• Title/Summary/Keyword: Bile duct

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Study of Radiation dose Evaluation using Monte Carlo Simulation while Treating Extrahepatic Bile Duct Cancer with High Dose Rate Intraluminal Brachytherapy (간외 담도암 고선량률 관내근접방사선치료 시 몬테카를로 시뮬레이션을 통한 주변장기의 선량평가 연구)

  • Park, Ju-Kyeong;Lee, Seung-Hoon;Cha, Seok-Yong;Lee, Sun-Young
    • The Journal of the Korea Contents Association
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    • v.14 no.2
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    • pp.467-474
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    • 2014
  • The relative dose calculated by MCNPX and the relative dose measured by ionization chamber and solid phantoms evaluated the accuracy comparing with Monte Carlo simulation. In order to apply Monte Carlo simulation the intraluminal brachytherapy of extrahepatic bile duct cancer, 192Ir sealed radioactive source replicate, Bile duct and surrounding organs were made using KMIRD phantom based on a South Korea standard man. To check the absorbed dose of normal organs around bile duct, we set the specific effective energy and initial radioactivity to 1 Ci using MCNPX. Evaluation of the accuracy of the Monte Carlo simulation, the difference of the relative dose is the most 1.96% that satisfy the criteria that is the relative error less than 2% suggested by MCNPX code. In addition, The specific effective energy and absorbed dose of normal organs that were relatively adjacent to bile duct such as right side of kidney, liver, pancreas, transverse colon, spinal cord, stomach and small intestine were relatively high. on the contrary, the organs that were relatively distant to bile duct such as left side of kidney, spleen, ascending colon, descending colon and sigmoid colon were relatively low.

Ability of Biochemical Parameters to Distinguish between Bile Duct Cancer and Gall Bladder Stones - A Case Control Study in a Tertiary Care Hospital of Pokhara Valley

  • Yadav, Shambhu Kumar;Mittal, Ankush;Sapkota, Kumar;Gupta, Satrudhan Prasad;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.817-819
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    • 2013
  • Background: The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease. Materials and Methods: A hospital based case-control study was carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2010 and $31^{st}$ December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin, AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine the statistical significance of differences between groups. A post-hoc LSD test was applied for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant. Results: The mean age of cases and controls was $53.2{\pm}21.2$ years. The levels of serum cholesterol were higher in cases of cancer $192.5{\pm}21.5$ mg/dl in comparison to stone cases $168.7{\pm}16.1$ mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer $7.6{\pm}3.2$ mg/dl in comparison to stone cases $2.5{\pm}0.8$ mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer $251.5{\pm}20.1$ IU/l when compared to stone cases $173.2{\pm}12.6$ IU/l of bile duct. In contrast, there was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer $59.1{\pm}8.9$ IU/l and $105.5{\pm}26.5$ IU/l when compared to stone cases $56.9{\pm}7.9$ IU/l and $84.5{\pm}13.5$ IU/l respectively. Conclusions: LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.

Utility of Bile Duct Brush Cytology in Pancreaticobiliary Diseases - Prospective Comparative Study of Conventional Smear and $MonoPrep2^{TM}$ Liquid Based Cytology - (췌담관질환에서 담관 솔질세포검사의 유용성 - 통상도말과 $MonoPrep2^{TM}$ 액상세포검사의 전향적 비교연구 -)

  • Lee, Dong-Wha;Kim, Mee-Sun;Cho, Young-Deok;Cheon, Young-Koog;Choi, Min-Sung;Kim, Dong-Won;Jin, So-Young
    • The Korean Journal of Cytopathology
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    • v.17 no.1
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    • pp.38-45
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    • 2006
  • Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using $MonoPrep2^{TM}$ system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.

Ultrastructural Change of the Bile Duct Fibroblast at Infected Rat with Clonorchis sinensis (간흡충에 감염된 실험쥐 담관 섬유모세포의 미세구조적 변화)

  • Kim, Soo-Jin;Min, Byoung-Hoon
    • Applied Microscopy
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    • v.34 no.2
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    • pp.121-130
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    • 2004
  • In this study, ultrastructural change of the bile duct fibroblast at infected rat with Clonorchis sinensis, and the distribution of lectin receptors and actin protein in cultured bile duct infected with Clonorchis sinensis. It explored using colloidal gold label complex with lectin WGA purified from wheat germ (Triticum vulgaris) and anti actin antibody purified actin (43 kDa) isolated from chicken back muscle. The lectin WGA with protein A gold complex labeled sections of the cultured fibroblast revealed gold particles specifically distributed on the multi vesicular form Golgi complex and cell surface of the fibroblast. The actin antibody with protein A gold complex labeled sections of the cultured fibroblast revealed gold particles specifically distributed on the cytoplasm of the fibroblast. Labeling of cultured fibroblast in rat bile duct infected with Clonorchis sinensis was then quantified and compared to that of cultured Fibroblast in Rat Bile duct. These results indicate that lectin WGA receptors are located in the multi vesicular form Golgi complex in the cytoplasm to the cytoplasmic process of the Rat bile duct fibroblast infected with Clonorchis sinensis. Therefore, the GlcNAc and NeuNac regions on the cell surface and cytoplasmic process appear to be functionally associated with cell-recognition and protection from other cell of the tissue, and linked with secretion and exocytosis of the fibroblst cytoplasm. GlcNAc and NeuNAc product in the multi vesicular form Golgi complex then it is transported to cell surface. Actin protein is many appears that infected fibroblast rather than normal fibroblast. The fibroblast of infected with Clonorchis sinensis are against of the physical and chemical stimulation. Then development of cytoplasmic process is relative some stimulation.

Effect of Bile juice on the Bioavailability and Pharmacokinetics of Acebutolol in Rabbits (토끼에서 체내담즙이 아세부톨롤의 생체이용률 및 체내동태에 미치는 영향)

  • 최준식
    • YAKHAK HOEJI
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    • v.46 no.1
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    • pp.47-51
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    • 2002
  • Although acebutolol (ABT) is almost completely absorbed in the gastrointestinal (Gl) tract, oral bioavailability of the drug is low due to extensive first-pass metabolism in the Gl tract and liver. In the present study, bioavailability and pharmacokinetics of ABT was studied in bile duct-bypassed rabbits after oral administration. For ABT the time to reach the plasma peak (T$_{max}$) and mean resident time (MRT) were increased by the treatment. For diacetolol (DAT), a metabolite of ABT area under the plasma concentration-time curve (AUC), T$_{max}$ and plasma half-life were increased by the treatment. These results indicate that oral bioavailability of ABT is associated with the enterohepatic recycling of bile juice components.nts.

Ultrastructural and Immunohistochemical Study of Hepatic Fibrosis after the Ligation of the Common Bile Duct in Rats (백서의 총담관 결찰에 의한 간 섬유화의 초미세구조적 및 면역조직화학적 연구)

  • Moon, Kyung-Rye;Rho, Young-Ill;Seo, Woo-Chul;Park, Yeong-Bong;Kim, Man-Woo;Seo, Jae-Hong;Park, Sang-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.185-193
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    • 1999
  • Purpose: Proliferation of bile duct-like structures and fibrosis is a hepatic cellular reaction observed in most forms of human liver disease and in a variety of experimental conditions associated with liver injury. The aim of this study was to investigate the activation of Ito cells and bile duct proliferation in the rat after common bile duct ligation (CBDL). Methods: Hepatic morphological abnormalities were examined in rats whose bile ducts had been irreversibly ligated for 15, 21, 24 and 28 days. The liver was examined by immunohistochemical staining for ${\alpha}$-smooth muscle actin, the known marker of activated Ito cells, and light and electron microscopes. Results: After CBDL, the bile canalicular proliferation and interstitial fibrosis were gradually increased in the periportal areas extended to hepatic sinusoids. Ito cells positive for ${\alpha}$-smooth muscle actin were frequently observed in the periductular space and in perisinusoidal space of Disse. Ito cells and myofibroblasts were gradually increased in the interstitial fibrosis until the 28th day after CBDL. Ito cells and myofibroblasts had microfilaments with dense body at the periphery of the cell. Conclusions: Our results suggest that Ito cells may be fibroblastic or myogenic. It has also been postulated that during the development of hepatic fibrosis, Ito cells become myofibroblasts or fibroblast like cells.

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Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report

  • Cho, Sung Hoon;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.294-298
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    • 2021
  • Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

Role of Image-Enhanced Endoscopy in Pancreatobiliary Diseases

  • Lee, Yun Nah;Moon, Jong Ho;Choi, Hyun Jong
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.541-546
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    • 2018
  • Recent advances in cholangiopancreatoscopy technology permit image-enhanced endoscopy (IEE) for pancreatobiliary diseases. There are limitations in endoscopy performance and in the study of the clinical role of IEE in bile duct or pancreatic duct diseases. However, currently available IEEs during cholangiopancreatoscopy including traditional dye-aided chromoendoscopy, autofluorescence imaging, narrow-band imaging, and i-Scan have been evaluated and reported previously. Although the clinical role of IEE in pancreatobiliary diseases should be verified in future studies, IEE is a useful promising tool in the evaluation of bile duct or pancreatic duct mucosal lesions.

Clinical Significance of Segmental Parenchymal Excretion Delay on Tc-99m DISIDA Hepatobiliary Scan (Tc-99m DISIDA 간담도 신티그라피에서 간 실질의 분절형 배설지연의 임상적 의의)

  • Kang, Do-Young;Ryu, Jin-Sook;Moon, Dae-Hyuk;Lee, Sung-Koo;Kim, Myung-Hwan;Lee, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.161-167
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    • 1998
  • Purpose: Segmental parenchymal excretion delay on Tc-99m DISIDA scan is caused by intrahepatic bile duct obstruction. However, the diagnostic value for intrahepatic bile duct obstruction is unknown. We conducted this study to assess the positive predictive value of segmental excretion delay for the diagnosis of intrahepatic bile duct obstruction, and additional benefit over other noninvasive radiologic studies. Materials and Methods: The study population consisted of 43 patients (48 scans) who showed segmental parenchymal excretion delay on Tc-99m DISIDA scan. The results of abdominal CT or ultrasonography, which was done within 1 month of Tc-99m DISIDA scan, were compared with scintigraphic findings. Results: The etiology of segmental parenchymal excretion delay was determined by ERC or PTC in 31 scans, and follow-up studies in 13 scans. No causes were identified in 4 scans. The positive predictive value of segmental parenchymal excretion delay for intrahepatic bile ductobstruction was 92% (44/48). On the other hand, 13% (5/38) of CT and 28% (5/18) of ultrasonography were normal. In 18% (7138) of CT and 17% (3/18) of ultrasonography, only intraheipatic bile duct dilatation was noted without any diagnostic findings of intrahepatic bile duct obstruction. Conclusion: Segmental parenchymal excretion delay on Tc-99m DISIDA scan had a high positive predictive value for the diagnosis of intrahepatic bile duct obstruction. Tc-99m DISIDA scan may be useful for the diagnosis of intrahepatic bile duct obstruction, especially in patients with nondiagnostic CT or ultrasonography. The diagnostic usefulness need to be confirmed by further prospective studies.

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Pancreaticobiliary Ductal Anatomy in the Normal Population

  • Jirasiritham, Jakrapan;Wilasrusmee, Chumpon;Poprom, Napaphat;Larbcharoensub, Noppadol
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4363-4365
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    • 2016
  • Background: The complex anatomy of the pancreaticobiliary duct was crucial in management of pancreatic and biliary tract disease. Materials and Methods: Fresh specimens of pancreas, common bile duct (CBD), and duodenum were obtained en bloc from autopsies of 160 patients. Results: Ninety-three male and 67 female patients were included. The length of the pancreas ranged from 9.8-20 cm (mean, 16.20 +/- 1.70 cm). The intrapancreatic portion of the CBD showed patterns of three types: most common (85.30%) was type A, in which the anterior surface of the common bile duct was totally covered, while its posterior surface was partially covered, by the pancreatic parenchyma. On dissection of the accessory duct of Santorini, the accessory duct was traceable to the duodenal wall in 67.6%. The anatomy of the Wirsung-choledochus confluence was grouped into five different types. The common channel was found in 75.60% and its length varied from just a common junction (so-called "V-type" anatomy) to 15 mm (Y-type-b). Separate papillae (so-called "II-type") were found in 15.3% of specimens. Conclusions: Several important points regarding the anatomy of the pancreaticobiliary junction and pancreatic ductal system were illustrated in this study.