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Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867.
Bile from the gallbladder is carried to the CBD and emptied into the duodenum. CBD drainage might be obstructed due to distal CBD stricture, which is narrowing of the CBD due to the presence of scar tissue within the duct, and choledocholithiasis, the presence of gallstones. Obstruction can occur when gallstones may be too large to pass through ...
Mayo Clinic is a nonprofit hospital system with campuses in Rochester, Minnesota; Scottsdale and Phoenix, Arizona; and Jacksonville, Florida. [22] [23] Mayo Clinic employs 76,000 people, including more than 7,300 physicians and clinical residents and over 66,000 allied health staff, as of 2022. [5]
Although they may not drain any liver parenchyma, they can be a source of a bile leak or biliary peritonitis after cholecystectomy in both adults and children. If an accessory bile duct goes unrecognized at the time of the gallbladder removal, 5–7 days post-operative the patient will develop bile peritonitis, [10] an easily treatable complication with a morbidity rate of 44% if left untreated.
A surgically created passage between the common bile duct and the jejunum in a procedure called a choledochojejunostomy, can be carried out to relieve the symptoms of biliary obstruction as well as allows the bile duct to drain. [5] In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.
The minor papilla drains the duct of Santorini, superior in position to the major papilla. In pancreatic divisum, in which the minor papilla drains the bulk of pancreatic secretions and major drains a minority of secretions (opposite of normal), a Santorinicele may develop leading to obstructed secretions/reflux resulting in pancreatitis.
It is formed by the union of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver). [3] The duct is about 3 cm long. [4] The common hepatic duct is about 6 mm in diameter in adults, with some variation. [5]
The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. [4]Its proximal supraduodenal part is situated within the free edge of the lesser omentum.Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava.