• 제목/요약/키워드: Common bile duct

검색결과 129건 처리시간 0.027초

둔상성 외상 후 양측 간내 담관에서 담즙 누출의 치료 사례 1례 (Management of Bile Leaks from Bilateral Intrahepatic Ducts after Blunt Trauma)

  • 김동훈;최석호;고승제
    • Journal of Trauma and Injury
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    • 제27권3호
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    • pp.89-93
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    • 2014
  • Bile leaks are complications that are much more frequent after a high-grade liver injury than after a low-grade liver injury. In this report, we describe the management of bile leaks that were encountered after angiographic embolization in a 27-year-old man with a high-grade blunt liver injury. He had undergone an abdominal irrigation and drainage with a laparotomy on post-injury day (PID) 16 due to bile peritonitis and continuous bile leaks from percutaneous abdominal drainage. He required three percutaneous drainage procedures for a biloma and liver abscesses in hepatic segments 4, 5 and 8, as well as endoscopic retrograde cholangiopancreatography with biliary stent placement into the intrahepatic biloma via the common bile duct. We detected communication between the biloma and the bilateral intrahepatic duct by using a tubogram. Follow-up abdominal computed tomography on PID 47 showed partial thrombosis of the inferior vena cava at the suprahepatic level, and the patient received anticoagulation therapy with low molecular weight heparin and rivaroxaban. As symptomatic improvement was achieved by using conservative management, the percutaneous drains were removed and the patient was discharged on PID 82.

Patterns of failure and prognostic factors in resected extrahepatic bile duct cancer: implication for adjuvant radiotherapy

  • Koo, Tae Ryool;Eom, Keun-Yong;Kim, In Ah;Cho, Jai Young;Yoon, Yoo-Seok;Hwang, Dae Wook;Han, Ho-Seong;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • 제32권2호
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    • pp.63-69
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    • 2014
  • Purpose: To find the applicability of adjuvant radiotherapy for extrahepatic bile duct cancer (EBDC), we analyzed the pattern of failure and evaluate prognostic factors of locoregional failure after curative resection without adjuvant treatment. Materials and Methods: In 97 patients with resected EBDC, the location of tumor was classified as proximal (n = 26) and distal (n = 71), using the junction of the cystic duct and common hepatic duct as the dividing point. Locoregional failure sites were categorized as follows: the hepatoduodenal ligament and tumor bed, the celiac artery and superior mesenteric artery, and other sites. Results: The median follow-up time was 29 months for surviving patients. Three-year locoregional progression-free survival, progression-free survival, and overall survival rates were 50%, 42%, and 52%, respectively. Regarding initial failures, 79% and 81% were locoregional failures in proximal and distal EBDC patients, respectively. The most common site was the hepatoduodenal ligament and tumor bed. In the multivariate analysis, perineural invasion was associated with poor locoregional progression-free survival (p = 0.023) and progression-free survival (p = 0.012); and elevated postoperative CA19-9 (${\geq}37U/mL$) did with poor locoregional progression-free survival (p = 0.002), progression-free survival (p < 0.001) and overall survival (p < 0.001). Conclusion: Both proximal and distal EBDC showed remarkable proportion of locoregional failure. Perineural invasion and elevated postoperative CA19-9 were risk factors of locoregional failure. In these patients with high risk of locoregional failure, adjuvant radiotherapy could be considered to improve locoregional control.

Numbers of New Cases and Trends of Cancer 1993-2012: Srinagarind Hospital Based Population, Khon Kaen, North-East Thailand

  • Wirasorn, Kosin;Suwanrungruag, Krittika;Wiangnon, Surapon;Punjaruk, Wiyada
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8423-8427
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    • 2014
  • Background: Cancer is the most common cause of death in Thailand, where treatment outcomes and prognosis are poor and mortality rates remain high. This study reports new cancer cases and trends of all cancers registered in Srinagarind Hospital from 1993 to 2012 and also provides a picture of the cancer situation in Northeast Thailand. Materials and Methods: All new cases of cancer registered in the hospital-based cancer registry at Faculty of Medicine, Srinagarind Hospital, Khon Kaen University during 1993-2012 were included in the study. Results and Conclusions: The number of new cancer cases has gradually increased each year during the last 20 years. The three most common cancers at present in males are liver and bile duct cancer, lung cancer and colorectal cancer, respectively. In females, liver and bile duct, breast and thyroid cancers are now the most frequent. Interestingly, the number of cases of both liver and bile duct cancer and colorectal cancer in males noticeably increased during the second decade of the study. Additionally, breast cancer greatly increased in the same decade and lung cancer in females climbed into the top five most common cancers. Thyroid cancer has also risen steadily in the last decade. Trends of common cancers are similar to those throughout Thailand.

Effects of Intravenous Administration of Taurocholate on Serum Aryl Sulfotransferase Activity in Cholestatic Rats

  • Mun Kyo-Cheol;Kim You-Hee;Kwak Chun-Sik
    • 대한의생명과학회지
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    • 제11권4호
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    • pp.503-508
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    • 2005
  • Possible mechanisms of increased serum aryl sulfotransferase (AST) isozyme activities in cholestatic rats were studied. Serum AST-I, II and -III, IV isozymes activities were determined from the experimental rats with common bile duct ligation (CBDL) or choledocho-caval shunt (CCS). The activities of serum AST-I, II and -III, IV isozymes were found to be increased significantly in both the CCS plus taurocholic acid (TCA) injected group, and the CBDL plus TCA group than those in each control group, such as CCS or CBDL alone groups. The above results suggest that the elevated serum AST most likely due to increased hepatocyte membrane permeability caused by TCA mediated liver cell necrosis.

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Effects of Intravenous Administration of Taurocholate on Hepatic Aryl Sulfotransferase Activity in Cholestatic Rats

  • ;;곽춘식
    • 대한의생명과학회지
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    • 제11권1호
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    • pp.37-43
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    • 2005
  • The possible mechanisms of increased aryl sulfotransferase (AST) isozymes activities in cholestatic rat liver were studied. Hepatic AST-I, II and -III, IV activities were determined from the experimental rats with common bile duct ligation (CBDL). The Michaelis-Menten constants in these hepatic enzymes were also measured. The activities of mitochondrial AST-I, II and -III, IV, and microsomal AST-III, IV as well as their Vmax values were found to be increased significantly in CBDL plus taurocholic acid (TCA) injected group than in the control group, such as CBDL alone groups. However, their Km values in the experimental groups did not vary. The results suggest that TCA stimulates biosynthesis of the AST in the liver.

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Effects of Intravenous Administration of Taurocholate on Hepatic Monoamine Oxidase A and B Activities in Cholestatic Rats

  • Do Jun-Young;Kwak Chun-Sik
    • 대한의생명과학회지
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    • 제10권4호
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    • pp.421-427
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    • 2004
  • The possible mechanisms of decreased monoamine oxidase (MAO) A and B activities in cholestatic rat liver were studied. Hepatic and serum MAG activities were determined from the experimental rats with common bile duct ligation (CBDL). The Michaelis-Menten constants in these hepatic enzymes were also measured. The activities of mitochondrial MAO A and B, and mircosomal MAO B as well as their Vmax values were found to be decreased significantly in CBDL plus taurocholic acid (TCA) injected group than in the control group, such as CBDL alone groups. However, their Km values in the experimental groups did not vary. Serum MAO activity increased significantly in the CBDL plus TCA injected group than in the control group. The above results suggest that TCA represses biosynthesis of the MAO in the liver. The elevated activity of the serum MAO is believed to be caused by the increment of membrane permeability ofhepatocytes upon TCA mediated liver cell necrosis.

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A Case of Epstein-Barr Virus Infection with Gall Bladder and Common Bile Duct Stones in an Otherwise Healthy Child

  • Park, Jong-Hyun;Noh, Jin-Chul;Park, Hyang-Mi;Jung, Yu-Soek;Park, Sei-Hyeog;Hong, H. Christian;Shin, Hye-Jung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제15권1호
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    • pp.57-61
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    • 2012
  • Cholelithiasis and choledocholithiasis are uncommon pediatric diseases, although clinicians have seen them with increasing frequency in children in recent years. Moreover, no case of Epstein-Barr virus (EBV) infection with cholelithiasis and choledocholithiasis has been previously reported in the English literature. We report a pediatric patient with EBV infection, a gall bladder stone, and a common bile duct stone, may have had GB and CBD stones prior to her EBV infection, whom we successfully treated with antibiotics and laparoscopic cholecystectomy for cholecystitis.

The Effects of Extrahepatic Cholestasis on Serum $\alpha$-D-Mannosidase Isozyme Activities in Ethanol Intoxicated Rats

  • Si-Woo Bae;Chun-Sik Kwak;Chong-Guk Yoon
    • 대한의생명과학회지
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    • 제8권4호
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    • pp.203-209
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    • 2002
  • Serum $\alpha$-D-mannosidase isozyme activities were measured in rats with ethanol intoxication combined with extrahepatic cholestasis induced by common bile duct ligation for the manifestation of the biochemical background of drinking hazards under the hepatobiliary disease. When chronic ethanol intoxication was combine with extraheparlc cholestasis, the activities of the rat's serum cytosolic, Iysosomal and Golgi $\alpha$-D-mannosidase isozymes increased at a more significant rate than those of the cholestasis alone. However, when acute ethanol intoxication was combined with extrahepatic cholestasis, the activities of the above isozymes were seen in the cholestasis alone. The results suggested that the elevated activities of these isozymes in chronic ethanol intoxication with cholestasis rather than in cholestasis alone were indications of increased hepatic damages, which caused these isozymes to leak into the blood in great quantity. Accordingly, the resulting data supported the fact that alcoholic drinks were enzymologically harmful to the hepatobiliary disease.

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Effects of Extrahepatic Cholestasis on Hepatic $\alpha$-D-Mannosidase Activity in Chronic Ethanol Intoxicated Rats

  • Si-Woo Bae;Chun-Sik Kwak;Chong-Guk Yoon
    • 대한의생명과학회지
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    • 제9권1호
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    • pp.21-27
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    • 2003
  • Hepatic subcellular $\alpha$-D-mannosidases activities and its Km and Vmax values were determined in chronic ethanol intoxicated rats with extrahepatic cholestasis induced by common bile duct ligation to manifest the biochemical background of alcohol drinking hazard under the hepatobiliary disease. In case of extrahepatic cholestasis, chronic ethanol intoxication in animals led to the increased activities of liver Golgi and microsomal $\alpha$-D-mannosidase as well as the Vmax values of these enzymes. However, the difference of Km values on hepatic subcellular enzymes were not found between the experimental groups. Therefore, the results indicate that the liver Golgi and microsomal $\alpha$-D-mannosidase may be more induced in chronic ethanol intoxication animals in case of cholestasis. Accordingly, the resulting data supported the fact that alcoholic drinks may led to enhancement of the hepatobiliary liver damage.

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A Case of Alveolar Echinococcosis Occurring in the Hilar Bile Duct

  • Yang, Jinyu;Zhao, Zhanxue;Li, Shuai;Chen, Hekai
    • Parasites, Hosts and Diseases
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    • 제57권5호
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    • pp.517-520
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    • 2019
  • Echinococcosis is a disease caused by the Echinococcus species that parasitizes in humans. Alveolar echinococcosis (AE) which is caused by Echinococcus multilocularis is harmful to humans. AE mainly occurs in the liver and can be transferred to retroperitoneal lymph nodes, lung, brain, bone, spleen and other organs through lymphatic and blood vessels. Cholangiocarcinoma can occur in of the intrahepatic and extrahepatic bile ducts and is more common in the hilar. We reported a case of hilar bile duct alveolar echinococcosis which was originally misdiagnosed an cholangiocarcinoma.