Choledoco

The authors study the results obtained in biliary surgery using modern radiological and electronic equipment, combining rapid-sequence image intensified fluorography modular cabinet, television screens and videorecorder. The performance of this apparatus has enabled them to obtain precise measurements of pressure as required, a continuous film reproducing the televised image, films taken in series at the time of and during the desired programming with a very short time required for setting up and with multiple views...

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A total of 134 cases are discussed, with suppurated acute obstructive angiocholitis, that underwent surgical treatment over a period of 10 years, representing 12,8% of the total number of organic obstructions of the hepato-choledocus. From the standpoint of the etiopathogenic mechanisms the angiocholitis was determined by biliary lithiasis in 59 cases, by sclerosis of the Oddi sphincter in 5 cases, by postoperative cicatriceal stenosis of the main biliary pathway in 2 cases, by hepatic hydatitosis in 16 cases, by Vater ampuloma in 10 cases by cancers of the main biliary pathway in 40 cases and by the congenital cyst of the choledocus in one case...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

One hundred and sixty-seven choledoco-duodenostomies for lithiasis of the common bile duct (CBD) were performed. The mean age of the patients was 74 +/- 1 years. Sixty p. 100 of the patients presented with at least one operative risk factor, usually related to their general condition. An anastomosis of at least 20 mm in diameter was possible as the diameter of the CBC was always larger than 10 mm. Immediate postoperative complications (within one month) were observed in 29 cases (17 p. 100). In 14 cases (8 p...

Biliary excretion rate of bilirubin and biliverdin from fasted and fed conscious rabbits has been investigated. The animals were cholecystectomized and fitted with a chronic surgical double recurrent choledoco-choledocal biliary fistula. The enterohepatic circulation of bile salts were maintained by bile administration. Mean bile flow, biliary concentrations and excretion rates of bilirubin and biliverdin remained constant during fasting conditions. After feeding bile flow and biliary output of biliverdin increased whereas that of bilirubin did not...

We report a technique of cephalic pancreatico-duodenectomy preserving the pylorus which differs from that initially devised by Longmire and Traverso. Restoration of digestive tract continuity consists successively of end-to-end duodeno-jejunal anastomosis, end-to-side choledoco-jejunal anastomosis and end-to-side pancreatico-jejunal anastomosis. The simple technique has the advantage of restoring a perfectly physiological circuit. It seems to produce satisfactory immediate and mid- or long-term results with improvements in the patients' comfort...

A 94-year old woman presented with gallstone formation above a stenotic choledoco-duodenal anastomosis, responsible for episodes of cholangitis. After percutaneous biliary tract drainage, the anastomosis was dilated with an angioplasty catheter. As several stones persisted despite washing out, percutaneous cholangioscopy was performed. To introduce a small fibroscope into the biliary canals, transhepatic dilation up to 28 F was necessary. The last stones were pushed into the duodenum with the endoscope. Freedom of the biliary tract and patency of the anastomosis were ascertained...

Previous experimental indications that the internal biliary diversion (IBD), consisting in bilio-jejunal anastomosis, provokes an increase in glucose tolerance in healthy rats provide the basis for testing the hypothesis that this surgical procedure is capable of correcting pharmacologically-induced diabetes mellitus. To this object, the carbohydrate metabolism of an experimental group of six rats suffering from streptozotocin diabetes and treated with IBD (Lambert prosthetic choledoco-jejunostomy) was studied and compared with that of three control groups: normal, diabetic without surgery and diabetic with sham-surgery...

Biliary fistula is an occasional complication of cholecystectomy and are usually associated to retained biliary stones, surgical trauma of the biliary ducts and local infection. They were mainly treated by surgical methods up to the acquisition of the new endoscopic and percutaneous techniques used together with parenteral and enteral nutrition and new antibiotics. A total of seven patients with diagnosis of biliary fistula were seen between 1984 and 1990 at the "Unidad de Gastroenterología y Cirugía Digestiva" of the Clínica Sanatrix en Caracas...

We present two years of our surgical experience in the Gastroenterologic department of General Hospital of Mexico city; we studied prospectively 23 patients with choledocholithiasis diagnosed preoperatively and postoperatively, 18 females (78%) and 5 males (22%). Diagnosis were performed preoperatively by sonogram, intravenous cholangiography and/or endoscopic retrograde pancreatocholangiography in 19 cases, and postoperatively in four cases. In 22 cases we performed colecistectomy with choledocotomy, extraction of calculi and placement of a "T" biliary catheter...

The place of total pancreatectomy in the treatment of pancreatitis is still ill- defined. The author makes a plea for this operation and notes the indications, the surgical technique and its results and possible complications. The operation is indicated in cases of total or 2/3 rds necrosis of the gland, in cases involving the head of the pancreas and part of the body. The gland should be dissected out and continuity should be restored by choledoco-jejunal and gastro-jejunal anastomoses. The important thing is to carry out this operation early, between the 3rd and 6th day, treating the areas of necrosis before the lesions become the site of uncontrolled infection...

The authors report a series of 62 choledoco-duodenal anastomoses carried out during surgical treatment of cholelithiasis and note the indications for this procedure, emphasizing the necessity for a wide common bile duct and a normal duodenum. Apart from complete obstruction of the common bile duct with gall stones, the main indication is organic obstruction of the terminal part and of the sphincter of Oddi. A 2 cm anastomosis is necessary. Duodeno-biliary reflux has no direct consequence in the absence of stenosis of the anastomosis and of pre-existing cholangitis...

Among 1,645 biliary operation carried out between 1952 and 1974, the authors count 177 organic stenoses of the Oddi region. They recall the authenticity of chronic odditis, the pathological substratum of which is Oddi sclerodystrophy, a primary and progressive lesion. They emphasise the radiomanodebimetric criteria. The risk of an error of interpretation was 2% in this series. After discussing the etiopathogenesis and the physiopathological consequences of Oddi sclerodystrophy, they discuss the therapeutic choice between sphincterotomy and choledoco-duodenostomy...