We describe an adenosquamous carcinoma of the gallbladder in a 40 year old male presenting with obstructive jaundice secondary to a bile duct stricture. The bile duct adjacent to the gallbladder was involved solely with adenocarcinoma and this was confirmed with immunohistochemistry using antibodies to ca 19.9. ca 125 and CEA. We postulate that only the adenocarcinoma component of the primary t...

Rupture of hydatid liver cyst into biliary tree is frequent complications that involvethe common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient ...

BACKGROUND/AIMS Common bile duct stones are associated with the extent of dilation of the common bile duct as well as its angulation. Multidetector computed tomography (MD CT) has a good resolution for the definition of the anatomical features of the common bile duct. METHODS The multiplanar reformation images of 398 patients that underwent multidetector CT for the diagnosis of disorders not ...

BACKGROUND The long term outcome of endoscopic papillotomy (EPT) is not well known. The aims of this study were to clarify the clinical course of post-EPT patients and to detect predictors for bile duct stone recurrence. METHODS A total of 1042 consecutive patients who underwent EPT for bile duct stones from December 1975 to September 1998 were prospectively followed up. Patients were divided...

I like to thank the AAST and President Cioffi for the great honor to present this Master Surgeon Lecture. On this date, I must acknowledge that it is September 11, and we need to take a moment of silence for our fallen colleagues and countrymen on that day. My topic today is, ‘‘Acute Cholecystitis: When to Operate and How to Do It Safely.’’ The obvious question is why did I select such a mundan...

Biliary type liver fibrosis develops as part of the wound healing response to bile duct injury in chronic cholestatic liver diseases. The origin of myofibroblasts accumulating together with extracellular matrix around proliferating bile duct structures (referred to as ductular reaction) in the setting of cholestatic injury, has been investigated mostly in the rat bile duct ligation model. Evide...

It is unknown why some patients with inflammatory bowel disease develop primary sclerosing cholangitis. We have recently shown that patients with primary sclerosing cholangitis have an increased prevalence of mutations in the gene responsible for cystic fibrosis (CFTR) compared with individuals with inflammatory bowel disease alone. Our aim was to examine whether induction of colitis by oral de...

BACKGROUND To distinguish cholangiocarcinoma from inflammatory disease remains difficult when stricture is present in the bile duct. Endoscopic brushing cytology is a convenient method for stricture in the bile duct, however, the diagnostic sensitivity of this method for malignancy is reported to be low (<60%). Msh homeobox 2 is frequently expressed in carcinoma cells of epithelial origin but n...

BACKGROUND AND OBJECTIVES Previously, risk factors for bile duct injury have been identified as acute cholecystitis, male gender, older age, aberrant biliary anatomy, and laparoscopic cholecystectomy. METHODS A retrospective analysis of the Nationwide Inpatient Sample from 1998 to 2006 was performed with an inclusion criterion of cholecystectomy performed on hospital day 0 or 1. Patient- and ...

BACKGROUND Conventional transabdominal ultrasound usually fails to visualize parts of the ureter or extrahepatic bile duct covered by bowel gas. In this study, we propose a new method for gaining acoustic access to the ureters and extrahepatic bile duct to help determine the nature of obstruction to these structures when conventional transabdominal ultrasound fails. METHODS The normal saline ...