19— endoscopic ultrasound of the gallbladder and bile ducts

... and gallbladder, James Toouli and Mayank Bhandari Pathology of the intrahepatic and extrahepatic bile ducts and gallbladder, 21 Kay Washington Epidemiology of diseases of the bile ducts and gallbladder, ... the round ligament and umbilical fissure The right lobe is further divided by the gallbladder fossa into the right hemiliver to the right of the gallbladder and the quadrate lobe to the left The ... compromising the drainage of segment [7] Another form of ectopic drainage of the intrahepatic ducts is the involvement of the cystic ducts and the gallbladder (Fig 1.4) As illustrated, these variations...

Ngày tải lên: 09/08/2014, 14:22

... examination They can Chapter 3: Epidemiology of diseases of the bile ducts and gallbladder be distinguished from stones by their fixed position in the gallbladder and by the lack of an acoustic ... idiopathic disease of the biliary tract characterized by strictures and dilatations of the large intra- and extrahepatic bile ducts The etiology and pathogenesis of PSC are unknown The prevalence ... gallbladder, bile ducts, and pancreatic duct The ability to evaluate the pancreas and most distal aspect of the common bile duct/ampulla with ultrasound is variable, depending upon the nature of surrounding...

Ngày tải lên: 09/08/2014, 14:22

... enhancement and thickening of the wall of the extrahepatic bile ducts, and increased enhancement of the periphery of the liver during the hepatic arterial phase Cystic dilatation of the bile duct Congenital ... Al- though ultrasound does not reliably visualize the bile ducts at their extremes (i.e the peripheral intrahepatic ducts at one end and the distal common bile duct at the other), the central ... the advantage of high spatial resolution, which allows depiction of both the lumen and the wall of the bile ducts, but has the disadvantage of imaging only in the axial plane This is offset by multidetector...

Ngày tải lên: 09/08/2014, 14:22

... approaches for the biliary tree and gallbladder by irradiation They further characterized the injury as “vacuolation, swelling, and necrosis of the epithelial cells of the ducts, and by a slow and atypical ... al The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and ... [6] The distal left or right main bile ducts and the common hepatic duct are the most common sites of involvement (Fig 6.12) The tumor occurs at the junction of the left and right main hepatic ducts...

Ngày tải lên: 09/08/2014, 14:22

... classical injuries The deceptive flaring appearance is caused by the separation of the cystic and common hepatic ducts or the side of the common hepatic duct and the side of the gallbladder Note ... injuries There are two scenarios In the first, the common duct is mistaken for the cystic duct, and is clipped and divided (Fig 10.9A, point x) To complete the excision of the gallbladder the bile ducts ... approaches for the biliary tree and gallbladder Figure 10.10 The “critical view of safety.” The triangle of Calot is dissected free of all tissue except for cystic duct and artery and the base of the liver...

Ngày tải lên: 09/08/2014, 14:22

... intravenously and will normally be taken up by the liver and then the gallbladder Uptake by the liver and excretion into the duodenum without filling of the gallbladder is indicative for occlusion of the ... treatment the gallstone disimpacts and falls back into the gallbladder, which allows emptying of the gallbladder, resulting in reduction of the inflammation The theoretical aim of fasting is to rest the ... distention of the gallbladder induces the release of mediators, such as prostaglandin E2 and I 2, which cause an inflammatory response within the gallbladder [5] Infection of the accumulated bile fluid...

Ngày tải lên: 09/08/2014, 14:22

... resection of the gallbladder fossa includes which segments of the liver? a I and IVb b IVb and V c V and VIII d IVb and VIII The term “extended cholecystectomy” may encompass a resection of all of the ... Further investigations demonstrate fusiform cystic dilatations of the common bile duct with thickening of the bile duct wall and extension of the cystic abnormalities into the left lobe of the ... may be the source of CBD stones and cholangitis, and the gallbladder is normal in up to one-third of the patients In the absence of gallbladder stones, cholecystectomy is not indicated and may...

Ngày tải lên: 09/08/2014, 14:22

... confluence of the left and right main hepatic bile ducts (perihilar: 67% of the cases) [11] The tumor has a tendency to spread along the bile ducts and perineural sheets Distant metastases are rare and ... over the last decade as discussed in more detail in Chapters 4, 5, and The first step is an abdominal ultrasound The dilatation of the bile ducts is easily visualized, and the location of the biliary ... Further investigation to delineate the role of these peptides in the etiology of PSC is required The major criticism of the theories of colonic toxins causing PSC comes from studies looking at the...

Ngày tải lên: 09/08/2014, 14:22

... atresia of the gallbladder and all external bile ducts Variants include atresia of the proximal hepatic ducts with patency of the gallbladder and distal duct, or atresia of the distal ducts and patency ... excluding the gallbladder, and the fundus of the gallbladder is approximated to the dissection at the hilum of the liver In this way, the gallbladder and bile duct act as the conduit through which bile ... atresia) and that the proximal ducts dilate in response to obstruction [32] The operative strategy required will depend on the age of the child, the size of the ducts, and the location of the perforation...

Ngày tải lên: 09/08/2014, 14:22

... to the center of the portal tract to become the interlobular bile ducts The ductal plate cells around the periphery of the portal tract normally involute, but some elements remain to form the ducts ... reflects some degree of failure of the normal formation of the interlobular bile ducts, and results in a characteristic portal tract lesion consisting of persistence of some remnant of the ductal plate ... Pathology of the intrahepatic and extrahepatic bile ducts and gallbladder b c a d False d True False a 10 c Chapter 3, Epidemiology of diseases of the bile ducts and gallbladder a, e b, c, e a,...

Ngày tải lên: 09/08/2014, 14:22

... distended and showed wall thickening There was a palpable mass felt on the surface of the gallbladder neck portion The patient underwent surgical resection of the gallbladder and the left lobe of the ... tumor of the gallbladder and liver: a case report World Journal of Surgical Oncology 2011 9:84 Conclusions We report the first case of synchronous double primary malignancies of gallbladder and ... adenocarcinoma of gallbladder with invasion to the perimuscular connective tissue The patient was diagnosed with synchronous double primary cancer of the gallbladder and liver, so additional resection of...

Ngày tải lên: 09/08/2014, 02:20

... located on the free surface of the body and fundus of the gallbladder Neither metastases nor direct invasion to the liver was found The entire mass and gallbladder were excised and intact Pathological ... body and fundus of the gallbladder (Fig 3) Histologically, the tumor was seen infiltrating into the mucosa extensively, and some penetrated the muscular layer but not through the serosa of the gallbladder ... Journal of Surgical Oncology 2010, 8:12 http://www.wjso.com/content/8/1/12 Page of Figure Resected specimen of the gallbladder presenting a tumor (arrow) in the body and fundus of the gallbladder gallbladder...

Ngày tải lên: 09/08/2014, 03:21

... KP, NGS, AT, and ETP edited and wrote part of the manuscript KB and GNM were major contributors to the review and editing of the manuscript NF was the main pathologist and revised the manuscript ... normal gallbladder, a distended gallbladder, and alcohol ingestion, the last of which increases the tone of sphincter of Oddi and the biliary tract pressure Our patient had a history of chronic ... low cost and the ability to perform the test at the bedside in the emergency department Non-visualization of the gallbladder at ultrasonography should raise the suspicion of a traumatic gallbladder...

Ngày tải lên: 10/08/2014, 23:20

... suggestive of an NET tumor The determination of the histological type of the tumor and differential diagnosis from GB adenocarcinoma are often difficult The identification of neuroendocrine cells and the ... somatostatin, and gastrin were normal, as were Figure Abdominal ultrasound image of a polypoid mass between the neck and body of a gallbladder Page of Figure Hematoxylin -and- eosin section of a carcinoid ... indicating the lack of metastases and the successful surgical treatment of a “typical” carcinoid of the GB Indeed, in one study, 82.4% of GB carcinoids remained localized and only 11.8% of patients...

Ngày tải lên: 10/08/2014, 23:22

... in the neck of the gallbladder, thus leading to the clinical presentation and the imaging and intra-operative findings of gallbladder empyema in our patient Incidental finding of gallbladder ... preoperative and postoperative management of the patient and to critical review of the manuscript GA and HG carried out the histopathologic evaluation and contributed to writing of the manuscript ... the operation and contributed to acquisition of consent and critical review of the manuscript MG contributed to manuscript conception, research, acquisition of data, drafting and writing of the...

Ngày tải lên: 11/08/2014, 17:21

... (16.7%) .The difference was statistically significant with p < 0.01 3.1.2.4 .The structure of the lesions on US and CT Table 3.8 The structure of the lesion on US The structure of the lesions Number of ... clustered and scattered in the liver parenchyma 3.1.2.5 The effects of lesions to the portal veins (PV) on US and CT Table 3.9 The effects of lesions to the PV US (n = 126) CT (n = 126) P Number of ... Thus, the result of our research is also consistent with the results of other authors that most of the small lesions are concentrated on clusters with ill-defined boders 4.1.2.3 The shape of the...

Ngày tải lên: 01/07/2016, 11:15

... Following the suggestions of scientific literature on the advantages of the compactness, reliability, ease of use and affordability of the 980 nm Diode Lasers, we evaluated the efficacy and safety of ... are reduced [17,18] The lasers normally adopted offer the enormous advantage of being conveyed in a fibre, which serves as the working tip at the end of the handpiece The use of flexible, length-adjustable ... question the efficacy of the 980nm Laser for photosclerosis of lesions and areas with little melanin and hemoglobin pigmentation [7] Furthermore, to avoid exaggerated fluences and thermal damage to the...

Ngày tải lên: 26/10/2012, 09:48

... (CO2), ammonia (NH3) and methane (CH4) into the atmosphere ♦ Most of the H2O vapor condensed to form the oceans ♦ As a result of three key processes (outlined on the next slide), the air ended up ... grew much warmer, thereby preventing freezing and accelerating surface “weathering” Except for Oxygen, almost all of the Earth’s atmosphere today Evolution of the Earth Process and Equation” its ... Multi-celled organisms appeared, and some of these evolved into soft-bodied worm-like animals with a variety of organs, and still later into the first hard-shelled creatures capable of leaving fossils ♦...

Ngày tải lên: 04/04/2013, 10:51

... techniques The report then describes the recent status of each of the issues RESEARCH AND DEVELOPMENT IN INCREASING OZONE CONCENTRATION Ozone generation Method and scale of use Table summarizes the ... concentration and decomposition RESEARCH AND DEVELOPMENT IN OZONATION TECHNOLOGY Objectives of ozonation The main objectives of ozonation are to reduce trihalomethane and to remove taste and odor These ... treate the cryptosporidium parvum by chlorine disinfection, the turbidity at the exit of the sand filtration basin is set to a turbidity of 0.1 degrees or less However, this method is neither safe...

Ngày tải lên: 05/09/2013, 08:40

... proposed the necessity of city-wide recycling system and other measures The fluctuation of water consumption in this period reflects the people’s consideration on the WCP introduced The people ... relocation of large-scale factories in Tokyo such as Toyosu Gas, Ebisu Brewery, Kirin Beer and others to the outskirts of Tokyo Another major factor was the reduction of water use in the factory ... conservation They also continuously make efforts to promote the utilization of SWT devices including the distribution of free SWT-tap developed by them as shown in Fig.7 On the other hand, for triggering...

Ngày tải lên: 05/09/2013, 10:17