scholarly journals TREATMENT OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE (review)

2018 ◽  
Vol 5 (2) ◽  
pp. 84-92
Author(s):  
A. Sochnieva
Keyword(s):  
Surgical Treatment ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Hepatic Impairment ◽  
Life Quality ◽  
Biliary Tree ◽  
Biliary Decompression ◽  
Surgical Interventions ◽  
Bile Duct Diseases

TREATMENT OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE (review)Sochneva A.L.The article presents the up-to-date data concerning the treatment of common bile duct diseases complicated by obstructive jaundice. Nowadays, specialized clinics widely use mini-invasive interventions to treat this complicated pathology. Biliary tree decompression is the main objective of operative treatment. It is reasonable to perform antegrade and retrograde endobiliary interventions as preparatory and final stages of surgical treatment and in order to improve the patients’ life quality and avoid hepatic impairment progression. Reconstructive-reparative operations following prior biliary decompression yield significantly better results as compared to surgical interventions without it.Key words: common bile duct diseases, obstructive jaundice, antegrade interventions, retrograde interventions, reconstructive-reparative operations. ЛІКУВАННЯ ЗАХВОРЮВАНЬ ГЕПАТИКОХОЛЕДОХА, УСКЛАДНЕНИХ МЕХАНІЧНОЮ ЖОВТЯНИЦЕЮ (огляд літератури)Сочнева А.Л.У статті висвітлені сучасні дані по лікуванню захворювань гепатикохоледоха, ускладнених механічною жовтяницею. В даний час в спеціалізованих клініках широко застосовуються мініінвазивні втручання в лікуванні такої складної патології. Декомпресія біліарного дерева є основною метою при виконанні оперативних втручань. Антеградний і ретроградні ендобіліарні втручання доцільно застосовувати в якості як підготовчого, так і завершального етапів хірургічного лікування, а також поліпшити якість життя хворих і уникнути прогресування печінкової недостатності. Виконання реконструктивно-відновлювальні операцій після попередньої біліарної декомпресії демонструє значно кращі результати в порівнянні з оперативними втручаннями, виконаними без неї.Ключові слова: захворювання гепатикохоледоха, механічна жовтяниця, антеградний втручання, ретроградні втручання, реконструктивно-відновлювальні операції. Лечение заболеваний гепатикохоледоха, осложненных механической желтухой: обзор литературы ЛЕЧЕНИЕ ЗАБОЛЕВАНИЙ ГЕПАТИКОХОЛЕДОХА, ОСЛОЖНЕННЫХ МЕХАНИЧЕСКОЙ ЖЕЛТУХОЙ (обзор литературы)Сочнева А.Л.В статье освещены современные данные по лечению заболеваний гепатикохоледоха, осложненных механической желтухой. В настоящее время в специализированных клиниках широко применяются миниинвазивные вмешательства в лечении столь сложной патологии. Декомпрессия билиарного дерева является основной целью при выполнении оперативных вмешательств. Антеградные и ретроградные эндобилиарные вмешательства целесообразно применять в качестве как подготовительного, так и завершающего этапов хирургического лечения, а также улучшить качество жизни больных и избежать прогрессирования печеночной недостаточности. Выполнение реконструктивно-восстановительные операций после предварительной билиарной декомпрессии демонстрирует значительно лучшие результаты в сравнении с оперативными вмешательствами, выполненными без нее.Ключевые слова: заболевания гепатикохоледоха, механическая желтуха, антеградные вмешательства, ретроградные вмешательства, реконструктивно-восстановительные операции.

PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY IN THE DIAGNOSTICS OF COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE*

2021 ◽  
Vol 8 (2) ◽  
pp. 62-67
Author(s):  
Valeriy V. Boyko ◽  
Yuriy V. Avdosyev ◽  
Anastasiia L. Sochnieva ◽  
Denys O. Yevtushenko ◽  
Dmitro V. Minukhin
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tract ◽  
Percutaneous Transhepatic Cholangiography ◽  
Biliary Decompression ◽  
Biliodigestive Anastomosis ◽  
Bile Duct Diseases

Aim: Evaluation of the effectiveness of percutaneous transhepatic cholangiography in the diagnostics of bile duct diseases complicated by obstructive jaundice. Material and methods: This article presents the experience of using percutaneous transhepatic cholangiography in 88 patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Results: Methods of direct contrasting of the biliary tract make it possible to visualize choledocholithiasis with 86.5% accuracy, with 84.1% common bile duct strictures, with 87.8% stricture of biliodigestive anastomosis and with 97.5% accuracy of cholangiocarcinomas. Conclusions: Direct antegrade bile duct enhancement should be used if ERCPG has low explanatory value. PTCG in case of “endoscopically complicated forms” of choledocholithiasis, CBD and BDA strictures and cholangiocarcinomas enhances all bile duct sections and helps assess the level and completeness of biliary blockade. Following PTCG, measures can be taken to achieve biliary decompression regardless of OJ genesis.

scholarly journals OPTIMUM DURATION OF PERCUTANEOUS TRANSHEPATIC CHOLANGIODRAINAGE IN COMMON BILE DUCT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE

2020 ◽  
Vol 73 (9) ◽  
pp. 1915-1925
Author(s):  
Anastasiia L. Sochnieva
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Total Bilirubin ◽  
Biliary Decompression ◽  
Bile Duct Diseases ◽  
Optimum Duration ◽  
Percutaneous Transhepatic Cholangiodrainage ◽  
Group 3 ◽  
Group 2

The aim: Is to determine the optimum duration of percutaneous transhepatic cholangiodrainage depending on the duration of obstructive jaundice and the baseline total bilirubin level in patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Materials and methods: The experience of applying percutaneous transhepatic cholangiodrainage was combined for 88 patients with common bile duct diseases complicated by obstructive jaundice. The patients were divided into three groups: the Group 1 included 15 patients (17.1%) with benign common bile duct diseases, the Group 2 included 11 patients (12.5%) with resectable cholangiocarcinomas, and the Group 3 included 62 patients (70.4%) with unresectable cholangiocarcinomas. To determine optimal terms of biliary decompression using percutaneous transhepatic cholangiodrainage, the Poisson process was applied, and, to be more precise, the quasi-Poisson distribution. Results: It was found that the reduction of total bilirubin was the fastest in Group 3 patients. It took these patients an average of 7-8 days to reduce total bilirubin to 50 μmole/l. In Group 1 patients, the process is somewhat slower. The duration of biliary decompression in this category of patients averages 10-12 days. For Group 2 patients, biliary decompression requires at least 12 days. Conclusions: Using the Poisson process, or, to be more precise, the quasi-Poisson distribution, we managed to determine the optimum duration of biliary decompression using percutaneous transhepatic cholangiodrainage depending on the obstructive jaundice duration and the baseline total serum bilirubin.

scholarly journals Hydatid Disease of liver communicating with common bile duct managed by ERCP - A case report

2017 ◽  
Vol 5 (2) ◽  
pp. 38-40
Author(s):  
Anurag Jha ◽  
Rahul Pathak ◽  
Sashi Sharma ◽  
Prem Khadga
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Hydatid Cyst ◽  
Signs And Symptoms ◽  
Biliary Tree ◽  
Thin Wall ◽  
Post Intervention ◽  
Right Lobe ◽  
Left And Right

Cystic hepatic disease is common in Asia, South America and Africa. Rupture of the hydatid cyst into the biliary tree can lead to serious cholangitis. In this report, a 53-year-old lady presented with the signs and symptoms of obstructive jaundice and cholangitis. Ultrasonography reported dilated common bile duct(CBD) with sludge and hydatid cysts in the liver. CECT revealed large cysts with enhancing thin wall in left and right lobe of liver with communicating into CBD and right IHBD respectively and features of obstructive biliopathy. Due to signs and symptoms of obstructive jaundice in addition to lab data and imaging modalities, ruptured hydatid cyst into the biliary tree was considered, and ERCP intervention was performed, after  endoscopic sphincterotomy , membranes of the cysts were extracted. Post intervention, signs and symptoms and cholestasis enzymes subsided.Journal of Advances in Internal Medicine Vol.5(2) 2016: 38-40

scholarly journals Successful Surgical Treatment of Hepatocellular Carcinoma Invading Into Biliary Tree

HPB Surgery ◽  
1991 ◽  
Vol 4 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Kazuo Tanoue ◽  
Takashi Kanematsu ◽  
Takashi Matsumata ◽  
Ken Shirabe ◽  
Keizo Sugimachi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Single Case ◽  
Intrahepatic Bile Duct ◽  
Biliary Tree ◽  
Large Mass ◽  
Primary Hepatocellular Carcinoma ◽  
The Common

A 41-year-old woman was admitted to hospital with obstructive jaundice. Computed tomography showed a large mass in the right hepatic lobe and marked dilatation of the biliary tree in the left lateral segment of the liver. Angiography showed evidence of neovascularity. Percutaneous transhepatic cholangiography revealed complete obstruction of the common bile duct just below the bifurcation. The serum level of alpha-fetoprotein on admission was 1,080,000 ng/ml. These findings suggested to us a primary hepatocellular carcinoma invading the intrahepatic bile duct. Extended right lobectomy and hepaticojejunostomy for bile drainage was carried out. The patient is doing well 3 years after surgery.Hepatocellular carcinoma (HCC) invading to the portal vein is not so rare, but invasion into the bile duct is much less common. In 1947, Mallory1 described a single case of HCC invading the gallbladder and obstructing extrahepatic bile ducts. In 1975, Lin2 termed this HCC “Icteric type hepatoma”. The incidence of such HCC in Japan was reported to be 1.9-9%2,3.Obstructive jaundice is a clinical manifestation of the terminal stage in HCC. We describe here our treatment of a woman with HCC invading the common bile duct. Right extended lobectomy and reconstruction of hepaticojejunostomy were effective.

Causes, diagnosis, and treatment of postoperative obstructive jaundice

2021 ◽  
Vol 29 (2) ◽  
pp. 257-266
Author(s):  
Makhmadsho K. Gulov ◽  
Kakhramon R. Ruziboyzoda
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Minimally Invasive ◽  
Biliary Tract ◽  
Hepatic Duct ◽  
Abdominal Cavity ◽  
Surgical Interventions ◽  
Laparoscopic Operation ◽  
The Common

AIM: This study aimed to analyze the causes, diagnosis, and clinical treatment of postoperative obstructive jaundice (POOJ) in routine surgical practice. MATERIALS AND METHODS: Twenty-four patients with POOJ that developed in the organs of the hepatobiliary system after surgical interventions were included in this study. The patients were subjected to the following procedures to diagnose the causes of POOJ and choose the treatment methods: general clinical examination, biochemical blood tests, dynamic postoperative ultrasound examination of the abdominal organs, video laparoscopy, computed tomography, magnetic resonance imaging, fistulocholangiography, endoscopic retrograde cholagiopancreatography, and percutaneous transhepatic cholangiostomy. RESULTS: POOJ occurred in 18 cases after they had different variants of surgical interventions on the biliary tract after traditional (n = 6) and video laparoscopic cholecystectomy (n = 12). POOJ also developed in 6 cases after they underwent surgery on the liver: atypical (n = 2) and anatomical (n = 2) resection of the liver. This condition manifested after the opening and draining of liver abscesses under US control (n = 2). POOJ was treated with different methods to alleviate the developed complications. After surgical interventions on the liver and biliary tract in 6 cases, relaparotomy, sequestrectomy with sanation, drainage of the abdominal cavity (n = 4), and right-sided hemihepatectomy (n = 2) were performed. In 6 other cases, on days 34 of the development of POOJ after laparoscopic operation (n = 2), relaparotomy was performed, clips and ligature were removed from the choledoch with the formation of Roux-en-Y hepaticojejunostomy. Minimally invasive methods of POOJ correction were applied to 12 cases. Of the 12 cases, 5, 2, and 1 were subjected to endoscopic papillosphincterotomy with lithoextraction, endoscopic papillosphincterotomy with lithoextraction coupled with nasobiliary drainage, and relaparoscopy and redrainage of the common bile duct, respectively. In 4 cases, percutaneous transhepatic cholangiostomy was performed at the first stage. At the second stage, after POOJ resolution, the following procedures were implemented: redrainage of the common bile duct (n = 2) and dilatation of the orifice of the right hepatic duct with reconstruction of hepaticojejunostomy on the hidden transhepatic drainage. CONCLUSION: POOJ is still encountered in clinical practice in a sufficient number of cases. Treatment results largely depend on the time of diagnosis and the choice of optimal surgical strategies. The main causes of POOJ are tactical and technical diagnostic and treatment errors. POOJ is diagnosed on the basis of the data of modern radiation and laboratory and instrumental examination methods. Surgical tactics for POOJ are individually active and dependent on the severity, time, and causes of development. They also depend on the general condition of patients. Along with minimally invasive interventions for POOJ, early relaparotomy is less dangerous than passive expectation tactics.

scholarly journals Tuberculosis of the Common Bile Duct

HPB Surgery ◽  
1991 ◽  
Vol 3 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Samrerng Ratanarapee ◽  
Arun Pausawasdi
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Biliary Tree ◽  
Complete Recovery ◽  
Tuberculous Lymphadenitis ◽  
Tube Drainage ◽  
T Tube ◽  
The Common ◽  
Common Combination

The intrahepatic biliary tree can occasionally be infected by Mycobacteriurn tuberculosis, but tuberculosis of the common bile duct has not previously been reported. A 38-year-old man with obstructive jaundice, who was originally thought to have cholangiocarcinoma associated with opisthorchiasis (a common combination in Thailand), was finally proved to have tuberculosis of the common bile duct with adjacent tuberculous lymphadenitis. Following T-tube drainage and antitubercular therapy, he made a complete recovery. The importance of a tissue diagnosis in all cases of obstructive jaundice is emphasized to avoid missing rare but curable diseases.

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.

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