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Gastrointestinal Endoscopy Jan 2015
Review
Topics: Advisory Committees; Bile Duct Diseases; Bile Duct Neoplasms; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Intestinal Fistula; Pancreatic Diseases; Pancreatic Neoplasms; Quality Indicators, Health Care; Rectal Diseases
PubMed: 25480097
DOI: 10.1016/j.gie.2014.07.054 -
Annals of Surgical Oncology Apr 2024Intrahepatic cholangiocarcinoma (ICC) is subclassified into small and large duct types. The impact of these subclassifications for identifying appropriate surgical...
BACKGROUND
Intrahepatic cholangiocarcinoma (ICC) is subclassified into small and large duct types. The impact of these subclassifications for identifying appropriate surgical strategies remains unclear.
PATIENTS AND METHODS
This study included 118 patients with ICC who underwent liver resection. Based on the pathological examination results, the participants were divided into the small duct-type ICC group (n = 64) and large duct-type ICC group (n = 54). The clinicopathological features and postoperative outcomes were compared between the two groups to investigate the impact of subclassification for selecting appropriate surgical strategies.
RESULTS
Ten patients in the small duct-type ICC group had synchronous or metachronous hepatocellular carcinoma. The large duct-type ICC group had higher proportions of patients who underwent major hepatectomy, extrahepatic bile duct resection, portal vein resection, and lymph node sampling or dissection than the small duct-type ICC group. The large duct-type ICC group had significantly higher incidences of lymph node metastasis/recurrence and pathological major vessel invasion than the other. The small duct-type ICC group exhibited significantly higher recurrence-free and overall survival rates than the large duct-type ICC group. Further, the large duct-type ICC group had a significantly higher incidence of lymph node metastasis/recurrence than the small duct-type ICC at the perihilar region group.
CONCLUSIONS
Suitable surgical strategies may differ between the small and large duct-type ICCs. In patients with large duct-type ICCs, hepatectomy with lymph node dissection and/or biliary reconstruction should be considered, whereas hepatectomy without these advanced procedures can be suggested for patients with small duct-type ICCs.
Topics: Humans; Bile Ducts, Intrahepatic; Lymphatic Metastasis; Cholangiocarcinoma; Hepatectomy; Bile Duct Neoplasms; Liver Neoplasms
PubMed: 38180706
DOI: 10.1245/s10434-023-14833-1 -
Veterinary Ophthalmology May 2022This study sought to describe the anatomical characteristics of the nasolacrimal duct of Persian cats as observed by computed tomographic dacryocystography.
OBJECTIVE
This study sought to describe the anatomical characteristics of the nasolacrimal duct of Persian cats as observed by computed tomographic dacryocystography.
ANIMAL STUDIED
Ten cats weighing 3-6 kg (three live cats and seven cadaveric specimens).
PROCEDURES
The animals were submitted to bilateral computed tomographic dacryocystography, totaling 20 nasolacrimal ducts. Dorsal, sagittal, and transverse planes were studied. Two additional skulls were also dissected following latex injection into the nasolacrimal duct. The length and width of the nasolacrimal duct and lacrimal canaliculi, and the distance between the nasolacrimal duct and the root of the upper canine tooth at the point of closest proximity were measured.
RESULTS
The nasolacrimal duct followed a convoluted course, particularly in the middle and rostral portions. Duct stenosis (width reduction equal to or >75%) and dilations (width increase equal to or >50%) were also detected, particularly in the rostral portion. Nasolacrimal duct length and width ranged from 1.3 to 1.5 cm and 1.5 to 2.3 mm, respectively. Mean lacrimal canaliculus length and width corresponded to 3.1 mm and 0.4 mm, respectively. Mean distance from the nasolacrimal duct to the canine tooth was 2.4 mm. The root of this tooth interfered with the course of the nasolacrimal duct.
CONCLUSION
This study provided anatomical information for clinical assessment of the nasolacrimal drainage system in Persian cats.
Topics: Animals; Cat Diseases; Cats; Dacryocystography; Eyelids; Humans; Lacrimal Apparatus; Lacrimal Duct Obstruction; Nasolacrimal Duct; Tomography, X-Ray Computed
PubMed: 35226782
DOI: 10.1111/vop.12980 -
Orbit (Amsterdam, Netherlands) Oct 2021Cerebral palsy (CP) is a congenital syndrome with systemic manifestations secondary to a non-progressive lesion of the immature brain. It is associated with numerous...
Cerebral palsy (CP) is a congenital syndrome with systemic manifestations secondary to a non-progressive lesion of the immature brain. It is associated with numerous cerebral and non-cerebral malformations. The present report describes a 2-year-old baby with spastic CP, diplegic type, associated with congenital cardiac malformations and right eye complex congenital nasolacrimal duct obstruction (CNLDO) (bony nasolacrimal duct stenosis and buried probe) requiring endoscopic dacryocystorhinostomy and left eye simple CNLDO which resolved on probing the system. This report also lays emphasis on the need for examination of the lacrimal drainage system in all patients with CP, so as to treat them appropriately and reduce the morbidity.
Topics: Cerebral Palsy; Child; Child, Preschool; Dacryocystitis; Dacryocystorhinostomy; Humans; Infant; Lacrimal Duct Obstruction; Nasolacrimal Duct; Retrospective Studies; Treatment Outcome
PubMed: 32718225
DOI: 10.1080/01676830.2020.1797827 -
Annals of Surgical Oncology Jul 2019
Topics: Bile Duct Neoplasms; Cholangiocarcinoma; Global Health; Healthcare Disparities; Humans
PubMed: 30820787
DOI: 10.1245/s10434-019-07176-3 -
Frontiers in Surgery 2022This study aimed to decrease the incidence of residual stones in the cystic duct and consequently decrease the incidences of intractable pain and the formation of a...
This study aimed to decrease the incidence of residual stones in the cystic duct and consequently decrease the incidences of intractable pain and the formation of a small gallbladder after laparoscopic cholecystectomy (LC). We changed the order of the clamps when performing LC, used the "semicut" skill of the cystic duct, and removed the stones residing in the cystic duct. A total of 45 patients underwent the operation, and all operations were completed successfully. This technique did not increase the operation time or difficulty. In conclusion, the "semicut" skill of the cystic duct is a safe and feasible surgical method that may change the occurrence of intractable pain after LC.
PubMed: 36684355
DOI: 10.3389/fsurg.2022.1004290 -
The Journal of Small Animal Practice Mar 2018To summarise CT cholangiography findings in dogs with gallbladder mucocoele.
OBJECTIVES
To summarise CT cholangiography findings in dogs with gallbladder mucocoele.
MATERIALS AND METHODS
Each of 10 dogs with gallbladder mucocoele underwent CT cholangiography using meglumine iotroxate before cholecystectomy. The following structures of the biliary system were evaluated: the right and left hepatic ducts, common hepatic duct, cystic duct, common bile duct and gallbladder.
RESULTS
The hepatic duct, cystic duct, common bile duct and gallbladder were imaged by contrast-enhanced CT cholangiography. The passage of the contrast medium through the bile duct into the duodenum was visible in nine dogs. The curved planar reformation images of two dogs showed they had filling defects in the bile duct system. In one dog with hyperbilirubinaemia due to chronic hepatitis, the bile duct system was not completely contrast-enhanced. Surgical exploration revealed no evidence of common bile duct obstruction in any dog.
CLINICAL SIGNIFICANCE
CT cholangiography delineates the structural characteristics of the biliary system and partially estimates its patency in dogs with gallbladder mucocoele. Therefore this procedure may be useful as a preoperative screen of the bile duct system in dogs with gallbladder mucocoele.
PubMed: 29603237
DOI: 10.1111/jsap.12832 -
Experimental and Therapeutic Medicine Dec 2022Due to the lack of a suitable model, research on biliary biology is far behind that on other organs. A mouse model of common bile duct (CBD) dilation (BDD) was first...
Due to the lack of a suitable model, research on biliary biology is far behind that on other organs. A mouse model of common bile duct (CBD) dilation (BDD) was first established and compared with CBD ligation mice (BDL). Then, in a transplantation experiment, the dilated CBD of recipient BDD mice was injured by making an elliptical incision and repaired by transplanting a bile duct patch from donor BDD mice. Biochemical and histological changes were analyzed and cell proliferation of the bile duct grafts was determined. Slightly dilated and unblocked CBD with a diameter of 2.89±0.76 mm was obtained in BDD mice, while the CBD diameter was 0.51±0.08 mm in the Sham group and 4.71±0.64 mm in the BDL group on day 14 after surgery. The liver damage was very mild in BDD mice compared with BDL mice, proving that the BDD model could be further used for bile duct transplantation. By cross transplanting the bile duct patch from enhanced green fluorescence protein and wild-type BDD mice, it was found that the CBD injury was well repaired and the cells of the bile duct patch were completely replaced by recipient-derived cells at 12 week after the repair operation. α Smooth muscle actin, Ki67 and cytokeratin 19 immunofluorescence staining showed that the proliferation of bile duct epithelial cells and abundant active fibroblasts were found within the bile duct patch during the regeneration process. Therefore, a reliable new mouse model of bile duct injury and repair was successfully established and can be used in the study of biliary repair mechanisms and tissue engineering of biliary ducts.
PubMed: 36478886
DOI: 10.3892/etm.2022.11675 -
Journal of Pediatric Ophthalmology and... Sep 2016
Topics: Dacryocystorhinostomy; Humans; Infant; Intubation; Lacrimal Duct Obstruction; Nasolacrimal Duct
PubMed: 27637019
DOI: 10.3928/01913913-20160829-01 -
Physiological Reports May 2022The thoracic duct is responsible for the circulatory return of most lymphatic fluid. The return is a well-timed synergy between the pressure in the thoracic duct, venous...
The thoracic duct is responsible for the circulatory return of most lymphatic fluid. The return is a well-timed synergy between the pressure in the thoracic duct, venous pressure at the thoracic duct outlet, and intrathoracic pressures during respiration. However, little is known about the forces determining thoracic duct pressure and how these respond to mechanical ventilation. We aimed to assess human thoracic duct pressure and identify elements affecting it during positive pressure ventilation and a brief ventilatory pause. The study examined pressures of 35 patients with severe congenital heart defects undergoing lymphatic interventions. Thoracic duct pressure and central venous pressure were measured in 25 patients during mechanical ventilation and in ten patients during both ventilation and a short pause in ventilation. TD contractions, mechanical ventilation, and arterial pulsations influenced the thoracic duct pressure. The mean pressure of the thoracic duct was 16 ± 5 mmHg. The frequency of the contractions was 5 ± 1 min resulting in an average increase in pressure of 4 ± 4 mmHg. During mechanical ventilation, the thoracic duct pressure correlated closely to the central venous pressure. TD contractions were able to increase thoracic duct pressure by 25%. With thoracic duct pressure correlating closely to the central venous pressure, this intrinsic force may be an important factor in securing a successful return of lymphatic fluid. Future studies are needed to examine the return of lymphatic fluid and the function of the thoracic duct in the absence of both lymphatic complications and mechanical ventilation.
Topics: Central Venous Pressure; Humans; Lymph; Positive-Pressure Respiration; Respiration, Artificial; Thoracic Duct
PubMed: 35581742
DOI: 10.14814/phy2.15258