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Extrahepatic Biliary Tract and Gallbladder

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Cognitive Pearls in General Surgery

Abstract

This chapter discusses the embryologic origin and anatomy of the biliary structures. Explanations regarding biliary anatomy as it pertains to cholecystectomy are provided. The physiology of the biliary tree is discussed, as it applies to the clinical presentation of biliary disease and surgical findings. The general principles of biliary reconstruction and the management of biliary cancer are covered.

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References

  1. Noto M, Miwa K, Kitagawa H, et al. Pancreas head carcinoma: frequency of invasion to soft tissue adherent to the superior mesenteric artery. Am J Surg Pathol. 2005;29:1056–61.

    PubMed  Google Scholar 

  2. Bergamaschi R, Ignjatovic D. More than two structures in Calot’s triangle. A postmortem study. Surg Endosc. 2000;14:354–7.

    Article  CAS  PubMed  Google Scholar 

  3. Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220:50–2.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Neilan RE, Groce JR, Jalil S, Raju GS. White bile (with video). Gastrointest Endosc. 2007;66:180–1; discussion 181.

    Article  PubMed  Google Scholar 

  5. Hashmonai M, Kam I, Schramek A. The etiology of “white bile” in the biliary tree. J Surg Res. 1984;37:479–86.

    Article  CAS  PubMed  Google Scholar 

  6. Munoz C, Fernandez M, Brahm J. Traumatic hemobilia: a case report and literature review. Gastroenterol Hepatol. 2008;31:79–81.

    Article  PubMed  Google Scholar 

  7. Massoumi H, Kiyici N, Hertan H. Bile leak after laparoscopic cholecystectomy. J Clin Gastroenterol. 2007;41:301–5.

    Article  PubMed  Google Scholar 

  8. Singh B, Ramsaroop L, Allopi L, Moodley J, Satyapal KS. Duplicate gallbladder: an unusual case report. Surg Radiol Anat. 2006;28:654–7.

    Article  CAS  PubMed  Google Scholar 

  9. Dhulkotia A, Kumar S, Kabra V, Shukla H. Aberrant gallbladder situated beneath the left lobe of liver. HPB (Oxford). 2002;4:39–42.

    Article  CAS  Google Scholar 

  10. Blanton DE, Bream CA, Mandel SR. Gallbladder ectopia. A review of anomalies of position. Am J Roentgenol Radium Ther Nucl Med. 1974;121:396–400.

    Article  CAS  PubMed  Google Scholar 

  11. de Csepel J, Carroccio A, Pomp A. Soft-tissue images. “Phrygian cap” gallbladder. Can J Surg. 2003;46:50–1.

    PubMed Central  PubMed  Google Scholar 

  12. Freeman ME, Rose JL, Forsmark CE, Vauthey J. Mirizzi syndrome: a rare cause of obstructive jaundice. Dig Dis. 1999;17:44–8.

    Article  CAS  PubMed  Google Scholar 

  13. Kochar K, Vallance K, Mathew G, Jadhav V. Intrahepatic perforation of the gall bladder presenting as liver abscess: case report, review of literature and Niemeier’s classification. Eur J Gastroenterol Hepatol. 2008;20:240–4.

    Article  PubMed  Google Scholar 

  14. Franko J, Nussbaum ML, Morris JB. Choledochal cyst cholangiocarcinoma arising from adenoma: case report and a review of the literature. Curr Surg. 2006;63:281–4.

    Article  PubMed  Google Scholar 

  15. Okada A, Hasegawa T, Oguchi Y, Nakamura T. Recent advances in pathophysiology and surgical treatment of congenital dilatation of the bile duct. J Hepatobiliary Pancreat Surg. 2002;9:342–51.

    Article  PubMed  Google Scholar 

  16. Edil BH, Cameron JL, Reddy S, et al. Choledochal cyst disease in children and adults: a 30-year single-institution experience. J Am Coll Surg. 2008;206:1000–5; discussion 1005–8.

    Article  PubMed  Google Scholar 

  17. Iwai N, Yanagihara J, Tokiwa K, Shimotake T, Nakamura K. Congenital choledochal dilatation with emphasis on pathophysiology of the biliary tract. Ann Surg. 1992;215:27–30.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Lipsett PA, Pitt HA, Colombani PM, Boitnott JK, Cameron JL. Choledochal cyst disease. A changing pattern of presentation. Ann Surg. 1994;220:644–52.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Visser BC, Suh I, Way LW, Kang SM. Congenital choledochal cysts in adults. Arch Surg. 2004;139:855–60; discussion 860–2.

    Article  PubMed  Google Scholar 

  20. Vakili K, Pomfret EA. Biliary anatomy and embryology. Surg Clin North Am. 2008;88:1159–74.

    Article  PubMed  Google Scholar 

  21. Ohkubo M, Nagino M, Kamiya J, et al. Surgical anatomy of the bile ducts at the hepatic hilum as applied to living donor liver transplantation. Ann Surg. 2004;239:82–6.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Zheng S, Luo Y, Wang W, Xiao X. Analysis of the pathomorphology of the intra- and extrahepatic biliary system in biliary atresia. Eur J Pediatr Surg. 2008;18:98–102.

    Article  CAS  PubMed  Google Scholar 

  23. Bates MD, Bucuvalas JC, Alonso MH, Ryckman FC. Biliary atresia: pathogenesis and treatment. Semin Liver Dis. 1998;18:281–93.

    Article  CAS  PubMed  Google Scholar 

  24. Bassett MD, Murray KF. Biliary atresia: recent progress. J Clin Gastroenterol. 2008;42:720–9.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Caroli-Bosc FX, Pugliese P, Peten EP, et al. Gallbladder volume in adults and its relationship to age, sex, body mass index, body surface area and gallstones. An epidemiologic study in a nonselected population in France. Digestion. 1999;60:344–8.

    Article  CAS  PubMed  Google Scholar 

  26. O’Donnell LJ, Fairclough PD. Gall stones and gall bladder motility. Gut. 1993;34:440–3.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Wood JR, Svanvik J. Gall-bladder water and electrolyte transport and its regulation. Gut. 1983;24:579–93.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Jahan M, Xiao P, Go A, Cheema M, Hameed A. Intraductal and invasive adenocarcinoma of duct of Luschka, mimicking chronic cholecystitis and cholelithiasis. World J Surg Oncol. 2009;7:4.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Ko K, Kamiya J, Nagino M, et al. A study of the subvesical bile duct (duct of Luschka) in resected liver specimens. World J Surg. 2006;30:1316–20.

    Article  PubMed  Google Scholar 

  30. Terada T. Gallbladder adenocarcinoma arising in Rokitansky-Aschoff sinus. Pathol Int. 2008;58:806–9.

    Article  PubMed  Google Scholar 

  31. Warshauer D, Scott G, Gottschalk A. Focal acute acalculous cholecystitis. AJR Am J Roentgenol. 1987;149:505–6.

    Article  CAS  PubMed  Google Scholar 

  32. van Eijck FC, van Veen RN, Kleinrensink GJ, Lange JF. Hartmann’s gallbladder pouch revisited 60 years later. Surg Endosc. 2007;21:1122–5.

    Article  PubMed  Google Scholar 

  33. Dasgupta D, Stringer MD. Cystic duct and Heister’s “valves”. Clin Anat. 2005;18:81–7.

    Article  CAS  PubMed  Google Scholar 

  34. Ooi RC, Luo XY, Chin SB, Johnson AG, Bird NC. The flow of bile in the human cystic duct. J Biomech. 2004;37:1913–22.

    Article  CAS  PubMed  Google Scholar 

  35. Ko CW, Lee SP. Gallstone formation. Local factors. Gastroenterol Clin North Am. 1999;28:99–115.

    Article  CAS  PubMed  Google Scholar 

  36. Madden JL. Primary common bile duct stones. World J Surg. 1978;2:465–71.

    Article  CAS  PubMed  Google Scholar 

  37. Saharia PC, Zuidema GD, Cameron JL. Primary common duct stones. Ann Surg. 1977;185:598–604.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Ariche A, Czeiger D, Gortzak Y, Shaked G, Shelef I, Levy I. Gastric outlet obstruction by gallstone: Bouveret syndrome. Scand J Gastroenterol. 2000;35:781–3.

    Article  CAS  PubMed  Google Scholar 

  39. O’Neill C, Colquhoun P, Schlachta CM, Etemad-Rezai R, Jayaraman S. Gastric outlet obstruction secondary to biliary calculi: 2 cases of Bouveret syndrome. Can J Surg. 2009;52:E16–8.

    PubMed Central  PubMed  Google Scholar 

  40. Zaliekas J, Munson JL. Complications of gallstones: the Mirizzi syndrome, gallstone ileus, gallstone pancreatitis, complications of “lost” gallstones. Surg Clin North Am. 2008;88:1345–68.

    Article  PubMed  Google Scholar 

  41. Strasberg SM. Avoidance of biliary injury during laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg. 2002;9:543–7.

    Article  PubMed  Google Scholar 

  42. McPartland KJ, Pomposelli JJ. Iatrogenic biliary injuries: classification, identification, and management. Surg Clin North Am. 2008;88:1329–43.

    Article  PubMed  Google Scholar 

  43. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25:1241–4.

    Article  CAS  PubMed  Google Scholar 

  44. Tsalis K, Zacharakis E, Vasiliadis K, et al. Bile duct injuries during laparoscopic cholecystectomy: management and outcome. Am Surg. 2005;71:1060–5.

    PubMed  Google Scholar 

  45. Gordon FD. Primary sclerosing cholangitis. Surg Clin North Am. 2008;88:1385–407.

    Article  PubMed  Google Scholar 

  46. Attasaranya S, Fogel EL, Lehman GA. Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Med Clin North Am. 2008;92:925–60.

    Article  PubMed  Google Scholar 

  47. Lim JH. Oriental cholangiohepatitis: pathologic, clinical, and radiologic features. AJR Am J Roentgenol. 1991;157:1–8.

    Article  CAS  PubMed  Google Scholar 

  48. Thinh NC, Breda Y, Faucompret S, Farthouat P. Louis C [Oriental biliary lithiasis. Retrospective study of 690 patients treated surgically over 8 years at Hospital 108 in Hanoi (Vietnam)]. Med Trop (Mars). 2001;61:509–11.

    CAS  Google Scholar 

  49. Maker AV, Butte JM, Oxenberg J, et al. Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol. 2012;19:409–17.

    Google Scholar 

  50. Brown KM. Multidisciplinary approach to tumors of the pancreas and biliary tree. Surg Clin North Am. 2009;89:115–31.

    Article  PubMed  Google Scholar 

  51. Lai CH, Lau WY. Gallbladder cancer–a comprehensive review. Surgeon. 2008;6:101–10.

    Article  PubMed  Google Scholar 

  52. Misra S, Chaturvedi A, Misra NC, Sharma ID. Carcinoma of the gallbladder. Lancet Oncol. 2003;4:167–76.

    Article  PubMed  Google Scholar 

  53. Mashima H. Studies on pruritus in obstructive jaundice cases with special references to serum bile acid fractions. Fukuoka Igaku Zasshi. 1991;82:445–57.

    CAS  PubMed  Google Scholar 

  54. Ustundag Y, Bayraktar Y. Cholangiocarcinoma: a compact review of the literature. World J Gastroenterol. 2008;14:6458–66.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Akoad M, Jenkins R. Proximal biliary malignancy. Surg Clin North Am. 2008;88:1409–28.

    Article  PubMed  Google Scholar 

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Maker, V.K., Guzman-Arrieta, E.D. (2015). Extrahepatic Biliary Tract and Gallbladder. In: Cognitive Pearls in General Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1850-8_17

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  • DOI: https://doi.org/10.1007/978-1-4939-1850-8_17

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1849-2

  • Online ISBN: 978-1-4939-1850-8

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