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| | Dunbar Law Office Newsletter |
 | | The better practice is to pull the base of the gallbladder to the patient's right so that the cystic duct is perpendicular to the common bile duct. | | | While it is not necessary to see the common duct, it is at this point that the surgeon has achieved the critical view of safety and the cystic structures may be occluded because they have been conclusively identified. | | | The ampulla of vater is the sphincter of tissue that controls the flow of bile from the common bile duct into the small intestine. |
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http://www.freeadvice.com/resources/articles/dunbar.htm
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| | Poly Cystic Ovaries |
| | Cystic fibrosis 1: '''Cystic fibrosis''' ('''CF'''), also called '''mucoviscid 11: s recommended for families who may be carriers of cystic fibrosis. | | | Cystic medial necrosis 1: '''Cystic medial necrosis''' is a disorder of large arter | | | Hypoglycemia 280: ] (in distal intestinal obstruction syndrome of cystic fibrosis) |
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http://www.moviewavspage.com/sand/43078-poly-cystic-ovaries.html
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| | W. John B. Hodgson, MD - Postoperative Monitoring after Laparoscopic Surgery |
| | In July 1991, Hunter advocated that surgeons changed from the 0 to the 30 degree scope, because the common bile duct [CBD] is rarely seen with the 0 degree scope and the 30 degree frequently shows the CBD without any dissection of this area. | | | It also became clear that dissection should commence at the gallbladder infundibulum, clearing towards the CBD, but with no attempt being made to clear the entire length of the cystic duct, since as the CBD was approached, any bleeding would be difficult to control without risking damage to the CBD. | | | Opening the angle by lateral traction on the gallbladder infundibulum solves this problem, although it is more difficult with the 0 degree scope than with the 30 degree scope. |
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http://www.hemorrhoidsplus.com/lap/postop.html
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| | Laguna Medical Systems |
| | The needle is then removed and the catheter advanced into the desired bile duct for external biliary drainage. | | | Endoscopic retrograde sphincterotomy is a therapeutic application of ERCP in which soft tissues and muscle fibers at the sphincter of Oddi are divided with electrocautery to permit passage of ductal calculi into the duodenum. | | | The pain results from spasm of the smooth muscle in the ducts combined with contractions of the gallbladder that attempt to move the stone through the ducts. |
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http://www.lagunamedsys.com/edgearchive/feature071598.htm
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| | MedForumsLive.comGallstones |
| | If they do not, it is likely that gallstones were left in the ducts, there is a second problem within the bile ducts, or there is sphincter of Oddi dysfunction. | | | Sepsis is a condition in which bacteria from any source within the body, including the gallbladder or bile ducts, get into the blood stream and spread throughout the body. | | | During a meal, the muscle that makes up the wall of the gallbladder contracts and squeezes the concentrated bile in the gallbladder back through the cystic duct into the common duct and then into the intestine. |
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http://www.medforumslive.com/terms/gallstones.html
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| | Medical Malpractice Attorneys: Surgical Accidents and Surgical Mistakes |
| | The surgeon then presumes that this angle represents the juncture of the cystic duct and the common bile duct, failing to recognize that the angle is instead caused by tension the surgeon is placing upon the gallbladder. | | | The surgeon, thinking the cystic duct is at hand, observes an angle between the apparent cystic duct and another duct-like structure. | | | Appropriate standards of practice for radiologists interpreting cholangiograms require that they immediately notify a surgeon if the flow of dye does not fill both the common bile duct and common hepatic duct. |
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http://www.pa-cervicalcancer.com/surgical.html
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| | Laparoscopy.com - TRANSCYSTIC COMMON BILE DUCT EXPLORATION. |
| | More contrast material is used to verify the anatomy and the obstruction. | | | Those with advanced laparoscopic skills, as is the case with Dr. Pekolj, are able to employ a laparoscopic approach. | | | Abnormal cholangiogram showing no passage of the contrast material into the duodenum. |
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http://www.laparoscopy.com/pictures/tccbde.html
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| | The Kumar Pre-View Cholangiography |
| | The needle length is only 1.25 cm and the angle of entry of the needle does not point towards the back wall of the Hartmann’s pouch. | | | Is there leakage of bile from the needle hole after the needle is removed? | | | If a stone is located in the Hartmann’s pouch, can it be pushed by the needle or washed by the dye in to the common bile duct? |
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http://www.nashvillesurg.com/message.html
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| | Laparoscopic Cholecystectomy |
| | Early in the national experience with laparoscopic cholecystectomy it became apparent that some surgeons who were in the early phases of their training would misidentify the anatomy and inadvertently clip and divide the common bile duct thinking it to be the cystic duct. | | | Minimally invasive surgery represents a great step forward in the field of general surgery, however, there is no reason to sacrifice safety in it's performance. | | | The results of this consensus conference were less than definitive except that it was decided that laparoscopic cholecystectomy is a worthwhile procedure that can be done safely given proper training, supervision and experience and: |
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http://www.lectlaw.com/med/med12.htm
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| | Complications of Laparoscopic Cholecystect |
| | Because bile duct injuries are uncommon, the opportunity to obtain the necessary experience is largely confined to specific surgeons in tertiary care medical centers. | | | It is not surprising, therefore, that the ability to accomplish these technical objectives improves with experience and that the outcome of operations for bile duct injuries is so strongly related to the surgeon's previous experience. | | | The procedure however is surgically demanding and introduces specific risks unique to the laparoscopic surgery that are not present during the performance of open cholecystectomy. |
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http://www.danaise.com/Lap-Chole.html
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| | VESTA: Training Critical Steps |
| | Bile duct injury can be the result of poor technique or misinterpretation of the anatomy. | | | The surgeon may confuse the common bile duct (the large duct leading to the intestine) for the cystic duct. | | | Based on our analysis of 139 bile duct injuries, a few simple rules have been developed to reduce the likelihood of injury (with layperson's explanations in parentheses): |
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http://itsa.ucsf.edu/~frankt/critical.html
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| | The Kumar Pre-View Cholangiography |
| | The Clamp applies completely across the lower part of the body of the gallbladder and the catheter needle punctures the Hartmann's pouch of the gallbladder for biliary access or aspiration. | | | Instructions for Use: (This is not a primer of surgical techniques or cholecystectomy) | | | The clinical experience is that such tiny stones do pass uneventfully. |
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http://www.nashvillesurg.com/instruct.html
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| | Laparoscopic Cholecystectomy Cases: Maximizing Your Client's Recovery |
| | The most important contraindication is "surgical inexperience." [2] When you obtain your client's medical records, be sure to determine their preoperative health and review the surgeon's pre-op notes to nail down the indications for performing surgery. | | | The most common (and irritating) defense to a botched gallbladder surgery case is, "The injury to the common duct is a known risk of the procedure, so it's not negligence to cause the injury." Here are some approaches to dealing with this defense: | | | These risks are frequently covered in patient education materials given to the patient when surgery is discussed. |
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http://www.nucleushealth.com/article_cholecystectomy.php
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| | eMedicine - Mirizzi Syndrome : Article by Jeffrey W Ross, MD |
| | Consequently, the CBD may be mistaken for the cystic duct, and ligation or permanent injury may occur during surgery (Becker, 1984). | | | In 1963, Dietrich reported a low CBD insertion in as many as 18% of his patients who underwent surgical cholangiography (Dietrich, 1963; Toscano, 1994). | | | Extensive adhesions may make visualization of the biliary anatomy exceptionally difficult, especially within the hepatoduodenal ligament. |
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http://www.emedicine.com/radio/topic451.htm
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| | Gallbladder removal |
| | obstruction of the cystic duct leading to severe abdominal pain (biliary colic) |
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http://adam.about.com/reports/000107.htm
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| | bile duct: Definition and Much More From Answers.com |
| | The top half of the common bile duct is associated with the liver, while the bottom half of the common bile duct is associated with the pancreas, through which it passes on its way to the intestine. | | | This condition is called jaundice and the skin and eyes become yellow from the accumulated bile in the blood. | | | Jaundice is commonly caused by conditions such as pancreatic cancer caused by blockage of the bile duct passing through the cancerous portion of the pancreas, cholangiocarcinoma, blockage by a stone in patients with gallstones and from scarring after injury to the bile duct during gallbladder removal. |
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http://www.answers.com/topic/bile-duct
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| | Procedure of the Month January 1998 |
| | In this patient the common bile duct (CBD) is seen, as is activity in the intestine. | | | CBD represents the common bile duct running from the liver to the intestine. | | | However, the gallbladder is not seen in this patient with acute cholecystitis. |
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http://www.nucmednet.com/biliary.htm
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| | Gallbladder and Extrahepatic Bile Ducts - Printer Friendly Version |
| | 2-8% develop biliary tract carcinoma (20x normal risk) at mean age 34 years, lower risk if surgery earlier in life (age 10 years or less), carcinoma may develop within wall of cyst, within gallbladder or bile ducts | | | Chronic active cholecystitis and chronic acalculous cholecystitis suggests primary sclerosing cholangitis, choledocholithiasis or other extrahepatic bile duct obstruction | | | Inversion of distal fundus into body, to which it may become adherent |
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http://www.pathologyoutlines.com/gallbladderpf.html
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| | SAGES Primary Care Physician Information: Laparoscopic Common Bile Duct Exploration |
| | The transcystic approach is particularly useful when the cystic duct is ample in diameter and enters the common duct via a relatively straight, lateral approach. | | | Absence of any of the indications above, instability of the patient, and local conditions in the porta hepatis that would make exploration hazardous are also contraindications. | | | While these techniques achieve excellent results as a drainage procedure, they are logistically quite difficult to accomplish. |
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http://www.sages.org/primarycare/cbdexplore.html
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| | Congenital neck masses, branchial cleft anomalies, thyroglossal duct remnants, lymphangiomas, cystic hygromas, ... |
| | Because airway obstruction is always a concern with a deep neck infection, an ear, nose and throat specialist is usually consulted immediately to help manage the airway and determine whether surgical therapy is needed. | | | During fetal development connections may occur causing cysts made up of these channels to grow. | | | A congenital neck mass is a growth that is present at birth and slowly becomes noticeable to the patient or family. |
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http://www.pediatric-ent.com/learning/problems/lump_neck.htm
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| | Surgical error, perforation of common bile duct by surgeon during arthroscopic gallbladder procedure, failure of ... |
| | The surgery is performed in such a manner so as not to injure or cut the common bile duct. | | | He found that the cholangiogram would have revealed the plaintiff’s anatomical variation which would have resulted in the defendant converting from the laparoscopic to open technique thereby allowing the defendant to correctly identify all the cystic structures and not cut the common bile duct. | | | During the procedure, the defendant encountered many difficulties including tearing of the gall bladder, dense scar tissue and recent infection which made dissection of the surgical field very tedious and time consuming. |
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http://www.medicalattys.com/rep/Gallbladder1.htm
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| | About Laparoscopic Common Bile Duct Exploration (LCBDE) and Bile Duct Stone Extraction |
| | Conclusion: Both laparoscopic choledochotomy and cystic duct approach are feasible approaches to LCBDE and are superior to ERCP in terms of patient safety and cost. | | | Click Here for excerpts from medical articles regarding Intraoperative Cholangiogram (IOC) and Laparoscopic Common Bile Duct Exploration (LCBDE). | | | In a case study comprising 1,353 laparoscopic cholecystectomies by Dr. Wenner and Associates, choledocholithiasis was diagnosed in 8.4% of those cases. |
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http://lapsurgical.com/about.html
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| | OTHER DISEASES OF DIGESTIVE SYSTEM |
| | Calculus of bile duct [any] with cholecystitis (chronic) | | | Calculus of bile duct [any] with acute cholecystitis | | | 574.8 Calculus of gallbladder and bile duct with acute and chronic cholecystitis |
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http://thera.info/icd9-cm/sect-570-579.html
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| | Laparoscopic Cholecystectomy - tutorial (2) |
| | Attention is focused on Calot's triangle, an arbitrary anatomic triangle defined by the cystic artery above, the cystic duct below and the common bile duct medially. | | | A view demonstrating an empty space between the liver and gallbladder neck, with the intervening cystic duct in between, sometimes called the critical view, is desirable for reasons of safety. | | | Dissection should continue in a lateral to medial direction, beginning at the infundibulum and continuing medially toward the entrance of the cystic duct into the gallbladder neck. |
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http://www.laparoendoscopy.com/choletutorial2.htm
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| | www.vgaur.com |
| | The dissection should be done with downward traction by duckbill grasper placed on the anterior edge of Hartmann's pouch, | | | The dissection of the cystic pedicle can be carried out with two handed technique. | | | The contrast medium should be injected slowly during screening and the patient should be in a slight trendelenberg position with the table rotated slightly to the right. |
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http://www.vgaur.com/lp_4.asp
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| | Liver |
| | The liver is frequently a site for secondary metastasis of cancer from almost any part of the body because of its great vascularity. | | | This is frequently a result of obstruction of the duct system. | | | Remember, when we studied the duodenum, that the common bile duct joins the major pancreatic duct to empty into the ampulla which then empties into the second part (descending part) of the duodenum. |
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http://mywebpages.comcast.net/wnor/liver.htm
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| | Laparoscopy.com - COMMON BILE DUCT EXPLORATION. |
| | Care should be taken to avoid passing the scope itself through the ampulla itself for fear of traumatizing it and causing spasm. | | | It is frequently possible to deliver most or all of the stones into the duodenum simply by "herding" them out with the tip of the 'scope and the aid of the saline flowing out through the tip of the 'scope itself. | | | It is often difficult to maneuver the flexible scope proximally into the hepatic ducts. |
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http://www.laparoscopy.com/pictures/cbd.html
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| | Duodenum, Pancreas, Liver & Gallbladder - Dissector Answers |
| | Identify the structures passing into and out of the porta hepatis and some of the most common variations on this pattern. | | | The anatomical lobes of the liver, which are based on external appearance, differ slightly from the functional (surgical) lobes of the liver, which are based on distribution of the portal vein, hepatic arteries, and hepatic bile ducts. | | | Identify parts of the liver and describe the relationships of its portal venous, hepatic arterial, and hepatic venous circulation. |
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http://anatomy.med.umich.edu/gastrointestinal_system/duodenum_ans.html
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| | Anatomy Tables - Duodenum, Pancreas, Liver, & Gallbladder |
| | fiberoptic endoscopy for duodenal observation and cannulation of vater's ampulla in order to visualize the pancreatic and biliary duct system by retrograde (against the usual direction of flow) injection of contrast media | | | Symptoms include abdominal pain, abdominal swelling, jaundice, weight loss and anorexia. | | | Yellowing of the skin (and whites of eyes) by bilirubin, a bile pigment. |
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http://anatomy.med.umich.edu/abdomen/duodenum_tables.html
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| | Bile Duct |
| | When this happens, the bile flows into the gallbladder and is stored there. | | | The canals of neighboring lobules unite to form larger ducts, and these converge to become the "hepatic ducts." They merge, in turn, to form the "common hepatic duct." The "common bile duct" is formed by the union of the common hepatic and the cystic ducts. | | | This sphincter normally remains contracted until the bile is needed, so that bile collects in the common bile duct and backs up to the cystic duct. |
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http://www.innerbody.com/text/dige20.html
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| | MSN Encarta - Search Results - cystic duct |
| | Cystic Fibrosis, incurable hereditary disorder that causes the body to secrete an abnormally thick, sticky mucus that clogs the pancreas and the... | | | The function of the gallbladder is to store bile, secreted by the liver and transmitted from that organ via the cystic and hepatic ducts, until it is... | | | Culinary school: Become a chef, or at least a better cook |
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http://encarta.msn.com/cystic+duct.html
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| | Common bile duct - Wikipedia, the free encyclopedia |
| | The common bile duct has proven, so far, to be one of those tubes in the body that defy replacement, either by artificial tubes or stripped veins or any other material. | | | This page was last modified 21:29, 13 Mar 2005. | | | common hepatic duct and the cystic duct and ends at the Ampulla of Vater in the |
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http://en.wikipedia.org/wiki/Common_bile_duct
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| | PicTour of a Laparoscopic Operation |
| | The liver produces bile which flows down to the intestine in a tube called the "Bile duct". | | | Below is a description of steps involved in removing a gall bladder in Laparoscopic Surgery. | | | The gall bladder is a bag-like organ which is like a branch on the right side of the bile duct. |
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http://www.geocities.com/cybersurg.geo/pictour.html
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| | 23.11 |
| | MeSH does not have a term to cover "cystic duct diseases", so *CYSTIC DUCT must be indexed. | | | (If BILE DUCT DISEASES had not been available, the Trees would have been consulted for the term under which BILE DUCTS is treed, and the corresponding disease term for that anatomical part would have been used as the IM coordinate.) | | | Then the indexer must check the Trees to see what term CYSTIC DUCT is indented under; in this case BILE DUCTS. |
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http://www.nlm.nih.gov/mesh/indexingmanual/23_11.htm
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| | CYSTIC DUCT |
| | The medical glossary has been made possible by a generous donation from: | | | A gallstone that blocks the cystic duct can lead to inflammation and infection of the gallbladder. | | | A bile duct that connects the gallbladder to the common bile duct. |
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http://www.medhelp.org/glossary/new/gls_1392.htm
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| | Anatomy of the Gallbladder - Medical Illustration |
| | This full color medical-legal chart demonstrates the relationship of the gallbladder to the cystic duct, common bile duct and cystic artery. | | | Labels identify the gallbladder, cystic duct, common bile duct, cystic artery and liver. | | | YOU MAY ALSO WANT TO REVIEW THESE ITEMS: |
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http://catalog.nucleusinc.com/generateexhibit.php?ID=663
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