
Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both.
Surgical removal of the GALLBLADDER.
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.
Presence or formation of GALLSTONES in the COMMON BILE DUCT.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).
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.
Endoscopic examination, therapy or surgery of the luminal surface of the duodenum.
Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).
The act of dilating.
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.
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.
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.
Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.
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.
Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes.
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.
Any surgical procedure performed on the biliary tract.
The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus.
Tumors or cancer of the BILE DUCTS.
Swollen veins in the lower part of the RECTUM or ANUS. Hemorrhoids can be inside the anus (internal), under the skin around the anus (external), or protruding from inside to outside of the anus. People with hemorrhoids may or may not exhibit symptoms which include bleeding, itching, and pain.
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.
Excision of the gallbladder through an abdominal incision using a laparoscope.
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.
Presence or formation of GALLSTONES in the GALLBLADDER.
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.
Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.
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.
Measurement of the pressure or tension of liquids or gases with a manometer.
A nontoxic radiopharmaceutical that is used in RADIONUCLIDE IMAGING for the clinical evaluation of hepatobiliary disorders in humans.
A condition with abnormally elevated level of AMYLASES in the serum. Hyperamylasemia due to PANCREATITIS or other causes may be differentiated by identifying the amylase isoenzymes.
A malignant tumor arising from the epithelium of the BILE DUCTS.
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.
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.
A short thick vein formed by union of the superior mesenteric vein and the splenic vein.
A process whereby bile is delivered from the gallbladder into the duodenum. The emptying is caused by both contraction of the gallbladder and relaxation of the sphincter mechanism at the choledochal terminus.
Endoscopic examination, therapy or surgery of the digestive tract.
Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
Hand-held tools or implements used by health professionals for the performance of surgical tasks.
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.
Pathological processes of the PANCREAS.
Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures.
The condition of an anatomical structure's being constricted beyond normal dimensions.
Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).
Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases.
Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from CATHETERIZATION in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body.
A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
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.
Diagnostic and therapeutic procedures that are invasive or surgical in nature, and require the expertise of a specially trained radiologist. In general, they are more invasive than diagnostic imaging but less invasive than major surgery. They often involve catheterization, fluoroscopy, or computed tomography. Some examples include percutaneous transhepatic cholangiography, percutaneous transthoracic biopsy, balloon angioplasty, and arterial embolization.
Veins which drain the liver.
A series of steps taken in order to conduct research.
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.
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.
Surgery performed on the digestive system or its parts.
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.
Passages external to the liver for the conveyance of bile. These include the COMMON BILE DUCT and the common hepatic duct (HEPATIC DUCT, COMMON).
Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons.
Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.
A tube that transports URINE from the URINARY BLADDER to the outside of the body in both the sexes. It also has a reproductive function in the male by providing a passage for SPERM.
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.
Proposed spasmolytic with possible local anesthetic action used in gastrointestinal disorders.
Conditions which affect the structure or function of the pupil of the eye, including disorders of innervation to the pupillary constrictor or dilator muscles, and disorders of pupillary reflexes.
A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.
Polymers of silicone that are formed by crosslinking and treatment with amorphous silica to increase strength. They have properties similar to vulcanized natural rubber, in that they stretch under tension, retract rapidly, and fully recover to their original dimensions upon release. They are used in the encapsulation of surgical membranes and implants.
Bleeding or escape of blood from a vessel.
The return of a sign, symptom, or disease after a remission.
The BILE DUCTS and the GALLBLADDER.
Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.
Tumors or cancer of the gallbladder.
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.
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.
Semisynthetic penicillin-type antibiotic.
Solitary or multiple collections of PUS within the liver as a result of infection by bacteria, protozoa, or other agents.
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.
Examination of the portal circulation by the use of X-ray films after injection of radiopaque material.
Disease having a short and relatively severe course.
A branch of the celiac artery that distributes to the stomach, pancreas, duodenum, liver, gallbladder, and greater omentum.
Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).
Liver disease caused by infections with parasitic tapeworms of the genus ECHINOCOCCUS, such as Echinococcus granulosus or Echinococcus multilocularis. Ingested Echinococcus ova burrow into the intestinal mucosa. The larval migration to the liver via the PORTAL VEIN leads to watery vesicles (HYDATID CYST).
Radiographic visualization or recording of a vein after the injection of contrast medium.
Hemorrhage in or through the BILIARY TRACT due to trauma, inflammation, CHOLELITHIASIS, vascular disease, or neoplasms.
Toxic proteins produced from the species CLOSTRIDIUM BOTULINUM. The toxins are synthesized as a single peptide chain which is processed into a mature protein consisting of a heavy chain and light chain joined via a disulfide bond. The botulinum toxin light chain is a zinc-dependent protease which is released from the heavy chain upon ENDOCYTOSIS into PRESYNAPTIC NERVE ENDINGS. Once inside the cell the botulinum toxin light chain cleaves specific SNARE proteins which are essential for secretion of ACETYLCHOLINE by SYNAPTIC VESICLES. This inhibition of acetylcholine release results in muscular PARALYSIS.
Methods to repair breaks in tissue caused by trauma or to close surgical incisions.
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.
Elements of limited time intervals, contributing to particular results or situations.
Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)
Tumors or cancer of the DIGESTIVE SYSTEM.
Anastomosis of splenic vein to renal vein to relieve portal hypertension.
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.
Excision of all or part of the liver. (Dorland, 28th ed)
Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery.
Sterile, gelatin-base surgical sponge applied topically as an adjunct to hemostasis when the control of bleeding by conventional procedures is ineffective to reduce capillary ooze or is impractical. (From AMA Drug Evaluations Annual, 1994, p797)
Adenocarcinoma of the common hepatic duct bifurcation. These tumors are generally small, sharply localized, and seldom metastasizing. G. Klatskin's original review of 13 cases was published in 1965. Once thought to be relatively uncommon, tumors of the bifurcation of the bile duct now appear to comprise more than one-half of all bile duct cancers. (From Holland et al., Cancer Medicine, 3d ed, p1457)
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.
Use of a balloon CATHETER to block the flow of blood through an artery or vein.
Tumors or cancer in the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
I'm sorry for any confusion, but "Tokyo" is not a medical term that has a specific definition in the field of medicine. Tokyo is actually the capital city of Japan and is not used as a term in medicine.
The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.
Endoscopic examination, therapy or surgery of the gastrointestinal tract.
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).
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.
Administration of antineoplastic agents together with an embolizing vehicle. This allows slow release of the agent as well as obstruction of the blood supply to the neoplasm.
A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
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.
The circulation of BLOOD through the LIVER.
The transference of a part of or an entire liver from one human or animal to another.
A group of amylolytic enzymes that cleave starch, glycogen, and related alpha-1,4-glucans. (Stedman, 25th ed) EC 3.2.1.-.
Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.
Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval.
Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.
The period of confinement of a patient to a hospital or other health facility.
Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed)
A bile pigment that is a degradation product of HEME.
A specific decapeptide obtained from the skin of Hila caerulea, an Australian amphibian. Caerulein is similar in action and composition to CHOLECYSTOKININ. It stimulates gastric, biliary, and pancreatic secretion; and certain smooth muscle. It is used in paralytic ileus and as diagnostic aid in pancreatic malfunction.
A complication of gastrojejunostomy (BILLROTH II PROCEDURE), a reconstructive GASTROENTEROSTOMY. It is caused by acute (complete) or chronic (intermittent) obstruction of the afferent jejunal loop due to HERNIA, intussusception, kinking, VOLVULUS, etc. It is characterized by PAIN and VOMITING of BILE-stained fluid.
Tumors or cancer of the LIVER.
Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device.
Any fluid-filled closed cavity or sac that is lined by an EPITHELIUM. Cysts can be of normal, abnormal, non-neoplastic, or neoplastic tissues.
A CATHETER-delivered implant used for closing abnormal holes in the cardiovascular system, especially HEART SEPTAL DEFECTS; or passageways intentionally made during cardiovascular surgical procedures.
A type of surgical portasystemic shunt to reduce portal hypertension with associated complications of esophageal varices and ascites. It is performed percutaneously through the jugular vein and involves the creation of an intrahepatic shunt between the hepatic vein and portal vein. The channel is maintained by a metallic stent. The procedure can be performed in patients who have failed sclerotherapy and is an additional option to the surgical techniques of portocaval, mesocaval, and splenorenal shunts. It takes one to three hours to perform. (JAMA 1995;273(23):1824-30)
Production of an image when x-rays strike a fluorescent screen.

Tumors of the papilla of Vater--inadequate diagnostic impact of endoscopic forceps biopsies taken prior to and following sphincterotomy. (1/29)

BACKGROUND: It has been proposed that adenomas of the papilla of Vater are precursors of adenocarcinomas. Duodenoscopy with ERCP and forceps biopsies have substantially improved the morphologic exploration of the major duodenal papilla. Yet there is little and contradictory information as to the diagnostic accuracy of endoscopic biopsies in tumors of the papilla. Moreover, after endoscopic sphincterotomy data on the diagnostic impact of endoscopic biopsies from the papilla are scarce and, in most cases, retrospectively obtained. Thus, the aim of the present prospective and histopathologically controlled study was to assess the diagnostic accuracy of endoscopic biopsies taken from tumors of the papilla before and after sphincterotomy. PATIENTS AND METHODS: Forty patients with tumors of the papilla of Vater were included in the study. In each case, a comparison was made between endoscopic forceps biopsy diagnoses prior to and following sphincterotomy and the definitive histological diagnosis after surgical tumor resection. RESULTS: Resected tumors were diagnosed histomorphologically as follows: 19 adenocarcinomas (47%), 6 tubular adenomas (15%), 7 villous adenomas (17%), 7 inflammatory non-neoplastic lesions (pseudotumors) (17%), and one adenomyoma (2%). Overall accuracy for preoperative histopathological diagnosis was 62% (25 of 40, 95% CI: 47%-76%) prior to sphincterotomy while it was 70% (28 of 40, 95% CI: 55%-81%) following the procedure. Regarding adenocarcinomas, sensitivity was found to be 21% (4 of 19, 95% CI: 8%-43%) prior to and 37% (7 of 19, 95% CI: 19%-58%) after sphincterotomy while specificity was 100% at both times. CONCLUSIONS: Endoscopic forceps biopsies do not allow for reliable preoperative diagnosis of tumors of the papilla of Vater.  (+info)

Non-invasive management of Ascaris lumbricoides biliary tact migration: a prospective study in 69 patients from Ecuador. (2/29)

Ascariasis is one of the most common helminthic diseases. Its most feared complication is migration into the biliary tree. Some authors recommend immediate duodenoscopy in all cases of biliary migration, with sphincterotomy for the extraction of the parasites, and surgical extraction in case of intrahepatic ascariasis. We followed prospectively 69 patients with ultrasonographical evidence of migration. Initial treatment consisted of intravenous analgesics and antispasmodics, and albendazole 800 mg by mouth. Only patients with persisting symptoms or with high amylasaemia underwent duodenoscopy, with extraction in case of a visible worm. Surgery was limited to cases with persistent or progressive complications. In 97% of our cases the worms disappeared with noninvasive therapy alone. A duodenoscopy was done in 30 (42%) cases; in 10 (14%) a worm was found in the ampulla of Vater and extracted without sphincterotomy. In none of the 6 cases with A. lumbricoides in the intrahepatic biliary tree did the parasite persist. Only one patient required surgical intervention. Treatment of A. lumbricoides migration to the biliary tract should be principally medical. Duodenoscopy with extraction of a visible worm should be limited to cases with persisting pain and/or hyperamylasaemia. Invasive methods like sphincterotomy and surgery should be restricted to patients who do not respond to conservative treatment.  (+info)

Open transduodenal stenting as an option to failed endotherapy in pancreatic ascites. (3/29)

CONTEXT: Pancreatic ascites is rare and thought to be due to rupture of a pancreatic pseudocyst, main pancreatic duct disruption or leakage from an unknown site. CASE REPORT: We report the case of a 33-year-old gentleman with a history of chronic alcoholic pancreatitis who presented with pancreatic ascites and was successfully treated with open transduodenal stenting and pancreatic and biliary sphincteroplasty. CONCLUSION: Open transduodenal stenting is an option to failed endotherapy in pancreatic ascites.  (+info)

Extended transduodenal sphincteroplasty for bile duct stones associated with a periampullary diverticulum. (4/29)

Extended transduodenal sphincteroplasty has been suggested as an alternative to choledochoduodenostomy for the surgical management of bile duct stones associated with a periampullary diverticulum but its value has not previously been investigated. Over a 3 year period, nine patients underwent extended transduodenal sphincteroplasty for common bile duct calculi associated with a periampullary diverticulum with no operative or post-operative mortality and minimal morbidity. Follow-up ranging from 20 to 60 months has shown remission of pain in all but one patient, who has had a normal endoscopic cholangiogram and no further episodes of jaundice or cholangitis. Extended transduodenal sphincteroplasty is a safe and effective alternative to choledochoduodenostomy for the surgical management of choledocholithiasis associated with a periampullary diverticulum.  (+info)

Manometric and radiographic evaluation of transduodenal sphincteroplasty (papillary dilation) in dogs. (5/29)

PURPOSE: To evaluate, in dogs, the functions of biliary sphincter subjected to dilation hydrostatic balloon by the point of view of the radiographic and manometric alterations. METHODS: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10) - with balloon of 8mm inflated with pressure of 0,5atm, during 2 minutes or to the sham procedure - GB(n=10). The computerized manometry and the cholangiography were done before and immediately after the initial procedure, one and four weeks after the dilation or the sham. It was calculated from the radiographic images: the mean, standard deviation, absolute and percentual variation of the diameter measures of the papilla. It was measured: the basal pressure in the papilla region, the contraction amplitudes and the choledoc pressure in all observation times (t0, t7 and t28). RESULTS: There was not differences in the diameter measures of the papilla in t0 (GA=5,14 +/- 1,1) (GB=4,64 +/-0,9), as well as in the absolute (0,14 mm) or relative (-2,7%) variations. In the animals of GA the papilla basal pressure measure was found to be smaller in t28 (11,1) than in t0 (18,6) and t7 (16,2). The contraction amplitudes measures were significantly smaller in the postoperatory times (post-t0, t7 and t28) when comparing to the initial time (pre-t0), in the animals of groups A and B. The average pressure values in the choledoc were also smaller in t28 (7,5) than in t0 (17,8) and t7 (12,6) in the animals of GA. CONCLUSION: the function of the major duodenal papilla is partially committed with the dilation, therefore it provoked the basal pressure decrease and compromising of the capacity of sphincter in its cyclical contractions up to the 28 days of observation.  (+info)

Effects of structural injure in the bile bacterial contamination after balloon transduodenal sphincteroplasty (papillary dilation) in dogs. (6/29)

PURPOSE: To evaluate, in dogs, the biliary sphincter subjected to dilation by hydrostatic balloon by the point of view of structural alterations of the papilla and the biochemestry and bacterial contamination of the bile. METHODS: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla- GA(n=10) - with balloon of 8mm inflated with pressure of 0,5 atm, during 2 minutes or to the sham procedure - GB(n=10). Blood samples collected on times t(0 day), t(7 days) and t(28 days) were subjected to dosages of alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT) for cholestasis evaluation. The collected material from the gall bladder at the same times were registered and numbered to be submitted to culture in BHI, blood agar (rich, non-selective element) and Mac Conkey (selective element for Gram-negative bacillus. On the 28th day three fragments of the papilla were tranversally cut by the choledoc axis 3mm from the duodenal papilla and the cuts, stained with hematoxylin-eosin and Masson's tricome, were evaluated according to their inflammatory reaction. RESULTS: The GGT and ALP averages on the three periods in the groups A and B did not show significant differences, not being characterizes the cholestasis. The bacterian contamination was significantly higher in GA (2,19) than in GB (1,96); the contamination was lower in the initial time compared with 7 and 28 days (t0+info)

Selective sphincteroplasty of the papilla in cases at risk due to atypical anatomy. (7/29)

AIM: To analyze the indications, efficacy and safety of sphincteroplasty in our centre. METHODS: A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure consisted of duodenoscopy with Olympus TJF 145 Videoduodenoscope, approach to the biliary tract using a catheter with a guidewire, and dilatation of the papilla with a dilatation balloon catheter using a syringe with a manometer for control of the filling pressure. RESULTS: The indications included intradiverticular papilla in 26 patients (49%), stenosis of a previous sphincterotomy in 19 patients (35.8%), small size of the papilla in 4 patients (7.5%), Billroth II gastrectomy in 3 patients (5.6%), and coagulopathy in one patient (1.9%). The efficacy was 97.8%, with all the calculi extracted from the common bile duct in 84.4% of the patients, even though 21 of the patients (39.6%) had calculi with a diameter equal to or greater than 10 mm. Seven patients (13.2%) presented complications: haemorrhage in 1 patient (1.9%) and mild pancreatitis in 6 patients (11.3%). The mean hospital stay in case of complications was of 3 +/- 0.63 d. CONCLUSION: Sphincteroplasty is highly effective, with a complication rate similar to that of sphincterotomy, furthermore, the complications are of low clinical importance. The use of the 10 mm balloon makes it possible to extract calculi with a diameter of over 15 mm and to extract more than 3 calculi without increasing the rate of complications and reduces the need to resort to lithotripsy or rescue sphincterotomy.  (+info)

The possible role of sphincteroplasty and surgical sphincterotomy in the pathogenesis of recurrent common duct brown stones. (8/29)

The hypothesis has been tested that postcholecystectomy common duct stones of the brown subtype are a consequence of three factors: bile infection, old age and previous sphincterotomy. It was found that: (i) 27 of 39 consecutive patients with recurrent common duct stones had brown stones. Nineteen of these 27 patients (70.3%) had previous sphincterotomy or sphincteroplasty: (ii) six of 15 patients with stone and bile analysis both at the time of cholecystectomy and at the second operation and who had sterile operative bile and non brown stones at the first operation, formed brown stones after T-tube drainage and after the onset of bile infection; (iii) patients with both intra and postoperative negative bile culture (n = 39 out of 137) had a lower mean age (50.5 years) and less frequently had a sphincterotomy than did individuals with a negative culture at operation, who subsequently had bile infection (n = 37; mean age 58.5 years; sphincterotomy in 88.8% of cases). In addition, in a follow up study of 105 patients with sphincterotomy and with sphincteroplasty (including ERCP or i.v. cholangiography in all cases), mean follow-up interval 6.1 years, 11.3% of patients had brown recurrent common duct stones. It is suggested that, since brown recurrent common duct stones are secondary to bile stasis and infection and the duodenum is going to be colonized by bacteria with increasing age, sphincterotomy (and subsequent stricture), facilitating bile contamination and bacterial overgrowth, could be one of the major determinants of brown recurrent common duct stones (RCS) formation. In particular, more than 11% of the patients with a sphincterotomy are going to form in the future RCS of the brown subtype.  (+info)

Endoscopic sphincterotomy is a medical procedure that involves the use of an endoscope (a flexible tube with a light and camera) to cut the papilla of Vater, which contains the sphincter of Oddi muscle. This procedure is typically performed to treat gallstones or to manage other conditions related to the bile ducts or pancreatic ducts.

The sphincterotomy helps to widen the opening of the papilla, allowing stones or other obstructions to pass through more easily. It may also be used to relieve pressure and pain caused by spasms of the sphincter of Oddi muscle. The procedure is usually done under sedation or anesthesia and carries a risk of complications such as bleeding, infection, perforation, and pancreatitis.

Transhepatic sphincterotomy is a medical procedure that involves the incision or cutting of the papilla of Vater, which is a small muscular structure located at the junction of the common bile duct and the main pancreatic duct, with the ampulla of Vater, within the second part of the duodenum. This procedure is performed using a special type of endoscope that is passed through the liver (transhepatically) to access the bile ducts.

The goal of transhepatic sphincterotomy is to relieve obstructions or blockages in the bile ducts, such as gallstones or tumors, that cannot be removed using other endoscopic techniques. This procedure is typically performed by an interventional radiologist or a gastroenterologist with specialized training in endoscopic retrograde cholangiopancreatography (ERCP).

Transhepatic sphincterotomy is considered a higher-risk procedure than traditional ERCP sphincterotomy due to the need for liver puncture and the potential complications associated with this approach, including bleeding, infection, and injury to surrounding organs. However, it may be necessary in certain situations where traditional ERCP is not feasible or has failed.

The Sphincter of Oddi is a muscular valve that controls the flow of bile and pancreatic juice from the pancreatic and bile ducts into the duodenum, which is the first part of the small intestine. It is named after Ruggero Oddi, an Italian physiologist who discovered it in 1887. The Sphincter of Oddi has two parts: the sphincter papillae, which surrounds the common opening of the pancreatic and bile ducts into the duodenum, and the sphincter choledochus, which is located more proximally in the bile duct. The contraction and relaxation of these muscles help regulate the release of digestive enzymes from the pancreas and the flow of bile from the liver to aid in digestion.

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that combines upper gastrointestinal (GI) endoscopy and fluoroscopy to diagnose and treat certain problems of the bile ducts and pancreas.

During ERCP, a flexible endoscope (a long, thin, lighted tube with a camera on the end) is passed through the patient's mouth and throat, then through the stomach and into the first part of the small intestine (duodenum). A narrow plastic tube (catheter) is then inserted through the endoscope and into the bile ducts and/or pancreatic duct. Contrast dye is injected through the catheter, and X-rays are taken to visualize the ducts.

ERCP can be used to diagnose a variety of conditions affecting the bile ducts and pancreas, including gallstones, tumors, strictures (narrowing of the ducts), and chronic pancreatitis. It can also be used to treat certain conditions, such as removing gallstones from the bile duct or placing stents to keep the ducts open in cases of stricture.

ERCP is an invasive procedure that carries a risk of complications, including pancreatitis, infection, bleeding, and perforation (a tear in the lining of the GI tract). It should only be performed by experienced medical professionals in a hospital setting.

Gallstones are small, hard deposits that form in the gallbladder, a small organ located under the liver. They can range in size from as small as a grain of sand to as large as a golf ball. Gallstones can be made of cholesterol, bile pigments, or calcium salts, or a combination of these substances.

There are two main types of gallstones: cholesterol stones and pigment stones. Cholesterol stones are the most common type and are usually yellow-green in color. They form when there is too much cholesterol in the bile, which causes it to become saturated and form crystals that eventually grow into stones. Pigment stones are smaller and darker in color, ranging from brown to black. They form when there is an excess of bilirubin, a waste product produced by the breakdown of red blood cells, in the bile.

Gallstones can cause symptoms such as abdominal pain, nausea, vomiting, and bloating, especially after eating fatty foods. In some cases, gallstones can lead to serious complications, such as inflammation of the gallbladder (cholecystitis), infection, or blockage of the bile ducts, which can cause jaundice, a yellowing of the skin and eyes.

The exact cause of gallstones is not fully understood, but risk factors include being female, older age, obesity, a family history of gallstones, rapid weight loss, diabetes, and certain medical conditions such as cirrhosis or sickle cell anemia. Treatment for gallstones may involve medication to dissolve the stones, shock wave therapy to break them up, or surgery to remove the gallbladder.

A fissure in ano, also known as anal fissure, is a linear tear or split in the lining of the anus, usually occurring in the posterior midline. It can cause pain and bleeding during bowel movements. Anal fissures are often caused by constipation, passing hard stools, or prolonged diarrhea. They can also be associated with underlying conditions such as inflammatory bowel disease or anal cancer. Treatment typically involves increasing fiber intake, using stool softeners, and topical treatments to promote healing and relieve pain. In some cases, surgery may be required for severe or chronic fissures that do not respond to conservative treatment.

Common bile duct diseases refer to conditions that affect the common bile duct, a tube that carries bile from the liver and gallbladder into the small intestine. Some common examples of common bile duct diseases include:

1. Choledocholithiasis: This is the presence of stones (calculi) in the common bile duct, which can cause blockage, inflammation, and infection.
2. Cholangitis: This is an infection or inflammation of the common bile duct, often caused by obstruction due to stones, tumors, or strictures.
3. Common bile duct cancer (cholangiocarcinoma): This is a rare but aggressive cancer that arises from the cells lining the common bile duct.
4. Biliary strictures: These are narrowing or scarring of the common bile duct, which can be caused by injury, inflammation, or surgery.
5. Benign tumors: Non-cancerous growths in the common bile duct can also cause blockage and other symptoms.

Symptoms of common bile duct diseases may include abdominal pain, jaundice (yellowing of the skin and eyes), fever, chills, nausea, vomiting, and dark urine or light-colored stools. Treatment depends on the specific condition and severity but may include medications, endoscopic procedures, surgery, or a combination of these approaches.

Biliary tract diseases refer to a group of medical conditions that affect the biliary system, which includes the gallbladder, bile ducts, and liver. Bile is a digestive juice produced by the liver, stored in the gallbladder, and released into the small intestine through the bile ducts to help digest fats.

Biliary tract diseases can cause various symptoms such as abdominal pain, jaundice, fever, nausea, vomiting, and changes in stool color. Some of the common biliary tract diseases include:

1. Gallstones: Small, hard deposits that form in the gallbladder or bile ducts made up of cholesterol or bilirubin.
2. Cholecystitis: Inflammation of the gallbladder, often caused by gallstones.
3. Cholangitis: Infection or inflammation of the bile ducts.
4. Biliary dyskinesia: A motility disorder that affects the contraction and relaxation of the muscles in the biliary system.
5. Primary sclerosing cholangitis: A chronic autoimmune disease that causes scarring and narrowing of the bile ducts.
6. Biliary tract cancer: Rare cancers that affect the gallbladder, bile ducts, or liver.

Treatment for biliary tract diseases varies depending on the specific condition and severity but may include medications, surgery, or a combination of both.

Cholangiography is a medical procedure that involves taking X-ray images of the bile ducts (the tubes that carry bile from the liver to the small intestine). This is typically done by injecting a contrast dye into the bile ducts through an endoscope or a catheter that has been inserted into the body.

There are several types of cholangiography, including:

* Endoscopic retrograde cholangiopancreatography (ERCP): This procedure involves inserting an endoscope through the mouth and down the throat into the small intestine. A dye is then injected into the bile ducts through a small tube that is passed through the endoscope.
* Percutaneous transhepatic cholangiography (PTC): This procedure involves inserting a needle through the skin and into the liver to inject the contrast dye directly into the bile ducts.
* Operative cholangiography: This procedure is performed during surgery to examine the bile ducts for any abnormalities or blockages.

Cholangiography can help diagnose a variety of conditions that affect the bile ducts, such as gallstones, tumors, or inflammation. It can also be used to guide treatment decisions, such as whether surgery is necessary to remove a blockage.

Cholangitis is a medical condition characterized by inflammation of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are two types of cholangitis: acute and chronic. Acute cholangitis is a sudden and severe infection that can cause symptoms such as abdominal pain, fever, jaundice (yellowing of the skin and eyes), and dark urine. It is usually caused by a bacterial infection that enters the bile ducts through a blockage or obstruction.

Chronic cholangitis, on the other hand, is a long-term inflammation of the bile ducts that can lead to scarring and narrowing of the ducts. This can cause symptoms such as abdominal pain, itching, and jaundice. Chronic cholangitis can be caused by various factors, including primary sclerosing cholangitis (an autoimmune disease), bile duct stones, or tumors in the bile ducts.

Treatment for cholangitis depends on the underlying cause of the condition. Antibiotics may be used to treat bacterial infections, and surgery may be necessary to remove blockages or obstructions in the bile ducts. In some cases, medications may be prescribed to manage symptoms and prevent further complications.

Cholecystectomy is a medical procedure to remove the gallbladder, a small pear-shaped organ located on the right side of the abdomen, just beneath the liver. The primary function of the gallbladder is to store and concentrate bile, a digestive fluid produced by the liver. During a cholecystectomy, the surgeon removes the gallbladder, usually due to the presence of gallstones or inflammation that can cause pain, infection, or other complications.

There are two primary methods for performing a cholecystectomy:

1. Open Cholecystectomy: In this traditional surgical approach, the surgeon makes an incision in the abdomen to access and remove the gallbladder. This method is typically used when there are complications or unique circumstances that make laparoscopic surgery difficult or risky.
2. Laparoscopic Cholecystectomy: This is a minimally invasive surgical procedure where the surgeon makes several small incisions in the abdomen, through which a thin tube with a camera (laparoscope) and specialized surgical instruments are inserted. The surgeon then guides these tools to remove the gallbladder while viewing the internal structures on a video monitor.

After the gallbladder is removed, bile flows directly from the liver into the small intestine through the common bile duct, and the body continues to function normally without any significant issues.

The ampulla of Vater, also known as hepatopancreatic ampulla, is a dilated portion of the common bile duct where it joins the main pancreatic duct and empties into the second part of the duodenum. It serves as a conduit for both bile from the liver and digestive enzymes from the pancreas to reach the small intestine, facilitating the digestion and absorption of nutrients. The ampulla of Vater is surrounded by a muscular sphincter, the sphincter of Oddi, which controls the flow of these secretions into the duodenum.

Choledocholithiasis is a medical condition characterized by the presence of one or more gallstones in the common bile duct, which is the tube that carries bile from the liver and gallbladder to the small intestine. Bile is a digestive fluid produced by the liver that helps break down fats in the small intestine. Gallstones are hardened deposits of digestive fluids that can form in the gallbladder or, less commonly, in the bile ducts.

Choledocholithiasis can cause a variety of symptoms, including abdominal pain, jaundice (yellowing of the skin and eyes), nausea, vomiting, and fever. If left untreated, it can lead to serious complications such as infection or inflammation of the bile ducts or pancreas, which can be life-threatening.

The condition is typically diagnosed through imaging tests such as ultrasound, CT scan, or MRI, and may require endoscopic or surgical intervention to remove the gallstones from the common bile duct.

Drainage, in medical terms, refers to the removal of excess fluid or accumulated collections of fluids from various body parts or spaces. This is typically accomplished through the use of medical devices such as catheters, tubes, or drains. The purpose of drainage can be to prevent the buildup of fluids that may cause discomfort, infection, or other complications, or to treat existing collections of fluid such as abscesses, hematomas, or pleural effusions. Drainage may also be used as a diagnostic tool to analyze the type and composition of the fluid being removed.

Bile duct diseases refer to a group of medical conditions that affect the bile ducts, which are tiny tubes that carry bile from the liver to the gallbladder and small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are several types of bile duct diseases, including:

1. Choledocholithiasis: This occurs when stones form in the common bile duct, causing blockage and leading to symptoms such as abdominal pain, jaundice, and fever.
2. Cholangitis: This is an infection of the bile ducts that can cause inflammation, pain, and fever. It can occur due to obstruction of the bile ducts or as a complication of other medical procedures.
3. Primary Biliary Cirrhosis (PBC): This is a chronic autoimmune disease that affects the bile ducts in the liver, causing inflammation and scarring that can lead to cirrhosis and liver failure.
4. Primary Sclerosing Cholangitis (PSC): This is another autoimmune disease that causes inflammation and scarring of the bile ducts, leading to liver damage and potential liver failure.
5. Bile Duct Cancer: Also known as cholangiocarcinoma, this is a rare form of cancer that affects the bile ducts and can cause jaundice, abdominal pain, and weight loss.
6. Benign Strictures: These are narrowing of the bile ducts that can occur due to injury, inflammation, or surgery, leading to blockage and potential infection.

Symptoms of bile duct diseases may include jaundice, abdominal pain, fever, itching, dark urine, and light-colored stools. Treatment depends on the specific condition and may involve medication, surgery, or other medical interventions.

The common bile duct is a duct that results from the union of the cystic duct (which drains bile from the gallbladder) and the common hepatic duct (which drains bile from the liver). The common bile duct transports bile, a digestive enzyme, from the liver and gallbladder to the duodenum, which is the first part of the small intestine.

The common bile duct runs through the head of the pancreas before emptying into the second part of the duodenum, either alone or in conjunction with the pancreatic duct, via a small opening called the ampulla of Vater. The common bile duct plays a crucial role in the digestion of fats by helping to break them down into smaller molecules that can be absorbed by the body.

Cholelithiasis is a medical term that refers to the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located beneath the liver that stores bile, a digestive fluid produced by the liver. Gallstones are hardened deposits that can form in the gallbladder when substances in the bile, such as cholesterol or bilirubin, crystallize.

Gallstones can vary in size and may be as small as a grain of sand or as large as a golf ball. Some people with gallstones may not experience any symptoms, while others may have severe abdominal pain, nausea, vomiting, fever, and jaundice (yellowing of the skin and eyes) if the gallstones block the bile ducts.

Cholelithiasis is a common condition that affects millions of people worldwide, particularly women over the age of 40 and those with certain medical conditions such as obesity, diabetes, and rapid weight loss. If left untreated, gallstones can lead to serious complications such as inflammation of the gallbladder (cholecystitis), infection, or pancreatitis (inflammation of the pancreas). Treatment options for cholelithiasis include medication, shock wave lithotripsy (breaking up the gallstones with sound waves), and surgery to remove the gallbladder (cholecystectomy).

Obstructive Jaundice is a medical condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes due to the accumulation of bilirubin in the bloodstream. This occurs when there is an obstruction or blockage in the bile ducts that transport bile from the liver to the small intestine.

Bile, which contains bilirubin, aids in digestion and is usually released from the liver into the small intestine. When the flow of bile is obstructed, bilirubin builds up in the blood, causing jaundice. The obstruction can be caused by various factors, such as gallstones, tumors, or strictures in the bile ducts.

Obstructive jaundice may present with additional symptoms like dark urine, light-colored stools, itching, abdominal pain, and weight loss, depending on the cause and severity of the obstruction. It is essential to seek medical attention if jaundice is observed, as timely diagnosis and management can prevent potential complications, such as liver damage or infection.

Duodenoscopy is a medical procedure that involves the insertion of a duodenoscope, which is a flexible, lighted tube with a camera and tiny tools on the end, through the mouth and down the throat to examine the upper part of the small intestine (duodenum) and the opening of the bile and pancreatic ducts.

During the procedure, the doctor can take tissue samples for biopsy, remove polyps or other abnormal growths, or perform other interventions as needed. Duodenoscopy is commonly used to diagnose and treat conditions such as gastrointestinal bleeding, inflammation, infection, and cancer.

It's important to note that duodenoscopes have been associated with the spread of antibiotic-resistant bacteria in some cases, so healthcare providers must follow strict cleaning and disinfection protocols to minimize this risk.

Cholestasis is a medical condition characterized by the interruption or reduction of bile flow from the liver to the small intestine. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats. When the flow of bile is blocked or reduced, it can lead to an accumulation of bile components, such as bilirubin, in the blood, which can cause jaundice, itching, and other symptoms.

Cholestasis can be caused by various factors, including liver diseases (such as hepatitis, cirrhosis, or cancer), gallstones, alcohol abuse, certain medications, pregnancy, and genetic disorders. Depending on the underlying cause, cholestasis may be acute or chronic, and it can range from mild to severe in its symptoms and consequences. Treatment for cholestasis typically involves addressing the underlying cause and managing the symptoms with supportive care.

Dilation, also known as dilatation, refers to the process of expanding or enlarging a body passage or cavity. In medical terms, it typically refers to the widening of a bodily opening or hollow organ, allowing for increased flow or access. This can occur naturally, such as during childbirth when the cervix dilates to allow for the passage of a baby, or it can be induced through medical procedures or interventions.

For example, dilation of the pupils is a natural response to darkness or certain medications, while dilation of blood vessels is a common side effect of some drugs and can also occur in response to changes in temperature or emotional state. Dilation of the stomach or intestines may be necessary for medical procedures such as endoscopies or surgeries.

It's important to note that dilation can also refer to the abnormal enlargement of a body part, such as dilated cardiomyopathy, which refers to an enlarged and weakened heart muscle.

Endoscopy is a medical procedure that involves the use of an endoscope, which is a flexible tube with a light and camera at the end, to examine the interior of a body cavity or organ. The endoscope is inserted through a natural opening in the body, such as the mouth or anus, or through a small incision. The images captured by the camera are transmitted to a monitor, allowing the physician to visualize the internal structures and detect any abnormalities, such as inflammation, ulcers, or tumors. Endoscopy can also be used for diagnostic purposes, such as taking tissue samples for biopsy, or for therapeutic purposes, such as removing polyps or performing minimally invasive surgeries.

Sphincter of Oddi dysfunction (SOD) is a condition characterized by abnormalities in the functioning of the Sphincter of Oddi, which is a muscular valve that controls the flow of bile and pancreatic juice from the pancreas and gallbladder into the duodenum (the first part of the small intestine).

In SOD, the sphincter may either fail to relax properly or become overactive, leading to a variety of symptoms such as abdominal pain, nausea, vomiting, bloating, and elevated liver enzymes. The condition can be classified into two types: Type I, which is associated with elevated liver enzymes and/or pancreatic enzymes, and Type II, which is characterized by abdominal pain without biochemical abnormalities.

The diagnosis of SOD typically involves a series of tests such as manometry (measuring the pressure inside the sphincter), endoscopic ultrasound, or magnetic resonance cholangiopancreatography (MRCP) to visualize the anatomy and function of the sphincter. Treatment options may include medications to relax the sphincter, endoscopic therapy to cut or stretch the muscle, or surgery in severe cases.

Pancreatitis is a medical condition characterized by inflammation of the pancreas, a gland located in the abdomen that plays a crucial role in digestion and regulating blood sugar levels. The inflammation can be acute (sudden and severe) or chronic (persistent and recurring), and it can lead to various complications if left untreated.

Acute pancreatitis often results from gallstones or excessive alcohol consumption, while chronic pancreatitis may be caused by long-term alcohol abuse, genetic factors, autoimmune conditions, or metabolic disorders like high triglyceride levels. Symptoms of acute pancreatitis include severe abdominal pain, nausea, vomiting, fever, and increased heart rate, while chronic pancreatitis may present with ongoing abdominal pain, weight loss, diarrhea, and malabsorption issues due to impaired digestive enzyme production. Treatment typically involves supportive care, such as intravenous fluids, pain management, and addressing the underlying cause. In severe cases, hospitalization and surgery may be necessary.

A biliary fistula is an abnormal connection or passage between the biliary system (which includes the gallbladder, bile ducts, and liver) and another organ or structure, usually in the abdominal cavity. This connection allows bile, which is a digestive fluid produced by the liver, to leak out of its normal pathway and into other areas of the body.

Biliary fistulas can occur as a result of trauma, surgery, infection, or inflammation in the biliary system. Symptoms may include abdominal pain, fever, jaundice (yellowing of the skin and eyes), nausea, vomiting, and clay-colored stools. Treatment typically involves addressing the underlying cause of the fistula, such as draining an infection or repairing damaged tissue, and diverting bile flow away from the site of the leak. In some cases, surgery may be necessary to repair the fistula.

Catheterization is a medical procedure in which a catheter (a flexible tube) is inserted into the body to treat various medical conditions or for diagnostic purposes. The specific definition can vary depending on the area of medicine and the particular procedure being discussed. Here are some common types of catheterization:

1. Urinary catheterization: This involves inserting a catheter through the urethra into the bladder to drain urine. It is often performed to manage urinary retention, monitor urine output in critically ill patients, or assist with surgical procedures.
2. Cardiac catheterization: A procedure where a catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the heart. This allows for various diagnostic tests and treatments, such as measuring pressures within the heart chambers, assessing blood flow, or performing angioplasty and stenting of narrowed coronary arteries.
3. Central venous catheterization: A catheter is inserted into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, or nutrition, or to monitor central venous pressure.
4. Peritoneal dialysis catheterization: A catheter is placed into the abdominal cavity for individuals undergoing peritoneal dialysis, a type of kidney replacement therapy.
5. Neurological catheterization: In some cases, a catheter may be inserted into the cerebrospinal fluid space (lumbar puncture) or the brain's ventricular system (ventriculostomy) to diagnose or treat various neurological conditions.

These are just a few examples of catheterization procedures in medicine. The specific definition and purpose will depend on the medical context and the particular organ or body system involved.

Extrahepatic cholestasis is a medical condition characterized by the impaired flow of bile outside of the liver. Bile is a digestive fluid produced by the liver that helps in the absorption and digestion of fats. When the flow of bile is obstructed or blocked, it can lead to an accumulation of bile components, such as bilirubin, in the bloodstream, resulting in jaundice, dark urine, light-colored stools, and itching.

Extrahepatic cholestasis can be caused by various factors, including gallstones, tumors, strictures, or inflammation of the bile ducts. It is essential to diagnose and treat extrahepatic cholestasis promptly to prevent further complications, such as liver damage or infection. Treatment options may include medications, endoscopic procedures, or surgery, depending on the underlying cause of the condition.

Intrahepatic bile ducts are the small tubular structures inside the liver that collect bile from the liver cells (hepatocytes). Bile is a digestive fluid produced by the liver that helps in the absorption of fats and fat-soluble vitamins from food. The intrahepatic bile ducts merge to form larger ducts, which eventually exit the liver and join with the cystic duct from the gallbladder to form the common bile duct. The common bile duct then empties into the duodenum, the first part of the small intestine, where bile aids in digestion. Intrahepatic bile ducts can become obstructed or damaged due to various conditions such as gallstones, tumors, or inflammation, leading to complications like jaundice, liver damage, and infection.

Biliary tract surgical procedures refer to a range of operations that involve the biliary system, which includes the liver, gallbladder, and bile ducts. These procedures can be performed for various reasons, including the treatment of gallstones, bile duct injuries, tumors, or other conditions affecting the biliary tract. Here are some examples of biliary tract surgical procedures:

1. Cholecystectomy: This is the surgical removal of the gallbladder, which is often performed to treat symptomatic gallstones or chronic cholecystitis (inflammation of the gallbladder). It can be done as an open procedure or laparoscopically.
2. Bile duct exploration: This procedure involves opening the common bile duct to remove stones, strictures, or tumors. It is often performed during a cholecystectomy if there is suspicion of common bile duct involvement.
3. Hepaticojejunostomy: This operation connects the liver's bile ducts directly to a portion of the small intestine called the jejunum, bypassing a damaged or obstructed segment of the biliary tract. It is often performed for benign or malignant conditions affecting the bile ducts.
4. Roux-en-Y hepaticojejunostomy: This procedure involves creating a Y-shaped limb of jejunum and connecting it to the liver's bile ducts, bypassing the common bile duct and duodenum. It is often performed for complex biliary tract injuries or malignancies.
5. Whipple procedure (pancreaticoduodenectomy): This extensive operation involves removing the head of the pancreas, the duodenum, a portion of the jejunum, the gallbladder, and the common bile duct. It is performed for malignancies involving the pancreas, bile duct, or duodenum.
6. Liver resection: This procedure involves removing a portion of the liver to treat primary liver tumors (hepatocellular carcinoma or cholangiocarcinoma) or metastatic cancer from other organs.
7. Biliary stenting or bypass: These minimally invasive procedures involve placing a stent or creating a bypass to relieve bile duct obstructions caused by tumors, strictures, or stones. They can be performed endoscopically (ERCP) or percutaneously (PTC).
8. Cholecystectomy: This procedure involves removing the gallbladder, often for symptomatic cholelithiasis (gallstones) or cholecystitis (inflammation of the gallbladder). It can be performed laparoscopically or open.
9. Biliary drainage: This procedure involves placing a catheter to drain bile from the liver or bile ducts, often for acute or chronic obstructions caused by tumors, strictures, or stones. It can be performed endoscopically (ERCP) or percutaneously (PTC).
10. Bilioenteric anastomosis: This procedure involves connecting the biliary tract to a portion of the small intestine, often for benign or malignant conditions affecting the bile ducts or pancreas. It can be performed open or laparoscopically.

The anal canal is the terminal portion of the digestive tract, located between the rectum and the anus. It is a short tube-like structure that is about 1 to 1.5 inches long in adults. The main function of the anal canal is to provide a seal for the elimination of feces from the body while also preventing the leakage of intestinal contents.

The inner lining of the anal canal is called the mucosa, which is kept moist by the production of mucus. The walls of the anal canal contain specialized muscles that help control the passage of stool during bowel movements. These muscles include the internal and external sphincters, which work together to maintain continence and allow for the voluntary release of feces.

The anal canal is an important part of the digestive system and plays a critical role in maintaining bowel function and overall health.

Bile duct neoplasms, also known as cholangiocarcinomas, refer to a group of malignancies that arise from the bile ducts. These are the tubes that carry bile from the liver to the gallbladder and small intestine. Bile duct neoplasms can be further classified based on their location as intrahepatic (within the liver), perihilar (at the junction of the left and right hepatic ducts), or distal (in the common bile duct).

These tumors are relatively rare, but their incidence has been increasing in recent years. They can cause a variety of symptoms, including jaundice, abdominal pain, weight loss, and fever. The diagnosis of bile duct neoplasms typically involves imaging studies such as CT or MRI scans, as well as blood tests to assess liver function. In some cases, a biopsy may be necessary to confirm the diagnosis.

Treatment options for bile duct neoplasms depend on several factors, including the location and stage of the tumor, as well as the patient's overall health. Surgical resection is the preferred treatment for early-stage tumors, while chemotherapy and radiation therapy may be used in more advanced cases. For patients who are not candidates for surgery, palliative treatments such as stenting or bypass procedures may be recommended to relieve symptoms and improve quality of life.

Hemorrhoids are swollen veins in the rectum or anus that can cause pain, itching, bleeding, and bulging. They can be internal (inside the rectum) or external (under the skin around the anus). Internal hemorrhoids may protrude through the anus and become irritated, leading to bleeding. External hemorrhoids are more likely to cause pain and swelling, especially if they become thrombosed (formed a blood clot). Hemorrhoids can be caused by straining during bowel movements, pregnancy, obesity, chronic constipation or diarrhea, aging, and sitting for long periods of time. They are often treated with over-the-counter creams, suppositories, or warm sitz baths, but severe cases may require surgical intervention.

Bile ducts are tubular structures that carry bile from the liver to the gallbladder for storage or directly to the small intestine to aid in digestion. There are two types of bile ducts: intrahepatic and extrahepatic. Intrahepatic bile ducts are located within the liver and drain bile from liver cells, while extrahepatic bile ducts are outside the liver and include the common hepatic duct, cystic duct, and common bile duct. These ducts can become obstructed or inflamed, leading to various medical conditions such as cholestasis, cholecystitis, and gallstones.

Laparoscopic cholecystectomy is a surgical procedure to remove the gallbladder using a laparoscope, a thin tube with a camera, which allows the surgeon to view the internal structures on a video monitor. The surgery is performed through several small incisions in the abdomen, rather than a single large incision used in open cholecystectomy. This approach results in less postoperative pain, fewer complications, and shorter recovery time compared to open cholecystectomy.

The procedure is typically indicated for symptomatic gallstones or chronic inflammation of the gallbladder (cholecystitis), which can cause severe abdominal pain, nausea, vomiting, and fever. Laparoscopic cholecystectomy has become the standard of care for gallbladder removal due to its minimally invasive nature and excellent outcomes.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Cholecystolithiasis is the medical term for the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located under the liver that stores and concentrates bile, a digestive fluid produced by the liver. Gallstones are hardened deposits that can form in the gallbladder when substances in the bile, such as cholesterol or bilirubin, become concentrated and crystallize.

Gallstones can vary in size, from tiny grains of sand to large stones several centimeters in diameter. Some people may have a single gallstone, while others may have many. Gallstones may cause no symptoms at all, but if they block the flow of bile out of the gallbladder, they can cause pain, inflammation, and infection.

Symptoms of cholecystolithiasis may include abdominal pain, often in the upper right or center of the abdomen, that may be sharp or crampy and may occur after eating fatty foods. Other symptoms may include nausea, vomiting, fever, and chills. If gallstones are left untreated, they can lead to serious complications such as cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or cholangitis (infection of the bile ducts). Treatment for cholecystolithiasis may include medication to dissolve the gallstones, shock wave lithotripsy to break up the stones, or surgery to remove the gallbladder.

Cholecystostomy is a medical procedure that involves the creation of an opening or fistula between the gallbladder and the stomach or the skin surface to drain bile from the gallbladder. This procedure is typically performed when there is an obstruction in the cystic duct or common bile duct, leading to inflammation or infection of the gallbladder (cholecystitis).

There are two types of cholecystostomy: percutaneous and open. Percutaneous cholecystostomy is a minimally invasive procedure that involves inserting a small tube through the skin and into the gallbladder under the guidance of imaging techniques such as ultrasound or CT scan. Open cholecystostomy, on the other hand, requires an open surgical incision to access the gallbladder and create the fistula.

Cholecystostomy is usually a temporary measure to manage acute cholecystitis in high-risk patients who are not suitable candidates for surgery or until they become stable enough to undergo a more definitive treatment, such as cholecystectomy (surgical removal of the gallbladder).

Neurogenic bladder is a term used to describe bladder dysfunction due to neurological damage or disease. The condition can result in problems with bladder storage and emptying, leading to symptoms such as urinary frequency, urgency, hesitancy, incontinence, and retention.

Neurogenic bladder can occur due to various medical conditions, including spinal cord injury, multiple sclerosis, Parkinson's disease, diabetic neuropathy, and stroke. The damage to the nerves that control bladder function can result in overactivity or underactivity of the bladder muscle, leading to urinary symptoms.

Management of neurogenic bladder typically involves a multidisciplinary approach, including medications, bladder training, catheterization, and surgery in some cases. The specific treatment plan depends on the underlying cause of the condition and the severity of the symptoms.

Lithotripsy is a medical procedure that uses shock waves or other high-energy sound waves to break down and remove calculi (stones) in the body, particularly in the kidneys, ureters, or gallbladder. The procedure is typically performed on an outpatient basis and does not require any incisions.

During lithotripsy, the patient lies on a cushioned table while a lithotripter, a device that generates shock waves, is positioned around the area of the stone. As the shock waves pass through the body, they break the stone into tiny fragments that can then be easily passed out of the body in urine.

Lithotripsy is generally a safe and effective procedure, but it may not be suitable for everyone. Patients with certain medical conditions, such as bleeding disorders or pregnancy, may not be able to undergo lithotripsy. Additionally, some stones may be too large or too dense to be effectively treated with lithotripsy. In these cases, other treatment options, such as surgery, may be necessary.

Manometry is a medical test that measures pressure inside various parts of the gastrointestinal tract. It is often used to help diagnose digestive disorders such as achalasia, gastroparesis, and irritable bowel syndrome. During the test, a thin, flexible tube called a manometer is inserted through the mouth or rectum and into the area being tested. The tube is connected to a machine that measures and records pressure readings. These readings can help doctors identify any abnormalities in muscle function or nerve reflexes within the digestive tract.

Technetium Tc 99m Lidofenin is a radiopharmaceutical used in nuclear medicine imaging procedures, specifically for hepatobiliary scintigraphy. It is a technetium-labeled compound, where the radioisotope technetium-99m (^99m^Tc) is bound to lidofenin, a liver-imaging agent.

The compound is used to assess the function and anatomy of the liver, gallbladder, and biliary system. After intravenous administration, Technetium Tc 99m Lidofenin is taken up by hepatocytes (liver cells) and excreted into the bile ducts and ultimately into the small intestine. The distribution and excretion of this radiopharmaceutical can be monitored using a gamma camera, providing functional information about the liver and biliary system.

It is essential to note that the use of Technetium Tc 99m Lidofenin should be under the guidance and supervision of healthcare professionals trained in nuclear medicine, as its administration and handling require specific expertise and safety measures due to the radioactive nature of the compound.

Hyperamylasemia is a medical condition characterized by an elevated level of amylase in the blood. Amylase is an enzyme that is primarily produced by the pancreas and salivary glands, and it plays a crucial role in digesting carbohydrates.

Normally, the levels of amylase in the blood are relatively low, but when there is damage to the pancreas or salivary glands, such as in cases of pancreatitis, salivary gland inflammation, or blockage, the levels of amylase can rise significantly. This condition is called hyperamylasemia.

Mild elevations in amylase levels may not cause any symptoms and may be discovered only during routine blood tests. However, more significant elevations can indicate a serious underlying medical condition that requires prompt treatment. Symptoms of hyperamylasemia may include abdominal pain, nausea, vomiting, fever, and rapid heartbeat.

It is important to note that hyperamylasemia can also be caused by non-pancreatic conditions such as macroamylasemia, a benign condition where large amylase-containing protein complexes are formed and circulate in the bloodstream, leading to elevated amylase levels. Therefore, it is essential to perform further diagnostic tests to determine the underlying cause of hyperamylasemia.

Cholangiocarcinoma is a type of cancer that arises from the cells that line the bile ducts, which are small tubes that carry digestive enzymes from the liver to the small intestine. It can occur in different parts of the bile duct system, including the bile ducts inside the liver (intrahepatic), the bile ducts outside the liver (extrahepatic), and the area where the bile ducts join the pancreas and small intestine (ampulla of Vater).

Cholangiocarcinoma is a relatively rare cancer, but its incidence has been increasing in recent years. It can be difficult to diagnose because its symptoms are often nonspecific and similar to those of other conditions, such as gallstones or pancreatitis. Treatment options depend on the location and stage of the cancer, and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

The common hepatic duct is a medical term that refers to the duct in the liver responsible for carrying bile from the liver. More specifically, it is the duct that results from the convergence of the right and left hepatic ducts, which themselves carry bile from the right and left lobes of the liver, respectively. The common hepatic duct then joins with the cystic duct from the gallbladder to form the common bile duct, which ultimately drains into the duodenum, a part of the small intestine.

The primary function of the common hepatic duct is to transport bile, a digestive juice produced by the liver, to the small intestine. Bile helps break down fats during the digestion process, making it possible for the body to absorb them properly. Any issues or abnormalities in the common hepatic duct can lead to problems with bile flow and potentially cause health complications such as jaundice, gallstones, or liver damage.

The portal vein is the large venous trunk that carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder to the liver. It is formed by the union of the superior mesenteric vein (draining the small intestine and a portion of the large intestine) and the splenic vein (draining the spleen and pancreas). The portal vein then divides into right and left branches within the liver, where the blood flows through the sinusoids and gets enriched with oxygen and nutrients before being drained by the hepatic veins into the inferior vena cava. This unique arrangement allows the liver to process and detoxify the absorbed nutrients, remove waste products, and regulate metabolic homeostasis.

Gallbladder emptying refers to the process by which the gallbladder releases bile into the small intestine through the bile duct. The gallbladder is a small pear-shaped organ that stores and concentrates bile, a digestive fluid produced by the liver. After eating, especially when fatty or greasy foods are consumed, the hormone cholecystokinin (CCK) is released into the bloodstream, which stimulates the contraction of the gallbladder and relaxation of the sphincter of Oddi, a muscle that controls the opening and closing of the bile duct. This allows the concentrated bile to flow from the gallbladder into the small intestine, where it helps break down fats for absorption.

Gallbladder emptying can be assessed through various diagnostic tests, such as ultrasound or cholescintigraphy (also known as a HIDA scan), which measures the rate and degree of gallbladder emptying in response to CCK stimulation. Abnormalities in gallbladder emptying can contribute to conditions such as gallstones, biliary dyskinesia, and other functional gallbladder disorders.

Endoscopy of the digestive system, also known as gastrointestinal (GI) endoscopy, is a medical procedure that allows healthcare professionals to visually examine the inside lining of the digestive tract using a flexible tube with a light and camera attached to it, called an endoscope. This procedure can help diagnose and treat various conditions affecting the digestive system, including gastroesophageal reflux disease (GERD), ulcers, inflammatory bowel disease (IBD), and cancer.

There are several types of endoscopy procedures that focus on different parts of the digestive tract:

1. Esophagogastroduodenoscopy (EGD): This procedure examines the esophagus, stomach, and duodenum (the first part of the small intestine). It is often used to investigate symptoms such as difficulty swallowing, abdominal pain, or bleeding in the upper GI tract.
2. Colonoscopy: This procedure explores the large intestine (colon) and rectum. It is commonly performed to screen for colon cancer, as well as to diagnose and treat conditions like inflammatory bowel disease, diverticulosis, or polyps.
3. Sigmoidoscopy: Similar to a colonoscopy, this procedure examines the lower part of the colon (sigmoid colon) and rectum. It is often used as a screening tool for colon cancer and to investigate symptoms like rectal bleeding or changes in bowel habits.
4. Upper GI endoscopy: This procedure focuses on the esophagus, stomach, and duodenum, using a thin, flexible tube with a light and camera attached to it. It is used to diagnose and treat conditions such as GERD, ulcers, and difficulty swallowing.
5. Capsule endoscopy: This procedure involves swallowing a small capsule containing a camera that captures images of the digestive tract as it passes through. It can help diagnose conditions in the small intestine that may be difficult to reach with traditional endoscopes.

Endoscopy is typically performed under sedation or anesthesia to ensure patient comfort during the procedure. The images captured by the endoscope are displayed on a monitor, allowing the healthcare provider to assess the condition of the digestive tract and make informed treatment decisions.

Common bile duct neoplasms refer to abnormal growths that can occur in the common bile duct, which is a tube that carries bile from the liver and gallbladder into the small intestine. These growths can be benign or malignant (cancerous).

Benign neoplasms of the common bile duct include papillomas, adenomas, and leiomyomas. Malignant neoplasms are typically adenocarcinomas, which arise from the glandular cells lining the duct. Other types of malignancies that can affect the common bile duct include cholangiocarcinoma, gallbladder carcinoma, and metastatic cancer from other sites.

Symptoms of common bile duct neoplasms may include jaundice (yellowing of the skin and eyes), abdominal pain, dark urine, and light-colored stools. Diagnosis may involve imaging tests such as CT scans or MRCP (magnetic resonance cholangiopancreatography) and biopsy to confirm the type of neoplasm. Treatment options depend on the type and stage of the neoplasm and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Surgical instruments are specialized tools or devices that are used by medical professionals during surgical procedures to assist in various tasks such as cutting, dissecting, grasping, holding, retracting, clamping, and suturing body tissues. These instruments are designed to be safe, precise, and effective, with a variety of shapes, sizes, and materials used depending on the specific surgical application. Some common examples of surgical instruments include scalpels, forceps, scissors, hemostats, retractors, and needle holders. Proper sterilization and maintenance of these instruments are crucial to ensure patient safety and prevent infection.

Choledochostomy is a surgical procedure that involves creating an opening (stoma) into the common bile duct, which carries bile from the liver and gallbladder to the small intestine. This procedure is typically performed to relieve obstructions or blockages in the bile duct, such as those caused by gallstones, tumors, or scar tissue.

During the choledochostomy procedure, a surgeon makes an incision in the abdomen and exposes the common bile duct. The duct is then cut open, and a small tube (catheter) is inserted into the duct to allow bile to drain out of the body. The catheter may be left in place temporarily or permanently, depending on the underlying condition causing the obstruction.

Choledochostomy is typically performed as an open surgical procedure, but it can also be done using minimally invasive techniques such as laparoscopy or robotic-assisted surgery. As with any surgical procedure, choledochostomy carries risks such as bleeding, infection, and damage to surrounding tissues. However, these risks are generally low in the hands of an experienced surgeon.

Pancreatic diseases refer to a group of medical conditions that affect the structure and function of the pancreas, a vital organ located in the abdomen. The pancreas has two main functions: an exocrine function, which involves the production of digestive enzymes that help break down food in the small intestine, and an endocrine function, which involves the production of hormones such as insulin and glucagon that regulate blood sugar levels.

Pancreatic diseases can be broadly classified into two categories: inflammatory and non-inflammatory. Inflammatory pancreatic diseases include conditions such as acute pancreatitis, which is characterized by sudden inflammation of the pancreas, and chronic pancreatitis, which is a long-term inflammation that can lead to scarring and loss of function.

Non-inflammatory pancreatic diseases include conditions such as pancreatic cancer, which is a malignant tumor that can arise from the cells of the pancreas, and benign tumors such as cysts or adenomas. Other non-inflammatory conditions include pancreatic insufficiency, which can occur when the pancreas does not produce enough digestive enzymes, and diabetes mellitus, which can result from impaired insulin production or action.

Overall, pancreatic diseases can have serious consequences on a person's health and quality of life, and early diagnosis and treatment are essential for optimal outcomes.

A puncture, in medical terms, refers to a small hole or wound that is caused by a sharp object penetrating the skin or other body tissues. This can result in damage to underlying structures such as blood vessels, nerves, or organs, and may lead to complications such as bleeding, infection, or inflammation.

Punctures can occur accidentally, such as from stepping on a nail or getting pricked by a needle, or they can be inflicted intentionally, such as during medical procedures like injections or blood draws. In some cases, puncture wounds may require medical attention to clean and close the wound, prevent infection, and promote healing.

Pathological constriction refers to an abnormal narrowing or tightening of a body passage or organ, which can interfere with the normal flow of blood, air, or other substances through the area. This constriction can occur due to various reasons such as inflammation, scarring, or abnormal growths, and can affect different parts of the body, including blood vessels, airways, intestines, and ureters. Pathological constriction can lead to a range of symptoms and complications depending on its location and severity, and may require medical intervention to correct.

Duodenal diseases refer to a range of medical conditions that affect the duodenum, which is the first part of the small intestine. Here are some examples of duodenal diseases:

1. Duodenitis: This is inflammation of the duodenum, which can cause symptoms such as abdominal pain, nausea, vomiting, and bloating. Duodenitis can be caused by bacterial or viral infections, excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), or chronic inflammation due to conditions like Crohn's disease.
2. Peptic ulcers: These are sores that develop in the lining of the duodenum, usually as a result of infection with Helicobacter pylori bacteria or long-term use of NSAIDs. Symptoms can include abdominal pain, bloating, and heartburn.
3. Duodenal cancer: This is a rare type of cancer that affects the duodenum. Symptoms can include abdominal pain, weight loss, and blood in the stool.
4. Celiac disease: This is an autoimmune disorder that causes the immune system to attack the lining of the small intestine in response to gluten, a protein found in wheat, barley, and rye. This can lead to inflammation and damage to the duodenum.
5. Duodenal diverticulosis: This is a condition in which small pouches form in the lining of the duodenum. While many people with duodenal diverticulosis do not experience symptoms, some may develop complications such as inflammation or infection.
6. Duodenal atresia: This is a congenital condition in which the duodenum does not form properly, leading to blockage of the intestine. This can cause symptoms such as vomiting and difficulty feeding in newborns.

Cholecystitis is a medical condition characterized by inflammation of the gallbladder, a small pear-shaped organ located under the liver that stores and concentrates bile produced by the liver. Bile is a digestive fluid that helps break down fats in the small intestine during digestion.

Acute cholecystitis is a sudden inflammation of the gallbladder, often caused by the presence of gallstones that block the cystic duct, the tube that carries bile from the gallbladder to the common bile duct. This blockage can cause bile to build up in the gallbladder, leading to inflammation, swelling, and pain.

Chronic cholecystitis is a long-term inflammation of the gallbladder, often caused by repeated attacks of acute cholecystitis or the presence of gallstones that cause ongoing irritation and damage to the gallbladder wall. Over time, chronic cholecystitis can lead to thickening and scarring of the gallbladder wall, which can reduce its ability to function properly.

Symptoms of cholecystitis may include sudden and severe abdominal pain, often in the upper right or center of the abdomen, that may worsen after eating fatty foods; fever; nausea and vomiting; bloating and gas; and clay-colored stools. Treatment for cholecystitis typically involves antibiotics to treat any infection present, pain relief, and surgery to remove the gallbladder (cholecystectomy). In some cases, a nonsurgical procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be used to remove gallstones from the bile duct.

Intubation is a medical procedure in which a flexible plastic tube called an endotracheal tube (ETT) is inserted into the patient's windpipe (trachea) through the mouth or nose. This procedure is performed to maintain an open airway and ensure adequate ventilation and oxygenation of the lungs during surgery, critical illness, or trauma.

The ETT is connected to a breathing circuit and a ventilator, which delivers breaths and removes carbon dioxide from the lungs. Intubation allows healthcare professionals to manage the patient's airway, control their breathing, and administer anesthesia during surgical procedures. It is typically performed by trained medical personnel such as anesthesiologists, emergency medicine physicians, or critical care specialists.

There are two main types of intubation: oral and nasal. Oral intubation involves inserting the ETT through the patient's mouth, while nasal intubation involves passing the tube through the nostril and into the trachea. The choice of technique depends on various factors, including the patient's medical condition, anatomy, and the reason for intubation.

A diverticulum is a small sac or pouch that forms as a result of a weakness in the wall of a hollow organ, such as the intestine. These sacs can become inflamed or infected, leading to conditions like diverticulitis. Diverticula are common in the large intestine, particularly in the colon, and are more likely to develop with age. They are usually asymptomatic but can cause symptoms such as abdominal pain, bloating, constipation, or diarrhea if they become inflamed or infected.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries by inflating a tiny balloon inside the blocked artery to widen it.

The stent is then inserted into the widened artery to keep it open. The stent is usually made of metal, but some are coated with medication that is slowly and continuously released to help prevent the formation of scar tissue in the artery. This can reduce the chance of the artery narrowing again.

Stents are also used in other parts of the body, such as the neck (carotid artery) and kidneys (renal artery), to help maintain blood flow and prevent blockages. They can also be used in the urinary system to treat conditions like ureteropelvic junction obstruction or narrowing of the urethra.

Bile is a digestive fluid that is produced by the liver and stored in the gallbladder. It plays an essential role in the digestion and absorption of fats and fat-soluble vitamins in the small intestine. Bile consists of bile salts, bilirubin, cholesterol, phospholipids, electrolytes, and water.

Bile salts are amphipathic molecules that help to emulsify fats into smaller droplets, increasing their surface area and allowing for more efficient digestion by enzymes such as lipase. Bilirubin is a breakdown product of hemoglobin from red blood cells and gives bile its characteristic greenish-brown color.

Bile is released into the small intestine in response to food, particularly fats, entering the digestive tract. It helps to break down large fat molecules into smaller ones that can be absorbed through the walls of the intestines and transported to other parts of the body for energy or storage.

Interventional radiography is a subspecialty of radiology that uses imaging guidance (such as X-ray fluoroscopy, ultrasound, CT, or MRI) to perform minimally invasive diagnostic and therapeutic procedures. These procedures typically involve the insertion of needles, catheters, or other small instruments through the skin or a natural body opening, allowing for targeted treatment with reduced risk, trauma, and recovery time compared to traditional open surgeries.

Examples of interventional radiography procedures include:

1. Angiography: Imaging of blood vessels to diagnose and treat conditions like blockages, narrowing, or aneurysms.
2. Biopsy: The removal of tissue samples for diagnostic purposes.
3. Drainage: The removal of fluid accumulations (e.g., abscesses, cysts) or the placement of catheters to drain fluids continuously.
4. Embolization: The blocking of blood vessels to control bleeding, tumor growth, or reduce the size of an aneurysm.
5. Stenting and angioplasty: The widening of narrowed or blocked vessels using stents (small mesh tubes) or balloon catheters.
6. Radiofrequency ablation: The use of heat to destroy tumors or abnormal tissues.
7. Cryoablation: The use of extreme cold to destroy tumors or abnormal tissues.

Interventional radiologists are medical doctors who have completed specialized training in both diagnostic imaging and interventional procedures, allowing them to provide comprehensive care for patients requiring image-guided treatments.

The hepatic veins are blood vessels that carry oxygen-depleted blood from the liver back to the heart. There are typically three major hepatic veins - right, middle, and left - that originate from the posterior aspect of the liver and drain into the inferior vena cava just below the diaphragm. These veins are responsible for returning the majority of the blood flow from the gastrointestinal tract and spleen to the heart. It's important to note that the hepatic veins do not have valves, which can make them susceptible to a condition called Budd-Chiari syndrome, where blood clots form in the veins and obstruct the flow of blood from the liver.

In the context of medical research, "methods" refers to the specific procedures or techniques used in conducting a study or experiment. This includes details on how data was collected, what measurements were taken, and what statistical analyses were performed. The methods section of a medical paper allows other researchers to replicate the study if they choose to do so. It is considered one of the key components of a well-written research article, as it provides transparency and helps establish the validity of the findings.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

The digestive system is a series of organs that work together to convert food into nutrients and energy. Digestive system surgical procedures involve operations on any part of the digestive system, including the esophagus, stomach, small intestine, large intestine, liver, pancreas, and gallbladder. These procedures can be performed for a variety of reasons, such as to treat diseases, repair damage, or remove cancerous growths.

Some common digestive system surgical procedures include:

1. Gastric bypass surgery: A procedure in which the stomach is divided into two parts and the smaller part is connected directly to the small intestine, bypassing a portion of the stomach and upper small intestine. This procedure is used to treat severe obesity.
2. Colonoscopy: A procedure in which a flexible tube with a camera on the end is inserted into the rectum and colon to examine the lining for polyps, cancer, or other abnormalities.
3. Colectomy: A procedure in which all or part of the colon is removed, often due to cancer, inflammatory bowel disease, or diverticulitis.
4. Gastrostomy: A procedure in which a hole is made through the abdominal wall and into the stomach to create an opening for feeding. This is often done for patients who have difficulty swallowing.
5. Esophagectomy: A procedure in which all or part of the esophagus is removed, often due to cancer. The remaining esophagus is then reconnected to the stomach or small intestine.
6. Liver resection: A procedure in which a portion of the liver is removed, often due to cancer or other diseases.
7. Pancreatectomy: A procedure in which all or part of the pancreas is removed, often due to cancer or chronic pancreatitis.
8. Cholecystectomy: A procedure in which the gallbladder is removed, often due to gallstones or inflammation.

These are just a few examples of digestive system surgical procedures. There are many other types of operations that can be performed on the digestive system depending on the specific needs and condition of each patient.

Acute cholecystitis is a medical condition characterized by inflammation of the gallbladder (cholecystitis) that develops suddenly (acute). The gallbladder is a small pear-shaped organ located in the upper right part of the abdomen, beneath the liver. It stores bile, a digestive juice produced by the liver, which helps break down fats in the food we eat.

Acute cholecystitis occurs when the gallbladder becomes inflamed and irritated, often due to the presence of gallstones that block the cystic duct, the tube that carries bile from the gallbladder into the small intestine. When the cystic duct is obstructed, bile builds up in the gallbladder, causing it to become swollen, inflamed, and infected.

Symptoms of acute cholecystitis may include sudden and severe abdominal pain, often located in the upper right or middle part of the abdomen, that may radiate to the back or shoulder blade area. Other symptoms may include fever, nausea, vomiting, loss of appetite, and abdominal tenderness or swelling.

Acute cholecystitis is typically diagnosed through a combination of medical history, physical examination, laboratory tests, and imaging studies such as ultrasound or CT scan. Treatment may involve hospitalization, antibiotics to treat infection, pain relief medications, and surgery to remove the gallbladder (cholecystectomy). In some cases, nonsurgical treatments such as endoscopic sphincterotomy or percutaneous cholecystostomy may be used to relieve obstruction and inflammation.

Extrahepatic bile ducts refer to the portion of the biliary system that lies outside the liver. The biliary system is responsible for producing, storing, and transporting bile, a digestive fluid produced by the liver.

The extrahepatic bile ducts include:

1. The common hepatic duct: This duct is formed by the union of the right and left hepatic ducts, which drain bile from the corresponding lobes of the liver.
2. The cystic duct: This short duct connects the gallbladder to the common hepatic duct, allowing bile to flow into the gallbladder for storage and concentration.
3. The common bile duct: This is the result of the fusion of the common hepatic duct and the cystic duct. It transports bile from the liver and gallbladder to the duodenum, the first part of the small intestine, where it aids in fat digestion.
4. The ampulla of Vater (or hepatopancreatic ampulla): This is a dilated area where the common bile duct and the pancreatic duct join and empty their contents into the duodenum through a shared opening called the major duodenal papilla.

Extrahepatic bile ducts can be affected by various conditions, such as gallstones, inflammation (cholangitis), strictures, or tumors, which may require medical or surgical intervention.

An ointment is a semi-solid preparation, typically composed of a mixture of medicinal substance with a base, which is usually greasy or oily. The purpose of the base is to act as a vehicle for the active ingredient and allow it to be applied smoothly and evenly to the skin or mucous membranes.

Ointments are commonly used in dermatology to treat various skin conditions such as eczema, psoriasis, rashes, burns, and wounds. They can also be used to deliver medication for localized pain relief, muscle relaxation, and anti-inflammatory or antibiotic effects.

The base of an ointment may consist of various ingredients, including petrolatum, lanolin, mineral oil, beeswax, or a combination of these. The choice of the base depends on the desired properties such as consistency, spreadability, and stability, as well as the intended route of administration and the specific therapeutic goals.

A jejunostomy is a surgical procedure where an opening (stoma) is created in the lower part of the small intestine, called the jejunum. This stoma allows for the passage of nutrients and digestive enzymes from the small intestine into a tube or external pouch, bypassing the mouth, esophagus, stomach, and upper small intestine (duodenum).

Jejunostomy is typically performed to provide enteral nutrition support in patients who are unable to consume food or liquids by mouth due to various medical conditions such as dysphagia, gastroparesis, bowel obstruction, or after certain surgical procedures. The jejunostomy tube can be used for short-term or long-term nutritional support, depending on the patient's needs and underlying medical condition.

The urethra is the tube that carries urine from the bladder out of the body. In males, it also serves as the conduit for semen during ejaculation. The male urethra is longer than the female urethra and is divided into sections: the prostatic, membranous, and spongy (or penile) urethra. The female urethra extends from the bladder to the external urethral orifice, which is located just above the vaginal opening.

The gallbladder is a small, pear-shaped organ located just under the liver in the right upper quadrant of the abdomen. Its primary function is to store and concentrate bile, a digestive enzyme produced by the liver, which helps in the breakdown of fats during the digestion process. When food, particularly fatty foods, enter the stomach and small intestine, the gallbladder contracts and releases bile through the common bile duct into the duodenum, the first part of the small intestine, to aid in fat digestion.

The gallbladder is made up of three main parts: the fundus, body, and neck. It has a muscular wall that allows it to contract and release bile. Gallstones, an inflammation of the gallbladder (cholecystitis), or other gallbladder diseases can cause pain, discomfort, and potentially serious health complications if left untreated.

Trimebutine is an antispasmodic drug that is primarily used to treat functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). It works by relaxing the smooth muscles in the intestines, which helps to reduce cramping, pain, and spasms.

Trimebutine is a derivative of the opioid alkaloid thebaine, but it does not have any significant analgesic or addictive properties. It is thought to exert its effects by acting on certain receptors in the intestinal muscles, including 5-HT3 and mu-opioid receptors.

Trimebutine is available in various forms, such as tablets, capsules, and syrup, and it is typically taken orally several times a day. The dosage may vary depending on the individual's age, weight, and medical condition.

It is important to note that trimebutine should only be used under the supervision of a healthcare provider, as it can have side effects and interact with other medications. Some common side effects of trimebutine include dizziness, dry mouth, and constipation.

A pupil disorder refers to any abnormality or condition affecting the size, shape, or reactivity of the pupils, the circular black openings in the center of the eyes through which light enters. The pupil's primary function is to regulate the amount of light that reaches the retina, adjusting its size accordingly.

There are several types of pupil disorders, including:

1. Anisocoria: A condition characterized by unequal pupil sizes in either one or both eyes. This may be caused by various factors, such as nerve damage, trauma, inflammation, or medication side effects.

2. Horner's syndrome: A neurological disorder affecting the autonomic nervous system, resulting in a smaller pupil (miosis), partial eyelid droop (ptosis), and decreased sweating (anhidrosis) on the same side of the face. It is caused by damage to the sympathetic nerve pathway.

3. Adie's tonic pupil: A condition characterized by a dilated, poorly reactive pupil due to damage to the ciliary ganglion or short ciliary nerves. This disorder usually affects one eye and may be associated with decreased deep tendon reflexes in the affected limbs.

4. Argyll Robertson pupil: A condition where the pupils are small, irregularly shaped, and do not react to light but constrict when focusing on nearby objects (accommodation). This disorder is often associated with neurosyphilis or other brainstem disorders.

5. Pupillary dilation: Abnormally dilated pupils can be a sign of various conditions, such as drug use (e.g., atropine, cocaine), brainstem injury, Adie's tonic pupil, or oculomotor nerve palsy.

6. Pupillary constriction: Abnormally constricted pupils can be a sign of various conditions, such as Horner's syndrome, Argyll Robertson pupil, drug use (e.g., opioids, pilocarpine), or oculomotor nerve palsy.

7. Light-near dissociation: A condition where the pupils do not react to light but constrict when focusing on nearby objects. This can be seen in Argyll Robertson pupil and Adie's tonic pupil.

Prompt evaluation by an ophthalmologist or neurologist is necessary for accurate diagnosis and management of these conditions.

Therapeutic embolization is a medical procedure that involves intentionally blocking or obstructing blood vessels to stop excessive bleeding or block the flow of blood to a tumor or abnormal tissue. This is typically accomplished by injecting small particles, such as microspheres or coils, into the targeted blood vessel through a catheter, which is inserted into a larger blood vessel and guided to the desired location using imaging techniques like X-ray or CT scanning. The goal of therapeutic embolization is to reduce the size of a tumor, control bleeding, or block off abnormal blood vessels that are causing problems.

Silicone elastomers are a type of synthetic rubber made from silicone, which is a polymer composed primarily of silicon-oxygen bonds. They are known for their durability, flexibility, and resistance to heat, cold, and moisture. Silicone elastomers can be manufactured in various forms, including liquids, gels, and solids, and they are used in a wide range of medical applications such as:

1. Breast implants: Silicone elastomer shells filled with silicone gel are commonly used for breast augmentation and reconstruction.
2. Contact lenses: Some contact lenses are made from silicone elastomers due to their high oxygen permeability, which allows for better eye health.
3. Catheters: Silicone elastomer catheters are flexible and resistant to kinking, making them suitable for long-term use in various medical procedures.
4. Implantable drug delivery systems: Silicone elastomers can be used as a matrix for controlled release of drugs, allowing for sustained and targeted medication administration.
5. Medical adhesives: Silicone elastomer adhesives are biocompatible and can be used to attach medical devices to the skin or other tissues.
6. Sealants and coatings: Silicone elastomers can be used as sealants and coatings in medical devices to prevent leakage, improve durability, and reduce infection risk.

It is important to note that while silicone elastomers are generally considered safe for medical use, there have been concerns about the potential health risks associated with breast implants, such as capsular contracture, breast pain, and immune system reactions. However, these risks vary depending on the individual's health status and the specific type of silicone elastomer used.

Hemorrhage is defined in the medical context as an excessive loss of blood from the circulatory system, which can occur due to various reasons such as injury, surgery, or underlying health conditions that affect blood clotting or the integrity of blood vessels. The bleeding may be internal, external, visible, or concealed, and it can vary in severity from minor to life-threatening, depending on the location and extent of the bleeding. Hemorrhage is a serious medical emergency that requires immediate attention and treatment to prevent further blood loss, organ damage, and potential death.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

The biliary tract is a system of ducts that transport bile from the liver to the gallbladder and then to the small intestine. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats in the small intestine. The main components of the biliary tract are:

1. Intrahepatic bile ducts: These are the smaller branches of bile ducts located within the liver that collect bile from the liver cells or hepatocytes.
2. Gallbladder: A small pear-shaped organ located beneath the liver, which stores and concentrates bile received from the intrahepatic bile ducts. The gallbladder releases bile into the small intestine when food is ingested, particularly fats, to aid digestion.
3. Common hepatic duct: This is a duct that forms by the union of the right and left hepatic ducts, which carry bile from the right and left lobes of the liver, respectively.
4. Cystic duct: A short duct that connects the gallbladder to the common hepatic duct, forming the beginning of the common bile duct.
5. Common bile duct: This is a larger duct formed by the union of the common hepatic duct and the cystic duct. It carries bile from the liver and gallbladder into the small intestine.
6. Pancreatic duct: A separate duct that originates from the pancreas, a gland located near the liver and stomach. The pancreatic duct joins the common bile duct just before they both enter the duodenum, the first part of the small intestine.
7. Ampulla of Vater: This is the dilated portion where the common bile duct and the pancreatic duct join together and empty their contents into the duodenum through a shared opening called the papilla of Vater.

Disorders related to the biliary tract include gallstones, cholecystitis (inflammation of the gallbladder), bile duct stones, bile duct strictures or obstructions, and primary sclerosing cholangitis, among others.

The pancreatic ducts are a set of tubular structures within the pancreas that play a crucial role in the digestive system. The main pancreatic duct, also known as the duct of Wirsung, is responsible for transporting pancreatic enzymes and bicarbonate-rich fluid from the pancreas to the duodenum, which is the first part of the small intestine.

The exocrine portion of the pancreas contains numerous smaller ducts called interlobular ducts and intralobular ducts that merge and ultimately join the main pancreatic duct. This system ensures that the digestive enzymes and fluids produced by the pancreas are effectively delivered to the small intestine, where they aid in the breakdown and absorption of nutrients from food.

In addition to the main pancreatic duct, there is an accessory pancreatic duct, also known as Santorini's duct, which can sometimes join the common bile duct before emptying into the duodenum through a shared opening called the ampulla of Vater. However, in most individuals, the accessory pancreatic duct usually drains into the main pancreatic duct before entering the duodenum.

Gallbladder neoplasms refer to abnormal growths in the tissue of the gallbladder, which can be benign or malignant. Benign neoplasms are non-cancerous and typically do not spread to other parts of the body. Malignant neoplasms, also known as gallbladder cancer, can invade nearby tissues and organs and may metastasize (spread) to distant parts of the body. Gallbladder neoplasms can cause symptoms such as abdominal pain, jaundice, and nausea, but they are often asymptomatic until they have advanced to an advanced stage. The exact causes of gallbladder neoplasms are not fully understood, but risk factors include gallstones, chronic inflammation of the gallbladder, and certain inherited genetic conditions.

The duodenum is the first part of the small intestine, immediately following the stomach. It is a C-shaped structure that is about 10-12 inches long and is responsible for continuing the digestion process that begins in the stomach. The duodenum receives partially digested food from the stomach through the pyloric valve and mixes it with digestive enzymes and bile produced by the pancreas and liver, respectively. These enzymes help break down proteins, fats, and carbohydrates into smaller molecules, allowing for efficient absorption in the remaining sections of the small intestine.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

I'm sorry for any confusion, but "Sulbenicillin" is not a recognized or established term in medical science or pharmacology. It seems that there might be a spelling mistake or a mix-up with the names of antibiotics. If you meant "Subenicillin," it also doesn't exist in medical literature as a known drug.

If you have any other questions about medical definitions, please provide the correct term, and I will be happy to help.

A liver abscess is a localized collection of pus within the liver tissue caused by an infection. It can result from various sources such as bacterial or amebic infections that spread through the bloodstream, bile ducts, or directly from nearby organs. The abscess may cause symptoms like fever, pain in the upper right abdomen, nausea, vomiting, and weight loss. If left untreated, a liver abscess can lead to serious complications, including sepsis and organ failure. Diagnosis typically involves imaging tests like ultrasound or CT scan, followed by drainage of the pus and antibiotic treatment.

A Choledochal cyst is a congenital dilatation or abnormal enlargement of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps in the digestion of fats.

Choledochal cysts can be classified into several types based on their location and the anatomy of the biliary tree. The most common type, called Type I, involves dilatation of the common bile duct. Other types include dilatation of the intrahepatic bile ducts (Type II), dilatation of both the intrahepatic and extrahepatic bile ducts (Type III), and multiple cystic dilatations of the bile ducts (Type IV).

Choledochal cysts are more common in females than males, and they can present at any age. Symptoms may include abdominal pain, jaundice, vomiting, and fever. Complications of choledochal cysts can include bile duct stones, infection, and cancer. Treatment typically involves surgical removal of the cyst, followed by reconstruction of the biliary tree.

Portography is a medical term that refers to an X-ray examination of the portal vein, which is the large blood vessel that carries blood from the digestive organs to the liver. In this procedure, a contrast dye is injected into the patient's veins, and then X-rays are taken to visualize the flow of the dye through the portal vein and its branches. This test can help diagnose various conditions that affect the liver and surrounding organs, such as cirrhosis, tumors, or blood clots in the portal vein. It is also known as a portovenogram or hepatic venography.

An acute disease is a medical condition that has a rapid onset, develops quickly, and tends to be short in duration. Acute diseases can range from minor illnesses such as a common cold or flu, to more severe conditions such as pneumonia, meningitis, or a heart attack. These types of diseases often have clear symptoms that are easy to identify, and they may require immediate medical attention or treatment.

Acute diseases are typically caused by an external agent or factor, such as a bacterial or viral infection, a toxin, or an injury. They can also be the result of a sudden worsening of an existing chronic condition. In general, acute diseases are distinct from chronic diseases, which are long-term medical conditions that develop slowly over time and may require ongoing management and treatment.

Examples of acute diseases include:

* Acute bronchitis: a sudden inflammation of the airways in the lungs, often caused by a viral infection.
* Appendicitis: an inflammation of the appendix that can cause severe pain and requires surgical removal.
* Gastroenteritis: an inflammation of the stomach and intestines, often caused by a viral or bacterial infection.
* Migraine headaches: intense headaches that can last for hours or days, and are often accompanied by nausea, vomiting, and sensitivity to light and sound.
* Myocardial infarction (heart attack): a sudden blockage of blood flow to the heart muscle, often caused by a buildup of plaque in the coronary arteries.
* Pneumonia: an infection of the lungs that can cause coughing, chest pain, and difficulty breathing.
* Sinusitis: an inflammation of the sinuses, often caused by a viral or bacterial infection.

It's important to note that while some acute diseases may resolve on their own with rest and supportive care, others may require medical intervention or treatment to prevent complications and promote recovery. If you are experiencing symptoms of an acute disease, it is always best to seek medical attention to ensure proper diagnosis and treatment.

The hepatic artery is a branch of the celiac trunk or abdominal aorta that supplies oxygenated blood to the liver. It typically divides into two main branches, the right and left hepatic arteries, which further divide into smaller vessels to supply different regions of the liver. The hepatic artery also gives off branches to supply other organs such as the gallbladder, pancreas, and duodenum.

It's worth noting that there is significant variability in the anatomy of the hepatic artery, with some individuals having additional branches or variations in the origin of the vessel. This variability can have implications for surgical procedures involving the liver and surrounding organs.

Esophageal varices and gastric varices are abnormal, enlarged veins in the lower part of the esophagus (the tube that connects the throat to the stomach) and in the stomach lining, respectively. They occur as a result of increased pressure in the portal vein, which is the large blood vessel that carries blood from the digestive organs to the liver. This condition is known as portal hypertension.

Esophageal varices are more common than gastric varices and tend to be more symptomatic. They can cause bleeding, which can be life-threatening if not treated promptly. Gastric varices may also bleed, but they are often asymptomatic until they rupture.

The most common causes of esophageal and gastric varices are cirrhosis (scarring of the liver) and portal hypertension due to other liver diseases such as schistosomiasis or Budd-Chiari syndrome. Treatment options for esophageal and gastric varices include medications to reduce bleeding, endoscopic therapies to treat active bleeding or prevent recurrent bleeding, and surgical procedures to relieve portal hypertension.

Echinococcosis, hepatic is a type of parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus. The infection typically occurs when a person accidentally ingests microscopic eggs of the tapeworm, which can be present in contaminated food, water, or soil.

Once inside the body, the eggs hatch and release larvae that can migrate to various organs, including the liver. In the liver, the larvae form hydatid cysts, which are fluid-filled sacs that can grow slowly over several years, causing symptoms such as abdominal pain, nausea, vomiting, and jaundice.

Hepatic echinococcosis is a serious condition that can lead to complications such as cyst rupture, infection, or organ damage if left untreated. Treatment options include surgery to remove the cysts, medication to kill the parasites, or a combination of both. Prevention measures include good hygiene practices, avoiding contact with contaminated soil or water, and cooking meat thoroughly before eating it.

Phlebography is a medical imaging technique used to visualize and assess the veins, particularly in the legs. It involves the injection of a contrast agent into the veins, followed by X-ray imaging to capture the flow of the contrast material through the veins. This allows doctors to identify any abnormalities such as blood clots, blockages, or malformations in the venous system.

There are different types of phlebography, including ascending phlebography (where the contrast agent is injected into a foot vein and travels up the leg) and descending phlebography (where the contrast agent is injected into a vein in the groin or neck and travels down the leg).

Phlebography is an invasive procedure that requires careful preparation and monitoring, and it is typically performed by radiologists or vascular specialists. It has largely been replaced by non-invasive imaging techniques such as ultrasound and CT angiography in many clinical settings.

Hemobilia is a medical condition that refers to the presence of blood in the bile ducts, which can lead to the passage of blood in the stool or vomiting of blood (hematemesis). This condition usually results from a traumatic injury, rupture of a blood vessel, or a complication from a medical procedure involving the liver, gallbladder, or bile ducts. In some cases, hemobilia may also be caused by tumors or abnormal blood vessels in the liver. Symptoms of hemobilia can include abdominal pain, jaundice, and gastrointestinal bleeding. Diagnosis typically involves imaging tests such as CT scans or endoscopic retrograde cholangiopancreatography (ERCP) to visualize the bile ducts and identify the source of bleeding. Treatment may involve endovascular procedures, surgery, or other interventions to stop the bleeding and manage any underlying conditions.

Botulinum toxins are neurotoxic proteins produced by the bacterium Clostridium botulinum and related species. They are the most potent naturally occurring toxins, and are responsible for the paralytic illness known as botulism. There are seven distinct botulinum toxin serotypes (A-G), each of which targets specific proteins in the nervous system, leading to inhibition of neurotransmitter release and subsequent muscle paralysis.

In clinical settings, botulinum toxins have been used for therapeutic purposes due to their ability to cause temporary muscle relaxation. Botulinum toxin type A (Botox) is the most commonly used serotype in medical treatments, including management of dystonias, spasticity, migraines, and certain neurological disorders. Additionally, botulinum toxins are widely employed in aesthetic medicine for reducing wrinkles and fine lines by temporarily paralyzing facial muscles.

It is important to note that while botulinum toxins have therapeutic benefits when used appropriately, they can also pose significant health risks if misused or improperly handled. Proper medical training and supervision are essential for safe and effective utilization of these powerful toxins.

Wound closure techniques are methods used to bring the edges of a wound together, allowing for proper healing and minimizing the scar formation. The goal is to approximate the wound edges accurately while providing strength and support to the healing tissues. Several techniques can be employed depending on the type, location, and size of the wound. Some common wound closure techniques include:

1. Sutures (Stitches): A surgical thread is passed through the skin on either side of the wound and tied together to hold the edges in place. Sutures can be absorbable or non-absorbable, and various materials and needle types are used depending on the specific application.
2. Staples: Similar to sutures, staples are used to bring the wound edges together. They are typically faster to apply and remove than sutures, making them suitable for certain types of wounds, such as those on the scalp or torso.
3. Adhesive strips (Steri-Strips): These are thin adhesive bandages applied across the wound to keep the edges approximated. They are often used in conjunction with other closure techniques or for superficial wounds that do not require extensive support.
4. Tissue adhesives (Glues): A liquid adhesive is applied to the wound edges, which then hardens and forms a bond between them. This technique is typically used for minor wounds and can be less invasive than sutures or staples.
5. Skin closure tapes: These are specialized tapes that provide support to the healing wound while also protecting it from external factors. They can be used in combination with other closure techniques or on their own for superficial wounds.
6. Surgical sealants: These are medical-grade materials that create a barrier over the wound, helping to prevent infection and maintain moisture at the wound site. They can be used alongside other closure methods or as an alternative for certain types of wounds.

The choice of wound closure technique depends on various factors, including the location, size, and depth of the wound, patient preferences, and the healthcare provider's expertise. Proper wound care and follow-up are essential to ensure optimal healing and minimize scarring.

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive medical imaging technique that uses magnetic resonance imaging (MRI) to visualize the bile ducts and pancreatic duct. This diagnostic test does not use radiation like other imaging techniques such as computed tomography (CT) scans or endoscopic retrograde cholangiopancreatography (ERCP).

During an MRCP, the patient lies on a table that slides into the MRI machine. Contrast agents may be used to enhance the visibility of the ducts. The MRI machine uses a strong magnetic field and radio waves to produce detailed images of the internal structures, allowing radiologists to assess any abnormalities or blockages in the bile and pancreatic ducts.

MRCP is often used to diagnose conditions such as gallstones, tumors, inflammation, or strictures in the bile or pancreatic ducts. It can also be used to monitor the effectiveness of treatments for these conditions. However, it does not allow for therapeutic interventions like ERCP, which can remove stones or place stents.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Palliative care is a type of medical care that focuses on relieving the pain, symptoms, and stress of serious illnesses. The goal is to improve quality of life for both the patient and their family. It is provided by a team of doctors, nurses, and other specialists who work together to address the physical, emotional, social, and spiritual needs of the patient. Palliative care can be provided at any stage of an illness, alongside curative treatments, and is not dependent on prognosis.

The World Health Organization (WHO) defines palliative care as: "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual."

'Digestive System Neoplasms' refer to new and abnormal growths of tissue in the digestive system that can be benign or malignant. These growths are also known as tumors, and they can occur in any part of the digestive system, including the esophagus, stomach, small intestine, large intestine (colon and rectum), liver, bile ducts, pancreas, and gallbladder. Neoplasms in the digestive system can interfere with normal digestion and absorption of nutrients, cause bleeding, obstruct the digestive tract, and spread to other parts of the body (metastasis) if they are malignant.

Benign neoplasms are not cancerous and do not usually spread to other parts of the body. They can often be removed surgically and may not require further treatment. Malignant neoplasms, on the other hand, are cancerous and can invade nearby tissues and organs and spread to other parts of the body. Treatment for malignant neoplasms in the digestive system typically involves a combination of surgery, radiation therapy, and chemotherapy.

The causes of digestive system neoplasms are varied and include genetic factors, environmental exposures, lifestyle factors (such as diet and smoking), and infectious agents. Prevention strategies may include maintaining a healthy diet, avoiding tobacco and excessive alcohol consumption, practicing safe sex, getting vaccinated against certain viral infections, and undergoing regular screenings for certain types of neoplasms (such as colonoscopies for colorectal cancer).

A splenorenal shunt is a surgical procedure that creates a connection between the spleen and the left kidney vein (renal vein). This type of shunt is typically performed to reroute the flow of blood from the spleen when there is an obstruction in the portal vein, which carries blood from the gastrointestinal tract, liver, and spleen. The procedure helps to alleviate portal hypertension (high blood pressure in the portal vein) and its complications, such as variceal bleeding (bleeding from enlarged veins in the esophagus or stomach).

During a surgical splenorenal shunt procedure, the surgeon will make an incision in the left flank region to access both the spleen and the left renal vein. The splenic vein is then divided, and one end is connected to the left renal vein using a synthetic graft or a portion of the patient's own blood vessel (autograft). This connection allows the blood from the spleen to bypass the obstructed portal vein and flow directly into the systemic venous circulation.

It is important to note that splenorenal shunts have been largely replaced by transjugular intrahepatic portosystemic shunts (TIPS) as the first-line treatment for managing portal hypertension due to their lower invasiveness and fewer complications. However, surgical splenorenal shunts may still be considered in specific cases where TIPS is not feasible or has failed.

A reoperation is a surgical procedure that is performed again on a patient who has already undergone a previous operation for the same or related condition. Reoperations may be required due to various reasons, such as inadequate initial treatment, disease recurrence, infection, or complications from the first surgery. The nature and complexity of a reoperation can vary widely depending on the specific circumstances, but it often carries higher risks and potential complications compared to the original operation.

Hepatectomy is a surgical procedure that involves the removal of part or all of the liver. This procedure can be performed for various reasons, such as removing cancerous or non-cancerous tumors, treating liver trauma, or donating a portion of the liver to another person in need of a transplant (live donor hepatectomy). The extent of the hepatectomy depends on the medical condition and overall health of the patient. It is a complex procedure that requires significant expertise and experience from the surgical team due to the liver's unique anatomy, blood supply, and regenerative capabilities.

The splenic vein is a large, thin-walled vein that carries oxygenated blood from the spleen and pancreas to the liver. It is formed by the union of several smaller veins that drain the upper part of the stomach, the pancreas, and the left side of the colon (splenic flexure). The splenic vein runs along the top border of the pancreas and merges with the superior mesenteric vein to form the portal vein. This venous system allows for the filtration and detoxification of blood by the liver before it is distributed to the rest of the body.

A gelatin sponge, absorbable is a surgical implant material that is derived from animal collagen. It is prepared in the form of a sterile, compressed sponge which can be expanded with the addition of fluids. The sponge is designed to absorb and hold surgical drainage, promote healing by providing a framework for the growth of new tissue, and then gradually break down and be absorbed by the body over time. It is often used in neurosurgery, plastic surgery, and other surgical specialties for its hemostatic (bleeding control) and supportive properties.

A Klatskin's tumor, also known as a perihilar cholangiocarcinoma, is a rare and aggressive form of cancer that occurs at the junction where the right and left hepatic ducts come together to form the common hepatic duct, which then becomes the common bile duct. This type of tumor can obstruct the flow of bile from the liver into the small intestine, leading to jaundice, itching, abdominal pain, and other symptoms. Klatskin's tumors are often difficult to diagnose and treat due to their location and tendency to spread quickly. Surgical resection is the preferred treatment option when possible, although chemotherapy and radiation therapy may also be used in some cases.

Surgical anastomosis is a medical procedure that involves the connection of two tubular structures, such as blood vessels or intestines, to create a continuous passage. This technique is commonly used in various types of surgeries, including vascular, gastrointestinal, and orthopedic procedures.

During a surgical anastomosis, the ends of the two tubular structures are carefully prepared by removing any damaged or diseased tissue. The ends are then aligned and joined together using sutures, staples, or other devices. The connection must be secure and leak-free to ensure proper function and healing.

The success of a surgical anastomosis depends on several factors, including the patient's overall health, the location and condition of the structures being joined, and the skill and experience of the surgeon. Complications such as infection, bleeding, or leakage can occur, which may require additional medical intervention or surgery.

Proper postoperative care is also essential to ensure the success of a surgical anastomosis. This may include monitoring for signs of complications, administering medications to prevent infection and promote healing, and providing adequate nutrition and hydration.

Balloon occlusion is a medical procedure that involves the use of a small, deflated balloon at the end of a catheter, which can be inserted into a blood vessel or other tubular structure in the body. Once the balloon is in position, it is inflated with a fluid or gas to create a blockage or obstruction in the vessel. This can be used for various medical purposes, such as:

1. Controlling bleeding: By inflating the balloon in a blood vessel, doctors can temporarily stop the flow of blood to a specific area, allowing them to treat injuries or abnormalities that are causing excessive bleeding.
2. Vessel narrowing or blockage assessment: Balloon occlusion can be used to assess the severity of narrowing or blockages in blood vessels. By inflating the balloon and measuring the pressure differences upstream and downstream, doctors can determine the extent of the obstruction and plan appropriate treatment.
3. Embolization therapy: In some cases, balloon occlusion is used to deliver embolic agents (such as coils, particles, or glue) that block off blood flow to specific areas. This can be useful in treating conditions like tumors, arteriovenous malformations, or aneurysms.
4. Temporary vessel occlusion during surgery: During certain surgical procedures, it may be necessary to temporarily stop the flow of blood to a specific area. Balloon occlusion can be used to achieve this quickly and safely.
5. Assisting in the placement of stents or other devices: Balloon occlusion can help position and deploy stents or other medical devices by providing temporary support or blocking off blood flow during the procedure.

It is important to note that balloon occlusion procedures carry potential risks, such as vessel injury, infection, or embolism (the blockage of a blood vessel by a clot or foreign material). These risks should be carefully weighed against the benefits when considering this type of treatment.

Biliary tract neoplasms refer to abnormal growths or tumors that develop in the biliary system, which includes the gallbladder, bile ducts inside and outside the liver, and the ducts that connect the liver to the small intestine. These neoplasms can be benign (non-cancerous) or malignant (cancerous).

Malignant biliary tract neoplasms are often referred to as cholangiocarcinoma if they originate in the bile ducts, or gallbladder cancer if they arise in the gallbladder. These cancers are relatively rare but can be aggressive and difficult to treat. They can cause symptoms such as jaundice (yellowing of the skin and eyes), abdominal pain, weight loss, and dark urine.

Risk factors for biliary tract neoplasms include chronic inflammation of the biliary system, primary sclerosing cholangitis, liver cirrhosis, hepatitis B or C infection, parasitic infections, and certain genetic conditions. Early detection and treatment can improve outcomes for patients with these neoplasms.

I'm sorry for any confusion, but "Tokyo" is not a medical term. It is the capital city of Japan and the country's largest metropolitan area. If you have any questions about medical terms or topics, I would be happy to help with those!

The inferior vena cava (IVC) is the largest vein in the human body that carries deoxygenated blood from the lower extremities, pelvis, and abdomen to the right atrium of the heart. It is formed by the union of the left and right common iliac veins at the level of the fifth lumbar vertebra. The inferior vena cava is a retroperitoneal structure, meaning it lies behind the peritoneum, the lining that covers the abdominal cavity. It ascends through the posterior abdominal wall and passes through the central tendon of the diaphragm to enter the thoracic cavity.

The inferior vena cava is composed of three parts:

1. The infrarenal portion, which lies below the renal veins
2. The renal portion, which receives blood from the renal veins
3. The suprahepatic portion, which lies above the liver and receives blood from the hepatic veins before draining into the right atrium of the heart.

The inferior vena cava plays a crucial role in maintaining venous return to the heart and contributing to cardiovascular function.

X-ray computed tomography (CT or CAT scan) is a medical imaging method that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of the body. These cross-sectional images can then be used to display detailed internal views of organs, bones, and soft tissues in the body.

The term "computed tomography" is used instead of "CT scan" or "CAT scan" because the machines take a series of X-ray measurements from different angles around the body and then use a computer to process these data to create detailed images of internal structures within the body.

CT scanning is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CT imaging provides detailed information about many types of tissue including lung, bone, soft tissue and blood vessels. CT examinations can be performed on every part of the body for a variety of reasons including diagnosis, surgical planning, and monitoring of therapeutic responses.

In computed tomography (CT), an X-ray source and detector rotate around the patient, measuring the X-ray attenuation at many different angles. A computer uses this data to construct a cross-sectional image by the process of reconstruction. This technique is called "tomography". The term "computed" refers to the use of a computer to reconstruct the images.

CT has become an important tool in medical imaging and diagnosis, allowing radiologists and other physicians to view detailed internal images of the body. It can help identify many different medical conditions including cancer, heart disease, lung nodules, liver tumors, and internal injuries from trauma. CT is also commonly used for guiding biopsies and other minimally invasive procedures.

In summary, X-ray computed tomography (CT or CAT scan) is a medical imaging technique that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of the body. It provides detailed internal views of organs, bones, and soft tissues in the body, allowing physicians to diagnose and treat medical conditions.

Nitroglycerin, also known as glyceryl trinitrate, is a medication used primarily for the treatment of angina pectoris (chest pain due to coronary artery disease) and hypertensive emergencies (severe high blood pressure). It belongs to a class of drugs called nitrates or organic nitrites.

Nitroglycerin works by relaxing and dilating the smooth muscle in blood vessels, which leads to decreased workload on the heart and increased oxygen delivery to the myocardium (heart muscle). This results in reduced symptoms of angina and improved cardiac function during hypertensive emergencies.

The drug is available in various forms, including sublingual tablets, sprays, transdermal patches, ointments, and intravenous solutions. The choice of formulation depends on the specific clinical situation and patient needs. Common side effects of nitroglycerin include headache, dizziness, and hypotension (low blood pressure).

Gastrointestinal endoscopy is a medical procedure that allows direct visualization of the inner lining of the digestive tract, which includes the esophagus, stomach, small intestine, large intestine (colon), and sometimes the upper part of the small intestine (duodenum). This procedure is performed using an endoscope, a long, thin, flexible tube with a light and camera at its tip. The endoscope is inserted through the mouth for upper endoscopy or through the rectum for lower endoscopy (colonoscopy), and the images captured by the camera are transmitted to a monitor for the physician to view.

Gastrointestinal endoscopy can help diagnose various conditions, such as inflammation, ulcers, tumors, polyps, or bleeding in the digestive tract. It can also be used for therapeutic purposes, such as removing polyps, taking tissue samples (biopsies), treating bleeding, and performing other interventions to manage certain digestive diseases.

There are different types of gastrointestinal endoscopy procedures, including:

1. Upper Endoscopy (Esophagogastroduodenoscopy or EGD): This procedure examines the esophagus, stomach, and duodenum.
2. Colonoscopy: This procedure examines the colon and rectum.
3. Sigmoidoscopy: A limited examination of the lower part of the colon (sigmoid colon) using a shorter endoscope.
4. Enteroscopy: An examination of the small intestine, which can be performed using various techniques, such as push enteroscopy, single-balloon enteroscopy, or double-balloon enteroscopy.
5. Capsule Endoscopy: A procedure that involves swallowing a small capsule containing a camera, which captures images of the digestive tract as it passes through.

Gastrointestinal endoscopy is generally considered safe when performed by experienced medical professionals. However, like any medical procedure, there are potential risks and complications, such as bleeding, infection, perforation, or adverse reactions to sedatives used during the procedure. Patients should discuss these risks with their healthcare provider before undergoing gastrointestinal endoscopy.

Pancreatic neoplasms refer to abnormal growths in the pancreas that can be benign or malignant. The pancreas is a gland located behind the stomach that produces hormones and digestive enzymes. Pancreatic neoplasms can interfere with the normal functioning of the pancreas, leading to various health complications.

Benign pancreatic neoplasms are non-cancerous growths that do not spread to other parts of the body. They are usually removed through surgery to prevent any potential complications, such as blocking the bile duct or causing pain.

Malignant pancreatic neoplasms, also known as pancreatic cancer, are cancerous growths that can invade and destroy surrounding tissues and organs. They can also spread (metastasize) to other parts of the body, such as the liver, lungs, or bones. Pancreatic cancer is often aggressive and difficult to treat, with a poor prognosis.

There are several types of pancreatic neoplasms, including adenocarcinomas, neuroendocrine tumors, solid pseudopapillary neoplasms, and cystic neoplasms. The specific type of neoplasm is determined through various diagnostic tests, such as imaging studies, biopsies, and blood tests. Treatment options depend on the type, stage, and location of the neoplasm, as well as the patient's overall health and preferences.

Jaundice is a medical condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes due to an excess of bilirubin in the bloodstream. Bilirubin is a yellow-orange pigment produced when hemoglobin from red blood cells is broken down. Normally, bilirubin is processed by the liver and excreted through bile into the digestive system. However, if there's an issue with bilirubin metabolism or elimination, it can accumulate in the body, leading to jaundice.

Jaundice can be a symptom of various underlying conditions, such as liver diseases (hepatitis, cirrhosis), gallbladder issues (gallstones, tumors), or blood disorders (hemolysis). It is essential to consult a healthcare professional if jaundice is observed, as it may indicate a severe health problem requiring prompt medical attention.

Chemoembolization, therapeutic is a medical procedure that involves the delivery of chemotherapy drugs directly to a tumor through its blood supply, followed by the blocking of the blood vessel leading to the tumor. This approach allows for a higher concentration of the chemotherapy drug to be delivered directly to the tumor while minimizing exposure to the rest of the body. The embolization component of the procedure involves blocking the blood vessel with various substances such as microspheres, gel foam, or coils, which can help to starve the tumor of oxygen and nutrients.

Therapeutic chemoembolization is typically used in the treatment of liver cancer, including primary liver cancer (hepatocellular carcinoma) and metastatic liver cancer. It may also be used in other types of cancer that have spread to the liver. The procedure can help to reduce the size of the tumor, relieve symptoms, and improve survival rates in some patients. However, like all medical procedures, it carries a risk of complications such as infection, bleeding, and damage to surrounding tissues.

In medical terms, pressure is defined as the force applied per unit area on an object or body surface. It is often measured in millimeters of mercury (mmHg) in clinical settings. For example, blood pressure is the force exerted by circulating blood on the walls of the arteries and is recorded as two numbers: systolic pressure (when the heart beats and pushes blood out) and diastolic pressure (when the heart rests between beats).

Pressure can also refer to the pressure exerted on a wound or incision to help control bleeding, or the pressure inside the skull or spinal canal. High or low pressure in different body systems can indicate various medical conditions and require appropriate treatment.

'Alloys' is not a medical term. It is a term used in materials science and engineering to describe a mixture or solid solution composed of two or more elements, at least one of which is a metal. The components are typically present in significant amounts (>1% by weight). The properties of alloys, such as their strength, durability, and corrosion resistance, often differ from those of the constituent elements.

While not directly related to medicine, some alloys do have medical applications. For example, certain alloys are used in orthopedic implants, dental restorations, and other medical devices due to their desirable properties such as biocompatibility, strength, and resistance to corrosion.

A chronic disease is a long-term medical condition that often progresses slowly over a period of years and requires ongoing management and care. These diseases are typically not fully curable, but symptoms can be managed to improve quality of life. Common chronic diseases include heart disease, stroke, cancer, diabetes, arthritis, and COPD (chronic obstructive pulmonary disease). They are often associated with advanced age, although they can also affect children and younger adults. Chronic diseases can have significant impacts on individuals' physical, emotional, and social well-being, as well as on healthcare systems and society at large.

Portal hypertension is a medical condition characterized by an increased pressure in the portal vein, which is the large blood vessel that carries blood from the intestines, spleen, and pancreas to the liver. Normal portal venous pressure is approximately 5-10 mmHg. Portal hypertension is defined as a portal venous pressure greater than 10 mmHg.

The most common cause of portal hypertension is cirrhosis of the liver, which leads to scarring and narrowing of the small blood vessels in the liver, resulting in increased resistance to blood flow. Other causes include blood clots in the portal vein, inflammation of the liver or bile ducts, and invasive tumors that block the flow of blood through the liver.

Portal hypertension can lead to a number of complications, including the development of abnormal blood vessels (varices) in the esophagus, stomach, and intestines, which are prone to bleeding. Ascites, or the accumulation of fluid in the abdominal cavity, is another common complication of portal hypertension. Other potential complications include encephalopathy, which is a condition characterized by confusion, disorientation, and other neurological symptoms, and an increased risk of bacterial infections.

Treatment of portal hypertension depends on the underlying cause and the severity of the condition. Medications to reduce pressure in the portal vein, such as beta blockers or nitrates, may be used. Endoscopic procedures to band or inject varices can help prevent bleeding. In severe cases, surgery or liver transplantation may be necessary.

Liver circulation, also known as hepatic circulation, refers to the blood flow through the liver. The liver receives blood from two sources: the hepatic artery and the portal vein.

The hepatic artery delivers oxygenated blood from the heart to the liver, accounting for about 25% of the liver's blood supply. The remaining 75% comes from the portal vein, which carries nutrient-rich, deoxygenated blood from the gastrointestinal tract, spleen, pancreas, and gallbladder to the liver.

In the liver, these two sources of blood mix in the sinusoids, small vessels with large spaces between the endothelial cells that line them. This allows for efficient exchange of substances between the blood and the hepatocytes (liver cells). The blood then leaves the liver through the hepatic veins, which merge into the inferior vena cava and return the blood to the heart.

The unique dual blood supply and extensive sinusoidal network in the liver enable it to perform various critical functions, such as detoxification, metabolism, synthesis, storage, and secretion of numerous substances, maintaining body homeostasis.

Liver transplantation is a surgical procedure in which a diseased or failing liver is replaced with a healthy one from a deceased donor or, less commonly, a portion of a liver from a living donor. The goal of the procedure is to restore normal liver function and improve the patient's overall health and quality of life.

Liver transplantation may be recommended for individuals with end-stage liver disease, acute liver failure, certain genetic liver disorders, or liver cancers that cannot be treated effectively with other therapies. The procedure involves complex surgery to remove the diseased liver and implant the new one, followed by a period of recovery and close medical monitoring to ensure proper function and minimize the risk of complications.

The success of liver transplantation has improved significantly in recent years due to advances in surgical techniques, immunosuppressive medications, and post-transplant care. However, it remains a major operation with significant risks and challenges, including the need for lifelong immunosuppression to prevent rejection of the new liver, as well as potential complications such as infection, bleeding, and organ failure.

Amylases are enzymes that break down complex carbohydrates, such as starch and glycogen, into simpler sugars like maltose, glucose, and maltotriose. There are several types of amylases found in various organisms, including humans.

In humans, amylases are produced by the pancreas and salivary glands. Pancreatic amylase is released into the small intestine where it helps to digest dietary carbohydrates. Salivary amylase, also known as alpha-amylase, is secreted into the mouth and begins breaking down starches in food during chewing.

Deficiency or absence of amylases can lead to difficulties in digesting carbohydrates and may cause symptoms such as bloating, diarrhea, and abdominal pain. Elevated levels of amylase in the blood may indicate conditions such as pancreatitis, pancreatic cancer, or other disorders affecting the pancreas.

Gastrointestinal (GI) hemorrhage is a term used to describe any bleeding that occurs in the gastrointestinal tract, which includes the esophagus, stomach, small intestine, large intestine, and rectum. The bleeding can range from mild to severe and can produce symptoms such as vomiting blood, passing black or tarry stools, or having low blood pressure.

GI hemorrhage can be classified as either upper or lower, depending on the location of the bleed. Upper GI hemorrhage refers to bleeding that occurs above the ligament of Treitz, which is a point in the small intestine where it becomes narrower and turns a corner. Common causes of upper GI hemorrhage include gastritis, ulcers, esophageal varices, and Mallory-Weiss tears.

Lower GI hemorrhage refers to bleeding that occurs below the ligament of Treitz. Common causes of lower GI hemorrhage include diverticulosis, colitis, inflammatory bowel disease, and vascular abnormalities such as angiodysplasia.

The diagnosis of GI hemorrhage is often made based on the patient's symptoms, medical history, physical examination, and diagnostic tests such as endoscopy, CT scan, or radionuclide scanning. Treatment depends on the severity and cause of the bleeding and may include medications, endoscopic procedures, surgery, or a combination of these approaches.

A portosystemic shunt is a surgical procedure that creates a connection between the portal vein (the blood vessel that carries blood from the digestive organs to the liver) and another systemic vein (a vein that carries blood away from the liver). This procedure is typically performed in animals, particularly dogs, to treat conditions such as portal hypertension or liver disease.

In a surgical portosystemic shunt, the surgeon creates a connection between the portal vein and a systemic vein, allowing blood from the digestive organs to bypass the liver. This can help to reduce the pressure in the portal vein and improve blood flow to the liver. The specific type of shunt created and the surgical approach used may vary depending on the individual patient's needs and the surgeon's preference.

It is important to note that while a surgical portosystemic shunt can be an effective treatment for certain conditions, it is not without risks and potential complications. As with any surgical procedure, there is always a risk of infection, bleeding, or other complications. Additionally, the creation of a portosystemic shunt can have long-term effects on the liver and overall health of the patient. It is important for pet owners to carefully consider the risks and benefits of this procedure and to discuss any questions or concerns they may have with their veterinarian.

Peripheral catheterization is a medical procedure that involves the insertion of a thin, flexible tube (catheter) into a peripheral vein, which is a blood vessel located outside of the chest and abdomen. This type of catheterization is typically performed to administer medications, fluids, or nutritional support, or to monitor various physiological parameters such as central venous pressure.

Peripheral catheters are usually inserted into veins in the hands or arms, although they can also be placed in other peripheral veins. The procedure is typically performed using aseptic technique to minimize the risk of infection. Once the catheter is in place, it may be secured with a dressing or suture to prevent movement and dislodgement.

Peripheral catheterization is a relatively safe and common procedure that is routinely performed in hospitals, clinics, and other healthcare settings. However, like any medical procedure, it carries a small risk of complications such as infection, bleeding, or damage to the vein or surrounding tissues.

"Length of Stay" (LOS) is a term commonly used in healthcare to refer to the amount of time a patient spends receiving care in a hospital, clinic, or other healthcare facility. It is typically measured in hours, days, or weeks and can be used as a metric for various purposes such as resource planning, quality assessment, and reimbursement. The length of stay can vary depending on the type of illness or injury, the severity of the condition, the patient's response to treatment, and other factors. It is an important consideration in healthcare management and can have significant implications for both patients and providers.

A Gastrectomy is a surgical procedure involving the removal of all or part of the stomach. This procedure can be total (complete resection of the stomach), partial (removal of a portion of the stomach), or sleeve (removal of a portion of the stomach to create a narrow sleeve-shaped pouch).

Gastrectomies are typically performed to treat conditions such as gastric cancer, benign tumors, severe peptic ulcers, and in some cases, for weight loss in individuals with morbid obesity. The type of gastrectomy performed depends on the patient's medical condition and the extent of the disease.

Following a gastrectomy, patients may require adjustments to their diet and lifestyle, as well as potential supplementation of vitamins and minerals that would normally be absorbed in the stomach. In some cases, further reconstructive surgery might be necessary to reestablish gastrointestinal continuity.

Bilirubin is a yellowish pigment that is produced by the liver when it breaks down old red blood cells. It is a normal byproduct of hemoglobin metabolism and is usually conjugated (made water-soluble) in the liver before being excreted through the bile into the digestive system. Elevated levels of bilirubin can cause jaundice, a yellowing of the skin and eyes. Increased bilirubin levels may indicate liver disease or other medical conditions such as gallstones or hemolysis. It is also measured to assess liver function and to help diagnose various liver disorders.

Ceruletide is a synthetic analog of the natural hormone cholecystokinin (CCK). It is a decapeptide with the following sequence: cyclo(D-Asp-Tic-Phe-Ser-Leu-Hand-Ala-Lys-Thr-Nle-NH2).

Ceruletide has several pharmacological actions, including stimulation of the release of digestive enzymes from the pancreas, contraction of the gallbladder and sphincter of Oddi, and inhibition of gastric acid secretion. It is used in clinical medicine for diagnostic purposes to test the motor function of the biliary tract and to diagnose gastrointestinal motility disorders.

Ceruletide has also been investigated as a potential treatment for certain conditions such as pancreatitis, gallstones, and intestinal obstruction, but its use is limited due to its side effects, which include nausea, vomiting, abdominal cramps, and diarrhea.

Afferent loop syndrome is a relatively uncommon complication that can occur after certain gastrointestinal surgeries, particularly those involving the small intestine. The afferent loop refers to a portion of the small intestine that carries digestive secretions from the liver and pancreas towards the main part of the small intestine (the jejunum).

In afferent loop syndrome, this loop becomes obstructed or narrowed, leading to a backup of digestive enzymes and fluids. This can cause various symptoms, including abdominal pain, nausea, vomiting, and diarrhea. The vomit may contain bile, which is a yellowish-green fluid produced by the liver, indicating that the obstruction is located in the afferent loop.

Afferent loop syndrome can be caused by several factors, including post-surgical adhesions (scar tissue), inflammation, or tumors. The diagnosis of afferent loop syndrome typically involves imaging tests such as CT scans or upper gastrointestinal series to visualize the obstruction. Treatment may involve endoscopic procedures to clear the obstruction or surgery to repair or bypass the affected portion of the intestine.

Liver neoplasms refer to abnormal growths in the liver that can be benign or malignant. Benign liver neoplasms are non-cancerous tumors that do not spread to other parts of the body, while malignant liver neoplasms are cancerous tumors that can invade and destroy surrounding tissue and spread to other organs.

Liver neoplasms can be primary, meaning they originate in the liver, or secondary, meaning they have metastasized (spread) to the liver from another part of the body. Primary liver neoplasms can be further classified into different types based on their cell of origin and behavior, including hepatocellular carcinoma, cholangiocarcinoma, and hepatic hemangioma.

The diagnosis of liver neoplasms typically involves a combination of imaging studies, such as ultrasound, CT scan, or MRI, and biopsy to confirm the type and stage of the tumor. Treatment options depend on the type and extent of the neoplasm and may include surgery, radiation therapy, chemotherapy, or liver transplantation.

Minimally invasive surgical procedures are a type of surgery that is performed with the assistance of specialized equipment and techniques to minimize trauma to the patient's body. This approach aims to reduce blood loss, pain, and recovery time as compared to traditional open surgeries. The most common minimally invasive surgical procedure is laparoscopy, which involves making small incisions (usually 0.5-1 cm) in the abdomen or chest and inserting a thin tube with a camera (laparoscope) to visualize the internal organs.

The surgeon then uses long, slender instruments inserted through separate incisions to perform the necessary surgical procedures, such as cutting, coagulation, or suturing. Other types of minimally invasive surgical procedures include arthroscopy (for joint surgery), thoracoscopy (for chest surgery), and hysteroscopy (for uterine surgery). The benefits of minimally invasive surgical procedures include reduced postoperative pain, shorter hospital stays, quicker return to normal activities, and improved cosmetic results. However, not all surgeries can be performed using minimally invasive techniques, and the suitability of a particular procedure depends on various factors, including the patient's overall health, the nature and extent of the surgical problem, and the surgeon's expertise.

A cyst is a closed sac, having a distinct membrane and division between the sac and its surrounding tissue, that contains fluid, air, or semisolid material. Cysts can occur in various parts of the body, including the skin, internal organs, and bones. They can be caused by various factors, such as infection, genetic predisposition, or blockage of a duct or gland. Some cysts may cause symptoms, such as pain or discomfort, while others may not cause any symptoms at all. Treatment for cysts depends on the type and location of the cyst, as well as whether it is causing any problems. Some cysts may go away on their own, while others may need to be drained or removed through a surgical procedure.

A septal occluder device is a type of medical implant used to close defects or holes in the heart, specifically within the septum, which is the wall that separates the two sides of the heart. The device typically consists of two disc-shaped components connected by a waist, resembling a button or an umbrella.

The procedure for implanting a septal occluder device involves inserting it through a catheter, which is introduced into a vein in the leg and guided to the heart. Once in position, the discs of the device expand and are pressed against the septum on both sides of the hole, effectively closing it. Over time, tissue grows over the device, permanently sealing the defect.

Septal occluder devices are commonly used to treat atrial septal defects (ASD) and patent foramen ovale (PFO), which are two types of congenital heart defects that can cause symptoms such as shortness of breath, fatigue, and heart palpitations. The use of these devices has revolutionized the treatment of these conditions, allowing for less invasive procedures and faster recovery times compared to traditional surgical methods.

A Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a medical procedure that creates an alternative pathway for blood flow from the portal vein to the hepatic vein within the liver. This shunt is composed of a stent, which is a small metal tube that is inserted into the liver using a long needle that is passed through a vein in the neck (jugular vein).

TIPS is typically used to treat complications of portal hypertension, such as variceal bleeding, ascites, and hepatic hydrothorax. By creating a shunt that bypasses the liver, TIPS reduces the pressure in the portal vein, which can help to alleviate these symptoms. However, because the shunt allows blood to bypass the liver, it can also impair liver function and lead to other complications, such as hepatic encephalopathy.

It is important to note that TIPS is a complex procedure that should only be performed by experienced interventional radiologists in a hospital setting with appropriate medical backup and monitoring capabilities.

Fluoroscopy is a type of medical imaging that uses X-rays to obtain real-time moving images of the internal structures of the body. A continuous X-ray beam is passed through the body part being examined, and the resulting fluoroscopic images are transmitted to a monitor, allowing the medical professional to view the structure and movement of the internal organs and bones in real time.

Fluoroscopy is often used to guide minimally invasive procedures such as catheterization, stent placement, or joint injections. It can also be used to diagnose and monitor a variety of medical conditions, including gastrointestinal disorders, musculoskeletal injuries, and cardiovascular diseases.

It is important to note that fluoroscopy involves exposure to ionizing radiation, and the risks associated with this exposure should be carefully weighed against the benefits of the procedure. Medical professionals are trained to use the lowest possible dose of radiation necessary to obtain the desired diagnostic information.

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