Benign biliary disease and biliary injury- biliary physiology, pathology, presentation and management

Biliary anatomy. Common variants:TrifurcationRight anterior or posterior hepatic duct branches from common duct Cystic duct is variable in its course, may join right hepatic duct. Biliary anatomy. Biliary anatomy. Cystic artery is usually a branch of the R hepatic. Biliary histology. Layers of gallbladder:Epithelium (columnar)Lamina propriaSmooth muscleSubserosal connective tissueSerosaNo submucosa or muscularis mucosa!.

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Management of Biliary Disorders

Cholecystitis. Acute inflammation of the gallbladderCauses:90% gallstones. Cholelithiasis-- Overview. Presence of one or more gallstonesStones form when bile hardens Abnormal metabolism of cholesterol/bile saltsEtiology:Familial tendencyDietary habitsSedentary lifestyleImpaired fat metabolismIncreased cholesterol.

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Biliary Pancreatitis

Study

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Complications of biliary surgery

Complications of biliary surgery. Aswad Habeeb Hameed Al-Obeidy FICMS GE & Hep. Complications of biliary surgery. Include strictures, bile leaks, and sump syndrome The initial management of suspected bile duct injury must begin with diagnostic cholangiography

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Biliary Atresia

Kimberley Chien , MD Mercedes Martinez, MD Morgan Stanley Children’s Hospital of New York Reviewed by Melissa Jensen, MD of the Professional Education Committee. Biliary Atresia. Cases. 2 month old female referred by PMD presents with persistent jaundice

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Laparoscopic Cholecystectomy in Acalculous Biliary Disease

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Biliary Disease

Biliary Disease. Gallbladder and Biliary Tree. Imaging Studies Available X-ray Computed tomography Radioisotope scan ( hepatobiliary scan) Ultrasound: the most sensitive study for gallstone. Gallstones. 81% consist of cholesterol and are radiolucent ( cannot be seen on plain films)

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Biliary System

Biliary System. Objectives. At the end of the lecture, the student should be able to describe the: Location, surface anatomy, parts, relations & peritoneal reflection of the gall bladder. Blood supply, nerve supply and lymphatic drainage of gall bladder.

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Benign biliary disease

Benign biliary disease. Dr. Gili Halfteck Department of General Surgury Shaare Zedek Medical Center January 2014. Anatomy. Calot’s triangle. Physiology. Roles of bile secretion: Excretion of toxins and cellular metabolites ( bilirubin ) Lipids absorption Components of bile:

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Types of Biliary Atresia

Types of Biliary Atresia. Biliary Atresia. is a condition in which the normal extrahepatic biliary system is disrupted progressive damage of extrahepatic and intrahepatic bile ducts secondary to inflammation may occur, leading to fibrosis, biliary cirrhosis, and eventual liver failure

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Treatment of Biliary Cancers

Treatment of Biliary Cancers. Abby B. Siegel, MD, MS Columbia University Co-Chair, SWOG Hepatobiliary Committee NCI Task Force, Hepatobiliary Cancers. Biliary Anatomy. Adapted from De Groen et al, NEJM 1999 Oct 28;341(18):1368-78 .

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Biliary Tract Disease

Dr Julia Epstein Gastroenterology department Hadassah Medical center. Biliary Tract Disease. Biliary disease. Gallstones Congenital anomalies Extrinsic compression of the bile ducts Hepatobiliary parasitism Noncancerous strictures. Biliary tract anatomy. Ampullary anatomy.

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Pancreatic and biliary disease

Pancreatic and biliary disease. Intrahepatic cholestasis of pregnancy. Presents with sometimes intense pruritis Functional disorder of bile secretion ALP mod high, Bili high, Transaminases <200, NORMAL FUNCTIONAL TESTS, NORMAL PLTS, NORMAL COAGS

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Biliary Atresia

Biliary Atresia. Introduction. A cholangiodestructive disease affecting all parts of biliary tract. Untreated :cirrhosis,liver failure and death. Epidemiology. 1 in 10,000 – Japan and China 1 in 17,000 – UK, USA, and Europe F > M. Etiology. The cause of BA is not known Hypotheses

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Biliary System

Biliary System. Dr. Mahvash Khan. Biliary System. Includes Liver Gallbladder Ducts. Liver is the largest organ in the body Liver Has Very High Lymph Flow (half of the lymph formed in the body under resting conditions)

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Biliary Pathology

Biliary Pathology. Liver. Biliary tree. Gallbladder. RPC. Acute cholecystitis Empyema of gallbladder Mucoceal of gallbladder. Cholangitis. Pancreatitis. Biliary Patholgy. History and Examination Previous biliary surgery Previous history of biliary pathology Epigastic / RUQ pain

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BILIARY MALIGNANCIES

BILIARY MALIGNANCIES. Dr Sanjay De Bakshi MS(Cal.);FRCS (Eng Edin.). GALL BLADDER CANCER -Incidence. States of Uttar Pradesh, Bihar, West Bengal & Assam Delhi Madhya Pradesh; Bhopal have the highest incidence of Gall Bladder Cancer. AETIOLOGY.

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Biliary Imaging

Biliary Imaging. Ian Scharrer, MIV November 16, 2005. Clinical Scenario. A 46 year old woman presents to the clinic complaining of epigastric pain that she experiences after eating a large meal.

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Disorders of Biliary System

Disorders of Biliary System, Cholecystitis, Gall stones.

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Disease of the Liver and Biliary Tract

Disease of the Liver and Biliary Tract. General Surgery Department dr Sigid Djuniawan, SpB. LIVER. HEPATIC TRAUMA PENETRATING, BLUNT Liver injury scale Clinical : hypovolemic shock (hypotension, decreased urinary output, low cvp) Imaging : Ct scan, FAST Treatment : surgery

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