Primary closure of the common bile duct in acute cholangitis

1994 ◽  
Vol 81 (9) ◽  
pp. 1361-1361 ◽  
Author(s):  
R. Houdart ◽  
T. Perniceni
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
Acute Cholangitis ◽  
The Common

CHOLANGITIS AS A SYSTEMIC MANIFESTATION OF ACUTE BILIARY INFECTION

2020 ◽  
pp. 43-47
Author(s):  
A. O. Nekludov ◽  
M. O. Klosova ◽  
O. V. Volchenko ◽  
M. M. Goloborodko ◽  
A. Yu. Korolevska
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Water Column ◽  
Biliary Tract ◽  
Bile Ducts ◽  
Inflammatory Process ◽  
Acute Cholangitis ◽  
Biliary Infection ◽  
The Common ◽  
Further Development

The main causes of cholangitis are hypertension in the biliary ducts and infection. In order to determine the place of the infectious factor in the acute cholangitis development, a retrospective and prospective analysis of case histories of 176 patients with choledocholithiasis and manifestations of acute and chronic cholangitis was performed. Bile from the common bile duct in the patients with obstruction of the biliary tract was studied. In the patients with mechanical jaundice without and with cholangitis, the intraductal pressure in the common bile duct averaged 227.3±26.1 mm of water column, in the patients without signs of cholangitis that was 97.5±8.3 mm of water column. With mechanical jaundice without acute cholangitis, it was slightly elevated if compared to normal. This suggests that the increase in pressure in the bile ducts in acute cholangitis is not influenced by the fact of obstruction of the biliary tract, and the development of the inflammatory process in them. In the patients with cholangitis, the initial values of the number of colonizing units were much higher than in "pure" choledocholithiasis. After endoscopic papillosphincterotomy in the patients with vivid clinical cholangitis, in whom decompression was achieved, in the control study, this value decreased by 100−500 times, which was accompanied by clinical improvement. According to the results of the study, it was noted that in the patients with a manifested clinic sign of cholangitis there is a significant decrease in the number of colonizing units on the third day after endoscopic papillosphincterotomy. At the stone stuck in a papilla the choledoch turns into so−called analog of an abscess. The opening of the papilla provides a free passage of the contents of the choledochus (i.e. pus) into the duodenum, so there is an almost instant therapeutic effect. The increase in pressure in the bile ducts in acute cholangitis is influenced by the development of an inflammatory process, which indicates the manifestations of biliary infection. The presented research has a prospective character and needs further development. Key words: cholangitis, biliary infection, intraductal pressure, bile.

Primary closure of the common bile duct in open laparotomy for common bile duct stones

2006 ◽  
Vol 13 (5) ◽  
pp. 398-402 ◽  
Author(s):  
Masato Yamazaki ◽  
Hideki Yasuda ◽  
Souichirou Tsukamoto ◽  
Yoshio Koide ◽  
Tsutomu Yarita ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Open Laparotomy ◽  
The Common

Placement of a double-pigtail ERBD tube after primary closure of the common bile duct in three patients with choledocholithiasis

2005 ◽  
Vol 12 (5) ◽  
pp. 386-390 ◽  
Author(s):  
Masakazu Fujii ◽  
Motonori Okino ◽  
Kentaro Fujioka ◽  
Katsuyuki Yamashita ◽  
Kimikazu Hamano
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
The Common

scholarly journals Morphological features of the wall of common bile duct under the conditions of experimental opioid exposure

2020 ◽  
Vol 26 (2) ◽  
pp. 26-31
Author(s):  
L.R. Mateshuk-Vatseba ◽  
I.I. Hirniak ◽  
U.Y. Pidvalna
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
White Male ◽  
Acute Cholangitis ◽  
Medical Science ◽  
Male Rats ◽  
Pathological Changes ◽  
White Rats ◽  
The Common

The morphological condition of the bile ducts remains one of the most important problems of modern medical science. In order to obtain an analgesic effect in patients with acute cholangitis, opioids are often used. However, information on the effectiveness of opioids in the treatment of pathological conditions of the bile ducts is contradictory. The rapidly progressive destruction of the intrahepatic bile ducts associated with the use of narcotic agents has been described. Further study of the effect of opioids on the structural organization of the common bile duct is relevant. In order to establish the morphological state of the common bile duct under conditions of long-term opioid exposure, a study was performed on 24 sexually mature white male rats, aged 3.5-5.0 months and weighing 180-200 g, which were injected intramuscularly with Nalbuphine for 6 weeks. The study material is represented by histological specimens of the common bile duct of white rats. The “Aver Media” computer system was used to photograph microspecimens. The “ImageJ” computer program was used to measure the diameter of the lumen and the wall thickness of the common bile duct. After 2 weeks of Nalbuphine administration to white rats, plethora of wall microvessels and a significant increase in the longitudinal diameter of the lumen of the common bile duct were observed. After 4 weeks of the experiment, the common bile duct was dilated, the transverse and longitudinal diameters of its lumen almost doubled, pathological changes in its wall had all the signs of inflammation. In the later stages of the experiment (introduction of Nalbuphine for 6 weeks), the pathological changes increased and manifested by destructuring the wall of the common bile duct, disorganization of cholangiocytes, thinning of the cell layer due to detachment of cholangiocytes, polymorphism of their nuclei, destruction of intercellular junctions, stratification of its own plate, vacuolar dystrophy of the muscular membrane “varicose” expansion of venules, significant smooth muscle hyperplasia of arterioles, the presence of perivascular lymphocytic infiltrates in the duct wall.

scholarly journals Adenoma of the duodenal ampulla impacted in the common bile duct caused acute cholangitis

2012 ◽  
Vol 81 (2) ◽  
pp. 156-157
Author(s):  
Shosuke Hosaka ◽  
Shinichiro Sato ◽  
Kiyotaka Umeki ◽  
Takaaki Saito ◽  
Mitsuhiro Omura
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Cholangitis ◽  
The Common

scholarly journals Primary Closure of the Common Bile Duct and Double-Pigtail ERBD Tube in a Choledocholithiasis

2004 ◽  
Vol 37 (2) ◽  
pp. 252-256
Author(s):  
Masakazu Fujii ◽  
Motonori Okino ◽  
Kentaro Fujioka ◽  
Katsuyuki Yamashita
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
The Common

Urgent endoscopic retrograde cholangio-pancreatography: to whom, when and how to perform?

2012 ◽  
Vol 153 (37) ◽  
pp. 1456-1464
Author(s):  
László Czakó
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Cholangitis ◽  
Timely Manner ◽  
Endoscopic Retrograde ◽  
Biliary Decompression ◽  
The Common ◽  
Alternative Techniques ◽  
Severity Of The Disease ◽  
Bile Leaks

Although the effectivity of an urgent endoscopic retrograde cholangio-pancreatography was documented, some aspects relating to this method are still debated. Timing of this procedure has not been established yet. Indications for urgent endoscopic retrograde cholangio-pancreatography with stone extraction from the common bile duct in patients with biliary pancreatitis remains controversial. Biliary decompression and drainage is the cornerstone of acute cholangitis treatment. The timing of endoscopic retrograde cholangio-pancreatography should be based on the grade of the severity of the disease. Using endoscopic retrograde cholangio-pancreatography, the accurate diagnosis and treatment of bile leaks in a timely manner is imperative to limit associated morbidity and mortality. Difficulty in cannulating the common bile duct is one of the main risk factors for pancreatitis occurring after the procedure. Alternative techniques to facilitate difficult cannulation are discussed. Organized training and introduction of objective measures of the investigator’s competence are emphasized to improve the performance of the procedure in Hungary. Orv. Hetil., 2012, 153, 1456–1464.

Laparoscopic Primary Closure of Common Bile Duct Combined with Percutaneous Cholangiographic Drainage for Treating Choledocholithiasis

2010 ◽  
Vol 76 (5) ◽  
pp. 517-521 ◽  
Author(s):  
Shing-Moo Huang ◽  
Chung-Chin Yao ◽  
Ya-Wen Cheng ◽  
Ling-Yun Chen ◽  
Huichin Pan ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Primary Closure ◽  
Operation Time ◽  
Tube Placement ◽  
Control Group ◽  
Study Group ◽  
T Tube ◽  
Cbd Stones ◽  
The Common

The aim of this study was to compare the efficacy and safety of laparoscopic primary closure of the common bile duct (CBD) combined with percutaneous transhepatic cholangiographic drainage (PTCD) and laparoscopic choledocholithotomy with T-tube placement for the treatment of CBD stones. Between January 1991 and July 2002, 50 patients with choledocholithiasis and a CBD diameter larger than or equal to 1 cm underwent laparoscopic CBD explorations. The study group consisted of 10 patients undergoing laparoscopic primary closure of the CBD combined with PTCD. The control group consisted of 40 patients undergoing laparoscopic choledocholithotomy with T-tube placement. Parameters were compared statistically. The study group showed higher female/male ratio (6/4 vs 8/32, P = 0.02), less stone numbers (1.90 ± 0.88 vs 3.40 ± 1.65, P = 0.0078), shorter operation time (138 ± 37 minutes vs 191 ± 75 minutes, P = 0.014), and shorter postoperative stays (7 ± 3 days vs 10 ± 3 days, P = 0.0013). It seems that laparoscopic primary closure of the CBD combined with PTCD can shorten the operation time and postoperative stays as compared with laparoscopic choledocholithotomy with T-tube placement for the treatment of CBD stones.

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