1/77. Choledochoduodenal fistula at the anterior wall of the duodenal bulb: a rare complication of duodenal ulcer.A 38 year-old man was admitted to our hospital with the chief complaint of epigastralgia. His laboratory data revealed leukocytosis and increased serum amylase, and abdominal ultrasonography revealed diffuse swelling of the pancreas. Thus, he was diagnosed as having acute pancreatitis. Moreover, abdominal computed tomography showed pneumobilia in the gallbladder and the common bile duct. Gastroduodenal fiberscopy demonstrated peptic ulcer scars around a foramen with smooth margins at the anterior wall of the duodenal bulb. The bile juice flowed from the bottom of the foramen. Endoscopic retrograde cholangiopancreatography revealed the fistula between the common bile duct and the anterior wall of the duodenal bulb, but not the posterior wall. However, there was no pancreatico-biliary maljunction and no stones in the gallbladder or bile duct. This is a rare case of choledochoduodenal fistula at the anterior wall of the duodenal bulb caused by duodenal peptic ulcer disease.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/77. Biliary-enteric fistulas: report of five cases and review of the literature.Internal biliary fistulas (IBF) are seen rarely. Because the symptoms and signs of IBF are not specific and the diagnosis is not suspected, these patients are commonly investigated with plain abdominal films (PAF), ultrasonography (US), upper gastrointestinal series (UGIS), barium enema (BE), and computed tomography (CT), but not always with endoscopic retrograde cholangiopancreatography (ERCP). The purposes of this article are (a) to attract attention of radiologists to presumptive findings of IBF, so as not to misdiagnose this unsuspected and rare disease, and (b) review of the literature while presenting radiologic features of our cases. Five cases of IBFs in which extrahepatic biliary tree communicating with duodenum (four cases) and colon (one case) are reported. Diagnostic work-up of cases were done by PAF, US, UGIS, BE, and CT. Aerobilia, which cannot be explained using other means, ectopic gallstone and small bowel dilatation, nonvisualization of the gallbladder despite no history of cholecystectomy, and thick-walled shrunken gallbladder adherent to neighboring organs were suggestive findings of IBF in our study. knowledge of imaging findings suggestive of IBF and a high index of suspicion increase the diagnostic rate of IBFs.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
3/77. Advanced adenosquamous carcinoma of the gallbladder with bilio-biliary fistula: an uncommon case treated by hepatopancreatoduodenectomy.A 70 year-old female, who presented with jaundice and abdominal pain, was found to have an advanced gallbladder cancer involving the liver parenchyma, duodenum, and transverse colon. This was complicated by a bilio-biliary fistula between the gallbladder and both the right and left hepatic ducts. After obtaining an accurate pre-operative diagnosis, the patient underwent hepatopancreatoduodenectomy (HPD) with lymph node dissection around the hepatic pedicle, celiac trunk, aorta, and inferior vena cava. Histologic examination revealed adenosquamous carcinoma. This rare variant accounts for 3.5% of gallbladder cancers, and is associated with a worse prognosis than adenocarcinoma. The patient is in good condition without any signs of recurrence 42 months after the HPD. In this case report, we discuss the histological type and internal biliary fistula with regard to the literature, and the usefulness of an aggressive surgical procedure such as HPD with extended lymph node dissection which can improve survival and quality of life in selected patients.- - - - - - - - - - ranking = 3.5002003803066keywords = gallbladder, cancer (Clic here for more details about this article) |
4/77. gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.- - - - - - - - - - ranking = 2.5001001901533keywords = gallbladder, cancer (Clic here for more details about this article) |
5/77. Preservative treatment for biliobiliary fistula.Biliobiliary fistula is thought to be a rare type of internal biliary fistula. A 68-year-old man presented to our hospital with complaints of jaundice and general malaise. Endoscopic retrograde cholangiography was performed, but the gallbladder was not imaged. Mirizzi's sign was observed in the common hepatic duct. During the course of evaluating this inpatient, imaging revealed that a gallstone was extruded to the right hepatic duct. After incision of the papilla, stones in the bile duct were subjected to mechanical lithotripsy and were extracted. As a result of bile duct decompression, the biliobiliary fistula was closed completely 2 months later.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
6/77. Bronchobiliary fistula after hemihepatectomy: cholangiopancreaticography, computed tomography and magnetic resonance cholangiography findings.A bronchobiliary fistula (BBF), which is defined by an abnormal communication between the biliary system and the bronchial tree, is an uncommon complication after hemihepatectomy, trauma, hydatid disease, choledocholithiasis and other causes of biliary obstruction. We report the case of a 56-year-old man with colon cancer, who developed a BBF 2 months after right hemihepatectomy for liver metastases. The findings at endoscopic retrograde cholangiopancreaticography (ERCP), computed tomography (CT) and magnetic resonance cholangiography (MRC) included a stricture of the common bile duct and biliary leakage from the liver resection plane with biliary infiltration of the right lower lobe of the lung. The patient was treated successfully by endoscopic insertion of a biliary plastic stent which bridged the stricture and lead to closure of the fistula.- - - - - - - - - - ranking = 0.00010019015328674keywords = cancer (Clic here for more details about this article) |
7/77. mirizzi syndrome. Case presentation with review of the literature.mirizzi syndrome is a rare pathology of the extrahepatic biliary system caused by a large gallbladder calculous either compressing or eroding into the collecting biliary tree. This paper describes a case of mirizzi syndrome with atypical presentation. A review of the literature including diagnostic and therapeutic modalities are reported.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
8/77. Laparoscopic treatment of cholecystocolonic fistula: report of a case preoperatively diagnosed by barium enema.The authors present a case of cholecystocolonic fistula with no specific symptoms, such as severe diarrhea or pneumobilia, preoperatively diagnosed and treated by the laparoscopic approach. A preoperative barium enema demonstrated a cholecystocolonic fistula. The fistula was divided by the laparoscopic stapling technique. Important features in the management of this case are (1) preoperative diagnosis of the fistula by barium enema carried out for screening colorectal cancer, (2) dissection of the gallbladder from its bed before division of the fistula, and (3) use of the laparoscopic stapling technique to divide the fistula while preventing fecal soilage.- - - - - - - - - - ranking = 0.50010019015329keywords = gallbladder, cancer (Clic here for more details about this article) |
9/77. Laparoscopic repair of cholecystoduodenal fistula: report of two cases.BACKGROUND: Laparoscopic surgery has become the standard of care for benign gallbladder disease. patients AND methods: We treated two middle-aged women having acute exacerbations of chronic gallbladder disease with laparoscopic cholecystectomy. A cholecystoduodenal fistula was diagnosed intraoperatively in each case. These fistulae were repaired laparoscopically using an endoscopic stapling device without complication. RESULTS: Each patient did well postoperatively and was discharged to home on the second postoperative day in good condition. CONCLUSIONS: Biliary-enteric fistula is a known complication of chronic gallbladder disease that is traditionally considered a contraindication to laparoscopic cholecystectomy. However, we believe laparoscopic repair to be a safe and effective approach in the hands of surgeons with significant laparoscopic experience.- - - - - - - - - - ranking = 1.5keywords = gallbladder (Clic here for more details about this article) |
10/77. Biliopancreatic fistula associated with intraductal papillary-mucinous pancreatic cancer: institutional experience and review of the literature.Intraductal papillary-mucinous tumour is clinicopathologically characterized by papillary growth and mucin production within the pancreatic duct system. The category includes a wide range of dysplasia, ranging from adenoma to carcinoma, the latter designated as intraductal papillary-mucinous cancer. In general, the tumor renders a favorable prognosis after complete resection. However, intraductal papillary-mucinous tumor with overt invasion outside the gland has been reported to have a poor prognosis, as is the case with the usual type of duct cell cancer of the pancreas. We experienced two cases of intraductal papillary-mucinous cancer with obstructive jaundice due to impaction of thick mucus protruding from the pancreas via a "spontaneous" biliopancreatic fistula. Preoperative examinations of both patients showed a large intraductal papillary-mucinous tumor in the head of the pancreas with fistula formation between the intrapancreatic portion of the common bile duct and the main pancreatic duct. Histopathological investigation of the two resected specimens suggested that the fistula may not have developed from invasion by papillary or tubular adenocarcinoma, but from compression and destruction of the intercalating tissues by abundant mucinous secretion. The first patient died of peritoneal carcinomatosis with clinicopathologic features of pseudomyxoma peritonei 6 years after surgery. The second patient is alive and has been well for 2 years postoperatively. review of the world literature showed that half of the patients with intraductal papillary-mucinous cancer plus biliopancreatic fistula had no stromal invasion around the fistula, indicating that the fistula might have been caused by mechanical pressure. However, the other half of the cases did have stromal invasion around the fistula. Two-thirds of these cases, including our own patients, had foci of mucinous carcinoma in the stroma around the fistulization, implying that mucinous lakes in the stroma may have served as part of the "waterway" from the pancreatic duct to the bile duct, assisted by increased pressure by mucus production. Since intraductal papillary-mucinous cancer with biliopancreatic fistula has a comparatively favorable prognosis, surgical resection should be considered.- - - - - - - - - - ranking = 0.00090171137958063keywords = cancer (Clic here for more details about this article) |
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