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Results for “COMMON BILE DUCT”

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PubMed2002

Duodenum-preserving pancreatic head resection leads to relief of common bile duct stenosis.

BACKGROUND: Common bile duct stenosis (CBDS) is one of the most frequent complications in chronic pancreatitis with inflammatory mass in the head of the pancreas (IMH). METHODS: A total of 474 patients who underwent duodenum-preserving pancreatic head resection (DPPHR) between 1982 and 1998 were reevaluated; 219 patients (46%) with a mean duration of the disease of 45 months had a radiologically proven CBDS. RESULTS: One patient (0.5%) died of septic complications in the early postoperative course, 15 patients (6.8%) had to be reoperated on for complications. A follow-up investigation of 143 patients (92%) revealed a late mortality of 12%; no patient died of biliary complications. Seventy-five percent of the patients were completely free of pain, and 85% of the patients had a constant or even increasing body weight. CONCLUSIONS: The high percentage of pain-free patients with improved physical status and economical rehabilitation demonstrates the improvement of the quality of life after DPPHR for complicated chronic pancreatitis.

Adult↗
PubMed2000

A variant of an accessory common bile duct.

While variations of the common bile duct are relatively common, true duplication of the common bile duct is very rare. Such deviation from normal anatomy, if unrecognized, may cause problems during surgical intervention. Here we present a case of a unique variant of an accessory bile duct which arises from the confluence of the right and left hepatic ducts and runs down to join the pancreatic duct to form a long, common channel before opening into the papilla with the main duct.

Adult↗
PubMed1999

Laparoscopic intracorporeal ultrasound cystic duct length measurement: a new technique to prevent common bile duct injuries.

The incidence of common bile duct injury remains high. Intracorporeal ultrasound mapping of cystic duct anatomy, prior to laparoscopic cholecystectomy (LC), may assist surgeons in avoiding common bile duct injuries. A technique for intraoperative intracorporeal predissection ultrasound imaging (IIPUI) of the cystic duct length was tested. During LC, gallbladder adhesions were lysed, and with the gallbladder retracted by grasping forceps, the ultrasound examination was performed. Using a 7.5-MHz articulating ultrasound probe, visualization of the extrahepatic biliary tree was obtained in five separate planes. Success in visualizing each plane, time for ultrasound examination, and predissection accuracy of cystic duct length measurement were recorded. Intraoperative cholangiography or direct measurement of the dissected cystic duct was used to determine accuracy of the ultrasound cystic duct length estimates. Forty-three patients underwent IIPUI during LC. The time required to perform the examination varied, with a range of 5 to 17 min (mean 9.5 min). Success of visualization in planes 1 through 5 was 44%, 95%, 98%, 98%, and 70%, respectively. The accuracy rate for cystic duct length ultrasound measurement was 87.1%. No complications related to the examination were observed. In this preliminary study, cystic duct length was determined by predissection intracorporeal ultrasound with a high level of accuracy. Predissection imaging may assist in preventing common bile duct injury during LC.

Adult↗
PubMed1983

[Mechanism of the bile duct dilatation in congenital dilatation of the common bile duct].

Radiographic studies including operative cholangiography, endoscopic retrograde cholangiopancreaticography and percutaneous transhepatic cholangiography were performed in 44 patients with congenital dilatation of the common bile duct. The relation between the maximum transverse diameter of the common bile duct (CBD) as an indicator of the degree of dilatation and various possible factors causing dilatation of CBD was studied. Among these factors, the length of the narrow segment (X) was closely related with the maximum transverse diameter (Y). The relation of these two was expressed by a simple equation; log Y = 0.068X + 1.06 (r = 0.934, p less than 0.001, n = 19) Dilatation of CBD has been successfully produced by narrowing the ductal lumen with a small plastic tube encirculating the distal common bile duct in dogs. Experimental dilatation was quite similar with congenital dilatation. In addition, the relation between the maximum transverse diameter (Y') and the length of the narrow segment (X') was also expressed in the following simple equation; log Y' = 0.060X' + 0.88 (r = 0.972, p less than 0.001, n = 18) The present studies did not support the hypothesis that abnormal junction of the pancreatico-biliary system might be the primary cause of congenital dilatation of CBD. They suggest that the stenosis of the distal CBD in the fetal life may determine dilatation of CBD.

Animals↗