Hepatectomy for cholangiocarcinoma complicated with right umbilical portion: anomalous configuration of the intrahepatic biliary tree

2000 ◽  
Vol 7 (3) ◽  
pp. 321-326 ◽  
Author(s):  
Yuji Kaneoka ◽  
Akihiro Yamaguchi ◽  
Masatoshi Isogai ◽  
Tohru Harada
Keyword(s):  
Biliary Tree ◽  
Right Umbilical Portion

scholarly journals Percutaneous transhepatic biliary puncture simulator: a cord network prototype

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Rubén Lopez Benítez ◽  
Tomás Reyes del Castillo ◽  
David Benz ◽  
Carsten Fechner ◽  
Lorant Szabo ◽  
...  
Keyword(s):  
Training Session ◽  
Lower Lobe ◽  
Biliary Tree ◽  
Training Model ◽  
Polystyrene Foam ◽  
Wooden Frame ◽  
Biliary Ducts ◽  
Hand Coordination ◽  
Radiology Residents ◽  
Positive Results

Abstract Background The aim of this study was to present a percutaneous transhepatic biliary puncture simulator that can be used without radiation exposure and that reflects the conventional anatomy of the biliary ducts and its vicinity structures. Methods An anatomically based model of the biliary tree was developed using a cord network fixed to a wooden frame. The skin, ribs, intercostal muscles, and right lower lobe pleura were simulated using foam sponge, plastic tubes, a polystyrene foam panel, and an air pad, respectively. For the puncture, we used a 20-G Chiba needle and a wire with distal double arches; these were used to troll a cord, simulating the successful puncture of a bile duct. A camera was also placed above the model to allow the trainees to train eye-hand coordination while viewing the image on a monitor in real time. The simulator was tested with 60 radiology residents to evaluate the confidence and skills transferability of the training model. Results After receiving an introduction of the system and 5 min of training under tutor surveillance, all participants were able to troll a cord of the biliary simulator by themselves in less than 4 min. Only one participant punctured the simulated pleura. The participants’ evaluations showed positive results, with increased user confidence and skills transferability after the training session. Conclusions This proposed simulator can be an effective tool to improve a trainee’s confidence and competence while achieving procedural and non-procedural interventional radiology skills related to the liver. Trial registration Retrospectively registered

scholarly journals AB0545 GASTROINTESTINAL INVOLVEMENT IN SYSTEMIC SCLEROSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1569.2-1569
Author(s):  
A. Argibay ◽  
I. Novo ◽  
M. Ávila ◽  
P. Diéguez González ◽  
M. Estévez Gil ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Gastroesophageal Reflux ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Biliary Tree ◽  
Motility Disorder ◽  
Anatomical Site ◽  
Digital Ulcers ◽  
Lung Involvement ◽  
Imaging Results

Background:Systemic sclerosis (SSc) is a chronic, connective tissue disease with an autoimmune pattern characterized by inflammation, fibrosis and microcirculation changes leading to internal organs malfunctions. The gastrointestinal tract (GIT) is affected in up to 90% of patients with SSc. Any part of the GIT from the mouth to the anus can be affected. There are few descriptive studies about SSc-related GIT involvement.Objectives:We aimed to characterize the GIT involvement in patients with SSc.Methods:This retrospective study included all patients from SSc cohort of our autoimmune diseases unit in a tertiary referral centre. All patients fulfilled SSc criteria proposed by the American College of Rheumatology. All subjects’ histories were evaluated. Laboratory and imaging results were obtained from the hospital files. Patients with digestive manifestations were compared with patients without GIT involvement. Chi2 and t-student were used, using the statistical package SPSS25.0.Results:83 subjects with SSc were included, 68 (81,9%) of them were women. The mean age at the onset of SSc was 62,1 ± 15,3 years (range 26-89) with a mean follow-up of 9,6 ± 7,4 years. 80,7% of patients had limited SSc, 12% diffuse SSc, 4.8% SSc sine scleroderma and 2,4% early SSc. Considering the immunological profile 12 (14,5%) had Scl70 antibodies, 49 (59%) anticentromere and 21 (25,3%) had ANA antibodies without specificity for anti-Scl70 or anticentromere. 37,3% patients had lung involvement, 20,5% scleroderma and 30,1% digital ulcers. 79,5% of SSc patients were treated with proton pump inhibitors or H2 blockers. 53 (63,9%) patients with SSc had GIT involvement. In 11 patients (20,7%) digestive involvement was diagnosed before SSc (mean 26,2 months). Esophageal involvement occurred in 83%, gastric involvement in 28,3%, intestine involvement in 24,5% and liver and biliary tree involvement in 26,4%. See table 1. No significant differences in age, sex, SSc subtype, autoantibody profile, lung involvement, skin disease, mortality and therapy were observed between patients with or without GIT manifestations. There were no deaths associated with GIT involvement. The most common pharmacologic therapy used was proton pump inhibitors (86,8%), domperidone (20,8%) and antibiotic rotation (17%).EsophagealGastricIntestinalLiver and biliary tree44/53 (83%)15/53 (28,3%)12/53 (24,5%)14/53 (26,4%)Esophageal motility disorder 8 (15,1%)Gastroparesis 6 (11,3%)Small bacterial overgrowth 7 (13,2%)Primary biliary cholangitis 9 (17%)Gastroesophageal reflux 40 (75,5%)Abdominal pain /nausea 10 (18,9%)Colonic inertia 1 (1,9%)Autoimmune hepatitis 3 (5,7%)Dysphagia 11 (20,8%)Subacute gastritis 7 (13,2%)Diarrhea 6 (11,3%)Cholestatic liver enzymes 11 (20,8%)Flatulence / abdominal discomfort 6 (11,3%)Cirrhosis 2 (3,8%)Conclusion:Almost two thirds of our cohort of SSc have symptomatic gastrointestinal disease. GIT manifestations are heterogeneous. Symptoms are non-specific and overlapping for a particular anatomical site. Esophagus is the most commonly affected. More than seventy-five per cent of patients experience symptoms of gastroesophageal reflux. We did not find differences among patients with and without SSc GIT disease. 17% of patients had a Reynold’s syndrome.References:[1]Alastal Y et al. Gastrointestinal manifestations associated with systemic sclerosis: results from the nationwide inpatient simple. Ann Gastroenterol 2017; 30 (5): 1-6.[2]Savarino E et al. Gastrointestinal motility disorder assessment in systemic sclerosis. Rheumatology. 2013; 52(6):1095–100.[3]Steen VD et al. Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis and rheumatism. 2000; 43(11):2437–44.Disclosure of Interests:None declared

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

scholarly journals Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kamil Janowski ◽  
Elizabeth Shumbayawonda ◽  
Lin Cheng ◽  
Caitlin Langford ◽  
Andrea Dennis ◽  
...  
Keyword(s):  
Liver Function ◽  
Spin Echo ◽  
Rank Correlation ◽  
Biliary Tree ◽  
Liver Function Tests ◽  
Multiparametric Mri ◽  
Fast Spin Echo ◽  
Baseline Serum ◽  
Function Tests ◽  
Imaging Markers

AbstractAutoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) are two very closely related autoimmune liver diseases with overlapping clinical features and similar management strategies. The purpose of this study was to assess the utility of quantitative imaging markers to distinguish ASC from AIH in paediatrics. 66 participants (N = 52 AIH, N = 14 ASC) aged 14.4 ± 3.3 years scheduled to undergo routine biopsy and baseline serum liver biochemistry testing were invited to undergo MRI (non-contrast abdominal MRI and 3D fast spin-echo MRCP). Multiparametric MRI was used to measure fibro-inflammation with corrected T1 (cT1), while the biliary tree was modelled   using quantitative MRCP (MRCP +). Mann–Whitney U tests were performed to compare liver function tests with imaging markers between patient groups (ASC vs AIH). Receiver operating characteristic curves and stepwise logistic regressions were used to identify the best combination of markers to discriminate between ASC and AIH. Correlations between liver function tests and imaging markers were performed using Spearman’s rank correlation. cT1 was significantly correlated with liver function tests (range 0.33 ≤ R ≤ 56, p < 0.05), as well as with fibrosis, lobular and portal inflammation (range 0.31 ≤ R ≤ 42, p < 0.05). 19 MRCP + metrics correlated significantly with liver function tests (range 0.29 ≤ R ≤ 0.43, p < 0.05). GGT and MRCP + metrics were significantly higher in ASC compared to those with AIH. The best multivariable model for distinguishing ASC from AIH included total number of ducts and the sum of relative severity of both strictures and dilatations AUC: 0.91 (95% CI 0.78–1). Quantitative MRCP metrics are a good discriminator of ASC from AIH.

The case of the disappearing bullet: An extraluminal compression of the biliary tree

Trauma ◽  
2021 ◽  
pp. 146040862110009
Author(s):  
M Mihalik ◽  
N Allopi
Keyword(s):  
Obstructive Jaundice ◽  
South African ◽  
Surgical Intervention ◽  
Biliary Tree ◽  
Common Occurrence ◽  
Abdominal Injuries ◽  
Gun Shot ◽  
Shot Wounds

Penetrating abdominal injuries, especially from gun shot wounds, are a common occurrence in South African hospitals, and a vast majority of these patient receive surgical intervention for suspected intra-abdominal injuries. Not all bullets are found and removed however, and we detail the case of a gentleman who presented to our institution with obstructive jaundice secondary to an extraluminal compression of his biliary tree by a retained migrated bullet, that spontaneously resolved, without any surgical intervention.

scholarly journals Single Balloon Enteroscopy for Endoscopic Retrograde Cholangiography in a Patient with Hepaticojejunostomy after Liver Transplant

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Marta Di Pisa ◽  
Roberto Miraglia ◽  
Riccardo Volpes ◽  
Salvatore Gruttadauria ◽  
Mario Traina
Keyword(s):  
Small Bowel ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Biliary Tree ◽  
Endoscopic Retrograde ◽  
Balloon Enteroscopy ◽  
Post Transplant ◽  
Biliary Anastomosis ◽  
Single Balloon ◽  
Single Balloon Enteroscopy

We report a case of a post-transplant patient with hepaticojejunostomy in whom we used a single balloon enteroscopy to access the biliary tree. This procedure seems to be safe and feasible for approaching the biliary anastomosis by means of the overtube and fixation of the small bowel by the balloon.

Endogenous Opioids Modulate the Growth of the Biliary Tree in the Course of Cholestasis

2006 ◽  
Vol 130 (6) ◽  
pp. 1831-1847 ◽  
Author(s):  
Marco Marzioni ◽  
Gianfranco Alpini ◽  
Stefania Saccomanno ◽  
Samuele de Minicis ◽  
Shannon Glaser ◽  
...  
Keyword(s):  
Biliary Tree ◽  
Endogenous Opioids

Pluripotential liver stem cells: facultative stem cells located in the biliary tree

1996 ◽  
Vol 29 (7) ◽  
pp. 373-402 ◽  
Author(s):  
M. R. Alison ◽  
M. H. C. Golding ◽  
C. E. Sarraf
Keyword(s):  
Stem Cells ◽  
Biliary Tree ◽  
Liver Stem Cells

scholarly journals Fibrinolysis and the biliary tree.

Gut ◽  
1997 ◽  
Vol 40 (1) ◽  
pp. 92-94 ◽  
Author(s):  
D M Scott-Coombes ◽  
S A Whawell ◽  
E G Havranek ◽  
J N Thompson
Keyword(s):  
Biliary Tree
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