Project description:In several clinical situations, including resection of malignant or benign biliary lesions, reconstruction of the biliary system using the Roux-en-Y jejunum limb has been adopted as the standard procedure. The basic technique and the procedural knowledge essential for most gastroenterological surgeons are described in this article, along with a video supplement. Low complication rates involving anastomotic insufficiency or stricture can be achieved by using proper surgical techniques, even following small bile duct reconstruction. Using the ropeway method to stabilize the bile duct and jejunal limb allows precise mucosa-to-mucosa anastomosis with interrupted sutures of the posterior row of the anastomosis. Placement of a transanastomotic stent tube is the second step. The final step involves suturing the anterior row of the anastomosis. In contrast to the lower extrahepatic bile duct, the wall of the hilar or intrahepatic bile duct can be recognized within the fibrous connective tissue in the Glissonean pedicle. The portal side of the duct should be selected for the posterior wall during anastomosis owing to its thickness. Meticulous inspection to avoid overlooking small bile ducts could decrease the chance of postoperative intractable bile leakage. In reconstruction of small or fragile branches, a transanastomotic stent tube could work as an anchor for the anastomosis.

| S-EPMC3311849 | biostudies-literature

Endoscopic restoration of completely transected and prolapsed common bile duct.

Project description: Not available

| S-EPMC6251474 | biostudies-literature

Dilation Time in Endoscopic Papillary Balloon Dilation for Common Bile Duct Stones.

Project description:BackgroundTo assess the short-term outcomes after endoscopic sphincterotomy (EST) plus endoscopic papillary balloon dilation (EPBD) versus EPBD alone and appropriate balloon dilation time in EPBD alone.Materials and methodsA total of 413 patients with common bile duct stones (CBDSs) were included in the EST plus EPBD group and 84 were in the EPBD alone group. We retrospectively evaluated the safety and efficacy between EST plus EPBD and EPBD alone group. The patients in EPBD alone group were assigned to dilation time ≥5 minutes group (n=35) and time <5 minutes group (n=49). Further, we preliminarily discussed the influence of balloon dilation time on the procedure-related complications.ResultsCompared with EST plus EPBD, the patients in EPBD alone group were younger [56.6 (range: 18 to 95) vs. 65.1 (24 to 92) y; P=0.006], had smaller diameter of the largest stone [10.4 (range: 3 to 20) vs. 12.3 (5 to 30) mm; P<0.001] and were lesser frequently performed with jaundice [22 (26.2%) vs. 189 (45.8%); P=0.001]. The mean duration of postoperative hospital stay in EPBD alone group was significantly shorter than EST plus EPBD group [6.3 (range: 1 to 18) vs. 9.2 (1 to 44) d; P<0.001]. The patients in EPBD alone group had higher risk of post endoscopic retrograde cholangiopancreatography pancreatitis than EST plus EPBD group [11 (13.1%) vs. 22 (5.3%); P=0.009]. Patients in the dilation time <5 minutes group had higher risk to suffer from postoperative pancreatitis than the EST plus EPBD group [9 (18.4%) vs. 22 (5.3%); P=0.002], while patients in the dilation time ≥5 minutes group had less procedure-related hemorrhage than the EST plus EPBD group [0 vs. 36 (8.7%); P=0.047].ConclusionLong balloon dilation time in EPBD alone is safe and effective in treating CBDSs.

| S-EPMC5633320 | biostudies-literature

Endoscopic repair of surgically transected bile duct using overlapping covered metal stents.

Project description:Video 1Endoscopic repair of surgically transected bile duct using overlapping covered metal stents.

| S-EPMC10861805 | biostudies-literature

Endoscopic repair of complete bile duct transection by use of transpapillary cholangioperitoneoscopy.

Project description: Not available

| S-EPMC5965705 | biostudies-literature

An alternative palliative surgical method for advanced malignant obstructive jaundice: Laparoscopic bridge choledochoduodenostomy.

Project description:BackgroundThis study introduces an alternative palliative surgical procedure called laparoscopic bridge choledochoduodenostomy (LBCDD) for patients with advanced malignant obstructive jaundice (AMOJ).MethodsPatients with AMOJ who had LBCDD between January 2017 and August 2021 were identified from databases of two institutions in China.ResultsA total of 35 patients (male 12; female 23) with an average age of 64 years were enrolled. The average diameter of the tumor is 4.24 cm. All patients undertook LBCDD within an average operation time of 75 min with a mean blood loss of 32 ml. One patient had controlled bile leakage after the operation and two developed surgical site infection involving the epigastric orifices. All of them were solved by conservative treatment. All patients were discharged smoothly after an average hospital stay of 5.5 days, and no conversion to open surgery was required.ConclusionsLBCDD is a safe and efficient palliative surgery, which has a good therapeutic effect on patients with AMOJ.

| S-EPMC9852326 | biostudies-literature

A case of biliary fascioliasis mimicking a common bile duct tumor (with video).

Project description: Not available

| S-EPMC5418970 | biostudies-literature

Surgical clips in the common bile duct suspected on endoscopic ultrasound and confirmed on endoscopic retrograde cholangiopancreatography.

Project description:We report a 56-year-old lady presented with cholangitis due to post-surgical clip migration associated choledocholithiasis. She under-went laparoscopic cholecystectomy 2 years ago. Endoscopic ultrasound revealed linear nature of hyper-echoic lesion casting acoustic shadow in the distal common bile duct suggestive of metallic surgical clip, which was later confirmed by endoscopic cholangiography.

| S-EPMC4062261 | biostudies-literature

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