The complex architecture of the liver biliary network represents a structural prerequisite for the formation and secretion of bile as well as excretion of toxic substances through bile ducts. Disorders of the biliary tract affect a significant portion of the worldwide population, often leading to cholestatic liver diseases. Cholestatic liver disease is a condition that results from an impairment of bile formation or bile flow to the gallbladder and duodenum. Cholestasis leads to dramatic changes in biliary tree architecture, worsening liver disease and systemic illness. Recent studies show that the prevalence of cholestatic liver diseases is increasing. The availability of well characterized animal models, as well as development of visualization approaches constitutes a critical asset to develop novel pathogenetic concepts and new treatment strategies.
- MeSH
- Cholestasis diagnostic imaging physiopathology MeSH
- Humans MeSH
- Microscopy, Electron, Scanning methods MeSH
- Disease Models, Animal * MeSH
- Models, Theoretical MeSH
- Bile Ducts diagnostic imaging physiology physiopathology MeSH
- Biliary Tract diagnostic imaging physiology physiopathology MeSH
- Imaging, Three-Dimensional methods MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
SpyGlassTM direct visualization system umožňuje endoskopické vyšetření žlučových cest a pankreatického vývodu. Hlavními indikacemi k metodě jsou nejasná léze žlučových cest, nejasná patologie pankreatického vývodu a endoskopická léčba obtížné choledocholitiázy. Autoři prezentují výsledky léčby souboru 13 nemocných.
SpyGlassTM direct visualization system enables endoscopic examination of the biliary tract and the pancreatic duct. The most important indications are indeterminate biliary lesion, indeterminate pathology of the pancreatic duct and treatment of serious choledocholithiasis. The treatment results of 13 patients are presented here.
- MeSH
- Biliary Atresia diagnosis MeSH
- Endoscopic Ultrasound-Guided Fine Needle Aspiration methods instrumentation MeSH
- Cholangiopancreatography, Endoscopic Retrograde methods instrumentation MeSH
- Choledocholithiasis diagnostic imaging MeSH
- Cholestasis, Intrahepatic etiology therapy MeSH
- Humans MeSH
- Bile Duct Diseases * diagnostic imaging MeSH
- Check Tag
- Humans MeSH
BACKGROUND AND AIMS: Magnetic resonance cholangiopancreatography (MRCP) is often used for imaging of the biliary tree and is required by surgeons before liver transplantation. Advanced liver cirrhosis and ascites in patients however present diagnostic problems for MRCP. The aim of this study was to find out if the use of our negative per-oral contrast agent containing superparamagnetic iron oxide nanoparticles (SPIO) in MRCP is helpful for imaging of hepatobiliary tree in patients with liver cirrhosis. METHODS: Forty patients with liver cirrhosis were examined on a 1.5 T MR unit using standard MRCP protocol. Twenty patients (group A) underwent MRCP after administration of per-oral SPIO contrast agent 30 min before examination. In group B, twenty patients were examined without per-oral bowel preparation. Ascites was present in eleven patients from group A and in thirteen patients in group B. Four radiologists analyzed MR images for visibility and delineation of the biliary tree. χ(2) tests were used for comparison of the visibility of intrahepatic and extrahepatic biliary ducts in patients with and without ascites. RESULTS: Better extrahepatic biliary duct visualization and visibility of extraluminal pathologies in patients with ascites was proved after administration of SPIO contrast agent. No statistically significant difference between group A and B was found for visualization of extrahepatic biliary ducts in patients without ascites. Delineation of intrahepatic biliary ducts was independent on bowel preparation. CONCLUSIONS: Application of our negative per-oral SPIO contrast agent before MRCP improves the visualization of extrahepatic biliary ducts in patients with ascites which is helpful during the liver surgery, mainly in liver transplantation.
- MeSH
- Administration, Oral MeSH
- Adult MeSH
- Liver Cirrhosis pathology MeSH
- Contrast Media * MeSH
- Metal Nanoparticles * MeSH
- Middle Aged MeSH
- Humans MeSH
- Cholangiopancreatography, Magnetic Resonance methods MeSH
- Young Adult MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Ferric Compounds * MeSH
- Bile Ducts, Extrahepatic pathology MeSH
- Bile Ducts, Intrahepatic pathology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Evaluation Study MeSH
PURPOSE: Indocyanine green (ICG) fluorescence imaging enhances biliary visualization during pediatric laparoscopic cholecystectomy (LC), helping to identify anatomical variants and prevent bile duct injury. Standard pediatric recommendations suggest ICG administration 16-24 h preoperatively; however, this may be impractical. This study aims to evaluate the safety and effectiveness of short-interval ICG administration. METHODS: A prospective single-center study (October 2024-June 2025) included pediatric LC patients receiving intravenous Verdye® preoperatively. Visualization of extrahepatic biliary anatomy was assessed intraoperatively using a 5-point Likert scale, HELPFUL (usefulness), and DISTURBED (liver background interference) scores. Data included indication, ICG timing, operative time, and complications according to the Clavien-Dindo classification (C-D). RESULTS: Eleven patients (64% female), median age 14 years (IQR 12,7-15,7) and median weight 65,5 kg (IQR 46,5-80), were included. Five had BMI > 25 kg/m2; five (46%) underwent preoperative ERCP. ICG (median dose 0.34 mg/kg) was administered a median of 225 min before surgery. Median operative time was 65 min (IQR 58-68). Median Likert score was 5; HELPFUL 3; DISTURBED 1. No ICG-related or C-D complications occurred. CONCLUSION: Short-interval ICG administration was safe, feasible, and effective in enhancing biliary visualization during pediatric LC. This approach was well-tolerated and provided high-quality imaging without complications.
- MeSH
- Coloring Agents administration & dosage adverse effects MeSH
- Time Factors MeSH
- Surgery, Computer-Assisted * methods MeSH
- Cholecystectomy, Laparoscopic * adverse effects methods MeSH
- Operative Time MeSH
- Length of Stay MeSH
- Child MeSH
- Indocyanine Green * administration & dosage adverse effects MeSH
- Injections, Intravenous MeSH
- Humans MeSH
- Adolescent MeSH
- Optical Imaging * adverse effects methods MeSH
- Postoperative Complications epidemiology MeSH
- Preoperative Care adverse effects methods MeSH
- Prospective Studies MeSH
- Feasibility Studies MeSH
- Biliary Tract diagnostic imaging MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
Biliárny ileus je zriedkavá komplikácia cholecystolitiázy. Vyskytuje sa najmä vo vyššom veku a podľa literálnych údajov jej incidencia kolíše v rozsahu 1–4 %. Najčastejšie vzniká ako komplikácia prekonanej alebo konzervatívne liečenej cholecystitídy alebo ako komplikácia dekubitálnej nekrózy steny žlčníka. Tá vedie k vzniku cholecystoduodenálnej fistuly. V tomto prípade je cholecystolitiáza „nemá“ alebo sa klinicky manifestuje len asi u jednej tretiny pacientov. Na našej klinike sme za ostatných 5 rokov urobili celkom 1 560 cholecystektómií (1345 L-CHE a 215 konvenčných CHE). Pre biliárny ileus sme za sledované obdobie operovali len dvoch pacientov. Diagnózu sme v oboch prípadoch stanovili až pri operácii, i keď pri opakovanom preštudovaní zobrazovacích vyšetrení (NSB postojačky, CT) sme dospeli k názoru, že už nimi sme mohli stanoviť primárnu príčinu črevnej nepriechodnosti.
Biliary ileus is a rare complication of cholecystolithiasis. The condition occurs predominantly in the elderly with incidence rates of 1–4%, according to the literature data. Most commonly, it develops as a complication of cholelithiasis which remained untreated or was managed conservatively, or as a complication of a gallbladder decubitus necrosis. The condition results in a cholecysto- duodenal fistula. In this case, the cholecystolithiasis is latent or is clinically manifested in a third of the patients. A total of 1560 cholecystectomies (1345 L-CHE and 215 conventional CHE) were performed in our clinic during a five- year period. Biliary ileus was an indication for operation only in two subjects, during the studied period. In the both cases, the diagnosis was established intraoperatively, although upon re-examination of the visualization modalities views (upright native abdominal views, CT scans ) the authors concluded that the primary cause of the ileus could have already been identified, based on the above views.
- MeSH
- Endoscopy, Digestive System methods instrumentation MeSH
- Endoscopes trends MeSH
- Humans MeSH
- Bile Ducts, Extrahepatic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
