Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition


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Prevention of Fascioliasis. Transitory elimination after arrival to Denmark]. Hepatic fascioliasis and biliary surgery. Choutet P: Successful treatment of acute fascioliasis with Bithionol. Dytoc JNT: Clonorchis-associated cholangiocarcinoma: A report of two cases with unusual manifestations. FV Ona. Modern techniques in the diagnosis and treatment of gastrointestinal and biliary tree parasites. Clonorchiasis of the pancreas.

Jihe Lim , Young Tae Ko. However, tests commonly performed to diagnose many bile duct disorders may include:.

What is a bile duct obstruction?

Biliary disorders due to gallstones may be prevented by having the gallbladder surgically removed. The formation of gallstones may also be prevented by eating a well-balanced diet, maintaining a healthy weight and exercising regularly. Biliary Disease. Risk factors Heredity, increasing age, obesity, a high-fat diet, certain gastrointestinal conditions and certain prescription medications may increase the risk of developing biliary disease.

Symptoms of possible biliary disease Although symptoms may differ among bile duct disorders, symptoms common to many of the disorders include: Jaundice yellowing of the skin and whites of the eyes Abdominal pain, especially in the upper right side of the abdomen under the rib cage Nausea or vomiting Loss of appetite, which may result in weight loss Fatigue Fever or chills Itching Light brown urine Greasy or clay-colored stools Detection and diagnosis The tests performed vary according to the suspected bile duct disorder.

Produced by the liver, bile flows through small vessels into the larger hepatic ducts and ultimately through the cystic duct parts of the biliary tree into the gallbladder, where it is stored. At any one time, 30 to 60 millilitres 1. When food containing fat enters the digestive tract , it stimulates the secretion of cholecystokinin CCK from I cells of the duodenum and jejunum.

In response to cholecystokinin, the gallbladder rhythmically contracts and releases its contents into the common bile duct , eventually draining into the duodenum.

The bile emulsifies fats in partly digested food, thereby assisting their absorption. Bile consists primarily of water and bile salts , and also acts as a means of eliminating bilirubin , a product of hemoglobin metabolism, from the body. The bile that is secreted by the liver and stored in the gallbladder is not the same as the bile that is secreted by the gallbladder.

During gallbladder storage of bile, it is concentrated fold [16] by removal of some water and electrolytes.

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This is through the active transport of sodium and chloride ions [17] across the epithelium of the gallbladder, which creates an osmotic pressure that also causes water and other electrolytes to be reabsorbed. Gallstones form when the bile is saturated , usually with either cholesterol or bilirubin. If the stone lodges in the biliary system, jaundice may occur; and if the stone blocks the pancreatic duct , then pancreatitis may occur. Known as cholecystitis , inflammation of the gallbladder is commonly caused by obstruction of the duct with gallstones, which is known as cholelithiasis.

Gallbladder attack

Blocked bile accumulates, and pressure on the gallbladder wall, may lead to the release of substances that cause inflammation, such as phospholipase. There is also the risk of bacterial infection. An inflamed gallbladder is likely to cause pain and fever, and tenderness in the upper, right corner of the abdomen, and may have a positive Murphy's sign. Cholecystitis is often managed with rest and antibiotics, particularly cephalosporins and, in severe cases, metronidazole. A cholecystectomy is a procedure in which the gallbladder is removed.

It may be removed because of recurrent gallstones, and is considered an elective procedure. A cholecystectomy may be an open procedure, or one conducted by laparoscopy. In the surgery, the gallbladder is removed from the neck to the fundus, [20] and so bile will drain directly from the liver into the biliary tree. About 30 percent of patients may experience some degree of indigestion following the procedure, although severe complications are much rarer.

Biliary injury bile duct injury is the traumatic damage of the bile ducts. It is most commonly an iatrogenic complication of cholecystectomy — surgical removal of gall bladder , but can also be caused by other operations or by major trauma. The risk of biliary injury is more during laparoscopic cholecystectomy than during open cholecystectomy.

Biliary injury may lead to several complications and may even cause death if not diagnosed in time and managed properly. Ideally biliary injury should be managed at a center with facilities and expertise in endoscopy , radiology and surgery.


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  • Overview of Gallbladder and Bile Duct Disorders.

Biloma is collection of bile within the abdominal cavity. It happens when there is a bile leak, for example after surgery for removing the gallbladder laparoscopic cholecystectomy , with an incidence of 0. Other causes are biliary surgery, liver biopsy , abdominal trauma , and, rarely, spontaneous perforation. Cancer of the gallbladder is uncommon and mostly occurs in later life. When cancer occurs, it is mostly of the glands lining the surface of the gallbladder adenocarcinoma. Cancer of the gallbladder can cause attacks of biliary pain, yellowing of the skin jaundice , and weight loss.

A large gallbladder may be able to be felt in the abdomen. Liver function tests may be elevated, particularly involving GGT and ALP , with ultrasound and CT scans being considered medical imaging investigations of choice. Tests used to investigate for gallbladder disease include blood tests and medical imaging.

A full blood count may reveal an increased white cell count suggestive of inflammation or infection. Tests such as bilirubin and liver function tests may reveal if there is inflammation linked to the biliary tree or gallbladder, and whether this is associated with inflammation of the liver, and a lipase or amylase may be elevated if there is pancreatitis.

Gallbladder Disease: Overview, Types, and Diagnosis

Bilirubin may rise when there is obstruction of the flow of bile. A CA level may be taken to investigate for cholangiocarcinoma. Ultrasound is often the first medical imaging test performed when gallbladder disease such as gallstones are suspected. To have 'gall' is associated with bold behaviour, whereas to have 'bile' is associated with bitterness. In the Zangfu theory of Chinese medicine , the gallbladder not only has a digestive role, but is seen as the seat of decision-making. Most vertebrates have gallbladders, but the form and arrangement of the bile ducts may vary considerably.

In many species, for example, there are several separate ducts running to the intestine, rather than the single common bile duct found in humans. Several species of mammals including horses , deer , rats , and laminoids , [29] [30] several species of birds , lampreys and all invertebrates lack a gallbladder altogether.

Biliary parasites.

The bile from several species of bears is used in traditional Chinese medicine ; bile bears are kept alive in captivity while their bile is painfully extracted, in an industry characterized by animal cruelty. Depictions of the gallbladder and biliary tree are found in Babylonian models found from BCE, and in ancient Etruscan model from BCE, with models associated with divine worship.

Diseases of the Gallbladder

Diseases of the gallbladder have been recorded in humans since antiquity, with gallstones found in the mummy of Princess Amenen of Thebes dating to BCE. The first descriptions of gallstones appear to have been in the Renaissance , perhaps because of the low incidence of gallstones in earlier times owing to a diet with more cereals and vegetables, and less meat. The first surgical removal of a gallstone cholecystolithotomy was in by physician Joenisius, who removed the stones from a spontaneously occurring biliary fistula.


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The debate whether surgical removal of the gallbladder or simply gallstones was preferred was settled in the s, with consensus that removal of the gallbladder was preferred. From Wikipedia, the free encyclopedia. This is the latest accepted revision , reviewed on 20 September Gallbladder The gallbladder sits beneath the liver.

Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition
Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition
Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition
Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition
Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment, Second Edition

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