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PubMed1988

[Various problems of surgery of the extrahepatic bile ducts].

Debatable questions of indications to choledochotomy and placing bile-eliminating anastomoses are discussed on the basis of personal experiences and data of literature. It is supposed that the amount of choledochotomies should be restricted at the expense of wider use for the revision of extrahepatic bile ducts of the cystic duct stump. In cases when bile-elimination anastomoses are not supposed oblique choledochotomy should be preferred through the cystic duct stump. Indications to the creation of bile-elimination anastomoses should not be wider. In doubtful cases the question should be solved in favour of external drainage of the common bile duct.

Ampulla of Vater↗
PubMed1988

[Surgical treatment of chronic biliopancreatitis].

Surgical treatment of chronic biliopancreatitis has sometimes unsatisfactory results of cholecystectomy and supraduodenal choledochoduodenoanastomosis due to non-eliminated during the operation chronic alterations of the patency of terminal parts of the common bile duct and Wirsung's duct. In most patients with chronic biliopancreatitis good and satisfactory results were noted after performing associated surgical operations including cholecystectomy, transduodenal papillosphincterotomy, wirsungoduodenotomy, correction of duodenostasis and splanchnicectomies.

Adult↗
PubMed1988

[Biliary ascites and biliary peritonitis].

Questions concerned with the penetration of bile into the abdominal cavity are discussed. The observation of 9 patients was used. The effusion of infected bile into abdominal cavity results in the development of bile peritonitis requiring urgent surgical measures. If the bile is not infected, bile ascites is developing, its clinical picture being obliterated and the patients often remaining in satisfactory condition for a long time.

Adult↗
PubMed1988

Bilioportal fistula as a complication of choledochoduodenostomy.

A bilioportal fistula is rare. We report the case of a patient who had a bilioportal fistula 6 years after a choledochoduodenostomy. Percutaneous transhepatic opacification showed the bilioportal fistula to be associated with a thrombosed portal vein and a cavernous formation. Treatment consisted of separate percutaneous drainage of the portal and biliary tracts. Closure of the fistula was obtained by progressive proximal intrahepatic portal thrombosis. Our case contrasts with the four other cases of bilioportal fistula published in the literature in that (1) there was an absence of biliary lithiasis and (2) we did not use surgical treatment. The most likely explanation for our case of bilioportal fistula is an infectious complication related to the choledochoduodenostomy.

Bile Duct Diseases↗
PubMed1988

[Percutaneous transhepatic cholangiography and cholangiostomy in mechanical jaundice].

Under investigation there were 223 patients with mechanical jaundice, 132 patients were subjected to percutaneous transhepatic cholangiography, 102 patients--to percutaneous transhepatic cholangiostomy. The preoperative drainage of bile ducts was established to be efficient in order to reduce lethality. High diagnostic value of cholangiography is shown. Indications and contraindications to the application of cholangiostomy depending on etiology of jaundice, localization of the tumor, and its spread, degree of hepatic insufficiency and risk of operative procedures are formulated.

Cholangiography↗
PubMed1988

Motor pattern of the sphincter of Oddi in patients with bilioenteric shunt: a manometric study.

An endoscopic biliary manometry was performed on 11 patients with a surgical bilioenteric shunt--choledochoduodenostomy--and no pressure gradient between common bile duct and duodenum. Basal pressure and frequency of the phasic waves of the sphincter of Oddi were significantly higher in these patients than in controls or in patients with retained common bile duct stones. These results suggest a functional adaptation of the sphincter of Oddi in an attempt to recover the normal pressure in the biliary tract.

Aged↗