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Finally, an 8 French pigtail catheter or larger (if indicated) is inserted over the guide wire. Once the pigtail is visualized to be securely lodged into the gallbladder, the guide wire is removed and a gravity drain is attached to the catheter. The Seldinger technique allows for a smaller needle size, which decreases perforation risk. [9]
A hepatoportoenterostomy or Kasai portoenterostomy is a surgical treatment performed on infants with Type IVb choledochal cyst and biliary atresia to allow for bile drainage. In these infants, the bile is not able to drain normally from the small bile ducts within the liver into the larger bile ducts that connect to the gall bladder and small ...
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.
The wire exits the catheter approximately 3 cm before its distal end and re-enters the catheter approximately 3 mm from its tip. When tension is applied to the wire, the distal portion of the catheter becomes curved so that the exposed wire is brought upwards into contact with the biliary sphincter and papilla, away from the catheter. [1]
The common hepatic duct is the first part of the biliary tract. [2] 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]
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 ...
Percutaneous transhepatic biliary drainage (PTBD) is often performed if endoscopic retrograde biliary drainage (ERBD) is unsuccessful for biliary obstructions due to hepatocellular carcinoma. ERBD is the first line treatment because of its low bleeding risk.
Cholescintigraphic scanning is a nuclear medicine procedure to evaluate the health and function of the gallbladder and biliary system. A radioactive tracer is injected through any accessible vein and then allowed to circulate to the liver and starts accumulating in the gall bladder which can take up to an hour.