1/6. Bile duct of Luschka leading to bile leak after cholecystectomy--revisiting the biliary anatomy.bile ducts of Luschka (also called supravesicular ducts) are small bile ducts in the gallbladder bed. Although they do not drain any liver parenchyma, they can be a source of bile leak or biliary peritonitis after cholecystectomy in both adults and children, as shown in this case report. As a reminder, variations of biliary anatomy in the gallbladder bed and cholecysto-hepatic triangle of Calot, are reviewed.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/6. Laparoscopic excision of a triple gallbladder.Triplication of the gallbladder is a rare congenital anomaly of the biliary tract; there are only nine reported cases to date. We report a case in which laparoscopic cholecystectomy was performed in a patient with biliary colic and choledocholithiasis. Preoperative assessment with ultrasound and endoscopic retrograde cholangiopancreatography (ERCP) failed to reveal the eventual findings of a triple gallbladder. Successful excision of the triple gallbladder was carried out laparoscopically, and the final diagnosis was confirmed by the pathologist. The patient made an uneventful postoperative recovery and was free of gastrointestinal symptoms at follow-up. This case report describes the first laparoscopic excision of a triple gallbladder and highlights the importance of pre-/perioperative imaging to allow for the safe dissection of rare anomalies of the biliary tract via the laparoscopic approach.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
3/6. Oral contrast-enhanced CT cholangiography--an initial experience.OBJECTIVE: To describe our experience of CT (Computed tomographic) cholangiography examination for detection of choledocholithiasis at the Aga Khan University Hospital (AKUH) Karachi pakistan. methods: Seven patients underwent helical CT cholangiography for suspected choledocholithiasis. iopanoic acid (6 grams) was administered orally 8-12 hours before acquisition of a helical CT cholangiogram. Three-dimensional reconstructions and curved multiplanar reformations were generated from a set of axial source images. RESULTS: Our patients had no adverse reactions to iopanoic acid. The degree of biliary opacification was sufficient to perform three-dimensional and curved planar reformations in 5 patients. In two patients, the biliary tree was not opacified. Both of these studies were considered failures. Findings on CT cholangiography in the remaining 5 patients were the following: cholelithiasis with normal bile duct (n=2), choledocholithiasis (n=1), stone in gallbladder remnant with long cystic duct (n=1) and infiltrating adenocarcinoma of the gallbladder (n=1). CONCLUSION: Spiral CT cholangiography is a safe, non-invasive, and cost effective alternative test and, in a carefully selected patient population can play a role in the diagnostic work-up of patients with suspected choledocholithiasis.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
4/6. Laparoscopic exploration of the common bile duct in a patient with situs inversus totalis.situs inversus totalis (SIT) is a rare anomaly that can present technical difficulties during laparoscopic surgery. We report the first case of a combination of SIT and choledocholithiasis in a patient who was treated successfully with a laparoscopic exploration of the common bile duct (CBD). The chest x-ray showed a right-sided heart. An abdominal ultrasound and computerized tomography scan diagnosed the CBD and gallbladder stones as well as the SIT, with the liver and gallbladder on the left side, and the spleen on the right. The surgical techniques were modified in a mirror image fashion in order to provide access to the left upper quadrant. The surgeon and the camera assistant stood on the patient's right side, and the first assistant stood on the left. The ports were introduced in a mirror image of the conventional setup. The SIT was confirmed using a telescope via an umbilical incision. A laparoscopic exploration of the CBD with a cholecystectomy was carried out successfully. The postoperative course was uneventful. This report shows that a CBD stone in a patient with SIT can be treated safely using laparoscopic surgery.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
5/6. A pseudoepidermoid cyst arising from exuberant squamous metaplasia of the gallbladder.Squamous lesions of the gallbladder are uncommon. We report a case of a pseudoepidermoid cyst in a middle-aged woman arising on a background of chronic cholecystitis and cholelithiasis, which induced exuberant squamous metaplasia of the entire gallbladder mucosa, clinically mimicking a gallbladder tumor. To our knowledge, this is the first such reported case in the English literature.- - - - - - - - - - ranking = 3.5keywords = gallbladder (Clic here for more details about this article) |
6/6. Agenesis of the gallbladder with primary choledochal stones.OBJECTIVE: To report a case of true agenesis of the gallbladder (GB) with obstructive jaundice due to primary choledochal stone. CLINICAL PRESENTATION AND INTERVENTION: A 66-year-old woman presented with a full picture of obstructive jaundice, both clinically and biochemically. Ultrasound and endoscopic retrograde cholangiopancreatography failed to show the GB but showed dilatation of extrahepatic ducts with a stone in the common bile duct (CBD). Upon exploration, the GB was found to be absent and through a choledochotomy, the stone in the CBD was removed. CONCLUSION: This case shows that proper exploratory laparotomy and intraoperative cholangiography may be required to confirm absence of the GB.- - - - - - - - - - ranking = 2.5keywords = gallbladder (Clic here for more details about this article) |