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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]
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 drainage catheter is then removed over the guidewire and sheath is inserted into the ducts (7 to 8 French size). Contrast is then injected through the sheath to identify any stones or strictures. If a stricture is identified, put in biliary manipulation catheter with guidewire measuring 0.035 inches and commence balloon dilatation (with ...
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 ...
The rest of the gallbladder drains into 1-2 small cystic veins which then usually empty into either the hepatic portal vein within the liver, or [1] into tributaries of the hepatic portal venous system that drain either the proximal bile duct or hepatic ducts; [1] [2] rarely, one or more cystic vein(s) drain(s) into the right branch of the ...
The cystic lymph node is situated at the neck of the gallbladder. [2] [4] It is invariably situated lateral to the biliary tree. [9] The node receives lymphatic drainage from the gallbladder, cystic duct, hepatic duct, and the superior portion of the common bile duct. [10] It in turn drains lymph into the hepatic lymph nodes. [2] [4]
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.
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.
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