Bile Duct Cancer
Dongyou Liu in Tumors and Cancers, 2017
The bile ducts are thin tubes of 10-12.5 cm in length that connect the liver, gallbladder, and small intestine. The bile ducts are divided into two sections: intrahepatic and extrahepatic. The intrahepatic bile ducts are small ducts located within the liver. The extrahepatic bile ducts include part of the right and left hepatic ducts outside the liver. The main function of the bile ducts is to collect bile produced in the liver and to carry the bile via the cystic duct to the gallbladder for storage and via the distal extrahepatic bile duct and through the pancreas to the small intestine. Tumors of the intrahepatic bile ducts arise from the biliary epithelium of small intrahepatic ductules or large intrahepatic ducts near the bifurcation of the right and left hepatic ducts. Tumors of the extrahepatic bile ducts occur in the common bile duct located between the point where the cystic duct joins the common hepatic duct and the ampulla of Vater.
Medical Treatment of Vanishing Bile Duct Syndrome in Adults
Gianfranco Alpini, Domenico Alvaro, Marco Marzioni, Gene LeSage, Nicholas LaRusso in The Pathophysiology of Biliary Epithelia, 2020
Medical management of vanishing bile duct syndrome (VBDS) should be aimed at treating both the underlying disease and symptoms or complications of long-standing cholestasis. For the treatment of pruritus, the most specific symptom of VBDS, anion exchange resins represent the first-line therapy and only for patients resistant or intolerant to cholestyramine, rifampicin or opioid antagonists should be considered. The main complications of chronic cholestasis are metabolic bone disease, hyperlipidemia and malnutrition. In adults, the progressive destruction of bile ducts may be due to different aetiologic agents. Whatever the aetiologic agent, the retention of endogenous detergent bile acids and other hepatotoxins may initiate and/or aggravate liver cell injury, which may lead to liver cirrhosis and impairment of liver function. No drug experimented for the treatment of the underlying disease was able to affect fatigue. Pruritus represents the most typical symptom of cholestatic patients and, in several cases, may severely affect the quality of life leading to sleeplessness and major depression.
Drug-Induced Vanishing Bile Duct Syndromes
Gianfranco Alpini, Domenico Alvaro, Marco Marzioni, Gene LeSage, Nicholas LaRusso in The Pathophysiology of Biliary Epithelia, 2020
Various drugs have been implicated in the development of a particular form of liver damage, predominandy involving the bile ducts. Bile duct damage can be mild, but can also result in progressive ductopenia, posing the differential diagnostic problem with other vanishing bile duct syndromes like primary biliary cirrhosis. Clinically, drug-induced cholangiopathy may be acute or prolonged. Very important is that the presenting symptoms may be delayed for days or even weeks after the initiation of treatment or its cessation. Also the occurrence of cholestasis, its duration and severity are largely independent of the precocity of drug discontinuation. Acquired and genetic factors contribute to individual susceptibility to drug hepatotoxicity. Further elucidation of these factors is one of the challenges of the future.
Common Bile Duct Cancer with Massive Necrosis Mimicking Choledochal Dilatation on CT
Published in Acta Radiologica, 1991
Hidetoshi Miyake, S. Matsumoto, S. Ueda, T. Maeda, H. Aikawa, H. Mori
Carcinomas of the common bile duct are usually seen as dilatation of the bile duct proximal to a solid mass on CT. In the case reported here, the common bile duct cancer itself mimicked dilated common bile duct on CT because of massive necrosis. In a case of simulating dilated common bile duct on CT, and discrepancy between CT and ultrasonography or endoscopic retrograde cholangiopancreatography, a common bile duct cancer with massive necrosis should be included in the differential diagnosis.
Morphological Changes during Creation of a Neo-Bile Duct Using a Vein and a Biodegradable Endoluminal Stent
Published in Journal of Investigative Surgery, 2009
Daniel Palmes, Heiner Wolters, Hans-Ullrich Spiegel, Erhard M¨ller, Evgeny Minin, Hans Peter Heistermann
ABSTRACT Major bile duct lesions are usually treated by a hepaticojejunostomy which is often complicated by cholangitis and liver fibrosis. The aim of this study was to investigate the morphologic features of a neo-bile duct created from a vein and a biodegradable endoluminal stent. The neo-bile duct was created using a segment of the external jugular vein which was endoluminally stented by a biodegradable poly-lactate-acid stent. In 18 pigs, the common bile duct was resected and replaced by the vein with (n = 12) or without endoluminal stent (n = 6). Six animals served as controls. Survival, liver function and morphological changes of the neo-bile duct and the liver were observed for six months. After six months, the neo-bile duct morphologically resembled the native bile duct showing Ck7-positive columnar epithelium and newly formed capillaries in the bile duct wall. The biodegradable stent disappeared after four months. All animals survived and showed normal liver function and no cholestasis. In contrast, after sole vein reconstruction of the bile duct, four animals died due to biliary peritonitis and cholangitis. Creation of a neo-bile duct which morphologically resembles the native bile duct is feasible by using a body's own vein and a biodegradable endoluminal stent.
Carcinoid Tumour of the Common Bile Duct: Report of a Case and a Review of the Literature
Published in Acta Chirurgica Belgica, 2006
M. Caglikulekci, M. Dirlik, O. Aydin, C. Ozei, T. Colak, A. Dag, H. Canbaz, S. Aydin
Carcinoid tumours of the common bile duct are extremely rare lesions. In this article we report a case with an extrahepatic bile duct carcinoid tumour. A 40-year-old woman suffered from biliary colic and jaundice. Pre-operative computed tomography demonstrated a tumour in the biliary tract. At laparotomy there was a tumour invading the common bile duct . Common bile duct resection was performed. Carcinoid tumour of the common bile duct was diagnosed histopatho- logically. For extrahepatic bile duct carcinoid tumours surgical resection is the only treatment modality that offers a chance to provide a cure and prolonged disease-free survival. The favourable histopathological and biological features of these tumours encouraged the surgeons to use more aggressive approaches for advanced disease.
Related Knowledge Centers
- Digestion
- Common Bile Duct
- Liver
- Bile
- Gallbladder
- Intestine
- Cystic Duct