Biliary stricture: A continuing study

Percutaneous cholangioplasty is a commonly performed procedure for both benign and malignant diseases. The most common route for accessing the biliary tree is transhepatic, following ultrasound or fluoroscopic-guided percutaneous puncture. There are situations when alternative routes can be utilized to access the common bile duct (CBD). We accessed the CBD via T-tube placed surgically in a 57-year-old man who had obstructive jaundice of obscure etiology which was likely inflammatory.

show abstract

“…T-tube, PTBD, Hutson Russell loop), and length of stricture are all expected to have a bearing on the results of cholangioplasty. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

Balloon dilatation of a benign biliary stricture through a T-tube tract

Gupta

Kalra

Kumar

et al. 2015

Indian Journal of Radiology and Imaging

View full text Add to dashboard Cite

show abstract

“…Die Ergebnisse nach bilio-bilifirer Anastomose in konventioneller Technik sind jedoch oft unbefriedigend: ein hoher Prozentsatz yon bindegewebigen Stenosen [3,14,24] ist einerseits durch die longitudinale Gef/iBversorgung am Ductus choledochus mit Ischfimie nach Naht [11,16,17,21 ], anderseits dutch Galleaustritt an der Anastomose und den ausgel6sten starken Entztindungsreiz bedingt [4,15,23]. Eine wasserdichte Naht kann in konventioneller Technik jedoch nur durch eng gesetzte und straff angezogene Ffiden mit Minderdurchblutung an der Anastomose erreicht werden.…”

Section: Diskussionunclassified

“…Bei konventioneUer Nahttechnik von Gallengangsanastomosen entwickeln sich in einem hohen Anteil Stenosen durch eine progrediente perilumin/ire Fibrosierung [1,3,6,14,23,24]; dies ist einerseits durch die nahtabh/ingige lokale Isch/irnie [16,21], andererseits durch den Galleaustritt bei kleinen Undichtigkeiten bedingt [16,23]. Die Problematik liegt darin, dal3 a u f d e r einen Seite wasserdichte Anastomosen gefordert werden und daher straff angezogene N/J, hte erforderlich sind, andererseits eine gute Durchblutung im Anastomosenbereich nur eine lockere A d a p t a t i o n der Ffiden zul/il3t.…”

unclassified

Die mikrochirurgische Gallengangsanastomose Tierexperimentelle und klinische Untersuchung

Feller¹,

Riemenschneider²,

Küper³

1986

Langenbecks Arch Chiv

View full text Add to dashboard Cite

In 10 Göttingen-minipigs an end-to-end anastomosis of the normal common bile duct was accomplished under the microscope with 11/0 Polygalactin-sutures. Biliary flow was controlled by serum concentration of alkaline phosphatase, by cholangiography and by dynamic hepato-biliary scintigraphy 2 weeks, and 3 and 6 months after the operation. Anastomoses were judged by macroscopic, microscopic and scanning electronmicroscopic examination 6 or 12 months postoperatively. The anastomoses presented no stenosis at all, only a light periductal fibrosis with intact luminal epithelium. Alkaline phosphatases and cholangiography showed a normal pattern, the scintigraphy presented dyskinesia after 2 weeks and normal flow at the later controls. After a microsurgical operation one patient showed a normal anastomosis after 6 months. A biliary anastomosis should be made by microscope in all patients with a long life span and unchanged bile duct wall in spite of the more difficult operation.

show abstract

“…It is generally agreed by surgeons with experience of treatment of bile duct strictures that some form of hepatodochojejunostomy gives the best results (15,(20)(21)(22)(23)(24). The upper jejunal contents are sterile in one-third of normal individuals (25) and anaerobic bacteria are absent (26) so a Roux-en-Y loop is a suitable conduit from both surgical and bacteriological aspects.…”

Section: Cholelithiasis Without Stricturementioning

confidence: 99%

Bile bacteria in patients with benign bile duct stricture

Jackaman¹,

Hilson²,

Smith³

1980

British Journal of Surgery

View full text Add to dashboard Cite

Research unit of hydatidology of people's hospital of Xinjiang Autonomous Region, Urumqi, 830001 P.R. China There were 1,640 patients with hydatid disease who underwent surgical treatment in our hospital during 1953-1990. of these, 1,204 cases were liver hydatid disease, and 1,319 operations yielded 1,716 Echinococcus cysts. The methods of removal of hydatid cyst were: 1) hepatic lobectomy 2) removal of intact hydatid cyst 3) removal of hydatid cyst by aspiration. Removal of the cysts left in the liver residual ectocyst cavities as large as the cysts and bile-containing bloody retention cyst, usually resulted in secondary infection, causing liver abscess. The clinical observations and experimental studies of this series revealed the mechanism of intrahcpatic biliary fistula formation and the natural rule of cavity closure, allowing rational cavity management and modification of operative methods. This reduced the frequency of postoperative biliary fistula and of secondary infection, and also shortened the healing period. The video shows a case of hydatidosis of the left hepatic lobe, appearing on the surface of the parenchyma. Cisto-pericistectomy was performed. This is the treatment of choice, because it doesn't cause reduction of the functional parenchyma and has better possibilities for radical. Benign bile duct strictures are occasionally seen in early infancy. Usually, no cause can be identified and the stricture is said to be "congenital". Spontaneous bile duct perforation is a rare entity which occurs in the first 12 weeks after birth. This disease may present as a subacute illness with jaundice, acholic stools, failure to thrive and progressive biliary ascites. A pseudocyst may be found in the hepatoduodenal ligament at laparotomy. Both spontaneous perforation and the stricture of the duct tend to be located just proximal of the junction of common bile duct and cystic duct. We have analyzed our patient material in order to asses whether infants treated for a neonatal bile stricture could have had a bile duct perforation prior to the clinical manifestation of the stricture. Three cases were found. Two of them had a Roux-en-Y hepaticojejunostomy for a bile duct stricture located at the junction of the common bile duct and the cystic duct at an age of three and 20 months respectively. One infant had a transient period of moderate jaundice associated with dilated intrahepatic ducts at an age of one week. The other child had a period of melaena and haematemesis presumably caused by haemobilia two months after birth. In both cases the symptoms resolved spontaneously. The third infant had an explorative laparotomy for extrahepatic cholestasis five weeks after birth. A pseudocyst filled with bile was found which was located in the hepatoduodenal ligament. The cyst was drained. The perforation site could not be identified. Two weeks after surgery, a biliary fluid collection was drained percutaneously. These cases suggest that spontaneous bile duct perforation might pass unobserved when located in the hepatoduoden...

show abstract

Biliary stricture: A continuing study

Cited by 9 publications

References 5 publications

Balloon dilatation of a benign biliary stricture through a T-tube tract

Balloon dilatation of a benign biliary stricture through a T-tube tract

Die mikrochirurgische Gallengangsanastomose Tierexperimentelle und klinische Untersuchung

Bile bacteria in patients with benign bile duct stricture

Contact Info

Product

Resources

About