Intact Choledochal Cyst With Spontaneous Common Hepatic Duct Perforation

2015 ◽  
Vol 60 (1) ◽  
pp. e1
Author(s):  
Santosh B. Kurbet ◽  
Gowda P. Prashanth ◽  
Vishwanath D. Patil ◽  
Rajashekhar M. Wali
Keyword(s):  
Choledochal Cyst ◽  
Hepatic Duct ◽  
Common Hepatic Duct

Neuroendocrine tumor of the common hepatic duct, mimicking a choledochal cyst in a 6-year-old child

2009 ◽  
Vol 44 (6) ◽  
pp. e23-e25 ◽  
Author(s):  
Ursula Tonnhofer ◽  
Csilla Balassy ◽  
Carlos A. Reck ◽  
Anke Koller ◽  
Ernst Horcher
Keyword(s):  
Neuroendocrine Tumor ◽  
Choledochal Cyst ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
The Common

Hepatic ductoplasty and hepaticojejunostomy to treat narrow common hepatic duct during laparoscopic surgery for choledochal cyst

2015 ◽  
Vol 31 (10) ◽  
pp. 983-986 ◽  
Author(s):  
Naoto Urushihara ◽  
Koji Fukumoto ◽  
Hiroshi Nouso ◽  
Masaya Yamoto ◽  
Hiromu Miyake ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Choledochal Cyst ◽  
Hepatic Duct ◽  
Common Hepatic Duct

scholarly journals Diverticulum of common hepatic duct leading to obstructive jaundice, a case report

2019 ◽  
Vol 5 (2) ◽  
pp. 20180105
Author(s):  
Nicola Tarallo ◽  
Marco Curti ◽  
Valeria Molinelli ◽  
Anna Leonardi ◽  
Carlo Fugazzola
Keyword(s):  
Choledochal Cyst ◽  
Incidental Finding ◽  
Hepatic Duct ◽  
Acute Cholangitis ◽  
Biliary Tree ◽  
Common Hepatic Duct ◽  
Type Ii ◽  
Biliary Stones ◽  
Rare Type ◽  
Presenting Symptoms

Choledochal cyst is a dilation of the intrahepatic and/or extrahepatic biliary tree. The pathogenesis is unknown and potentially is multifactorial. In 1977, Todani classified the cysts under five different types according to their morphology, number and distribution along the biliary tree. Presenting symptoms of Choledocal cysts which include upper abdominal pain, acute cholangitis and jaundice, although often they are clinically silent and discovered as an incidental finding. Biliary complications include cholangitis, biliary stones, pancreatitis, portal hypertension and cholangiocarcinoma. We describe a case of a rare Type II Todani cyst located on the right side of the common hepatic duct characterised by a clinical presentation similar to that observed in Mirizzi Syndrome. The treatment of a Type II choledochal cyst consists in cystic excision.

Robotic Excision of Choledochal Cyst with Hepaticoduodenostomy (HD): Report of HD Technique, Initial Experience, and Early Outcome

2020 ◽  
Author(s):  
Saalim Nazki ◽  
Ravi Prakash Kanojia ◽  
Monika Bawa ◽  
Vineet Binu ◽  
Sadhna Lal ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Epigastric Pain ◽  
Hepatic Duct ◽  
Bile Reflux ◽  
Common Hepatic Duct ◽  
Initial Experience ◽  
Cyst Excision ◽  
Hida Scan ◽  
The Mean

Abstract Introduction Minimal access surgical approach to choledochal cyst (CC) is becoming a standard of care in pediatric age group. Robotic-assisted excision of CC is increasingly being practiced at centers which have access to the system. We present our experience and technique of hepaticoduodenostomy (HD). Over all initial experience, short-term outcomes and complications are also presented and discussed. Materials and Methods Patients with CC and undergoing robotic excision were retrospectively studied. Patients with active cholangitis, liver dysfunction, and perforated CC were excluded for robotic procedures. All included patients were preoperatively evaluated as per the defined protocol. They underwent excision of CC with HD. The duodenal anastomosis was done after limited mobilization and emphasis was laid on anastomosing the distal D2 part to the common hepatic duct. This prevents bile reflux into stomach. The follow-up evaluation was done for these patients. Hepatobiliary iminodiacetic acid (HIDA) scan for duodenogastric reflux (DGR) was done only if patients reported symptoms related to it. Results A total of 19 patients (10 females) were studied. The mean age was 84 months. Type 1b was present in 12 patients and the rest were type IVb. Complete cyst excision with HD was done in all patients except conversion to open in one patient. The mean surgical time was 170 ± 40 minutes with console time of 140 ± 20 minutes. Median follow-up duration is 2.5 years (range: 3.5–0.5 years). HIDA scan was done in five patients who had reported epigastric pain. Of these five, one patient had a positive DGR. He is on conservative management. Conclusion Robot-assisted CC excision with HD is feasible as proven by the outcome of 19 patients presented in this series. HD is to be done away from pylorus in distal part of down curving D2. This particular step prevents DGR and is the most important point of technique in doing HD. The presented series is the first report of robotic excision of CC with HD. The robot is a facilitator for complex and difficult operations as CC excision and HD.

Clinical aspects and surgical technique in Mirizzi syndrome: A systematic review

2020 ◽  
pp. 35871-35873
Keyword(s):  
Surgical Technique ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Signs And Symptoms ◽  
Mirizzi Syndrome ◽  
Common Hepatic Duct ◽  
Clinical Aspects ◽  
Main Diagnosis ◽  
Biliary Surgery ◽  
Electronic Library

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.

Enlarged common hepatic duct secondary to morphine in a neonate

1988 ◽  
Vol 18 (3) ◽  
pp. 235-236 ◽  
Author(s):  
A. E. Schlesinger ◽  
D. M. Null
Keyword(s):  
Hepatic Duct ◽  
Common Hepatic Duct

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

2018 ◽  
Vol 12 (3) ◽  
pp. 570-577 ◽  
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.

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

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
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.

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

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

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

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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