scholarly journals Intrahepatic Transposition of Bile Ducts

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Jasmin Delić ◽  
Admedina Savković ◽  
Eldar Isaković ◽  
Sergije Marković ◽  
Alma Bajtarevic ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Anatomical Variation ◽  
Intrahepatic Bile Duct ◽  
Main Research ◽  
Intrahepatic Bile Ducts ◽  
Anatomical Terminology ◽  
Segment Viii ◽  
Safe Performance

Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications.

scholarly journals Intraductal papillary mucinous neoplasm of the intrahepatic bile ducts: a case report and literature review

2020 ◽  
Author(s):  
fan jia ◽  
Ying Zhang ◽  
Ling-Qiang Zhang ◽  
Yu-Le Wang ◽  
Yan Liu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Bile Ducts ◽  
Early Stage ◽  
Intrahepatic Bile Duct ◽  
Invasive Adenocarcinoma ◽  
Mucinous Neoplasm ◽  
Intrahepatic Bile Ducts ◽  
Upper Abdominal

Abstract Background: Intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is a rare malignant tumor originated from the epithelium of the bile duct. It can secrete a large amount of mucin to cause biliary obstruction. This disease has just been recognized in recent years.Case presentation: We found a 60-year-old woman with intermittent right upper abdominal pain. Imaging examination showed that the left intrahepatic bile duct was dilated with a solid mass. We had left hepatectomy. During the operation, there was colloidal mucus in the bile duct. There was a papillary mass on the wall of the bile duct. -to have developed into invasive adenocarcinoma. At a postoperative 6 months follow-up, the patient had no recurrence and is in good conditions. Conclusion: In our case, IPMN-B has underwent a malignant transformation at the early stage. Therefore, we think that surgical resection should be done as early as possible after the diagnosis of IPMN-B, so as to get a favorable prognosis.

scholarly journals Paucity of intrahepatic bile ducts in infancy: experience of a tertiary center

2004 ◽  
Vol 41 (3) ◽  
pp. 190-192 ◽  
Author(s):  
Adriana Maria Alves De Tommaso ◽  
Agnes Sumi Kawasaki ◽  
Gabriel Hessel
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Portal Tract ◽  
Intrahepatic Bile Duct ◽  
University Hospital ◽  
Intrahepatic Bile Ducts ◽  
Tertiary Center ◽  
Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin

BACKGROUND: Intrahepatic cholestasis secondary to paucity of bile duct is an alteration of the anatomic integrity of the biliary tract. Can be defined only histologically and, clinically, two categories are recognized: syndromic and non-syndromic, where the prognosis is generally more severe. AIM: To evaluate the history, clinical and biochemical characteristics, etiology and improvement of children who have paucity of intrahepatic bile duct followed at tertiary center. PATIENTS AND METHODS: Eleven children with paucity of intrahepatic bile duct, followed at the Pediatric Hepatology Service of the University Hospital, Campinas, SP, Brazil, were evaluated in the period from 1986 to 2001. RESULTS: Among the patients, three presented the syndromic and eight the non-syndromic form (two with alpha-1-antitrypsin deficiency, one with lues, one secondary to sepsis, three with probable etiology by cytomegalovirus and one without a definite etiology). Referral ranged from 31 to 1185 days. Birth weights ranged from 1920 g to 3590 g. Most of the patients presented pale stools. The median bile duct/portal tract ratio was 0.14. The majority of the children presented a favorable follow-up, regardless of the form of presentation. CONCLUSION: Paucity of intrahepatic bile ducts should be considered in children with cholestasis and its differentiation from extrahepatic causes of neonatal cholestasis is important in order to avoid surgery. Diagnosis of non-syndromic form should not be regarded as unfavorable prognosis, as the evolution is probably related to the etiology in this form of presentation.

scholarly journals Anomalous choledocho-pancretic ductal junction in a choledochal cyst: A case report

2004 ◽  
Vol 132 (5-6) ◽  
pp. 179-181
Author(s):  
Miodrag Jovanovic ◽  
Dragoljub Bilanovic ◽  
Radoje Colovic ◽  
Nikica Grubor ◽  
Milenko Ugljesic
Keyword(s):  
Bile Duct ◽  
Choledochal Cyst ◽  
Bile Ducts ◽  
Postoperative Recovery ◽  
Biliary Colic ◽  
Duodenal Wall ◽  
Choledochal Cysts ◽  
Bile Duct Wall ◽  
Intrahepatic Bile Ducts ◽  
Inflammatory Changes

Choledochal cysts are rare congenital anomalies, mostly detected in adults. Pathogenesis of these cysts seems to be in anomalous junction between pancreatic and common bile duct, above the papillary sphincterand outside of the duodenal wall. The absence of the sphincter above the junction is followed by reflux of the pancreatic juice into the bile duct leading to dilatation and fibrous changes of bile duct wall. A 38-year-old female is presented in whom a choledochal cyst was found 11 years earlier, during the operation performed for obstructive jaundice, when cystojejunostomy with Roux-en Y jejunal limb was carried out. In February 1990, she was admitted to our Institution for jaundice and biliary colic. The patient was reoperated. Operative cholangiography showed an anomalous pancreatobiliary junction, choledochal cyst, dilated cystic duct and moderate dilatation of intrahepatic bile ducts. Cholecystectomy, desanastomosis with partial excision of choledochal cyst, and retrocolic choledochojejunostomy with the same Roux-en-Y jejunal limb were performed. Total excision of choledochal cyst was too risky due to chronic inflammatory changes in the hepatoduodenal ligament. Postoperative recovery was uneventful and the patient remained symptom-free so far.

EFFECTS OF PHENOBARBITAL ON BILE SALT METABOLISM IN CHOLESTASIS DUE TO INTRAHEPATIC BILE DUCT HYPOPLASIA

PEDIATRICS ◽  
1973 ◽  
Vol 51 (6) ◽  
pp. 992-997
Author(s):  
Adolf Stiehl ◽  
M. Thaler ◽  
William H. Admirand
Keyword(s):  
Bile Duct ◽  
Bile Salt ◽  
Peripheral Blood ◽  
Bile Salts ◽  
Bile Ducts ◽  
Enterohepatic Circulation ◽  
Control Period ◽  
Intrahepatic Bile Duct ◽  
Total Serum ◽  
Salt Excretion

The effects of phenobarbital (PB) on bile salt metabolism in a patient with severe cholestasis due to congenital paucity of perilobular bile ducts were studied with 14C-cholate and 3H-chenodeoxycholate. During the control period (without PB) cholate was the predominant bile salt in the peripheral blood, whereas chenodeoxycholate was predominant in the total bile salt pool. This difference in the distribution of the two primary bile salts appeared to be caused by relatively greater impairment of excretion of cholate from the liver cell into the bile. PB administration caused a decrease in the total serum bile salt concentration (from 132 to 62µg/ml), in the total bile salt pool (from 412 to 304 mg) and in the biologic half-life (cholate from 106 to 34 hours; chenodeoxycholate from 77 to 42 hours). The proportion of the total bile salt pool present in the peripheral blood decreased from 16.8% to 11.7%. In addition, PB markedly increased the fecal bile salt excretion. These data suggest the PB improves pruritus in this type of intrahepatic cholestasis by reducing serum bile salt concentrations. This is accomplished by a shift in bile salts from the peripheral blood into the enterohepatic circulation and by enhancing fecal bile salt excretion.

scholarly journals Preservation injury of the distal extrahepatic bile duct of donor livers is representative for injury of the intrahepatic bile ducts

2015 ◽  
Vol 63 (1) ◽  
pp. 284-287 ◽  
Author(s):  
Negin Karimian ◽  
Pepijn D. Weeder ◽  
Fernanda Bomfati ◽  
Annette S.H. Gouw ◽  
Robert J. Porte
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Ducts ◽  
Preservation Injury

scholarly journals Rationale for effectiveness of a new method of radial sphincterotomy during obstruction of extrahepatic bile ducts

2014 ◽  
Vol 95 (6) ◽  
pp. 816-821
Author(s):  
K R Yusifzade
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
High Efficiency ◽  
The Other ◽  
Improved Method ◽  
Safe Distance ◽  
Endoscopic Retrograde ◽  
Extrahepatic Bile Ducts

Aim. Determination of the effectiveness of the improved method of sphincterotomy in choledocholithiasis, called radial sphincterotomy. Methods. Analyzed were results of 38 operations performed by endoscopic retrograde cholangiopancreatography in patients with a diagnosis of choledocholithiasis. In the first group (23 patients) performed a standard sphincterotomy, in the second group - radial sphincterotomy. 21 patients of the first group had gallstones up to 20 mm, 2 patients - more than 20 mm; in 6 patients (out of 15) of a second group gallstones sizes exceeded 20 mm, the other patients had stones sizes 15-20 mm. Results. The technique developed radial sphincterotomy allows multiple incisions towards 11, 12 and 13 hour clock directions. Thus, the main incision can be made to the transverse folds, and other radial incisions should be carried out below it, not going beyond the proposed location of the intramural common bile duct. Anatomical and mathematical justifications of the method of radial sphincterotomy were presented. Depending on the cut and shape of papillae, the severity of the upper transverse folds defining a safe distance from the hole until it papillae, performed lateral radial incisions, thereby achieving an increase of sphincterotomy cut altogether. Neither group registered death. In 2 (8.7%) patients of the first group bleeding occurred during the procedure, after the operation pancreatitis has developed in 1 (4.3%) patients in first group and in 1 (6.7%) patients in the second group. Conclusion. The proposed technique of radial sphincterotomy is a safe way to increase the area of dissected papillae to provide high efficiency for removal of large gallstones.

scholarly journals Granulomatous Cholangitis Mimicking Hilar Cholangiocarcinoma: A Case Report

2020 ◽  
Author(s):  
Shigeru Fujisaki ◽  
Motoi Takashina ◽  
Ken-ichi Sakurai ◽  
Ryouichi Tomita ◽  
Tadatoshi Takayama
Keyword(s):  
Bile Duct ◽  
Obstructive Jaundice ◽  
Fungal Infection ◽  
Hilar Cholangiocarcinoma ◽  
Bile Ducts ◽  
Fungal Infections ◽  
Resected Specimen ◽  
Unique Case ◽  
Intrahepatic Bile Ducts ◽  
Serum Igg4

Abstract Background:Hilar biliary stricture caused by isolated fungal infections in immunocompetent patients are considered to be extremely rare and difficult to the diagnose from the outset.Case presentation:We report a unique case of granulomatous cholangitis based on isolated biliary fungal infection manifesting as obstructive jaundice and mimicking hilar cholangiocarcinoma in an immunocompetent woman. A 67-year-old Japanese woman was referred to our hospital for obstructive jaundice. She had been followed up for hypochondroplasia by the referring physician. Her total bilirubin level was 5.4 mg/dL. Viral hepatitis screening was found to be negative, and serum IgG4 was within normal limits; however, her CA19-9 level was high. Abdominal computed tomography revealed dilatation of the intrahepatic bile ducts. Abdominal echogram detected a solid mass in the hilar bile duct. Her magnetic resonance cholangiopancreatography has also revealed an abrupt stenosis of the primary biliary confluence with upstream dilatation of the intrahepatic bile ducts. Endoscopic nasobiliary drainage was then performed to improve the obstructive jaundice. Although biliary cytology did not reveal malignant findings, the bile duct in the hilum showed severe stenosis, and hilar cholangiocarcinoma could not be completely excluded. The patient had a developmental disorder based on chondrodystrophy. To avoid excessive surgical stress, such as hepatic lobectomy, we performed resection of the extrahepatic bile duct and Roux-en-Y hepaticojejunostomy reconstruction. Intraoperative frozen sections of the resection margins were determined to be negative for tumor. The resected specimen showed multiple strictures inside the common bile duct, numerous calculi in the lumen, and little free space. The final pathological diagnosis was granulomatous cholangitis due to fungal infection. The patient’s postoperative course was deemed uneventful. She was discharged from our hospital 23 days after surgery without antifungal treatment.Conclusions:For a unique case of granulomatous cholangitis based on isolated biliary fungal infection mimicking hilar cholangiocarcinoma, we were able to avoid excessive invasion and performed appropriate surgical management.

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