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    Biliary Tree: A and B, Abnormalities in Cholangiograms, Following Probably A Persistent Cystic Duct

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    Anonymous L3q7yHhh
    This document discusses complications and success rates of different procedures for visualizing the biliary tree, including transhepatic cholangiography using skinny needles versus large sheathed needles. It reports that using skinny needles achieved visualization in 95.6% of patients with nondilated ducts and 100% of patients with dilated ducts. A multi-institutional survey found an overall success rate of 97.8% for transhepatic cholangiography, with a lower complication rate compared to ERCP. Complications included sepsis, bile leakage, hemorrhage and death.

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    Biliary Tree: A and B, Abnormalities in Cholangiograms, Following Probably A Persistent Cystic Duct

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    Anonymous L3q7yHhh
    8 views2 pages
    This document discusses complications and success rates of different procedures for visualizing the biliary tree, including transhepatic cholangiography using skinny needles versus large sheathed needles. It reports that using skinny needles achieved visualization in 95.6% of patients with nondilated ducts and 100% of patients with dilated ducts. A multi-institutional survey found an overall success rate of 97.8% for transhepatic cholangiography, with a lower complication rate compared to ERCP. Complications included sepsis, bile leakage, hemorrhage and death.

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    442

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    This document discusses complications and success rates of different procedures for visualizing the biliary tree, including transhepatic cholangiography using skinny needles versus large sheathed needles. It reports that using skinny needles achieved visualization in 95.6% of patients with nondilated ducts and 100% of patients with dilated ducts. A multi-institutional survey found an overall success rate of 97.8% for transhepatic cholangiography, with a lower complication rate compared to ERCP. Complications included sepsis, bile leakage, hemorrhage and death.

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    8 views2 pages

    Biliary Tree: A and B, Abnormalities in Cholangiograms, Following Probably A Persistent Cystic Duct

    Uploaded by

    Anonymous L3q7yHhh
    This document discusses complications and success rates of different procedures for visualizing the biliary tree, including transhepatic cholangiography using skinny needles versus large sheathed needles. It reports that using skinny needles achieved visualization in 95.6% of patients with nondilated ducts and 100% of patients with dilated ducts. A multi-institutional survey found an overall success rate of 97.8% for transhepatic cholangiography, with a lower complication rate compared to ERCP. Complications included sepsis, bile leakage, hemorrhage and death.

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    442 BILIARY TREE

    NORMAL POST-OPERATIVE PERIOD

    Right hepatic duct

    Left hepatic duct

    Occasional through opening

    spillage surgical

    -Common hepatic duct

    C o m m o n bile duct

    Reflux into pancreatic duct Duodenum

    Tapered gently to a point in papilla major

    Filling defect from stones single or multiple

    "Reformed gallbladder which may contain defect or stone

    A
    Figure 4-41. A and B, Abnormalities in cholangiograms, following probably a persistent cystic duct.

    patients; but when the biliary tree was dilated, the success rate was even greater100 per cent. It was in the 45 patients with nondilated ducts that visualization was achieved in only 95.6 per cent. They described no mortality or transfusion requirement and very little morbidity. An analysis of the signs of common bile duct : retraction at percutaneous transhepatic cholan- giosrarh;- was carried out by Owen. He drew up a ".art pointing to objective differential find- - ;s m ire distal end of the common bile duct, with a -ansaca: analysis of this finding in relation to mi" :n the common bile duct, carcinoma of the -ancreas. chronic pancreatitis, and carcinoma inrv.-jig the ampulla :: \ ater Fig. -i-40). Fraser and associates had earlier pointed out that the hepatic ..mphatics were filled in 32 of their 102 cases but that dilated lymphatics were mainly seen in patients

    442 BILIARY TREE with biliary cirrhosis, inflammatory liver disease, or lymphoma. Complications requiring active medical intervention occurred in 3 of their cases, with a need for emergency surgery in one. Harbin, Mueller, and Ferrucci carried out a multi-institutional survey of complications and use patterns of skinny needle transhepatic cholangiography and compared their results with those of the transhepatic cholangiogram obtained with a large- sheathed needle and endoscopic retrograde cholangiopancreatography (ERCP). Their collected data was based on 2006 procedures, which included 293 from their own institutions. The overall incidence of serious complications was 3.4 per cent (sepsis, 1.40 per cent; bile leakage, 1.45 per cent; intraper- itoneal hemorrhage, 0.35 per cent; and death, 0.20 per cent). The overall success rate, however, was 97.8 per cent; it was 99 per cent when 12 to 14

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