• Title/Summary/Keyword: biliary tract

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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.

Carcinoembryonic Antigen Level in Liver Disease (간질환에서의 혈청 Carcinoembryonic Antigen 가(價))

  • Choi, Kyoo-Ok;Kim, Ki-Whang;Park, Chang-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.12 no.2
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    • pp.17-22
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    • 1978
  • Carcinoembryonic antigen was initially known as tumor specific antigen and had a potential diagnostic value in the detection of digestive tract malignancies. However, subsequent studies showed CEA and CEA-like antigen present in benign disease, particullary in liver. We had collected sera from 58 patients who had liver scan and later were diagnosed clinically and histologically as liver disease. We estimated CEA values and correlations were made with liver function tests in liver cirrhosis cases. The results: 1) The raised plasma carcinoembryonic antigen level were found in 13 (68.4%) of 19 patients in liver cirrhosis, 5(27.8%) of 18 patients in hepatoma, 5(71. %) of 7 patients in chronic active hepatitis, all 3 patients in liver abscesses, 2(66.7%) of 3 patients in liver ablscesses, 2(66.7%) of 3 patients in obstructive biliary disease and none in each one patient of traumatic liver hematoma, subphrenic abscess and clonorchiasis. 2) There is no linear correlation between carcinoembryodic antigen level and liver function tests including serum bilirubin, alkaline phosphatase, SGOT and prothrombin time in liver cirrhosis patients.

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Clinical Evaluation of Patients with Atrophied Left Lobe on the Liver Scan (간 스캔에서 나타난 간 좌엽위축의 임상적 의의)

  • Chung, Jin-Hong;Chung, Byung-Chun;Kim, Kwang-Won;Sohn, Sang-Kyun;Lee, Jae-Tae;Lee, Kyu-Bo;Whang, Kee-Suk
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.56-61
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    • 1990
  • We evaluated 85 cases with atrophy of left lobe among 11,133 cases performed liver scan using $^{99m}Tc-phytate$ from January 1984 to January 1990 at Kyungpook National University Hospital in association with underlying causes and related conditions. Seventeen cases seemed to be due to biliary tract diseases, eg, cholelithiasis, cholangiocarcinoma, clonorchiasis and postcholecystectomy state. Fifteen cases were patients with primary and metastatic hepatic malignancies. One case had a history of hepatic irradiation. Thirty cases comprised acute hepatitis, chronic hepatitis, liver cirrhosis and fatty liver. However no causative abnormalities could be detected in 22 cases despite of meticulous diagnostic work-up.

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Donor Surgical Morbidity in Pediatric Living-Donor Liver Transplant: A Portuguese Experience

  • dos Santos, Jose Pedro Fernandes;Martins, Ricardo;Lopes, Maria Francelina
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.528-534
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    • 2021
  • Purpose: Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center. Methods: We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system. Results: In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series. Conclusion: These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.

Contained Gallbladder Rupture in Two Dogs with Small-Sized Gallbladder

  • Chang-Hwan Moon;Hee-Jin Kim;Won-Jong Lee;Young-Sam Kwon;Jae-Min Jeong;Dae-Hyun Kim;Hae-Beom Lee;Seong Mok Jeong
    • Journal of Veterinary Clinics
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    • v.40 no.6
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    • pp.452-456
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    • 2023
  • This report presents two rare cases of gallbladder rupture in dogs with small gallbladders that did not result in bile leakage and their subsequent surgical treatment. The report includes a 5-year-old spayed female Chihuahua weighing 3.5 kg and a 9-year-old castrated male Poodle weighing 5.3 kg. Both dogs had elevated liver enzyme levels on blood chemistry. However, only the second dog (2) (Poodle) presented with hyperbilirubinemia and jaundice, whereas the first dog (Chihuahua (1)) did not display any specific clinical signs. Diagnostic imaging revealed a small gallbladder in both dogs, and the dogs were diagnosed with cholecystolithiasis (1) and extrahepatic biliary tract obstruction (2). No bile leakage-related abdominal effusion was observed. Gallbladder rupture and adhesion to the adjacent tissues were confirmed during cholecystectomy.

Cytopathologic Diagnosis of Bile Obtained by Percutaneous Biliary Drainage (담즙의 세포병리학적 진단에 관한 연구)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.3 no.1
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    • pp.1-11
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    • 1992
  • From the one hundred forty eight patients with evidence of biliary tract obstruction, 275 bile samples were obtained from percutaneously placed biliary drainage catheters. Of the 148 patients, ova of Clonorchis sinensis were demonstrated in 17 patients (11.5%), with the epithelial cells. Among them, one case also demonstrated coexisting adenocarcinoma. In 105 patients, the medical records were available for review and the clinical diagnoses were malignancy in 99 patients and benign lesion in 6 patients. Of the 99 patients in which clinico-radiologic diagnosis were malignant, cytologic results were positive in 23.2%. Dividing the patients Into two groups, the ones with tumor of bile duct origin (group I) and the others with tumors producing extrinsic compression of bile duct, such as periampullary carcinoma, pancreas head carcinoma or metastatic carcinoma in lymph nodes from tumors of adjacent organs (group II), the cytologic results were positive in 37% and 11.6%, respectively. In patients with histologic confirmation, the positive correlation was found in 50% and 20% in group I and group II, respectively, with remarkable difference between two groups. There were no false positives in cytologic diangosis. The overall concordance rate of cytologic diagnosis with diagnosis of clinical investigation in both benign and malignant lesions was 27.6% and the diagnostic specificity was 100%.

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Hypermethylation of the Ras Association Domain Family 1A (RASSF1A) Gene in Gallbladder Cancer

  • Kee, Se Kook;Lee, Ji Yun;Kim, Mi Jin;Lee, Su Man;Jung, Young Won;Kim, Young Joo;Park, Jae Yong;Bae, Han Ik;Hong, Hae Sook;Yun, Young Kook;Kim, Sang Geol;Kim, Dong Sun
    • Molecules and Cells
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    • v.24 no.3
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    • pp.364-371
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    • 2007
  • The tumor suppressor gene Ras association domain family 1A (RASSF1A) is highly methylated in a wide range of human sporadic tumors. The current study investigated the hypermethylation of RASSF1A, the expression of RASSF1A protein, and the correlation between these and the clinicopathological features of gallbladder (GB) cancer in Korean patients. Formalin-fixed, paraffin-embedded tumors and non-neoplastic GB tissues (22 carcinomas, 8 adenomas, 26 normal epithelia) were collected from patients who had undergone surgical resection. The methylation status of two regions of the RASSF1A CpG island was determined by methylation-specific PCR (MSP), and the expression of RASSF1A protein was examined by immunohistochemistry using tissue microarrays. The K-RAS mutation was analyzed by direct sequencing. Methylation of the RASSF1A promoter (region 1) was detected in 22.7% (5/22) of carcinomas, 12.5% (1/8) of adenomas, and 0% (0/26) of normal gallbladder epithelia (P = 0.025). Methylation of the first exon (region 2) was found in 36.4% (8/22) of carcinomas, 25.0% (2/8) of adenomas, and 8.0% (2/26) of normal gallbladder epithelia (P = 0.038). K-RAS mutations were present in 4.5% (1/22) of carcinomas and 25% (2/8) of adenomas. RASSF1A methylaton was not associated with clinicopathological factors or K-ras mutation. Reduction or loss of RASSF1A expression was observed in most methylated adenocarcinomas. Three RASSF1A-expressing human biliary tract cancer cell lines examined contained unmethylated promoters and exons 1. These results suggest that downregulation of RASSF1A expression by DNA hypermethylation may be involved in GB carcinogenesis.

Clinical Application of $^{99m}Tc-HIDA$ Cholescintigraphy in the Cholecystitis (담낭염 환자에서의 $^{99m}Tc-HIDA$ Scan의 진단적 의의)

  • Park, R.J.;Ahn, I.M.;Jang, Y.B.;Hong, K.S.;Yoon, Y.B.;Cho, B.Y.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.2
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    • pp.11-17
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    • 1981
  • Cholescintigraphic studies with $^{99m}Tc-HIDA$(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 12 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of $^{99m}Tc-HIDA$ respectively, 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 93.2%, 95.2% and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder (1) and normal findings (2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily, With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

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Pharmacokinetics of a New Antigastritic Agent, Eupatilin, an Active Component of StillenE®, in Rats

  • Jang, Ji-Myun;Park, Kyung-Jin;Kim, Dong-Goo;Shim, Hyun-Joo;Ahn, Byung-Ok;Kim, Soon-Hoe;Kim, Won-Bae
    • Biomolecules & Therapeutics
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    • v.11 no.3
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    • pp.163-168
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    • 2003
  • Pharmacokinetics of eupatilin (an active components of $Stillen^{\circledR}$, a new antigastritic agent) were investigated after both intravenous and oral administration at a dose of 30mg/kg to rats. After intravenous administration, the plasma concentrations of unchanged eupatilin declined rapidly with a mean terminal half-life of 0.101 h. Eupatilin was eliminated fast in rats; the total body clearance was 121 mL/min/kg. Eupatilin was mainly metabolized in rats; the percentage of intravenous dose of eupatilin excreted in 24 h urine and feces as unchanged eupatilin was only 2.5 and 0.919%, respectively. Eupatilin was mainly metabolized to form its glucuronide conjugate; after intravenous administration, 15.9 and 51.7% of intravenous dose was excreted in 24 h urine and feces, respectively, as eupatilin plus its glucuronide. After oral administration, the absolute bioavailability was only 3.86% based on $AUC_{0-24h}$ of eupatilin plus its glucuronide. Approximately 68.5% of oral dose was not absorbed from the entire gastrointestinal tract. Therefore, it could be concluded that the superior effect of eupatilin in experimental animal models of gastric ulcer and inflammatory bowel disease after oral administration could be due to the local action of eupatilin. Further pharmacokinetic studies to elucidate the local action of eupatilin are required.

Is Early Excision of Choledochal Cyst in Neonate Necessary? (신생아 담관 낭종의 수술 필요성에 대한 고찰)

  • Kim, Hyun-Young;Lee, Hye-Seung;Lee, Seong-Cheol;Jung, Sung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.11 no.1
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    • pp.19-26
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    • 2005
  • Choledochal cysts have been associated with complications such as cholangitis, pancreatitis, and malignancy of the biliary tract. Recently, the incidence of choledochal cyst in neonate and young infant is increasing due to advances in diagnostic imaging. The aim of this study is to investigate the rationale of excision of choledochal cyst during the neonatal period. The clinical outcome and correlation between age at surgery and the degree of liver fibrosis were reviewed retrospectively. A total of 198 patients with choledochal cyst who were managed surgically between January 1985 and December 2000 at the Department of Surgery, Seoul National University Children's Hospital were included in this study. The overall outcome and the outcome of patients who were managed surgically during the neonatal period were compared. Correlation between age and the degree of liver fibrosis was evaluated by chi-square test and Pearson exact test. The mean age of the patients was 2 years 7 months (ranged from 5 days to 15 years). Mean postoperative follow-up period was 7 years 1 month (7 months to 20 years). The results are as follows. Twelve patients (6%) had postoperative complications, cholangitis (7), bleeding (4) and ileus (1). Eleven patients operated during the neonatal period had no postoperative complications. The positive correlation between age group and degree of liver fibrosis was statistically significant (chi-square: p=0.0165, Pearson exact test: p=0.019). The results support the rationale that excision of choledochal cyst can be performed safely without increasing morbidity in neonates.

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