Peroral cholangioscopy has become an important tool in the diagnosis and treatment of a variety of biliary diseases, ranging from indeterminate biliary strictures to bile duct stones. Although the first cholangioscopy was performed in the 1970s, recent technological advances have provided us with cholangioscopes that yield high-resolution images, possess single-operator capability, and have ult...

A 20-year-old male presented with 2 months of progressive abdominal distension due to ascites and Budd-Chiari syndrome. He underwent transjugular intrahepatic portosystemic shunt (TIPS) placement, but soon after had elevated liver enzymes. MRCP revealed mild left intrahepatic biliary dilatation without stones or obvious stricture. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrat...

Electrohydraulic lithotripsy of human gall stones was investigated in vitro in a bath of saline and in a saline perfused bile duct. The technique was effective--only two stones could not be shattered. Electrohydraulic lithotripsy power requirement correlated with mechanical strength of stones, but not with biochemical composition. A trend toward higher power requirement was recorded with larger...

are misleading and likely to lead to faulty ideas in attributing both etiologic causes to the stones, and potential for succesful dissolution. It is now generally agreed that all stones in gallbladders harboring multiple stones are of approximately the same composition. Further, if one plots percent of patients undergoing elective cholecystectomy for biliary pain, but without complications (i.e...

In an attempt to evaluate the selective intraoperative biliary imaging in patients with gall stone disease and suspected CBD stones., Patients with symptomatic gall stone disease presenting for laparoscopic cholecystectomy were prospectively studied for the safety and effectiveness of selective intraoperative cholangiogram (IOC) policy. 182 patients underwent laparoscopic cholecystectomy [140 f...

Roux en Y hepatojejunostomy is the surgery of choice for bile duct repair. Anastomotical dysfunction after reconstruction has several etiopathologies. Besides technical factors, ischemia of the duct is responsible for late obstruction. Bile colonization with secondary stones and sludge can also be identified as a cause. An unusual cause of anastomotical dysfunction secondary to ascaris biliary ...

Duplicated common bile duct, often associated with conditions like lithiasis, biliary cysts and pancreatobiliary maljunction, could result in highly morbid and potentially fatal biliary injuries. Precise preoperative diagnosis and classification still remain a challenge. A female patient undergoing emergency laparoscopic cholecystectomy for acute calculous cholecystitis sustained iatrogenic bil...

Two hundred and twenty patients with a total of 412 gall bladder stones of between 8 and 38 mm in size were treated with extracorporeal shock wave lithotripsy, using the overhead module Lithostrar Plus. Fifty six per cent of stones were solitary (mean (SD) diameter 23 (5) mm) and 9.5% of the patients had more than three stones. Stones were successfully disintegrated in 218 patients (fragmentati...

Background Biliary stones are a common disease in western countries, and its management has changed dramatically over the past decade. Due to the increase of the middle-aged people, a larger number of elderly patients are affected by this disease. Laparoscopic cholecystectomy (LC) represents the gold standard for the treatment of gallbladder stones, and in cholecystectomized patients, the treat...

AIM To examine the influence of night duty (ND) on endoscopic therapy for biliary duct stones. METHODS The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by eight endoscopists after they had been on (ND group, n = 34 patients) or not [day duty (DD) group, n = 99 patients]. Patient characteristics (age, gender, history of abdominal ...