Common Hepatic Duct Stricture Due to Surgical Clip

Mirizzi syndrome is described in the 1940s as follows: partial obstruction of the secondary common hepatic duct by gallstones, impacted on the cystic duct or gallbladder infundibulum, associated with the inflammatory response that involved the cystic duct and the common hepatic duct. As it is a rare and delicate condition, differential diagnosis is extremely important, in which the patient's clinical condition is verified through anamnesis and complementary exams, where immediately after the surgical intervention can be performed. This work aims to describe, through a literature review, the clinical aspects and the surgical technique in Mirizzi Syndrome. Were used as a database for research sites containing scientific articles available online such as Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo) and PubMed. 154 articles were found through the descriptors, where after applying the inclusion and exclusion criteria 11 articles remained to write the work. According to the articles surveyed, it is clear that most of them do not report the syndrome as the main diagnosis, possibly because it is a pathology with signs and symptoms very close to other diseases of the bile duct, therefore leaving the syndrome sometimes described in the context of these other diseases. Finally, it concludes that even though the preoperative diagnosis is rare, it should be suspected in individuals undergoing biliary surgery.

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Enlarged common hepatic duct secondary to morphine in a neonate

Pediatric Radiology ◽

10.1007/bf02390403 ◽

1988 ◽

Vol 18 (3) ◽

pp. 235-236 ◽

Cited By ~ 5

Author(s):

A. E. Schlesinger ◽

D. M. Null

Keyword(s):

Hepatic Duct ◽

Common Hepatic Duct

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Repeated Plastic Stentings of Common Hepatic Duct for Portal Vein Aneurysm Compression in a Patient Unsuitable for Surgery

Case Reports in Gastroenterology ◽

10.1159/000492812 ◽

2018 ◽

Vol 12 (3) ◽

pp. 570-577 ◽

Cited By ~ 1

Author(s):

Jeffrey Sun ◽

Cheuk-Kwan Sun ◽

Cheuk-Kay Sun

Keyword(s):

Portal Vein ◽

Surgical Intervention ◽

Vascular Malformations ◽

Imaging Modality ◽

Hepatic Duct ◽

Therapeutic Option ◽

Clinical Signs ◽

Common Hepatic Duct ◽

Low Grade ◽

Portal Vein Aneurysm

Portal vein aneurysms are rare vascular malformations with unclear etiologies and optimal treatment guidelines. Although Doppler ultrasonography is the most commonly used diagnostic tool, there is no gold standard imaging modality. Despite recommendations of surgical treatment for symptomatic aneurysms, there are limited options in the management of portal vein aneurysm-related complications in patients unfit for surgical intervention. We describe an 85-year-old man who presented with abdominal pain and low-grade fever with clinical signs consistent with cholangitis. Endoscopic retrograde cholangiopancreatography revealed a common hepatic duct stricture and concomitant intraductal ultrasonography identified adjacent aneurysmal portal vein dilatation. The final diagnosis of portal vein aneurysm was made using contrast computerized tomography scan. The patient was considered unsuitable for surgery due to his advanced age and multiple comorbidities. Instead, an endoscopic biliary plastic stent was inserted as a therapeutic alternative, which successfully achieved complete resolution of symptoms 3 days after the procedure. The patient was regularly followed at the outpatient clinic with repeated stent replacements every 3 to 4 months. After a follow-up of over 3.5 years, the patient remained symptom-free without signs of portal vein aneurysm compression. The result suggests that repeated stent replacements may be a therapeutic option for biliary compression by portal vein aneurysm in patients contraindicated for surgical intervention.

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Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

Anatomy Research International ◽

10.1155/2012/838179 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Theodoros Mariolis-Sapsakos ◽

Vasileios Kalles ◽

Konstantinos Papatheodorou ◽

Nikolaos Goutas ◽

Ioannis Papapanagiotou ◽

...

Keyword(s):

Bile Ducts ◽

Hepatic Duct ◽

Anatomical Variations ◽

Common Hepatic Duct ◽

Drainage Pattern ◽

Left Hepatic Duct ◽

Surgical Interventions ◽

Drainage Patterns ◽

The Common ◽

The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

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Glissonean pedicle approach using Takasaki method in liver resection at Hue Central Hospital

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2019.54.2 ◽

2019 ◽

pp. 8-11

Author(s):

Van Linh Ho

Keyword(s):

Operative Time ◽

Hepatic Duct ◽

Postoperative Mortality ◽

Descriptive Study ◽

Common Hepatic Duct ◽

Effective Technique ◽

Female Ratio ◽

Male Female Ratio ◽

Glissonean Pedicle ◽

The Mean

Objective: To apply hepatectomy using Takasaki procedure to control Glissonean pedicle. Methods: A prospective, descriptive study on 31 patients undergoing hepatectomy using Takasaki Glissonean pedicle approach. Results: The mean age was 55 ± 11.7 (39 – 73 years), male/female ratio was 7.3. The mean operative time was 115 ± 37 minutes. The mean blood loss was 271 ± 119 ml. There was one case of common hepatic duct injury (3.6%). Postoperative complications occurred in 7(22.4%) patients. There was no postoperative mortality. Conclusions: Hepatectomy using Takasaki Glissonean pedicle approach was safe and effective technique. Keywords: Glissonean pedicle approach, hepatectomy

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When It Doesn't Fit: Congenital Anomalies of the Choledochus

European Journal of Pediatric Surgery Reports ◽

10.1055/s-0039-1693998 ◽

2020 ◽

Vol 08 (01) ◽

pp. e86-e89

Author(s):

Helena Reusens ◽

Mark Davenport

Keyword(s):

Case Report ◽

Bile Duct ◽

Common Bile Duct ◽

Extrahepatic Bile Duct ◽

Hepatic Duct ◽

Common Hepatic Duct ◽

Resected Specimen ◽

Cystic Dilatation ◽

Left Hepatic Duct ◽

Distal Common Bile Duct

Abstract Introduction Congenital choledochal malformations (CCMs) are characterized by intra- and/or extrahepatic bile duct dilatation. Five basic types (1–5) are recognized in Todani's classification and its modifications, of which types 1 and 4 typically have an associated anomalous pancreatobiliary junction and common channel (CC). We describe two cases with previously undescribed features. Case Report 1 Antenatal detection of a cyst at porta hepatis was made in an otherwise normal girl of Iranian parentage. She was confirmed to be a CCM (20 mm diameter), postnatally, with no evidence of obstruction. Surgical exploration was performed at 12 weeks. She had an isolated cystic dilatation of the right-hepatic duct only. The left-hepatic duct and common bile duct (CBD) were normal without a CC. Histology of the resected specimen showed stratified squamous epithelium. Case Report 2 A preterm (31 weeks of gestation) boy of Nigerian parentage was presented. His mother was HIV + ve and he was treated with nucleoside reverse transcriptase inhibitors following birth. He had persistent cholestatic jaundice and a dilated (10 mm) bile duct from birth. Although the jaundice resolved, the dilatation persisted and increased, coming to surgery aged 2.5 years. This showed cystic dilatation confined to the common hepatic duct, and otherwise normal distal common bile duct and no CC. Result Both underwent resection with the Roux-en-Y hepaticojejunostomy reconstruction to the transected right-hepatic duct alone in case 1, leaving the preserved left duct and CBD in continuity, and to the transected common hepatic duct in case 2. Conclusions Neither choledochal anomaly fitted into the usual choledochal classification and case 1 appears unique in the literature.

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Measurement of capacity of biliary tree in rats

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1963.205.6.1122 ◽

1963 ◽

Vol 205 (6) ◽

pp. 1122-1126 ◽

Cited By ~ 40

Author(s):

G. Barber-Riley

Keyword(s):

Hepatic Duct ◽

Biliary Tree ◽

Liver Weight ◽

Common Hepatic Duct ◽

Marker Substances ◽

The Common ◽

Made In

A method is described for measuring the capacity of the normal and of the distended biliary tree. The method depends on the use of dyes rapidly excreted in the bile, which are used as marker substances, and is here applied to rats. The use of an alternative suitable dye, or large alterations in the quantity injected, produced in most cases only small changes in the measured capacities. The measured capacity of both the normal and of the distended biliary tree was found to be proportional to the liver weight, and was altered by an expected amount when a lobe of the liver was functionally removed. The measured extra capacity produced by obstruction of the common hepatic duct was similar to that found using another method. The reliability of the method and some probable errors are briefly discussed. It is concluded that measurements made in this manner might be used to examine the biliary tree during short periods of obstruction.

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Endometrial clear cell carcinoma with metastasis to the common hepatic duct: A rare aetiology of obstructive jaundice, diagnosed by biliary cytology brushing specimen

Cytopathology ◽

10.1111/cyt.12807 ◽

2020 ◽

Vol 31 (3) ◽

pp. 240-242

Author(s):

Beena U. Ahsan ◽

Mohamed Alhamar ◽

Kathryn M. Hogan ◽

Daniel Schultz ◽

Tobias Zuchelli ◽

...

Keyword(s):

Obstructive Jaundice ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Hepatic Duct ◽

Common Hepatic Duct ◽

The Common ◽

Biliary Cytology

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