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

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.

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.

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

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.

scholarly journals Mirizzy syndrome complicated by acute cholangitis in pregnant

2020 ◽  
Vol 25 (1) ◽  
pp. 124-128
Author(s):  
A. V. Osipov ◽  
A. E. Demko ◽  
D. A. Surov ◽  
I. A. Soloviev ◽  
A. V. Sviatnenko ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Surgical Procedure ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
The Common

A case report of the patient at week 21 of pregnancy with Mirizzi type 2 syndrome complicated by acute cholangitis is described. During the examination, the level and cause of the biliary obstruction (cholecystocholedocheal fistula and gallstone of the common bile duct) were revealed. A detailed description of the surgical procedure is presented: subtotal laparoscopic cholecystectomy, choledochotomy, choledochoscopy, lithoextraction, drainage of the common bile duct. The analysis of information from literature sources is carried out.

scholarly journals PHOTODYNAMIC THERAPY OF EXPERIMENTAL CHOLANGITIS

2021 ◽  
Vol 19 (1) ◽  
pp. 96-105
Author(s):  
R. S. Shyla ◽  
◽  
E. М. Mahiliavets ◽  
K. S. Belyuk ◽  
N. I. Procopchik ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Laser Irradiation ◽  
Acute Cholangitis ◽  
White Blood Cells ◽  
Laser Action ◽  
Bactericidal Effect ◽  
The Third ◽  
The Common

Background. Photodynamic therapy of acute cholangitis involves the introduction of a photosensitizer into the common bile duct and subsequent laser irradiation of the liver. The study of combined laser action on the liver is promising. Purpose of the study. To evaluate in an experiment the effectiveness of photodynamic therapy of acute cholangitis with the introduction of a photosensitizer into the common bile duct and combined laser irradiation of the liver. Material and methods. Acute cholangitis was modeled in rabbits. In the first group, a saline solution was introduced into the common bile duct, in the second and third – "Photolon". Then, in the second group, photodynamic therapy with endocholedocheal laser irradiation of the liver was performed, in the third group – with combined irradiation. The general condition of the animals, their laboratory, microscopic and microbiological parameters were evaluated. After the autopsy, a histological examination of the liver and common bile duct was performed. Results. On the 2nd day of the experiment, all rabbits developed acute cholangitis. After treatment in the group "Experience 3", in comparison with other groups, there was a greater decrease in the indicators of inflammation and cholestasis in the blood, the number of microorganisms and white blood cells in the bile. In the first group, the formation of liver abscesses was histologically noted. Pathological changes in the wall of the common bile duct and liver in the third group were less pronounced than in the second. Conclusions. 1. The experimental model allows on the second day to reproduce acute cholangitis in rabbits. 2. Photodynamic therapy with Photolon photosensitizer with combined (endocholedocheal and surface) laser irradiation of the liver has a more pronounced bactericidal effect compared to endocholedocheal irradiation.

scholarly journals Migration of Surgical Clips into the Common Bile Duct after Laparoscopic Cholecystectomy

2017 ◽  
Vol 10 (3) ◽  
pp. 787-792 ◽  
Author(s):  
Krishn Kant Rawal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Acute Cholangitis ◽  
Endoscopic Retrograde ◽  
Surgical Clips ◽  
Cbd Stones ◽  
The Common ◽  
Retained Stones

Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC. Liver function tests revealed features of obstructive jaundice. Ultrasonography of the abdomen showed dilated CBD with few stones. In view of acute cholangitis, an urgent endoscopic retrograde cholangiopancreatography was done, which demonstrated few filling defects and 2 linear metallic densities in the CBD. A few retained stones along with 2 surgical clips were removed successfully from the CBD by endoscopic retrograde cholangiopancreatography after papillotomy using a Dormia basket. The patient improved dramatically following the procedure.

scholarly journals Endoscopic Treatment of Anastomotic Biliary Stenosis in Patients With Orthotopic Liver Transplantation

1995 ◽  
Vol 2 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Alfredo Rossi ◽  
Claudio Grosso ◽  
Giulio Zanasi ◽  
Pietro Gambitta ◽  
Marta Bini ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Cholangitis ◽  
Balloon Dilation ◽  
Endoscopic Stenting ◽  
Endoscopic Retrograde ◽  
Flow Through ◽  
The Common

The choledocho-choledochostomy stricture is one of the most frequent complications occurring after liver transplantation. Today endoscopic retrograde cholangiopancreatography may be considered one of the most common methodologic approaches for the diagnosis; at the same time it provides an effective treatment of the stenosis, avoiding more invasive surgery. Biliary flow through a strictured anastomosis definitely improves after endoscopic stenting which, in most cases, resolves the biliary obstruction syndrome; moreover, the stent could allow restoration of the anatomical and functional integrity of the common bile duct. We have successfully treated eight liver transplanted patients with biliary anastomotic stenosis by endoscopic stenting of the common bile duct or by balloon dilation (one patient). The stents were replaced every 3 to 4 months and then removed after 1 year of follow-up. We observed one patient with acute cholangitis due to the clogging of the prosthetic device.

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