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Experimental and Clinical... Dec 2018We investigated the effects of autologous vein transplant on bile duct injury repair, through observation of the hepatic and biliary system tissue morphology changes and...
OBJECTIVES
We investigated the effects of autologous vein transplant on bile duct injury repair, through observation of the hepatic and biliary system tissue morphology changes and animal survival after bile duct injury repair.
MATERIALS AND METHODS
Rabbits were equally divided into groups. Group A had cholecystectomy and common bile duct resection (length of 0.5 cm), transplant of an autologous vein (length of 0.5 cm), and stent implant. Group B had cholecystectomy and common bile duct resection (length of 1.0 cm), transplant of an autologous vein (length of 1.0 cm), and stent implant. The third group (group C) had cholecystectomy only.
RESULTS
Two rabbits died in group A and group B; all experimental animals from group C survived. Regarding liver biochemical indexes at preoperative week 1, at postoperative month 1, and at postoperative month 3, we found no significant differences (paired t test, P > .05). Liver biochemical indexes between groups were also not significantly different (P > .05). At month 3, postoperative liver pathology of experimental animals showed no significant changes and no cholestasis; biliary epithelial cells were seen in the transplant vascular.
CONCLUSIONS
We conclude that autologous vein graft can effectively repair bile duct injury for a short coloboma.
Topics: Animals; Autografts; Cholecystectomy; Common Bile Duct; Disease Models, Animal; Male; Prosthesis Implantation; Rabbits; Stents; Time Factors; Veins; Wounds and Injuries
PubMed: 29025383
DOI: 10.6002/ect.2016.0309 -
Endoscopic Ultrasound 2016Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. Endoscopic ultrasound (EUS) is often performed to evaluate idiopathic...
Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. Endoscopic ultrasound (EUS) is often performed to evaluate idiopathic pancreatitis and has been shown to have high accuracy in diagnosis of PD. The different techniques to identify PD by linear EUS have been described differently by different authors. If EUS is done with a proper technique it can be a valuable tool in the diagnosis of PD. The anatomical and technical background of different signs has not been described so far. This article summarizes the different techniques of imaging of pancreatic duct in a suspected case of PD and gives a technical explanation of various signs. The common signs seen during evaluation of pancreatic duct in PD are stack sign of linear EUS, crossed duct sign on linear EUS, the dominant duct and ventral dorsal duct (VD) transition. Few other signs are described which include duct above duct, short ventral duct /absent ventral duct, separate opening of ducts with no communication, separate opening of ducts with filamentous communication, stacking of duct of Santorini and indirect signs like santorinecele. The principles of the sign have been explained on an anatomical basis and the techniques and the principles described in the review will be helpful in technical evaluation of PD during EUS.
PubMed: 26879163
DOI: 10.4103/2303-9027.175878 -
International Journal of Medical... 2016To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human...
To explore the prevalence of lacrimal duct obstruction in patients with infectious keratitis, and the necessity of lacrimal duct dredge in the treatment of human infectious keratitis. The design is prospective, non-control case series. Thirty-one eyes from twenty-eight continuous patients with infectious keratitis were included in this study. The presence/absence of lacrimal duct obstruction was determined by the lacrimal duct irrigation test. The diagnosis of infectious keratitis was made based on clinical manifestations, cornea scraping microscopic examination and bacterial/fungus culture. Diagnosis of viral keratitis was set up based on the recurrent history, deep neovascularization and typical outlook of the cornea scar. The treatment of keratitis included drugs, eye drops or surgery, while treatment of chronic dacryocystitis was lacrimal duct dredging with supporting tube implantation surgery. In the thirty-one eyes with infectious keratitis, fifteen suffered from fungal keratitis (48%), two bacterial keratitis (6%), and fourteen viral keratitis (45%). Eleven eyes (35%) from ten patients with infectious keratitis also suffered from lacrimal duct obstruction. In those cases, six eyes also suffered from lower canalicular obstruction, three nasolacrimal duct obstruction and chronic dacryocystitis, one a combination of upper and lower canalicular obstruction, one upper canalicular obstruction. After local and systemic applications of anti-bacterial, anti-viral, anti-fungal and anti-inflammatory drugs, twenty-eight eyes (90%) recovered within three weeks, while the ulceration of three patients required the lacrimal duct dredging and supporting tube implantation surgery for the healing. Herein, we first report that the prevalence of infectious keratitis is closely correlated to the occurrence of lacrimal duct obstruction. When both confirmed, simultaneous treatment of keratitis and lacrimal duct obstruction promptly is required. Further evaluation of mechanism, prevention and control of the diseases are warranted.
Topics: Adult; Aged; Aged, 80 and over; Animals; China; Dacryocystitis; Endoscopy; Eye Infections, Fungal; Female; Humans; Keratoconjunctivitis, Infectious; Lacrimal Apparatus; Lacrimal Duct Obstruction; Male; Middle Aged; Prevalence; Prospective Studies; Young Adult
PubMed: 27766030
DOI: 10.7150/ijms.16515 -
Arquivos Brasileiros de Oftalmologia 2021Concomitant nasolacrimal duct obstruction can occur in cataract carriers, which increases the risk of postoperative endophthalmitis. The primary aim of this study is to...
PURPOSE
Concomitant nasolacrimal duct obstruction can occur in cataract carriers, which increases the risk of postoperative endophthalmitis. The primary aim of this study is to evaluate the knowledge of Brazilian cataract surgeons on the diagnosis and management of cataracts associated with nasolacrimal duct obstruction.
METHODS
This survey was based on a questionnaire involving Brazilian cataract surgeons that was conducted from March to April 2018. Data were collected on the participant's profile, time and experience in ophthalmic practice, previous training in diagnosis and management of nasolacrimal duct obstruction, and background with endophthalmitis after cataract surgery in patients with nasolacrimal duct obstruction. All data were entered into an Excel spreadsheet and analyzed according to the frequency of occurrence.
RESULTS
Ninety-one ophthalmologists answered the questionnaire. Most (63.7%) had been performing cataract surgery for >10 years, and most (84.6%) received training to diagnose and handle nasolacrimal duct obstruction during their medical residence training. Nasolacrimal duct obstruction was investigated in the preoperative period of the cataract by lacrimal sac expression test (53.8%) or by irrigation of the tear pathways (23.1%). Nasolacrimal duct obstruction was treated with antibiotic eye drops by 47.2% of respondents. Seventy-eight percent of surgeons indicate usually performing lacrimal surgery prior to the intraocular surgery, waiting for 4 to 6 weeks to proceed with the cataract surgery. The procedure of choice for treating nasolacrimal duct obstruction prior to cataract surgery was dacryocystorhinostomy (88.4%). Most participants recognized the need for a protocol to assist in the detection and management of nasolacrimal duct obstruction in cataract carriers.
CONCLUSION
Improvement in the diagnosis and management of nasolacrimal duct obstruction concomitant to cataract is needed, as this is a risk factor for endophthalmitis.
Topics: Cataract; Dacryocystorhinostomy; Humans; Lacrimal Duct Obstruction; Nasolacrimal Duct; Preoperative Period
PubMed: 33567033
DOI: 10.5935/0004-2749.20210044 -
American Journal of Translational... 2021To explore the clinical effectiveness and value of lacrimal duct endoscopy in lacrimal canaliculitis and nasolacrimal duct obstruction diseases.
OBJECTIVE
To explore the clinical effectiveness and value of lacrimal duct endoscopy in lacrimal canaliculitis and nasolacrimal duct obstruction diseases.
METHODS
We retrospectively analyzed 241 patients with lacrimal canaliculitis and nasolacrimal duct obstructions admitted to our hospital from January 2019 to June 2020. Among them, 165 patients underwent routine diagnosis and treatment and 76 patients underwent lacrimal duct endoscopy. The propensity score matching 1:1 nearest neighbor matching method was used to match 50 patients from each of the two methods to create a control group and an experimental group, respectively. We compared the two groups' effective treatment rates, incidences of adverse reactions, diagnostic accuracy, and IL-6, IL-8, and CRP expression levels.
RESULTS
in contrast with the control group, we observed a significantly higher effective treatment rate in the experimental group (P<0.05). The experimental group had a significantly better reactions rate than the control group (P<0.05). In terms of the diagnostic accuracy rate, the experimental group's results were much better (P<0.05). The IL-6, IL-8, and CRP expression levels in the experimental group were much lower in the comparison with the control group (P<0.05).
CONCLUSION
Lacrimal duct endoscopic diagnosis and treatment can significantly enhance the treatment efficiency and diagnostic accuracy in lacrimal canaliculitis and nasolacrimal duct obstruction patients and can help reduce adverse reactions and the IL-6, IL-8, and CRP expression levels during the treatment. Therefore, lacrimal duct endoscopy has a high clinical effectiveness in lacrimal canaliculitis and nasolacrimal duct obstruction patients.
PubMed: 34540056
DOI: No ID Found -
BMC Surgery May 2017This retrospective study aimed to investigate the incidence of each type of accessory hepatic duct by drip infusion cholangiography with CT (DIC-CT).
BACKGROUND
This retrospective study aimed to investigate the incidence of each type of accessory hepatic duct by drip infusion cholangiography with CT (DIC-CT).
METHODS
Five hundred sixty nine patients who underwent preoperative DIC-CT and laparoscopic cholecystectomy were reviewed. Accessory hepatic ducts were classified as follows: type I (accessory hepatic ducts that merged with the common hepatic duct between the confluence of the right and left hepatic ducts and the cystic duct confluence), type II (those that merged with the common hepatic duct at the same site as the cystic duct), type III (those that merged with the common bile duct distal to the cystic duct confluence), type IV (the cystic duct merged with the accessory hepatic duct), and type V (accessory hepatic ducts that merged with the common hepatic or bile duct on the left side).
RESULTS
Accessory hepatic ducts were observed in 50 patients. Type I, II, III, IV, and V accessory hepatic ducts were detected in 32, 3, 1, 11, and 3 patients, respectively. Based on their drainage areas, the accessory hepatic ducts were also classified as follows: a posterior branch in 22 patients, an anterior branch in 9 patients, a combination of posterior and anterior branches in 16 patients, a left-sided branch in 2 patients, and a caudate branch in 1 patient. None of the patients with accessory hepatic ducts suffered bile duct injuries.
CONCLUSION
There are a number of variants of the accessory hepatic duct. DIC-CT is useful to detect the accessory hepatic duct.
Topics: Cholangiography; Cholecystectomy, Laparoscopic; Common Bile Duct; Hepatic Duct, Common; Humans; Infusions, Intravenous; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 28482819
DOI: 10.1186/s12893-017-0251-9 -
Folia Morphologica 2023The morphometry and morphology of the components of extrahepatic biliary tree show extensive variations. A beforehand recognition of these variations is very crucial to... (Review)
Review
The morphometry and morphology of the components of extrahepatic biliary tree show extensive variations. A beforehand recognition of these variations is very crucial to prevent unintended complications while performing surgeries in this region. This study was conducted to analyse the configuration of the extrahepatic biliary tree and its possible variations, as well as measure the components that limit the cystohepatic triangle. Articles were searched in major online indexed databases (Medline and PubMed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar) using relevant key words. A total of 73 articles matched the search criteria of which 55 articles were identified for data extraction. The length of left and right hepatic duct in majority of studies was found to be > 10 mm. A wide range of diameters of hepatic ducts were observed between 5 and 43 mm. The average length of cystic duct is around 20 mm. The length and diameter of the common bile duct are 50-150 mm and 3-9 mm, respectively. The most frequently observed pattern of insertion of cystic duct into common hepatic duct is right lateral, rarely anterior, or posterior spiral insertion can present. The results of this study will provide a standard reference range which instead will help to differentiate the normal and pathological conditions.
Topics: Bile Ducts, Extrahepatic; Hepatic Duct, Common
PubMed: 35916381
DOI: 10.5603/FM.a2022.0069 -
The Ocular Surface Oct 2020Tear secretion is a complex process with the involvement of the main and accessory lacrimal glands, corneal and conjunctival epithelial cells and the Meibomian glands.... (Review)
Review
Tear secretion is a complex process with the involvement of the main and accessory lacrimal glands, corneal and conjunctival epithelial cells and the Meibomian glands. The lacrimal gland is the main source of fluid, electrolytes and proteins in tear fluid. Deficient ion and water secretion results in aqueous deficient dry eye with serious consequences on the integrity of the ocular surface. Functions of acinar cells are widely studied, whereas less information is available about the duct system of the lacrimal gland. Secretory mechanisms of duct epithelium may play an important role in tear production, but only limited studies have tried to elucidate the role of the duct system in tear secretion. Significant progress has been made in the past few years, resulting in new insight into lacrimal gland duct function. New experimental techniques were introduced, which contributed to the exploration of the role of lacrimal gland ducts in more detail. Therefore, the aim of this review is to summarize our present knowledge about the role of ducts in lacrimal gland function and tear secretion, which appears to be the first review with a focus on this topic. Short outline of pancreatic and salivary gland duct functions is also given for the purposes of comparison.
Topics: Cornea; Dry Eye Syndromes; Epithelium; Humans; Lacrimal Apparatus; Tears
PubMed: 32707335
DOI: 10.1016/j.jtos.2020.07.002 -
Asian Journal of Surgery Jan 2023To explore the risk factors of biliary tract infection after bile duct dilatation surgery.
OBJECTIVE
To explore the risk factors of biliary tract infection after bile duct dilatation surgery.
METHODS
The study included 135 patients with choledochal malformation after bile duct dilatation surgery at our hospital from January 2019 to June 2021. We analyzed general data of infected and uninfected groups after bile duct dilatation surgery. Single/multiple factor logistic regression was used to analyse the factors influencing postoperative biliary tract infection in bile duct dilatation.
RESULTS
There were statistically significant differences in preoperative history of biliary tract infection, partial hepatectomy, hilar anastomosis, and Todani staging between the two groups. Single factor Logistic regression analysis showed that preoperative history of biliary tract infection, partial hepatectomy, hepatic portal anastomosis and Todani staging IV and V were positively correlated with postoperative biliary tract infection following biliary duct dilatation (P<0.05). In addition, logistic regression analysis of these general data with differential indicators as independent variables and postoperative biliary tract infection in biliary duct dilatation as a dependent variable showed that history of preoperative biliary tract infection and hepatic portal anastomosis were risk factors of postoperative biliary tract infection following biliary duct dilatation.
CONCLUSION
Risk factors of biliary tract infection after bile duct dilatation include a history of preoperative biliary tract infection and hepatoportal anastomosis, which should be noted during clinical procedures to prevent or reduce the development of biliary tract infection after bile duct dilatation.
Topics: Humans; Hepatectomy; Common Bile Duct; Choledochal Cyst; Biliary Tract Surgical Procedures; Bile Duct Diseases; Risk Factors
PubMed: 35697611
DOI: 10.1016/j.asjsur.2022.05.127 -
Tissue Engineering and Regenerative... Dec 2019With the popularity of laparoscopic cholecystectomy, common bile duct injury has been reported more frequently. There is no perfect method for repairing porcine biliary...
BACKGROUND
With the popularity of laparoscopic cholecystectomy, common bile duct injury has been reported more frequently. There is no perfect method for repairing porcine biliary segmental defects.
METHODS
After the decellularization of human arterial blood vessels, the cells were cultured with GFP (carry green fluorescent protein) porcine bile duct epithelial cells. The growth and proliferation of porcine bile duct epithelial cells on the human acellular arterial matrix (HAAM) were observed by hematoxylin-eosin (HE) staining, electron microscopy, and immunofluorescence. Then, the recellularized human acellular arterial matrix (RHAAM) was used to repair biliary segmental defects in the pig. The feasibility of it was detected by magnetic resonance cholangiopancreatography, liver function and blood routine changes, HE staining, immunofluorescence, real-time quantitative PCR (RT-qPCR), and western blot.
RESULTS
After 4 weeks (w) of co-culture of HAAM and GFP porcine bile duct epithelial cells, GFP porcine bile duct epithelial cells grew stably, proliferated, and fused on HAAM. Bile was successfully drained into the duodenum without bile leakage or biliary obstruction. Immunofluorescence detection showed that GFP-positive bile duct cells could still be detected after GFP-containing bile duct cells were implanted into the acellular arterial matrix for 8 w. The implanted bile duct cells can successfully resist bile invasion and protect the acellular arterial matrix until the newborn bile duct is formed.
CONCLUSION
The RHAAM can be used to repair biliary segmental defects in pigs, which provides a new idea for the clinical treatment of common bile duct injury.
Topics: Animals; Arteries; Bile Duct Diseases; Bile Ducts; Cholangiopancreatography, Magnetic Resonance; Coculture Techniques; Common Bile Duct; Epithelial Cells; Humans; Keratin-7; Liver Function Tests; Swine
PubMed: 31824827
DOI: 10.1007/s13770-019-00212-z