BACKGROUND Major bile duct injury is an important therapeutic problem that can be associated with simultaneous injury to the hepatic artery. Limited information exists regarding the course of patients who have combined bile duct and arterial injuries. OBJECTIVE To compare the management and outcome of isolated bile duct injuries with bile duct and hepatic artery injuries. PATIENTS AND METHO...

Biliary papillomatosis (BP) is considered a rare condition of the biliary tract with a risk of malignant transformation and a high recurrence rate after operation due to the diffuse distribution of the disease. Clinical manifestations of BP are nonspecific, often misdiagnosed for clinical rarity. Recently, we experienced a case of BP of intra hepatic biliary tract in which Choledochoscopy playe...

PURPOSE The genetic alterations in biliary tract cancer and clinicopathological associations have not been studied in large population-based studies. EXPERIMENTAL DESIGN We evaluated genetic alterations such as K-ras mutation, p53 overexpression, microsatellite instability (MSI), and alterations of the polyadenine tract present in the transforming growth factor beta receptor type II (TGFbetaR...

The radiological report of gall bladder contraction 60 minutes after fatty meal, was compared with the computed volume and contraction of gall bladder using Siffert's technique. Of 46 oral cholecystograms, 34 were reported to be normal and 12 as poor contraction. On computation only 14 were found to be normal and 32 showed poor contraction. The difference was statistically significant.

Cholelithiasis is a prevalent condition in Western populations. Most cases are asymptomatic but complications can occur. Acute cholangitis, cholecystitis, and gallstone pancreatitis are the most common biliary tract emergencies and are usually caused by biliary calculi. Whenever possible, acute cholecystitis should be treated with early LC. AAC is an uncommon condition usually affecting patient...

GERM Cell Tumour is the modern term for a malignant tumour of the testis or ovary. It also includes some tumours that arise in extra-gonadal sites. This volume covers the epidemiology, pathology, diagnosis and clinical management of germ cell tumours. Inevitably the work is a multi-author presentation but the experience of three of the authors from the Department of Oncology at Charing Cross Ho...

Patients with suspected complications of gallstone disease should be evaluated for alternative diagnoses, as well as complications of gallstones such as pancreatitis and cholangitis. Laboratory evaluation for all these patients should include a complete blood count, basic serum chemistries, liver function tests, serum amylase and lipase, and urinalysis. A urine pregnancy test should always be p...

Several different types of tumors affect the pancreas, the biliary tree, and the liver. Each year, hundreds of articles are published regarding pancreatic, biliary, and hepatic cancers. Accordingly, this chapter concentrates on essential principles. In particular, it focuses on common malignant tumors, addressing benign tumors and uncommon tumors only insofar as they are important in differenti...

Biliary changes secondary to portal hypertension have rarely been described in published reports. Twenty consecutive patients with extrahepatic portal venous obstruction, all of whom showed a variable degree of abnormalities in the biliary tract suggestive of sclerosing cholangitis, are described. These biliary abnormalities were: focal narrowing, dilatations, and cholangitic changes affecting ...

Few randomized controlled trials (RCTs) with large numbers of patients have been conducted to date in patients with biliary tract cancer, and standard chemotherapy has not been established yet. In this article we review previous studies and clinical trials regarding chemotherapy for unresectable biliary tract cancer, and we present guidelines for the appropriate use of chemotherapy in patients ...