Academic literature on the topic 'Biliary duct obstruction'
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Journal articles on the topic "Biliary duct obstruction"
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Tanaka, Toshiyuki, Hideo Akiyoshi, Keiichiro Mie, Hitoshi Shimazaki, and Fumihito Ohashi. "Drip infusion cholangiography with CT in cats." Journal of Feline Medicine and Surgery 20, no. 12 (December 1, 2017): 1173–76. http://dx.doi.org/10.1177/1098612x17738615.
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Objectives Ultrasonography can detect extrahepatic biliary obstructions. However, visualisation of part of the bile duct using ultrasonography can be technically difficult if there is overlying bowel gas. This study investigated the safety and value of drip infusion cholangiography with computed tomography (DIC-CT) in the visualisation of the bile duct in healthy cats and extrahepatic biliary obstruction in cats with cholelithiasis. Methods DIC-CT was performed in three healthy cats and two cats with cholelithiasis. Meglumine iotroxate was administered by intravenous drip infusion over 30 mins. The attenuation value was measured perpendicular to the lumen by a region of interest covering about 50% of the area of the lumen. Results The bile ducts were visualised successfully with DIC-CT in all healthy cats without any significant adverse events. The attenuation value of the contrast medium was 271 ± 37 HU. In the two cats with cholelithiasis, the presence or absence of extrahepatic biliary obstruction was determined using DIC-CT without any significant adverse events. The attenuation value of cholelithiasis in the cat with an extrahepatic biliary obstruction was 933 ± 119 HU. In the cat with no extrahepatic biliary obstruction, the attenuation value of the contrast medium was 249 ± 53 HU and the attenuation value of cholelithiasis was 167 ± 28 HU. Conclusions and relevance DIC-CT visualises bile ducts and detects obstructive biliary disease without significant adverse events. Therefore, it appears to be a safe procedure for visualisation of the bile duct in cats.
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K.S., Swasthik, Preetha Sundaresan, and Varun Vijayan. "Extra-Hepatic Biliary Obstruction - A Cross-Sectional Study to Assess the Various Benign and Malignant Causes for Obstructive Jaundice among Patients Attending Trivandrum Medical College." Journal of Evolution of Medical and Dental Sciences 10, no. 9 (March 1, 2021): 600–603. http://dx.doi.org/10.14260/jemds/2021/129.
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BACKGROUND Extra-hepatic biliary tract obstruction can be due to a number of conditions. Most causes are due to stones in the common biliary duct or due to malignant obstruction. Malignant causes include carcinoma head of pancreas, periampullary carcinoma and cholangiocarcinoma. Besides calculus and malignant obstruction, benign and malignant strictures can also cause obstruction of extra hepatic biliary ducts. The objectives of the study were to describe the clinical profile of patients presenting with extra-hepatic biliary obstruction and to assess the known aetiological factors. METHODS The research was designed as a hospital based cross-sectional study in the general surgery wards of our institution from 2016 to 2017. All individuals who were diagnosed to have extra-hepatic biliary obstruction by imaging were included in the study. RESULTS Among the 66 cases studied, majority were due to malignancies and gall stones. The malignancies included carcinoma head of pancreas, periampullary carcinoma, cholangiocarcinoma and Klatskin’s tumour. Miscellaneous causes were bile duct stricture, cholelithiasis with biliary sludge and annular pancreas. For the malignant cases, Whipple surgery and its pylorus-preserving variant were the most common surgical procedures carried out. Biliary bypass procedures were also carried out in some patients. For patients with common bile duct (CBD) stones, cholecystectomy, choledocholithotomy and choledochojejunostomy were done. CONCLUSIONS Malignant causes of jaundice are more common than benign causes. Secondary stones are the commonest cause of non-malignant biliary obstruction. Jaundice is more severe and associated with pruritis and more intolerable and persistent in malignancy. Surgical bypass procedures give good palliation for obstructive jaundice. KEY WORDS Bile Ducts, Choledocholithiasis, Cholestasis, Extra Hepatic, Pancreatic Cancer, Periampullary Cancer
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Camacho, Juan C., Lynn A. Brody, and Anne M. Covey. "Treatment of Malignant Bile Duct Obstruction: What the Interventional Radiologist Needs to Know." Seminars in Interventional Radiology 38, no. 03 (August 2021): 300–308. http://dx.doi.org/10.1055/s-0041-1731269.
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AbstractManagement of malignant bile duct obstruction is both a clinically important and technically challenging aspect of caring for patients with advanced malignancy. Bile duct obstruction can be caused by extrinsic compression, intrinsic tumor/stone/debris, or by biliary ischemia, inflammation, and sclerosis. Common indications for biliary intervention include lowering the serum bilirubin level for chemotherapy, ameliorating pruritus, treating cholangitis or bile leak, and providing access for bile duct biopsy or other adjuvant therapies. In some institutions, biliary drainage may also be considered prior to hepatic or pancreatic resection. Prior to undertaking biliary intervention, it is essential to have high-quality cross-sectional imaging to determine the level of obstruction, the presence of filling defects or atrophy, and status of the portal vein. High bile duct obstruction, which we consider to be obstruction above, at, or just below the confluence (Bismuth classifications IV, III, II, and some I), is optimally managed percutaneously rather than endoscopically because interventional radiologists can target specific ducts for drainage and can typically avoid introducing enteric contents into isolated undrained bile ducts. Options for biliary drainage include external or internal/external catheters and stents. In the setting of high obstruction, placement of a catheter or stent above the ampulla, preserving the function of the sphincter of Oddi, may lower the risk of future cholangitis by preventing enteric contamination of the biliary tree. Placement of a primary suprapapillary stent without a catheter, when possible, is the procedure most likely to keep the biliary tree sterile.
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Stojanovic, Dragos, Mirjana Stojanovic, Predrag Milojevic, Zorica Caparevic, Djordje Lalosevic, and Dragan Radovanovic. "Strategies for endoscopic and surgical management of common bile duct stones." Medical review 56, no. 1-2 (2003): 69–75. http://dx.doi.org/10.2298/mpns0302069s.
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Introduction Common bile duct calculi represent a pathologic entity involving obstructive icterus, cholangitis, hepatic cirrhosis or pancreatitis. Common bile duct calculi mostly have a secondary origin (from gallbladder) in 95% of cases, while primary choledocholithiasis is rare. Classification From surgical aspect, common bile duct calculi can be: 1. Asymptomatic, without manifested symptoms or signs,2. Mobile, with intermittent biliar obstruction and disobstruction, 3. Fixed, with obstruction and signs of hepato-biliary and/or bilio-pancreatic duct, 4. Transitory, microcalculi which pass through Vater's Papilla by propulsion into duodenum with symptoms. Discussion Modern biliary surgery includes diagnosis of common bile duct calculi, and if possible preoperative endoscopic (endoluminal) surgery, which is less invasive for patients. If such approach is not possible, it is necessary to perform stone extraction and cholecystectomy. Conclusion Common bile duct calculi represent a common disease of the digestive system. Endoscopic diagnostic procedure is very important in management of choledocholithiasis Endoscopic treatment of common bile duct calculi prior to cholecystectomy is a method of choice and a strategy for associated cholecysto-choledocholithiasis.
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Mamontov, I. N., T. I. Tamm, K. A. Kramarenko, S. G. Belov, A. Ya Bardiuk, V. V. Nepomniashchyi, A. P. Zakharchuk, O. M. Reshetniak, and E. A. Shakalova. "The risk factors for development of an acute biliary pancreatitis and its signs in obstruction of extrahepaic bilairy ducts." Klinicheskaia khirurgiia 86, no. 10 (October 21, 2019): 3–7. http://dx.doi.org/10.26779/2522-1396.2019.10.03.
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Objective. A search for factors, promoting development of an acute biliary pancreatitis, and peculiarities of its signs in patients, suffering obstruction of extrahepatic biliary ducts.
Materials and methods. Retrospective analysis of treatment in 283 patients, suffering obstruction of extrahepaic biliary ducts, was conducted, together with various indices analysis in patients, suffering an acute biliary pancreatitis and without acute biliary pancreatitis.
Results. An acute biliary pancreatitis was diagnosed in 30 (10.6%) patients. Trustworthy differences (p < 0.05) were revealed, concerning pronounced pain syndrome, hyperthermia, leukocytosis, young neutrophils, general bilirubin, amylase in the blood, the gallbladder volume, choledocholithiasis, the fixed calculus and stenosis of duodenal papilla magna, cholangitis. Big calculi of hepaticocholedochus did not associated with development of an acute biliary pancreatitis, and a sludge in common biliary duct and stenosis of duodenal papilla magna were characteristic for an acute biliary pancreatitis (p < 0.001).
Conclusion. Sludge of common biliary duct, stenosis and fixed calculus of duodenal papilla magna, bilirubinemia 70 mcmol/l and higher constitute the risk factors for development of an acute biliary pancreatitis, and the pronounced abdominal pain syndrome, hyperthermia, hyperamylasemia, leucocytosis, increase of the young neutrophils content up to 7% and higher, the volume of a gallbladder 50 cm3 and more - served as the signs of an acute biliary pancreatitis in obstruction of extrahepatic biliary ducts. In obstruction of extrahepatic biliary ducts with an acute biliary pancreatitis, comparing with obstruction of extrahepatic biliary ducts without an acute biliary pancreatitis, cholangitis is revealed trustworthily: 16.7 and 5.1% accordingly (p < 0.05).
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Rousslang, Lee K., Omar Faruque, Kyler Kozacek, and J. Matthew Meadows. "Percutaneous Transhepatic Cholangioscopy and Stone Extraction in a Patient with Recurrent Cholangitis Following Liver Trauma." Journal of Clinical Imaging Science 11 (February 25, 2021): 11. http://dx.doi.org/10.25259/jcis_165_2020.
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Percutaneous transhepatic cholangioscopy (PTCS) is a safe and effective treatment for obstructive biliary stones, when endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful or unavailable. Once percutaneous access is gained into the biliary tree by an interventional radiologist, the biliary ducts can be directly visualized and any biliary stones can be managed with lithotripsy, mechanical fragmentation, and/or percutaneous extraction. We report a case of a 45-year-old man who sustained a traumatic liver laceration and associated bile duct injury, complicated by bile duct ectasia and intrahepatic biliary stone formation. Despite undergoing a cholecystectomy, multiple ERCPs, and percutaneous transhepatic cholangiogram with drain placement, the underlying problem was not corrected leading to recurrent bouts of gallstone pancreatitis and cholangitis. He was ultimately referred to an interventional radiologist who extracted the impacted intrahepatic biliary stones that were thought to be causing his recurrent infections through cholangioscopy. This is the first case of PTCS with biliary stone extraction in the setting of recurrent biliary obstruction and cholangitis due to traumatic bile duct injury.
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Doi, Yasuhiro, Yasushi Takii, Hiroyuki Ito, Norihiko Jingu, Kentaro To, Sinichiro Kimura, Koichi Kimura, et al. "Usefulness of Endoscopic Managements in Patients with Ceftriaxone-Induced Pseudolithiasis Causing Biliary Obstruction." Case Reports in Medicine 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/3835825.
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Ceftriaxone (CTRX) is known to cause reversible biliary stones/sludge, which is called biliary pseudolithiasis. We report two rare cases of biliary obstruction by pseudolithiasis shortly after completing CTRX treatment. Stones and sludge, which had not been detected before CTRX administration, appeared in the gallbladder and common bile duct and led to biliary obstruction and acute cholangitis. The obstructions were successfully treated with endoscopic retrograde biliary drainage and endoscopic sphincterotomy. CTRX-induced biliary pseudolithiasis has been reported mainly in children and adolescents but is also seen in adults with similar incidence rate. Although CTRX-induced biliary pseudolithiasis is usually asymptomatic and disappears spontaneously after discontinuing the drug, some patients develop biliary obstruction. Endoscopic managements should be considered in such cases.
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Tanoue, Kazuo, Takashi Kanematsu, Takashi Matsumata, Ken Shirabe, Keizo Sugimachi, and Chikao Yasunaga. "Successful Surgical Treatment of Hepatocellular Carcinoma Invading Into Biliary Tree." HPB Surgery 4, no. 3 (January 1, 1991): 237–44. http://dx.doi.org/10.1155/1991/80824.
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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.
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Zarubin, V. V., A. P. Kurazhov, V. D. Zavadovskaja, O. V. Rodionova, O. S. Tonkikh, I. Yu Klinovitskiy, M. A. Zorkaltsev, and V. I. Haritonkin. "CONTRAST-ENHANCED COMPUTED TOMOGRAPHIC CHOLANGIOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF THE MALIGNANT AND BENIGN CAUSES OF BILIARY OBSTRUCTION." Siberian journal of oncology 20, no. 4 (August 30, 2021): 39–48. http://dx.doi.org/10.21294/1814-4861-2021-20-4-39-48.
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Introduction. Determination of the cause of cholestasis and treatment of patients with obstructive jaundice syndrome remains challenging owing to the steady rise in diseases of the hepatopancreatoduodenal zone and the high frequency of diagnostic errors. In the differential diagnosis of the causes of obstructive jaundice, diagnostic imaging techniques are of the greatest importance. In the world literature, there are few reports on the assessment of the diagnostic potential of multispiral computed tomography under conditions of direct contrasting of the biliary tree using endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, or through pre-installed palliative drainage in the bile ducts. There is no generally accepted algorithm for determining the causes of biliary obstruction. It leads to ineffective use of various diagnostic imaging techniques, complicating the diagnostic process.The purpose of the study was to evaluate the diagnostic efficacy of contrast-enhanced ct cholangiography (ct-cg) in the differential diagnosis of causes of malignant and benign biliary obstruction in cases with obstructive jaundice syndrome.Material and methods. The study included 55 patients with obstructive jaundice, who were treated in a surgical hospital from july 2016 to july 2019.Results. It was found that contrast ct-cg in diagnosing the causes of biliary obstruction of both malignant and benign genesis is more informative than x-ray endoscopic retrograde cholangiopancreatography. The diagnostic efficacy of ct-cg in detecting causes of malignant biliary obstruction was: 93.3% sensitivity, 92.9% specificity, and 93.1% accuracy. The diagnostic efficacy of ct-cg in detecting causes of benign biliary obstruction was: 92.9%, 93.3% and 93.1%, respectively.Conclusion. Based on the high accuracy, contrast-enhanced ct-cg is a promising imaging technique in cases with bile duct obstruction.
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Volynets, G. V., A. I. Khavkin, and A. V. Nikitin. "Modern view of biliary atresia in children." Experimental and Clinical Gastroenterology, no. 1 (May 2, 2020): 40–55. http://dx.doi.org/10.31146/1682-8658-ecg-173-1-40-55.
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Atresia of the biliary tract, or biliary atresia (BA), is a destructive, inflammatory disease in which progressive biliary tree fibrosis in an infant leads to obstruction of the bile ducts and, as a result, to cirrhosis of the liver. If untreated, progressive cirrhosis leads to death by 2 years. Biliary atresia can be divided into 3 types, each of which depends on the level closest to biliary obstruction. Type I (obstruction of the common bile duct), type II (patency of the bile ducts to the level of the common hepatic duct), type III (obstruction at the level of the gates of the liver). It is very important to distinguish between types of BA and conduct differential diagnosis with other cholestatic diseases. There are nonsyndromic, syndromic, and BA, combined with other malformations. In diagnostics, in addition to clinical manifestations and specific changes in blood biochemical parameters characterizing cholestasis, an ultrasound examination of the abdominal cavity organs, gepatobiliscintigraphy, magnetic resonance cholecystopancreatocholangiography, according to indications, a puncture biopsy of the liver and histological examination are performed. The main method of treatment is hepatoportoenterostomy according to Kasai, which must be performed no later than 3 months, and with liver cirrhosis and hepatic insufficiency, liver transplantation. Additional methods of treatment include the use of ursodeoxycholic acid, fat-soluble vitamins.
Dissertations / Theses on the topic "Biliary duct obstruction"
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Campos, Marco Filipe Andrade. "Clínica e cirurgia em animais de companhia." Master's thesis, Universidade de Évora, 2021. http://hdl.handle.net/10174/29770.
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O presente relatório de estágio é composto por duas partes. A primeira parte é sobre a casuística acompanhada no Hospital Veterinário Central. A segunda parte consiste numa revisão bibliográfica sobre obstrução biliar extra-hepática. É uma condição potencialmente fatal, podendo ser causada por colangite, pancreatite, neoplasias, mucocele biliar e colelitíase. As manifestações mais comuns são: icterícia, anorexia, vómito, depressão e hepatomegalia. O diagnóstico pode ser feito por ecografia, onde é possível visualizar a vesícula e ductos biliares dilatados. O tratamento tem como objetivo o restabelecimento da drenagem biliar. Existem várias técnicas cirúrgicas para o trato biliar: cateterização coledocal e lavagem, colecistectomia, colecistoenterostomia, colecistotomia e coledocotomia, colocação de stents biliares e colecistostomia temporária. A taxa de mortalidade no tratamento da obstrução biliar aguda, em veterinária, é muito superior à verificada em medicina humana. A diminuição da mortalidade pode ser alcançada com boa estabilização pré-cirúrgica do paciente e prática de cuidados pós-cirúrgicos intensivos; Abstract:
Medicine and Surgery of Companion Animals
This report of internship is composed by two parts. The first part is about the casuistry followed in the Hospital Veterinário Central. The second part is a bibliographic review on extrahepatic biliary obstruction. It´s a potentially fatal condition that can be caused by cholangitis, pancreatitis, tumours, biliary mucocele and cholelithiasis. Frequent clinical manifestations are icterus, anorexia, emesis, depression and hepatomegaly. The diagnosis can be made by ultrasonography when a dilated gallbladder and biliary ducts are visualized. The treatment aims at the reestablishment of the biliary drainage. There are many biliary tract surgical techniques: choledochal catheterization and flushing, cholecystectomy, cholecystoenterostomy, cholecystotomy and choledochotomy, biliary stent placement and temporary cholecystostomy. The mortality rate in the assessment of acute biliary obstruction in veterinary is much higher than the reported in human medicine. A reduction in mortality can be achieved by stabilization of the patient before surgery and practice of intense post-surgical care.
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Daubenton, John David. "The differentiation of extrahepatic biliary atresia from the neonatal hepatitis syndrome." Doctoral thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/26576.
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The differentiation, in an infant with cholestasis, between extrahepatic biliary atresia (EHBA) and the neonatal hepatitis syndrome (NHS) is important in that laparotomy is always indicated in EHBA but is undesirable in NHS. This differentiation is particularly difficult in those infants with complete cholestasis. Hepatobiliary scintigraphy is a commonly used investigation in infants with obstructive jaundice. The scintigraphic demonstration of excretion into the gut excludes extrahepatic obstruction, however, absence of excretion may be due to EHBA, severe cholestasis with patent extrahepatic bile ducts or poor uptake of the agent, and is therefore not diagnostic. This study has examined the quantitative measurement of the hepatic uptake of p-butyl IDA and Sn colloid, and an estimation of liver shape, in a group of patients with complete cholestasis in whom conventional scan interpretation, based on excretion into the-gut, would not be useful. The scans were recorded as dynamic studies and the resultant time-activity curves were subjected to curve fitting to calculate a rate constant for uptake of radiopharmaceutical. Liver shape was determined from the anterior static image of the colloid scan. The results show a significant difference between the EHBA and the NHS patients in the rate of uptake of p-butyl IDA, in the ratio of the rate of uptake of p-butyl IDA/the rate of uptake of colloid and in the measurements used to express liver shape. Using this method of scan interpretation, a diagnostic accuracy of 85% was achieved in this study of patients who clinically, and on scan, had no evidence of bile flow. Hepatic scintigraphy is therefore a useful investigation in the diagnostic work-up of infants presenting with obstructive jaundice even when bile flow is completely absent.
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Loureiro, Jarbas Faraco Maldonado. "Drenagem biliar na paliação dos tumores malignos da confluência biliopancreática: estudo comparativo das abordagens cirúrgica e endoscópica ecoguiada." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-13082014-105934/.
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Introdução: A maioria dos pacientes acometidos pela neoplasia que envolve a confluência biliopancreática é diagnosticada em fase avançada. A Colangiopancreatografia Retrógrada Endoscópica (CPRE) é o método de escolha para a drenagem da via biliar obstruída. Todavia, existe um índice de insucesso em torno de 10%. Nesses casos, técnicas alternativas serão aplicadas, como drenagem percutânea trans-hepática e drenagens cirúrgicas. Objetivo: Avaliar o sucesso técnico, clínico, qualidade de vida e sobrevida da drenagem biliar pela cirurgia convencional e técnica endoscópica ecoguiada em pacientes portadores de neoplasia maligna da confluência biliopancreática. Método: No período de abril de 2010 a setembro de 2013, foram estudados 32 pacientes portadores de neoplasia maligna da confluência biliopancreática. Todos os que foram incluídos nesse estudo apresentaram falha na drenagem biliar por CPRE. Três deles foram excluídos por insucesso técnico (falha na confecção da anastomose hepaticojejunal e da formação da fístula coledocoduodenal ecoguiada). O Grupo I foi formado por 15 pacientes submetidos à Hepaticojejunostomia (HJT) em \"Y\" de Roux e derivação gastrojejunal. O Grupo II foi formado por 14 pacientes submetidos à coledocoduodenostomia ecoguiada (CDT). O sucesso clínico foi avaliado pela queda da bilirrubina sérica total em mais de 50% nos sete primeiros dias após o procedimento. A qualidade de vida foi avaliada pelo questionário SF-36 e a sobrevida pela curva de Kaplan-Meier. Resultados: O sucesso técnico foi de 93,75% (15/16) no Grupo I e de 87,5% (14/16) no Grupo II (p = 0,598). O sucesso clínico ocorreu em 14 (93,33%) pacientes pertencentes ao Grupo I e em 10 (71,43%) do Grupo II. Não houve diferença estatisticamente significativa (p = 0,169). O comportamento médio dos escores de qualidade de vida foi estatisticamente igual entre as técnicas ao longo do seguimento (p > 0,05 Técnica * Momento). Houve alteração média estatisticamente significativa ao longo do seguimento nos escores de capacidade funcional, saúde física, dor, aspectos sociais, aspectos emocionais e saúde mental em ambas as técnicas (p < 0,05). O escore de saúde mental foi, em média, estatisticamente maior nos do Grupo II (CDT) em todos os momentos (p = 0,035). O tempo médio de sobrevida daqueles pertencentes ao Grupo I foi de 82,27 dias e os do Grupo II, de 82,36 dias. Sessenta por cento dos pertencentes ao Grupo I faleceram até 90 dias após o procedimento cirúrgico. Por outro lado, 42,9% dos submetidos à CDT faleceram no mesmo período. Não houve diferença estatisticamente significativa no tempo de sobrevida entre os Grupos (p = 0,389). Conclusão: Os dados relacionados aos sucessos técnico, clínico, qualidade de vida e sobrevida foram semelhantes em ambos os grupos, não se verificando diferença estatisticamente significativaIntroduction: Most patients with neoplasm in the biliopancreatic junction are diagnosed at an advanced stage. Endoscopic retrograde cholangiopancreatography (ERCP) is the method of choice for drainage of obstructed biliary tract. However, there is a failure rate of about 10%. In such cases, alternative techniques, such as, percutaneous transhepatic drainage and surgical drainage are applied. Aim: To evaluate the technical and clinical success, quality of life and patient survival of biliary drainage by conventional surgery and endosonography-guided technique in patients with malignant neoplasm of the biliopancreatic junction. Methodology: From April 2010 to September 2013, 32 patients with malignant neoplasm of the biliopancreatic junction were studied. All patients included in this study had failed biliary drainage by ERCP. Three patients were excluded due to technical failure (failure in the construction of hepatico-jejuno anastomosis and formation of endosonography-guided choledochoduodenal fistula). Group I comprised of 15 patients who underwent Roux-en-Y hepaticojejunostomy (HJT) and gastrojejunal bypass. Group II consisted of 14 patients who underwent endosonography-guided choledochoduodenostomy (CDT). Clinical success was assessed by the decrease of more than 50% in total serum bilirubin in the first seven days after the procedure. Quality of life was assessed by SF-36 questionnaire and survival by Kaplan-Meier curve. Results: Technical success rate was 93.75% (15/16) in group I and 87.5% (14/16) in group II (p = 0.598). Clinical success occurred in 14 (93.33%) patients in group I and 10 (71.43%) patients in group II. There was no significant statistically difference (p = 0.169). The average quality of life score were statistically equal between the techniques during follow-up (p > 0.05 * Technical Moment). There were statistically significant mean changes during follow-up of functional capacity score, physical health, pain, social functioning, emotional and mental health aspects in both techniques (p < 0.05). The mental health score was, on average, statistically higher in group II (CDT) at all times (p = 0.035). The median survival time of patients in group I was 82.27 days and Group II patients was 82.36 days. Sixty percent of patients in group I died within 90 days after the surgical procedure. On the other hand, 42.9% of the patients who underwent CDT died in the same period. There was no statistically significant difference in survival time between the groups (p = 0.389). Conclusion: Data relating to technical and clinical success, quality of life and survival were similar in both groups and there were no statistically significant differences
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Laštovičková, Jarmila. "Úloha zobrazovacích metod a intervenční radiologie v programu transplantace jater: transarteriální chemoembolizace hepatocelulárního karcinomu a terapie cévních a biliárních komplikací po ortotopické transplantaci jater." Doctoral thesis, 2013. http://www.nusl.cz/ntk/nusl-327213.
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121 9. Summárý Purpose: This study was designed to evaluate the role of interventional radiology in liver transplantation programme. The aim is to present our experience, technical outcomes and long-term clinical results with chemoembolization of hepatocellular carcinoma in patients before liver transplantation and with percutaneous treatment of vascular and biliary complication after orthotopic liver transplantation. Methods: Twenty five patients (17 men, 8 women, mean age 57.76 years) with HCC were scheduled for TACE prior to liver transplantation from 2008 to 2012. Twenty three procedures were performed, 7 c-TACE in 2008 and 16 DEB TACE in next years. Thirty patients (13 men, 17 women, mean age 46.4 years) with biliary strictures after liver transplantation without endoscopic access possibility were treated with balloon dilatation and biliary duct drainage from 1996 and 2010. Twenty patients (13 men, 7 women, mean age 45.25 years) were treated with PTA/stent due to hepatic artery stenosis after liver transplantation between 1996 and 2011. Stents were placed to the hepatic/celiac artery in 16 PTAs, balloon dilatation alone was performed in 7 stenosis due to tortuosity of the vessel. Results: Liver transplantation was performed to 20 patients after TACE. Only one patient (4.5 %) was excluded from waiting...
Books on the topic "Biliary duct obstruction"
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Benign strictures of bile ducts. Madison, Conn: International Universities Press, 1987.
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Poterucha, John J. Hepatology. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199755691.003.0211.
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The evaluation of patients who have abnormal liver test results includes many clinical factors: the chief complaints of the patient, patient age, risk factors for liver disease, personal or family history of liver disease, medications, and physical examination findings. Because of these many factors, designing a standard algorithm for the evaluation of abnormal liver test results is difficult and often inefficient. Nevertheless, with basic information, abnormalities can be evaluated in an efficient, cost-effective manner. Diseases that predominantly affect the biliary system are called cholestatic diseases. They can affect the microscopic ducts (eg, primary biliary cirrhosis) or the large bile ducts (eg, pancreatic cancer causing obstruction of the common bile duct), or both (eg, primary sclerosing cholangitis).
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Keshav, Satish, and Alexandra Kent. Gall bladder disease. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0200.
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The gall bladder is a sac which lies underneath the liver and stores and concentrates bile produced by the liver. As food enters the duodenum, it stimulates the release of cholecystokinin, which in turn stimulates the release of bile, which passes via the cystic duct to the common bile duct, which connects to the duodenum at the sphincter of Oddi. Bile is required in digestion, especially for the emulsification and absorption of fat. Biliary disease can take several forms. Cholelithiasis refers to the presence of gallstones in the gall bladder, whereas choledocholithiasis refers to gallstones in the biliary tree. Cholecystitis is inflammation and infection of the gall bladder. Cholangitis is inflammation and infection of the biliary tree. Sphincter of Oddi dysfunction (SOD) is characterized by symptoms of biliary obstruction, with no structural cause. Other forms of biliary disease are gall bladder polyps, primary biliary cholangitis, and primary sclerosing cholangitis.
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Carle, Sarah. Cholecystitis and Cholangitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0034.
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Cholangitis is a bacterial infection of the biliary system that is commonly associated with mechanical obstruction of the cystic or common bile duct (CBD). Obstruction is usually caused by choledocholithiasis (which results from gallstone obstruction of the CBD) but may also be seen with biliary stricture, malignancy, or cyst. Bacterial proliferation may lead to gangrenous cholecystitis, gallbladder perforation (with potential for cholecystoenteric fistula creation), and/or sepsis. Patients should be managed based on clinical severity and symptoms with attention paid to volume and electrolyte status. General surgery should be consulted early in the course of acute cholecystitis and cholangitis. Many patients with acute cholangitis respond to antibiotic therapy and supportive treatments. Disposition decisions should be made in conjunction with consultants, but patients with acute cholecystitis and cholangitis generally require admission and prompt surgical intervention.
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Galperin, Edward I., Nikolai F. Kuzovlev, and Suren R. Karagiulian. Benign Strictures of Bile Ducts. Intl Universities Pr Inc, 1987.
Find full textBook chapters on the topic "Biliary duct obstruction"
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Kapoor, Vinay K. "Pathophysiology of Bile Leak, Bile Loss, and Biliary Obstruction." In Post-cholecystectomy Bile Duct Injury, 61–71. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-1236-0_6.
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Fuiano, G., V. Sepe, N. Comi, V. Bisesti, M. Balletta, M. Sabbatini, G. Colucci, and F. Uccello. "Early Effects of Acute Obstruction of Biliary Duct in the Rat." In New Therapeutic Strategies in Nephrology, 131–33. Boston, MA: Springer US, 1991. http://dx.doi.org/10.1007/978-1-4615-3884-4_37.
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Varghese, Jose C., Brian C. Lucey, and Jorge A. Soto. "33 Imaging of Biliary Disorders: Cholecystitis, Bile Duct Obstruction, Stones, and Stricture." In Evidence-Based Imaging, 527–51. New York, NY: Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-7777-9_33.
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Fazeli Dehkordy, Soudabeh, Ashish P. Wasnik, and Paul Cronin. "Acute Biliary Disorders in Adults: Evidence-Based Emergency Imaging of Acute Calculous and Acalculous Cholecystitis, Bile Duct Obstruction, and Choledocholithiasis." In Evidence-Based Imaging, 309–27. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-67066-9_21.
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Johnson, Colin, and Mark Wright. "Diseases of the gallbladder and biliary tree." In Oxford Textbook of Medicine, edited by Jack Satsangi, 3196–208. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0334.
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Diseases of the gallbladder and bile ducts are common, with gallstones and their complications being most frequent. Less common are biliary strictures, usually malignant, which are caused by adenocarcinomas of the pancreas, bile ducts, ampulla of Vater, and gallbladder. Rarely encountered are sclerosing cholangitis and a variety of congenital disorders. Disorders of the biliary system include gallstones, which cause biliary colic and cholecystitis by obstruction of the cystic duct, and bile duct obstruction (cholestasis), with jaundice, dark urine, and pale stools, itching, and sometimes constant right hypochondrial pain. Fevers and rigors may indicate bacterial infection of the biliary tract (cholangitis), which frequently accompanies partial obstruction. Weight loss may be due to fat malabsorption but can also be caused by malignancy. Prolonged biliary obstruction leads to skin changes of increased pigmentation (due to melanin) and cholesterol deposition (xanthelasma and xanthoma). Biliary cirrhosis can cause portal venous hypertension and liver cell failure. Disorders of the biliary system generally give rise to the biochemical picture of cholestasis: the serum (conjugated) bilirubin concentration may be normal or raised; serum alkaline phosphatase, γ-glutamyl transferase, and bile acids are elevated; serum transaminases show only modest elevation. Bilirubinuria is present, with the disappearance of urobilinogen from the urine indicating complete biliary obstruction. Imaging is critical in the diagnosis of biliary disease, initially by ultrasonography, with CT and MRI in more complicated cases. However, these investigations sometimes provide insufficient anatomical detail for diagnosis or planning of treatment, and further imaging with the cholangiographic techniques of magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) are required. ERCP and PTC can be used to place biliary stents.
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Lee, Christine U., and James F. Glockner. "Case 3.22." In Mayo Clinic Body MRI Case Review, edited by Christine U. Lee and James F. Glockner, 175–77. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199915705.003.0092.
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53-year-old man with an elevated level of alkaline phosphatase; US revealed intrahepatic biliary dilatation A partial volume MIP image from 3D FRFSE MRCP (Figure 3.22.1) shows dilatation of right-sided intrahepatic ducts with obstruction in the hilum at the level of the right duct division. Left-sided ducts are normal in caliber. Axial arterial (...
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Lee, Christine U., and James F. Glockner. "Case 17.24." In Mayo Clinic Body MRI Case Review, edited by Christine U. Lee and James F. Glockner, 835–36. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199915705.003.0442.
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64-year-old woman with pancreatic cancer and suspected hepatic metastases VR image from 3D MRCP (Figure 17.24.1) demonstrates moderate dilatation of intrahepatic ducts and marked extrahepatic biliary dilatation extending to the pancreatic head, where there is also obstruction of the pancreatic duct. Axial hepatobiliary phase 3D SPGR images obtained 20 minutes following gadoxetate disodium (Eovist) injection (...
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Marjot, Thomas. "Biliary disorders." In Best of Five MCQS for the European Specialty Examination in Gastroenterology and Hepatology, 72–100. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780198834373.003.0004.
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This chapter covers core curriculum topics relating to disorders of the biliary tract including physiology and biochemistry of bile formation and the pathogenesis of gallstones; complications of gallstones disease including biliary colic, acute cholecystitis, biliary obstruction, and cholangitis, and options for operative and non-operative management. Material is also provided on conditions of the gallbladder including adenomyomatosis, gallbladder polyps, and porcelain gallbladder; primary sclerosing cholangitis and other causes of cholangitistumours of the bile duct, gall bladder, and ampulla; indications and complications of endoscopic and radiological treatment of biliary disease including endoscopic retrograde choalngiopancreatography, cholangioscopy, and Percutaneous transhepatic cholangiography. There is also discussion on the diagnosis and management of biliary complications after liver transplantation. Additional curriculum material regarding disorders of the biliary tract will also be covered in the mock examination chapter.
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Rinaldi Adithya Lesmana, Cosmas, and Baiq Kirana D. Mandasari. "The New Era of Immunotherapy in Bile Duct Cancer Management." In Immunosuppression. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.94754.
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Bile duct carcinoma or well known as cholangiocarcinoma (CCA) is the second most common of primary liver malignancy after hepatocellular carcinoma (HCC). Although cholangiocarcinoma is a rare cancer, it has an aggressive feature with very poor prognosis. The epidemiological profile of cholangiocarcinoma varies widely across the world, which is reflecting the exposure of different risk factors, such as chronic inflammatory disease of the biliary tract, specific infectious disease, and congenital malformation. Diagnosis of CCA is quite challenging. CCA is generally asymptomatic in the early stages. Therefore, the management of this malignancy is often delayed due to late diagnosed, where the metastasis has already present or even when it is causing bile duct obstruction. Treatment for CCA is often difficult and should be managed in the tertiary referral hospital with a multidisciplinary team approach. Surgical treatment with complete resection could be benefit only for patient with early stage of the disease. Other treatment modalities as adjuvant therapy are also have been developed to improve survival of the patient, such as chemotherapy, radiotherapy, molecular targeted therapy, targeting angiogenesis and EGFR, and immunotherapy. Recently, immunotherapy has also been developed as a new cancer treatment option and showed a promising result. Whether immunotherapy can be useful for treatment biliary malignancy is still controversial. Hence, a lot of studies is still required to confirm the preliminary findings.
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Venier, Francesca, Chantal Rosa, Annette Kerins, Krizia Compagnone, and Benjamin Harris. "Extrahepatic biliary duct obstruction caused by an helmith in a cat in the UK." In BSAVA Congress Proceedings 2020, 429–30. British Small Animal Veterinary Association, 2020. http://dx.doi.org/10.22233/9781910443774.58.4.
Full textConference papers on the topic "Biliary duct obstruction"
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Bungardi, Adriana, Claudia Sirbe, Alina Grama, Bianca Simionescu, Otilia Fufezan, Marcel Tantau, and Tudor L. Pop. "P220 A case of ascariasis leading to recurrent obstruction of the biliary and pancreatic ducts." In 8th Europaediatrics Congress jointly held with, The 13th National Congress of Romanian Pediatrics Society, 7–10 June 2017, Palace of Parliament, Romania, Paediatrics building bridges across Europe. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-313273.308.
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