Biliary tract surgery

Abstract

The use of the laparoscope in biliary tract surgery continues to play a major role in improving the operative management of patients with biliary diseases. Laparascopic cholecystectomy has been safely performed as a day-case procedure and has lowered the morbidity of cholecystectomy in the setting of acute cholecystitis. Laparoscopic common bile duct exploration allows cholecystectomy and the removal of common bile duct stones to be performed during the same procedure, thereby decreasing hospital stay. Several new noninvasive modalities have been recently developed to image the biliary tract. In addition, laparoscopic ultrasound has led to rapid intraoperative imaging of the extrahepatic biliary tree. The long-term results of laparoscopic bile duct injuries have been better defined during the past several years. Finally, the role of surgical resection for gallbladder cancer detected during or after laparoscopic cholecystectomy has recently been evaluated.

Spectrum of Clinico - Pathological Presentations of Gallstone Diseases in a Tertiary Care Institute in Rohilkhand Region

“…20 Coelho et al (1984) observed 25% incidence of acute cholecystitis which was higher than incidence observed in the present study. 15 Acute acalculus cholecystitis accounts for 5% to 10% of all patients with acute cholecystitis and is the diagnosis in approximately 1% to 2% of patients undergoing cholecystectomy (Ahrendt et al, 2004). 21 So our results are close to the results of other standard studies.…”

“…15 Acute acalculus cholecystitis accounts for 5% to 10% of all patients with acute cholecystitis and is the diagnosis in approximately 1% to 2% of patients undergoing cholecystectomy (Ahrendt et al, 2004). 21 So our results are close to the results of other standard studies. Khanna et al (2006) conducted a histopathological study of 140 consecutive gallbladders, electively resected for cholelithiasis.…”

“…This is higher than whatever studied in literature. Approximately 1% of all elective cholecystectomies performed for cholelithiasis harbor an occult gallbladder cancer (Ahrendt and Pitt, 2004). 21 The incidence of gallbladder cancer is approximately 7 times more common in the presence of cholelithiasis and chronic cholecystitis than in people without gallstones.…”

Imaging the Liver

“…These tumors demonstrate variable echotextures due to the presence of varying amounts of fibrosis and necrosis. Approximately 60%-70% 392 Imaging the Liver of cholangiocarcinomas occur at the hepatic duct bifurcation, and the remainder occur in the distal common bile duct (20%-30%) or within the liver (5%-15%) [46]. The associated biliary ductal dilatation is well demonstrated on US.…”

Cholangiocarcinoma: An-eight-year Experience in a Tertiary-Center in Iran

“…The cholangiocarcinoma can appear as intrahepatic, hilar, and extrahepatic (Nagorney et al, 1993;Nakeeb et al, 1996;Blechacz and Gores, 2008). By the time, a diagnosis is usually made, intrahepatic cholangiocarcinoma is demonstrated as a large mass because the tumor does not cause clinical symptoms in its early stages, while, extrahepatic cholangiocarcinoma is commonly small at the time of presentation because the bile ducts are sealed in its early stage and patients present with jaundice (Nagorney et al, 1993;Nakeeb et al, 1996;Ahrendt et al, 2001). The precise reason of cholangiocarcinoma is unknown; however there are several conditions as primary sclerosing cholangitis (PSC), bile duct cysts and chronic biliary irritation that can increase risk of cholangiocarcinoma (Boberg et al, 2002).…”