Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CYSTIC DUCT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1975

A critical analysis of the cystic duct remnant.

The cystic duct remnant can be an etiologic factor for distress after cholecystectomy, justifying reoperation and excision of the stump. In connection with cholecystectomy, it is not justified to leave any cystic duct stump unless there is a special reason for it. Stones in the cystic duct remnant, overlooked or newly formed, scar tissues and cystic duct syndrome of whatever cause--inflammation and stasis of the bile, a poorly healing stump end and neuroma--can also be factors producing the discomfort. Unresorbable suture material which provokes foreign body granulomas should be avoided in operations upon the biliary tract since, together with even a normal nerve under pressure, it may cause biliary distress. For the same reason, special attention should be devoted to careful trimming of the cystic nerve in cholecystectomy, and ligation or cautery of nerve tissues should be avoided. The cystic duct remnant is more often visualized in peroperative cholangiography than in an intravenous examination but even then not unfailingly. The cholangiographic finding alone does not justify surgical intervention, since in a number of patients troubles deriving from elsewhere in the biliary tract or from adjacent organs persist and not all cystic stumps apparently produce discomfort.

Adolescent↗
PubMed1978

[Clinical evaluation of common bile duct drainage via the cystic duct stump after cholecystectomy for chronic calculous cholecystitis].

From target studies of the clinical value of choledochal drainage through the stump of the cystic duct by Halsted-Pikovsky method, following cholecystectomy for Courvosier's gallbladder without choledochotomy, the authors have come to the conclusion that such drainage does not improve the postoperative clinical course, while evolving an added risk of some complications.

Cholecystectomy↗
PubMed2002

Absence of the common bile duct and junction of the cystic duct with the left hepatic duct in a patient with chronic portal vein thrombosis.

A50-year-old male patient was admitted to the hospital because of fatigue and a palpable abdominal mass. The diagnoses of chronic renal failure and portal vein thrombosis were established by specific investigations. Incidentally, junction of the cystic duct with the left hepatic duct and absence of the common bile duct were found during endoscopic retrograde cholangiopancreatography study. To the authors' knowledge, this is the first reported case of an absence of the common bile duct and junction of the cystic duct with the left hepatic duct in a patient with chronic portal vein thrombosis. Such lesions may cause unexpected complications during biliary surgery.

Chronic Disease↗
PubMed1991

Laparoscopic ligation of a leaking cystic duct.

Laparoscopic cholecystectomy (LC) has rapidly become an acceptable surgical technique. Indeed it may become the preferred method for cholecystectomy, with the open method reserved for complicated cases. Early series of LC have shown a mortality rate of 0-1%, comparing favorably to the open method. However, complications such as bile duct injury, cystic duct leaks, and biliary collections may be more frequent. We report the first case of cystic duct leakage after LC successfully managed by subsequent laparoscopic ligation.

Adult↗
PubMed2000

The "hidden cystic duct" syndrome and the infundibular technique of laparoscopic cholecystectomy--the danger of the false infundibulum.

BACKGROUND: The "classical" biliary injury usually involves misidentification of the common bile duct as the cystic duct. The purpose of this study was to determine if the method of cholecystectomy, specifically the "infundibular technique," might be a contributing factor in this injury. STUDY DESIGN: Twenty-one operative notes of patients who were referred with injury to the common bile duct were examined. Notes were classified as to informativeness. Patient and operative variables potentially related to injury were searched for. RESULTS: Inflammation was the main patient variable associated with injury. The main operative variable was that in most of the injuries the cystic duct was isolated and divided as the first step in the procedure. Often the operative note contained a statement indicating that the surgeon believed that the "cystic" duct (actually the common bile duct) was emanating from the infundibulum of the gallbladder and that this was the anatomic rationale for identification of the cystic duct. In no case was the triangle of Calot completely dissected before injury. CONCLUSIONS: The cystic duct may be hidden in some patients having laparoscopic cholecystectomy, especially in the presence of inflammation. This may lead to the deceptive appearance of a false infundibulum that misleads the surgeon into identifying the common duct as the cystic duct. Biliary injury is more likely when cystic duct identification is made by relying solely on the appearance of the junction of the cystic duct with the infundibulum of the gallbladder, and this technique should be abandoned.

Adolescent↗
PubMed1989

Percutaneous dislodgement of an impacted cystic duct stone.

An obstructing cystic duct stone was dislodged with an angiographic catheter and guidewire via a percutaneous cholecystostomy tract in a mildly sedated patient. After brief stenting of the cystic duct, the patient remained asymptomatic with internal bile drainage. When endoscopic negotiation of the cystic duct is difficult, an impacted cystic duct stone can sometimes be dislodged with standard angiographic techniques.

Aged↗
PubMed1991

Carcinoma of the cystic duct.

Carcinoma of the cystic duct is a rare neoplasm, and we herein report four cases of carcinoma of the cystic duct. The patients consisted of a 69 year old and 71 year old woman and a 61 year old and 93 year old man. They complained of either abdominal pain or abdominal mass. All the tumors were microscopically well-differentiated adenocarcinoma, mostly limited to the wall, that showed no lymph node or distant metastasis. Three patients who had undergone resection were doing well 20 days, 67 months, and 125 months after the operation, respectively. These findings may suggest that not only the early development of symptoms caused by obstruction of the narrow lumen of the cystic duct, but also slow growth and late metastasis produce a favorable clinical course in patients with carcinoma of the cystic duct.

Aged↗
PubMed1982

Ultrasound measurement of contraction response of the gallbladder: comparison with the radionuclide test for cystic duct patency.

Two tests of cystic duct patency were compared in 37 patients with suspected acute cholecystitis. Ultrasound (US) measurement of gallbladder contraction induced by 40 Ivy dog units of cholecystokinin (CCK) was followed by the radionuclide (RN) test for cystic duct patency. In all 13 patients in whom US showed significant gallbladder contraction after CCK, the cystic duct was proved to be patent by the RN test. The gallbladder did not contract significantly in 24 patients. Eleven of these patients had acute cholecystitis, with evidence of cystic duct obstruction, and 12 had patent cystic ducts and final diagnoses other than acute cholecystitis. The measurement of contraction of the gallbladder in response to CCK is a valuable improvement over simple US when cystic duct obstruction is excluded; failure of contraction is not specific, and independent evaluation of cystic duct patency is required.

Adult↗
PubMedDate not supplied

The cystic duct: normal anatomy and disease processes.

The cystic duct can be depicted with a variety of imaging modalities but is optimally visualized with direct cholangiography or magnetic resonance cholangiopancreatography. Nevertheless, unrecognized anatomic variants of the cystic duct may cause confusion on imaging studies and complicate subsequent surgical, endoscopic, and percutaneous procedures. Primary entities involving the cystic duct include calculous disease, Mirizzi syndrome, cystic duct-duodenal fistula, biliary obstruction, neoplasia, and primary sclerosing cholangitis. The cystic duct may also be secondarily involved by adjacent malignant or inflammatory processes. Postoperative alterations are seen after liver transplantation or cholecystectomy when a portion of the cystic duct is left behind as a remnant. Recognized postoperative complications include retained cystic duct stones, cystic duct leakage, and malposition of T tubes in the remnant. Pitfalls encountered in cystic duct imaging include pseudocalculous defects from overlap of the cystic duct and common bile duct, underfilling of the cystic duct during direct cholangiography, and admixture defects at the cystic duct orifice. Pseudomass or pseudotumor defects may result from an impacted cystic duct stone or from a tortuous, redundant cystic duct. Familiarity with the imaging appearance of the normal cystic duct, its anatomic variants, and related disease processes facilitates accurate diagnosis and helps avoid misinterpretation.

Bile Duct Diseases↗
PubMed1975

Repair of common bile duct defects using the gallbladder or cystic duct as a pedicled graft.

To repair defects in the common bile duct, part of the gallbladder and the cystic duct may be used as a pedicled graft. This has the advantage of an independent blood supply and a related mucosal lining. The method is illustrated by four patients who had excellent primary and short term results. In two patients, the defect was due to large cholecystocholedochal fistulas caused by migrating large gallstones. In one patient with marked stenosis of the duct, the defect occurred when the stenosis was opened through a longitudinal incision. The fourth patient had a large duodenal ulcer that penetrated into the common duct, causing a defect that could not be closed by suture. A definite evaluation of the procedure must await a longer period of follow-up study.

Adult↗
PubMed1989

Sonography of the distal cystic duct.

This prospective study of 139 patients was performed for evaluation of the normal and abnormal distal cystic duct and cystic duct remnant after cholecystectomy. The normal distal cystic duct could be demonstrated in 51% of the patients with normal common bile duct and normal gallbladder. The average diameter of the normal distal cystic duct was 1.8 mm. In 95% of the patients, the distal cystic duct was located posterior to the common bile duct and, in 5% of the patients, anterior to the common duct. Echoes produced by cystic duct insertion into the common bile duct occasionally can be mistaken for stones in the common bile duct. These echoes, however, are not associated with acoustic shadowing. Sludge and stones could be demonstrated in the distal cystic duct as well as in the cystic duct remnant after cholecystectomy.

Aged↗