The vast majority of bile duct injuries is iatrogenic and occurs during abdominal surgeries or other interventions such as endoscopic or percutaneous cannulation of the biliary tree. Accidental traumas are responsible only for 1–5% of the total number of biliary injuries. The diagnosis of non-iatrogenic traumatic bile duct injuries is challeng‐ ing as current cross-sectional imaging tests are n...

Bile is normally sterile. Bactibilia occurs when bile flow is impaired and bacteria gain access to the biliary duct by the papilla or portal circulation. Bile duct obstruction leads sequentially to increase in intra biliary pressure, infection of bile, cholangiovenous and cholangiolymphatic reflux leading to bacteremia [1-3]. The bacteria described commonly in biliary tract infections include E...

The development of intra- and extrahepatic bile duct stones has been reported as one of the most serious complications after choledochal cyst excision with biliary-enteric reconstruction through Roux-en-Y hepaticojejunostomy (HJ). Here, we report our experience with extracorporeal shock wave lithotripsy (ESWL) in a case of giant intrahepatic stones developing after choledochal cyst surgery. ESW...

INTRODUCTION T tubes can be placed in the bile ducts either open or laparoscopically for several reasons such as: extraction of stones, biliary reconstruction after liver transplant and in end-to-end anastomosis in iatrogenic injuries. Inadequate placement of the T tube, long term stay and technical difficulties that can affect the outcome, can lead to an injury that usually requires a biliodig...

BACKGROUND Intrahepatic stones, though common in East Asia, are uncommon in India. There is paucity of data from India regarding the treatment and long-term outcome of patients with intrahepatic stones. METHODS We retrospectively analyzed medical records of 35 patients with intrahepatic stones who had been treated surgically. Endoscopic biliary drainage had been used in patients who presented...

INTRODUCTION Sir Alfred Cuschieri,in 1990,hailed laparoscopic cholecystectomy (LC) as the beginning of a new, exciting era, but alerted surgeons to be cautious so as to avoid a substantial surgically induced morbidity. Twenty five years later, the small increase in the rate of iatrogenic major biliary injury is tolerated, thanks to the great benefits of this minimally invasive approach. Indeed ...

Recent advances in videolaparoscopic surgery have made this method the treatment of choice for many biliary diseases. However, it has not been used in certain cases, such as primary intrahepatic lithiasis. The authors report a case of a 62-year-old woman with a history of several episodes of cholangitis. Investigation revealed dilated intra- and extrahepatic bile ducts with intrahepatic stones....

SAJS The management of patients with primary intrahepatic stones may be complex as the natural history is frequently complicated by further episodes of cholangitis after initial treatment because of residual or recurrent intrahepatic stones or strictures. Curative segmental or lobar hepatic resection of atrophic segments and diseased ducts is possible in only the 20% of patients with localised ...

Background and study aims  Endoscopic removal of biliary stones has high success rates, ranging between 85 % to 95 %. Nevertheless, some stones may be challenging and different endoscopic methods have evolved. Papillary large balloon dilation after sphincterotomy is a widely used technique with success rates ranging from 68 to 90 % for stones larger than 15 mm. Cholangioscopy allows performing ...

BACKGROUND Choledocholithiasis presents in 5-10% of the patients with biliary lithiasis. Numerous treatment algorithms have been considered for this disease, however, up to 10% of these therapeutic procedures may fail. Intraoperative choledochoscopy has become a useful tool in the treatment of patients with difficult-to-manage choledocholithiasis. OBJECTIVES To determine the usefulness of int...