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Hepatic Duct (hepatic + duct)

Distribution by Scientific Domains
Medical Sciences90%

Kinds of Hepatic Duct

  • common hepatic duct
    		•

    Selected Abstracts

    Mirizzi syndrome Type IV: A rare entity

    DIGESTIVE ENDOSCOPY, Issue 4 2003
    Everson Luiz De Almeida Artifon
    Mirizzi's syndrome, characterized by obstructive jaundice due to an extrinsic compression of common hepatic duct by an impacted gallstone in the cystic duct or the neck of the gallbladder, is a rare complication of gallstone disease. The present case describes Mirizzi's syndrome classified as Type IV in a 50-year-old man with obstructive jaundice. Abdominal computed tomography scan demonstrated a dilated intrahepatic biliary tree and a tumoral mass at the porta hepatis, suggesting cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography also suggested cholangiocarcinoma involving the entire circumference of the common hepatic duct in porta hepatis. The diagnosis of Mirizzi's syndrome Type IV was confirmed during cholecystectomy, withdrawal of gallstone and Roux-en-Y hepaticojejunostomy. [source]

    A case of cholecystohepatic duct with atrophic common hepatic duct

    HPB, Issue 4 2003
    A Schofield
    Background Cholecystohepatic ducts are rare congenital variants of the biliary tree. Case outline An 81-year-old woman presented with biliary colic and elevated liver function tests. An ERCP demonstrated a common bile duct stone and stricture of the common hepatic duct. An operative cholangiogram demonstrated an atrophic common hepatic duct and retrograde filling of the gallbladder through a large cholecystoheptic duct. The patient had a cholecystectomy and reconstructive cholecystohepatic duct jejunostomy. Discussion This case demonstrates a rare congenital anomaly where the gallbladder fills retrograde during an intraoperative cholangiogram despite clipping of the cystic duct. The major path of biliary drainage was through a large cholecystoheptic duct similar to a gallbladder interposition; however, the common hepatic duct was still present but atrophic. This anomaly has not been described previously. [source]

    Reconstruction of the main portal vein for a large saccular aneurysm

    HPB, Issue 3 2003
    Vojko Flis
    Background A large aneurysm of the main portal vein is rare, and the appropriate surgical procedure is uncertain. Reconstruction of a main portal vein affected by a large saccular aneurysm is described. Case outline Abdominal pain led to the diagnosis of a large saccular aneurysm of the main portal vein in a 58-year-old woman who had undergone cholecystectomy 10 years earlier. At laparotomy a dorsolateral approach to the hepatoduodenal ligament was performed with no attempt at extensive separate exposure of the anatomical structures in the hepatoduodenal ligament, so as to avoid the devascularisation of the common hepatic duct and additional weakening of the portal vein wall. The aneurysm was longitudinally incised, and the portal vein was reconstructed from the walls of the aneurysm with a longitudinal running suture. The rest of the aneurysmal wall was wrapped around the portal vein, leaving it normal in size and contour. Recovery was uneventful. Follow-up CT scan showed a patent portal vein in the region of the former aneurysm. Discussion Large saccular aneurysms can rupture, bleed and cause death. The potential hazards of manipulation of large portal vein aneurysms are negligible in comparison with the possible complications of the aneurysm itself. In our opinion the ease with which the main portal vein was dissected and reconstructed make an elective operation in such cases a reasonable approach. [source]

    Handling of biliary complications following laparoscopic cholecystectomy in the setting of Tripoli Central Hospital

    HPB, Issue 3 2002
    A Elhamel
    Background Laparoscopic cholecystectomy (LC) has an increased incidence of bile duct injury and bile leak when compared with open cholecystectomy. This study reviews management of these complications in a general hospital setting. Data collected from patients diagnosed and treated in one surgical unit for biliary complications after LC between 1992 and 1996 were analysed. Method A total of 14 patients were examined. Diagnosis was defined mainly by Endoscopic retrograde cholangiopancreatography (ERCP) and undetected choledocholitiasis was discovered in association with two of these complications. 43% of patients presented after LC with early postoperative bile leak or jaundice due to partial or complete bile duct excision or slippage of clips from the cystic duct. 57% presented with late biliary strictures. Thirteen patients were treated surgically, with biliary reconstruction (11 patients), direct repair (one) and cystic duct ligation in combination with clearance of bile duct from large multiple stones (one). One patient, who had clip displacement from cystic duct in combination with misplaced clip on right hepatic duct, was treated elsewhere. Postoperatively, one patient developed anastomotic leak and another died from sequellaie of bile duct transection requiring staged operations. Conclusions It is concluded that, in an environment similar to that where the authors had to work, LC should be performed in hospitals with facility to perform ERCP or when access for this technique is available in a nearby institution. Early recognition and immediate management of biliary injuries is dependent on individual resources and circumstances but, if required, consultation with colleagues or referral of patients with suspected or established biliary complications should not be delayed. [source]

    Portal vein phlebolithiasis found post-liver transplantation in the native liver of a child with biliary atresia

    PEDIATRIC TRANSPLANTATION, Issue 1 2001
    B. Bilezikçi
    Abstract: Biliary atresia is defined as partial or total obliteration of the extra-hepatic bile ducts. In advanced cases, liver transplantation (LTx) is considered the most appropriate treatment. This report describes a female patient whose biliary atresia and subsequent cirrhosis required LTx at 1 yr of age. Macroscopic inspection of the hilar region of the native liver post-Tx revealed the formation of a pouch in the hepatic duct and a stone in the lumen of the portal vein. X-ray diffraction analysis showed that the stone was composed of cholesteryl cinnamate, gluconic acid phenylhydrazide, Na , broma-allyl mercaptomethyl penicillinate, and Al2O3 crystals. While the cholesterol component is a known element of gallstones, we attributed the Na , broma-allyl mercaptomethyl penicillinate to the patient's drug therapy. Our literature search revealed no previous record or crystallographic analysis of portal vein phlebolithiasis. In this report we describe this rare finding. [source]

    Traumatic neuroma of the right hepatic duct undertaken right hemihepatectomy

    ANZ JOURNAL OF SURGERY, Issue 1-2 2009
    Sae Byeol Choi MD
    No abstract is available for this article. [source]

    Potential of laparoscopic ultrasonography as an alternative to operative cholangiography in the detection of bile duct stones

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2001
    S. E. Tranter
    Background: Intraoperative cholangiography (IOC) is time consuming, requires radiation and sometimes fails. In contrast, laparoscopic ultrasonography (LUS) is a comparatively quick, safe and non-invasive technique. The aim of this study was to assess the potential of LUS as an alternative to IOC. Methods: LUS was performed on 367 patients undergoing laparoscopic cholecystectomy. Laparoscopic duct exploration was performed in the presence of duct stones. Data were collected prospectively. The presence or absence and number of duct stones detected by LUS were recorded. The maximum bile duct diameter determined by LUS was compared with a preoperative ultrasonographic measurement according to age and the presence of duct stones. The final arbiter was the demonstration of stones removed at laparoscopic duct exploration (59 patients) or subsequently by endoscopic retrograde cholangiopancreatography (two patients). Results: LUS visualized the CBD in 99 per cent of patients and the common hepatic duct in 92 per cent. It identified stones in 56 of the 61 patients with duct stones. No stones were demonstrated in the remaining 306 patients (sensitivity 92 per cent, specificity 100 per cent, positive predictive value 100 per cent, negative predictive value 98 per cent). LUS underestimated the total number of stones in 18 per cent of patients with common duct stones. The mean common bile duct diameter was 5·0 mm before operation and 5·9 mm during the procedure in patients without duct stones, rising significantly to a mean of 9·2 mm before operation and 11·2 mm at LUS in those with duct stones (P < 0·0001). Conclusion: The combination of the demonstration of duct stones and bile duct diameter measurement makes LUS a potential replacement for IOC. Improved demonstration of the common hepatic duct would be advantageous. © 2001 British Journal of Surgery Society Ltd [source]

    Variant anatomy of the cystic artery in adult Kenyans

    CLINICAL ANATOMY, Issue 8 2007
    Hassan Saidi
    Abstract Knowledge of the variant vascular anatomy of the subhepatic region is important for hepatobiliary surgeons in limiting operative complications due to unexpected bleeding. The pattern of arterial blood supply of 102 gallbladders was studied by gross dissection. The cystic artery originated from the right hepatic artery in 92.2% of cases. The rest were aberrant and originated from the proper hepatic artery. Accessory arteries were observed to originate from proper hepatic artery (n = 5), left hepatic artery (n = 2), and right hepatic artery (n = 1). Most of the arteries approached the gallbladder in relation to the common hepatic duct (anterior 45.1%, posterior, 46.1%). The other vessels passed anterior to common bile duct (2.9%), posterior to common bile duct (3.9%), or were given off in Calot's triangle. Cystic arteries in this data set show wide variations in terms of relationship to the duct systems. In about one tenth of patients, an accessory cystic artery may need to be ligated or clipped during cholecystectomy. Clin. Anat. 20:943,945, 2007. © 2007 Wiley-Liss, Inc. [source]

    Jejunal access loop cholangiogram and intervention using image guided access

    JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2010
    KS Amitha Vikrama
    Summary Jejunal access loop is fashioned in patients who undergo Roux en Y hepaticojejunostomy and biliary intervention is anticipated on follow up. Post-operative study of the biliary tree through the access loop is usually done under fluoroscopic guidance. We present a series of 20 access loop cholangiograms performed in our institution between August 2004 and November 2008. We aimed to evaluate the safety and efficacy of the procedure and to highlight the role of CT guidance in procuring access. Access loop was accessed using CT (n = 13), ultrasound (n = 3) or fluoroscopic guidance (n = 4). Fluoroscopy was used for performing cholangiograms and interventions. Twelve studies had balloon plasty of the stricture at anastomotic site or high up in the hepatic ducts. Seven studies showed normal cholangiogram. Plasty was unsuccessful in one study. Technical success in accessing the jejunal access loop was 100%; in cannulation of anastomotic site and balloon plasty it was 95%. One case required two attempts. Procedure-related complications were not seen. All patients who underwent balloon plasty of the stricture were doing well for variable lengths of time. Access loop cholangiogram and interventions are safe and effective. CT guidance in locating/procuring the access loop is a good technique. [source]