Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver disease of unknown cause characterized by diffuse inflammation and fibrosis of intrahepatic and/or extrahepatic bile ducts and is strongly associated with inflammatory bowel disease (IBD). PSC is ultimately progressive, leading to…
Classification of Cystic Disorders of the Bile Ducts In 1959 Alonso-Lej first classified extrahepatic bile duct cystic dilatation into the following three types: type I is congenital cystic dilatation of the common bile duct in which the intrahepatic tree is…
Biliary atresia is a disease characterized by progressive obliterative destruction of intrahepatic and extrahepatic biliary structures. It is the most common cause of direct hyperbilirubinemia in infancy and must be quickly and effectively differentiated from the numerous other causes of…
Bile duct strictures can result from a myriad of conditions, both benign and malignant. These strictures represent a significant clinical problem and if not managed correctly can result in major morbidity, both short and long term, and possible mortality. Complications…
Bile duct injuries most commonly occur after primary operations on the gallbladder or biliary tree. Biliary injuries themselves are also among the most difficult challenges that a surgeon will face. Although numerous technologic developments have facilitated diagnosis and management, bile…
Benign Gallbladder Tumors Benign tumors of the gallbladder are relatively common, with up to 5% of patients undergoing abdominal ultrasonography being found to harbor gallbladder polyps. Benign gallbladder tumors can be broadly categorized as epithelial (adenomas), mesenchymal (fibromas, lipomas, hemangiomas),…
Since the first endoscopic visualization and cannulation of the major papilla with cholangiopancreatogram was completed in 1968, rapid advances in the field of endoscopy have increased the capabilities of physicians to detect, classify, and more recently, provide therapy to disease…
Biliary dyskinesia and sphincter of Oddi dysfunction (SOD) are functional disorders of the pancreas and biliary tract that challenge the practicing surgeon. Both disease entities are characterized by pancreatobiliary pain syndromes and are fraught with controversy over their definition, diagnosis,…
Choledocholithiasis is a common condition that often requires a procedural intervention in order to treat. There are a number of different treatment strategies used when managing patients who present with common bile duct (CBD) stones. As such, the debate about…
With an annual rate of greater than a quarter of a million hospital admissions and an associated cost of greater than two billion dollars, cholelithiasis and cholecystitis have a tremendous impact on the health care system. Their diagnosis and associated…