• 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.

• Journal of radiological science and technology
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• v.20 no.1
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• Biomedical Science Letters
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• v.10 no.1
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• pp.43-48
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• 2004

Changes of thiol methyltransferase (TMT) activity in cholestatic rat liver were studied. Hepatic subcellular and serum TMT activities were determined in cholestatic rat induced by common bile duct (CBD) ligation over a period 28 days. The mitochondrial and microsomal TMT activities in cholestatic rat liver were found to be significantly increased between the 1st and the 28th day after CBD ligation. The TMT activity in serum was significantly increased throughout the experiments. The Vmax values of the above hepatic TMT in cholestatic rat were significantly increased at the 7th day after CBD ligation. However, the Km values of the above hepatic enzymes did not vary in all the experimental groups. Therefore, the results indicate that the biosynthesis of TMT was increased in cholestatic rat liver. The elevated serum TMT activity is most likely caused by increased hepatocytes membrane permeability due to cholestasis mediated liver cell necrosis.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.318-321
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• 2018

Primary neuroendocrine tumors originating from the extrahepatic bile duct are rare. Among these tumors, large cell neuroendocrine carcinomas (NECs) are extremely rare. A 59-year-old man was admitted to Sanggye Paik Hospital with jaundice that started 10 days previously. He had a history of laparoscopic cholecystectomy, which he had undergone 12 years previously due to chronic calculous cholecystitis. Laboratory data showed abnormally elevated levels of total bilirubin 15.3 mg/dL (normal 0.2-1.2 mg/dL), AST 200 IU (normal 0-40 IU), ALT 390 IU (normal 0-40 IU), and gamma-glutamyl transferase 1,288 U/L (normal 0-60 U/L). Serum CEA was normal, but CA 19-9 was elevated 5,863 U/mL (normal 0-37 U/mL). Abdominal CT revealed a 4.5 cm sized mass involving the common bile duct and liver hilum and dilatation of both intrahepatic ducts. Percutaneous transhepatic drainage in the left hepatic duct was performed for preoperative biliary drainage. The patient underwent radical common bile duct and Roux-en-Y hepaticojejunostomy for histopathological diagnosis and surgical excision. On histopathological examination, the tumor exhibited large cell NEC (mitotic index >20/10 high-power field, Ki-67 index >20%, CD56 [+], synaptophysin [+], chromogranin [+]). Adjuvant concurrent chemotherapy and radiotherapy were started because the tumor had invaded the proximal resection margin. No recurrence was detected at 10 months by follow-up CT.

• Applied Microscopy
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• v.24 no.2
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• pp.78-92
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• 1994

Lysozyme has been reported to be present in the secretory granules of the Paneth cell, and lysozyme immunoreactivity has been detected by immunogold method in Paneth cells of the intestine of human, mouse and rat. The present study was aimed at clarifying the intracellular distribution and changes of the lysozyme immunoreactivity in rabbit Paneth cell after common bile duct ligation of rabbit, using the electron microscope immunogold technique. Healthy adult rabbits weighing about 2kg body weight were divided into normal and bile duct ligated groups. Common bile duct ligation was performed aseptically under ether anesthesia. Experimental animals were sacrificed on the 1st, the 3rd, the 5th, the 7th and the 14th day after the operation. Mucosal specimens from the intestinal gland of ileum were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde, followed by 1% osmium tetroxide, embedded in araldite mixture, cut with LKB-V ultratome. Ultrathin sections were placed on parlodion coated nickel grids (200mesh). The section-bearing grids were floated upside down on the added substance in a moist chamber at room temperature except for the primary antibody step, which was at $4^{\circ}C$. Sections were etched with a saturated solution of sodium m-periodate for 60min. After etching, sections were pretreated with 0.02M tris buffered saline (TBS), pH 8.4, with 1% bovine serum albumin (BSA, Sigma) for 60min, then treated polyclonal rabbit anti-human lysozyme (Dakipatts) diluted 1 : 50 in TBS with 0.1% BSA for 20hr. Subsequently, grids were incubated 60min in biotinylated goat anti rabbit IgG (Amersham) diluted 1 : 100 in TBS with 0.1% BSA. After this, sections were incubated 60min on streptavidin gold G10 (Amersham) diluted 1 : 50 in TBS with 0.1% BSA. After each step, the grids were briefly rinsed with TBS with 0.1% BSA. After the strepavidin gold step, the sections were jet washed with distilled water. Counterstain of the sections performed by uranyl acetate and lead citrate, and observed with JEM 100 CX II electron microscope. Observed results were as follow; 1. Secretory granules of mouse Paneth cells have a lysozyme immunoreactivity and also eosinophil leucocyte of rabbit applied for the positive-control stain, are well labeld with gold particles. 2. Normal rabbit Paneth cells have a lysozyme immunoreactivity restricted on the secretory granules. 3. Amount lysosomes containing myelin figures in the Paneth cells were significantly increased from 5th day after the common bile duct ligation. 4. Immunoreactivity of Paneth cell secretory granules were more activated on the 3rd day after the common bile duct ligation as compared with those of the normal animal. But the lysozyme immunoreactivity were decreased from the 5th day after the common bile duct ligation. 5. Considering the above finding, lysozyme contained Paneth cell are affected following of common bile duct ligation, whereas lysosomes containing myelin-figure do not exhibit any immunoreactive relationship with those of secretory granules.

• Toxicological Research
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• v.19 no.1
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• pp.67-72
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• 2003

Cholestatic liver injury results from the accumulation of toxic bile salts within the liver. The aim of the present study is to elucidate the changes in expression and cellular localization of apoptosis related proteins in the liver of bile duct-ligated (BDL) rat. Extrahepatic cholestasis was induced by double ligation of the common bile duct and cut between the ligatures. Animals were sacrificed at day 3 and at week 1, 2, 4, 6, and 8 after BDL. The number of TUNEL positive cells was increased significantly after 3 days of BDL, decreased over 2 weeks and remained constant thereafter. Fas expression was not changed and activation of caspase 8 did not occur. Fas immunoreactivity was exclusively observed in the cytoplasm of hepatocytes, indicating that Fas expressed in rat hepatocytes is a soluble form. Hepatocyte apoptosis was associated with Bax expression, which showed a peak at day 3 and decreased over time gradually. Immnunostaining of Bax was observed in hepatocytes and bile duct epithelial cells (BEC) of control and BDL rats. Bcl-2 was increased over time in BDL rats. These results suggest that apoptosis of hepatocytes in BDL rats is independent of Fas and controlled by Bax expression.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.100-109
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• 1998

The anomalous pancreaticobiliary duct union (APBDU) might cause the formation of choledochal cyst and malignancies of hepatopancreaticobiliary system. The purpose of this study is to make an experimental animal model of APBDU similar to that of human. One to two-month-old Mongrel dogs (n=12) were divided into two groups; the control group (n=2) had a sham operation performed, and in the experimental group (n=10) the end of distal ' common bile duct (CBD) was anastomosed to the side of the dorsal pancreatic duct making APBDD. Serum was obtained for chemical analysis on the 10th postoperative day. The dogs were sacrificed at the 5th week (n=3), the 6th week (n=3), the 7th week (n=2), the 8th week (n=2) and the 6th month (n=2) after the experimental surgery. With sacrifice, operative cholangiogram was taken, and bile juice was obtained for chemistry and bacterial culture. The en-bloc specimens of the hepatopancreaticobiliary system were removed for microscopic examination. Serum and bile juice amylase levels were elevated in the experimental group(n=10), but not in the control group(n=2). Operative cholangiograms of control group revealed no evidence of bile duct dilatation.. On the other hand, the bile duct in the experimental group was markedly dilated without any evidence of stenosis at the anastomosis site (n=10). Histologic examination of the hepatopancreaticobiliary system in the experimental group resembled the findings of choledochal cyst in human. The APBDU of this animal model can produce bile duct dilatation by pancreaticobiliary reflux. We think that this animal model can be potentially promising for the research about the APBDU associated hepatopancreaticobiliary diseases.

• Korean Journal of Veterinary Research
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• v.34 no.1
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• pp.1-7
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• 1994

The distribution of the bile and hepatic ducts within the liver of 24 Korean native cattle were observed. Vinylite solution was injected into common bile ducts on 13 cases for cast preparation. The angiography was prepared in 11 cases which were injected 30% barium sulfate solution into the common bile ducts and then radiographed on X-ray apparatus. The results were summarized as follows; 1. The dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, and ducts of papillary process were collected into left hepatic ducts. The dorsal and ventral ducts of right hepatic lobe, ducts of caudate process and papillary process were collected into right hepatic ducts. 2. The bile ducts in the left hepatic lobes were collected into dorsal, ventral and intermediate ducts of left hepatic lobes. The intermediate ducts of left hepatic lobes was absent in some cases(5 cases, 20.83%). 3. In some cases, the ventral ducts of right hepatic lobes were collected into right hepatic ducts directly. 4. The ducts of quadate lobes were collected into left hepatic ducts(8 cases, 33.33%), ventral ducts of left hepatic lobes(13 cases, 54.17%), and dorsal duct of left hepatic lobes, intermediate and ventral ducts of left hepatic lobe, common trunk collected into intermediate and ventral duct of left hepatic lobe and left hepatic duct(1 cases, 4.17%) respectively. 5. The ducts of papillary process were collected into left and right hepatic ducts(12 cases, 50%), left hepatic ducts only(11 cases, 45.83%) or right hepatic duct only(1 cases, 4.17%). 6. The average length of right hepatic ducts was 26.87(6-45.8)mm. The average length of left hepatic ducts was 56.68(6-127)mm. The length of gallbladder was 128.60(104-160)mm on the average. The breadth of gallbladder was 67.16(38.4-153.4)mm on the average. But there was a difference in the length and the breadth according to the quantity of bile. 7. The ramified angles of dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, ducts of papillary processes and caudate processes, dorsal and ventral ducts of right hepatic lobes and cystic ducts were 130-170, 160-200, 190-250, 240-300, 90-140, 320-350, 30-100, 270-330 and 240-300 degrees respectively.

• BMB Reports
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• v.32 no.4
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• pp.331-338
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• 1999

Ethanol catabolism is thought to produce metabolic disorders resulting in alcoholic liver disease. To investigate the mutual effects of ethanol catabolism and cholestasis induced by common bile duct ligation on the activities of carboxylesterase, we have determined the enzyme activities in rat hepatic (cytosolic, mitochondrial, and microsomal) preparations as well as in rat serum using ten animal models: normal rats (group 1), sham-operated rats (group 2), common bile duct-ligated rats (group 3), ethanol-intoxicated rats (group 4), sham-operation plus chronic ethanol-intoxicated rats (group 5), common bile duct-ligated plus chronic ethanol-intoxicated rats at 1.5h and 24h (groups 7A and 7B), and duct-ligated and acute ethanol intoxicated rats at 1.5 h and 24 h (groups 8A and 8B). The $K_m$ and $V_{max}$ values of carboxylesterase from these hepatic preparations of cholestatic rat liver combined with chronic ethanol intoxication were also measured by using ethyl valerate as the substrate from the 14th day post-ligation. Carboxylesterase activities of all hepatic preparations and rat serum (group 3) showed significant decreases compared to the activities from the sham-operated control (group 2). Enzyme kinetic parameters indicated that $V_{max}$ of carboxylesterase from all the hepatic preparations in cholestatic rats (group 3) decreased significantly, although the $K_m$ values were about the same as in the sham-operated control (group 2). When cholestasis was combined with chronic ethanol intoxication (group 6), carboxylesterase activities showed further decrease in all the hepatic preparations and serum compared to the control activity (group 5). The $V_{max}$ also decreased significantly, although $K_m$ values did not change. When common bile duct ligation was combined with acute ethanol intoxication (group 8), the enzyme activities in the rat liver and serum showed significant decrease compared to the activity from acute ethanol-intoxicated rats (group 7). However, quite contrary to this, the activities of serum from acute ethanol intoxication 1.5 h (group 7A) increased significantly compared to the activities in the normal control (group 1). These results, therefore, suggest that the biosynthesis of hepatic carboxyl-esterase seems to decrease when cholestasis is combined with chronic and acute ethanol intoxication, and the decrease in activity is more significant than from cholestasis alone.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.224-229
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• 2022

Biliary cast syndrome is an unusual complication in patients who have previously undergone liver transplantation. It occurs in approximately 5%-18% of such patients. Rare cases of biliary cast syndrome in patients without liver transplants have also been reported. The pathogenesis of biliary cast has not been clearly identified, although etiologic factors including post-transplant bile duct damage, ischemia, biliary infection, and presence of a post-operative biliary drainage tube have been proposed. Here we present a case of biliary cast that developed in a 49-year-old male who underwent a non-liver surgery after endoscopic and percutaneous management of common bile duct stone.