Biliary Tract Dilatation Research Articles

Biliary tract dilatation in the nonjaundiced patient.

The significance of intra- or extrahepatic biliary distension (or both) in 33 anicteric patients was investigated. The entire biliary tree and pancreas were sonographically evaluated. Correlation with the biochemical profile, cholangiography, endoscopy, and surgery were obtained when available. Fourteen patients had common bile duct stones, nine had partially obstructing masses, four had papillary stenosis, and three had common bile duct strictures. Two postcholecystectomy patients had dilatation without obstruction. Two patients had mild intrahepatic biliary tract distension without other evidence of biliary tract disease. Sonography is a more sensitive indicator of partial obstruction of the biliary tract than the serum bilirubin. If biliary distension exists, further investigation is warranted, unless an obstructing lesion is clearly defined by the sonogram.

Ultrasonography of biliary tract dilatation without jaundice.

The significance of intrahepatic biliary distension in the nonjaundiced patient was studied. Biochemical profiles and endoscopic and surgical findings were evaluated. Biliary tract disease was proven in 11 of 12 patients, with nine of the 11 having concurrent pancreatic disease. Ultrasound proved a more sensitive indicator of partial biliary obstruction than the serum bilirubin levels. The biliary tract of nonjaundiced patients with ultrasonographic evidence of biliary distension should be evaluated by additional studies regardless of the biochemical profile.

Congenital biliary tract dilatation and anomalous junction of the pancreatico-biliary ductal system

Anomalous junction of the pancreaticobiliary ductal system (AJPBDS) was found not only in 6 of 28 children with congenital dilatation of the bile duct, but in 3 of 57 children with congenital biliary atresia, in 2 of 17 children with infantile hepatitis and in one child with chronic pancreatitis during the past 17 yr at the Kagoshima University Hospital. A new technique of selective choledochopancreatography has been developed in which the mid-choledochus is clamped and dye is selectively injected into the distal choledochus to demonstrate the pathology of the bile duct. This technique has been successful even in small children when other cholangiographic techniques have failed to show AJPBDS. AJPBDS can be divided into two main types: (1) with biliary tract dilatation and (2) without biliary tract dilatation. The preferred treatment for type 1 is considered to be Roux-en-Y limb hepaticojejunostomy with primary excision of the choledochal cyst in order to prevent reflux of pancreatic juice flow into the choledochus, postoperative gall stone formation, or cancer from arising in the remaining choledochal cyst. Hepatic portocholecystostomy for biliary atresia with patency between gall bladder and papilla duodeni associated with AJPBDS can not be recommended since it may cause dilatation or obstruction of the bile duct postoperatively. Further studies concerning the etiology or therapy for AJPBDS are necessary.

Abnormal choledocho-pancreatico ductal joining in congenital dilatation of biliary tract: T. Miyano, A. Takahashi, and K. Suruga. Jap J Pediatr Surg 10:539–546 (May), 1978

Abnormal choledocho-pancreatico ductal joining in congenital dilatation of biliary tract: T. Miyano, A. Takahashi, and K. Suruga. Jap J Pediatr Surg 10:539–546 (May), 1978

A case report of congenital biliary atresia which showed localized cystic dilatation of extra biliary tract after external cholecystostomy

A case report of congenital biliary atresia which showed localized cystic dilatation of extra biliary tract after external cholecystostomy