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Indian Journal of Otolaryngology and... Jan 2010Salivary gland stones are most common in the ductal system of submandibular glands and are calcified. A rare case of multiple submandibular duct (Wharton's duct) calculi...
Salivary gland stones are most common in the ductal system of submandibular glands and are calcified. A rare case of multiple submandibular duct (Wharton's duct) calculi of unusual size and shape in a 42-year-old male patient, who presented with pain and swelling in the region of submandibular gland and hence reported. Sometimes a small stone comes out into the mouth on its own or with gentle probing. However in this case a small intra-oral procedure was needed to remove the stones.
PubMed: 23120690
DOI: 10.1007/s12070-010-0018-4 -
Annals of Maxillofacial Surgery 2020The parotid duct (Stenson's duct) can be damaged during traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great...
The parotid duct (Stenson's duct) can be damaged during traumatic injuries and surgical interventions. Early diagnosis and treatment of a duct injury is of great importance because complications such as sialocele and salivary gland fistula may develop if the duct is not surgically repaired. We think that the feeding tube is an ideal material in the parotid duct repair because of its technical characteristics, availability, and low cost. In this article, we described the use of a feeding tube for the treatment of a parotid duct rupture in a facial stab wound laceration, as it is a low-cost and easy-to-access material readily available in every operating room.
PubMed: 33708598
DOI: 10.4103/ams.ams_238_19 -
The Eurasian Journal of Medicine Aug 2011The variations in the anatomy of the biliary tract need to be recognized in modern liver surgery. The purpose of this clinical and anatomical study is to describe...
OBJECTIVE
The variations in the anatomy of the biliary tract need to be recognized in modern liver surgery. The purpose of this clinical and anatomical study is to describe several novel biliary tract variations and to outline their practical importance for liver resections and transplantations.
MATERIALS AND METHODS
Over the previous 10 years, the anatomic variations of the bile ducts were examined during 600 intraoperative cholangiographies, 104 segmentectomies and 54 hemihepatectomies in patients with liver diseases. The intraoperative anatomies of the right and left hepatic ducts and the common hepatic duct confluence were analyzed.
RESULTS
Twenty-two variations occurred in 59.5% of the patients. Six variations were described for the first time: an accessory right hepatic duct in which a cystic duct drained; a tetrafurcation from the right anterior hepatic duct, right posterior hepatic duct and bile ducts for Segments 2 and 3 with aberrant bile drainage from Segment 4 into the bile duct for Segment 8; an aberrant bile drainage from Segments 6 and 7 into the common hepatic duct; an accessory bile duct for Segment 6 that drained into the bile duct for Segment 3; a tetrafurcation from the right anterior hepatic duct and the bile ducts for Segments 6, 3 and 2 with bile from Segment 7 draining into the bile duct for Segment 2; and an accessory bile duct for the left hemiliver that drained bile from the Type 4 small accessory hepatic lobe (according to Caygill & Gatenby) into the common hepatic duct.
CONCLUSION
These newly described biliary tract variations should be recognized by liver surgeons to avoid unwanted postoperative complications.
PubMed: 25610166
DOI: 10.5152/eajm.2011.16 -
Cirugia Y Cirujanos Dec 2017Cervical thoracic duct cysts are a rare anomaly. (Review)
Review
BACKGROUND
Cervical thoracic duct cysts are a rare anomaly.
OBJECTIVE
To report a case of cervical thoracic duct cyst, and perform a literature review.
CLINICAL CASE
A 78-year-old female, with a one-year history of a left-sided asymptomatic supraclavicular cystic mass. Computerized tomography revealed a cystic mass 42mm in diameter. We performed a fine needle aspiration puncture, obtaining a thick, milky, whitish liquid. The patient underwent surgery; finding a left-sided supraclavicular cystic mass, with some lymph vessels heading towards the jugulo subclavian venous junction. We performed a ligation of these lymph vessels and resection of the mass. The histopathologic study confirmed the diagnosis of thoracic duct cyst.
CONCLUSION
Diagnosis of cervical thoracic duct cyst should be suspected with a cystic lesion in the left supraclavicular region, which when perforated exudes a very distinctive thick milky, whitish liquid with a high content of lymphocytes and triglycerides. Treatment should be complete removal with ligation of the lymphatic afferent vessels.
Topics: Aged; Biopsy, Fine-Needle; Female; Humans; Ligation; Lymphatic Vessels; Mediastinal Cyst; Thoracic Duct; Tomography, X-Ray Computed
PubMed: 28040230
DOI: 10.1016/j.circir.2016.11.010 -
Indian Journal of Otolaryngology and... Jun 2023The purpose of this study was to conduct a cadaveric dissection study on the anatomical variation of the sublingual (SLG) excretory ducts and dictate an improved...
The purpose of this study was to conduct a cadaveric dissection study on the anatomical variation of the sublingual (SLG) excretory ducts and dictate an improved understanding of the anatomical communication between the SLG duct and submandibular (SMG) ducts. This study is carried out by standardized dissection of anterior floor of mouth in 6 formalin-fixed adult cadavers in Silent Mentor Workshop University Malaya in August 2020. The cadavers had no trace of scars, adhesions, signs of trauma or operation. SMG duct opening was identified lateral to the lingual frenulum through a papilla in the floor of mouth behind the lower incisor tooth. A horizontal incision line was done over floor of mouth just lateral to the opening. SMG duct and SLG was traced and skeletonized. Any presence of major duct arising from the SLG and its communication with SMG duct were investigated. We found there are 3 patterns of SLG excretory duct variants; (1) One major (Bartholin's) duct which open independently at its own orifice adjacent to the orifice of the Wharton's duct of SMG. (2) One major (Bartholin's) duct which joined into the Wharton's duct of SMG. (3) Absent of a major duct arising from SLG. The overall mean diameter of SLG ducts were 1.3 ± 0.41 and the mean length of SLG ducts were 18.5 ± 6.55. The overall mean diameter of SMG ducts was 2.6 ± 0.74 and the mean length of SMG ducts were 46.5 ± 6.57. Excretory ductal system of SLG showed great variations, not only between the different cadavers but also within the different sides of the same cadaver. Awareness of potential anatomical variations can aid in the accurate diagnosis and treatment of patients with salivary gland pathology as well as help surgeons reveal potential risk factor and avoid complications during surgical procedures in the floor of mouth.
PubMed: 36406798
DOI: 10.1007/s12070-022-03261-4 -
Cirugia Y Cirujanos 2022To determine the average value of the diameter of the common bile duct by age group in adult patients without bile duct pathology.
OBJECTIVE
To determine the average value of the diameter of the common bile duct by age group in adult patients without bile duct pathology.
METHOD
A cross-sectional, observational, descriptive and prospective study in adults without bile duct pathology who underwent abdominal ultrasound. The internal diameter of the common bile duct was measured after questioning. In the descriptive analysis, absolute frequencies, percentages, mean and standard deviation were used in the inferential Student's t test and Pearson's correlation.
RESULTS
608 patients without bile duct pathology were included, the mean diameter of the common bile duct was 4.04 ± 1.11 mm; with a minimum of 1.9 mm and a maximum of 8.8 mm. The mean for the population under 30 years was 3.8 ± 0.87, for the 30-39 years group it was 4.27 ± 0.89, for the 40-49 years group it was 4.39 ± 0.83, for the 50-59 years 4.86 ± 1, for the 60-69 years group it was 5.4 ± 0.95, and for those over 70 years it was 6.9 ± 0.8.
CONCLUSIONS
The diameter of the common bile duct in adult patients without biliary pathology is greater at older age.
Topics: Adult; Bile Ducts; Common Bile Duct; Cross-Sectional Studies; Humans; Prospective Studies; Ultrasonography
PubMed: 35944397
DOI: 10.24875/CIRU.20001391 -
Annals of the Royal College of Surgeons... Mar 2013Neurofibromas of the common bile duct are extremely rare. The lack of specific clinical or radiological features makes preoperative diagnosis in the absence of histology... (Review)
Review
Neurofibromas of the common bile duct are extremely rare. The lack of specific clinical or radiological features makes preoperative diagnosis in the absence of histology difficult. We report the case of a female patient who presented with obstructive jaundice and evidence of a common bile duct stricture on imaging. She underwent an exploratory laparotomy, and intraoperative frozen section confirmed clear margins and a benign lesion. Excision of the extrahepatic bile duct and A Rouxen-Y hepaticojejunostomy was performed. We discuss the clinical features and management of neurofibromas of the bile duct in light of the literature.
Topics: Aged; Common Bile Duct Neoplasms; Female; Humans; Jaundice, Obstructive; Neurofibroma
PubMed: 23484980
DOI: 10.1308/003588413X13511609955931 -
International Journal of Surgery Case... 2020Combination of choledochocele and extra-hepatic duct duplication is an extremely rare congenital abnormality.
BACKGROUND
Combination of choledochocele and extra-hepatic duct duplication is an extremely rare congenital abnormality.
CASE PRESENTATION
The patient was an 81-year-old Japanese man. He visited the emergency room for severe abdominal colic pain. He was diagnosed with severe pancreatitis with cholelithiasis and treated conservatively by percutaneous trans-hepatic gallbladder drainage (PTGBD) for 4 months. Thereafter, he was transferred to our institute and cholangiography was performed via the PTGBD tube, revealing cholecysto- and choledocho-lithiasis. The cystic-duct joined the right hepatic duct with extra-hepatic bile duct duplication and the terminal bile duct flowed into the cystic papilla of Vater. The main pancreatic duct also joined into the cystic papilla. These observations confirmed choledochocele with extra-hepatic bile duct duplication. Surgical exploration was performed, and hepatico-jejunostomy with hepatic-ductplasty and cholecystectomy with choledocholithotomy were carried out. He was discharged and his course was uneventful.
CONCLUSION
A very rare combined case of choledochocele with bile duct duplication, which would escalate the pancreatitis and cholangitis, was successfully treated. Their pathogeneses in relation to pancreaticobiliary maljunction is discussed.
PubMed: 33032048
DOI: 10.1016/j.ijscr.2020.09.137 -
Annals of Hepato-biliary-pancreatic... Aug 2021A secure pancreatic-enteric anastomosis is widely accepted as the 'Achilles heel' in reconstruction following a pancreaticoduodenectomy. Most morbidity following the...
A secure pancreatic-enteric anastomosis is widely accepted as the 'Achilles heel' in reconstruction following a pancreaticoduodenectomy. Most morbidity following the procedure is related to the failure of this anastomosis, resulting in intra-abdominal collections, secondary haemorrhage, delayed gastric emptying, need for radiological interventions and re-operation for some patients. Of several techniques available, the 'duct-to-mucosa' technique is widely employed for pancreaticojejunal anastomosis. Among several refinements to facilitate this anastomosis, viz; mobilization of pancreatic stump, magnification with loupes and modifications made on the jejunal side to enable a tension free anastomosis, none seems to address the pancreatic duct in particular. The operative technique of anterior pancreatic duct split described by us enables a wider, well visualized pancreatic duct for a secure duct to mucosa pancreaticojejunal anastomosis.
PubMed: 34402438
DOI: 10.14701/ahbps.2021.25.3.371 -
Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Apr 2022Objective To evaluate the safety and effectiveness of laparoscopic common bile duct exploration in the treatment of common bile duct stones. Methods A retrospective...
Objective To evaluate the safety and effectiveness of laparoscopic common bile duct exploration in the treatment of common bile duct stones. Methods A retrospective analysis was conducted for 158 patients with cholecystolithiasis and choledocholithiasis admitted to the Number One Hospital of Zhangjiakou from January 2015 to December 2019.The patients were assigned into three groups according to the diameters of cystic duct and common bile duct,degrees of abdominal infection and tissue edema,and operation method.Group A(16 cases):laparoscopic cholecystectomy,transcystic choledochoscopic exploration for stone removal;Group B(94 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,T tube drainage;Group C(48 cases):laparoscopic cholecystectomy,common bile duct incision exploration combined with choledochoscopy for stone removal,primary closure of the common bile duct.The operation time,residual rate of stones,and complication(bleeding,bile leakage,and wound infection) rate were compared between groups. Results The operation time of groups A,B,and C was(95.1±14.7),(102.2±18.1),(110.1±16.4) minutes,respectively,which showed no statistical difference between each other(=0.020,=0.887).One case in group A had residual stones,while no residual stone appeared in groups B and C.The overall stone clearance rate was 99.4% and the overall complication rate was 1.9%.There was no perioperative death. Conclusion It is generally safe and effective to carry out laparoscopic cholecystectomy and common bile duct exploration for stone removal in suitable populations.
Topics: Choledocholithiasis; Common Bile Duct; Gallstones; Humans; Laparoscopy; Retrospective Studies
PubMed: 35538764
DOI: 10.3881/j.issn.1000-503X.14240