• Korean Journal of Veterinary Research
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• v.34 no.1
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• pp.1-7
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• 1994

The distribution of the bile and hepatic ducts within the liver of 24 Korean native cattle were observed. Vinylite solution was injected into common bile ducts on 13 cases for cast preparation. The angiography was prepared in 11 cases which were injected 30% barium sulfate solution into the common bile ducts and then radiographed on X-ray apparatus. The results were summarized as follows; 1. The dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, and ducts of papillary process were collected into left hepatic ducts. The dorsal and ventral ducts of right hepatic lobe, ducts of caudate process and papillary process were collected into right hepatic ducts. 2. The bile ducts in the left hepatic lobes were collected into dorsal, ventral and intermediate ducts of left hepatic lobes. The intermediate ducts of left hepatic lobes was absent in some cases(5 cases, 20.83%). 3. In some cases, the ventral ducts of right hepatic lobes were collected into right hepatic ducts directly. 4. The ducts of quadate lobes were collected into left hepatic ducts(8 cases, 33.33%), ventral ducts of left hepatic lobes(13 cases, 54.17%), and dorsal duct of left hepatic lobes, intermediate and ventral ducts of left hepatic lobe, common trunk collected into intermediate and ventral duct of left hepatic lobe and left hepatic duct(1 cases, 4.17%) respectively. 5. The ducts of papillary process were collected into left and right hepatic ducts(12 cases, 50%), left hepatic ducts only(11 cases, 45.83%) or right hepatic duct only(1 cases, 4.17%). 6. The average length of right hepatic ducts was 26.87(6-45.8)mm. The average length of left hepatic ducts was 56.68(6-127)mm. The length of gallbladder was 128.60(104-160)mm on the average. The breadth of gallbladder was 67.16(38.4-153.4)mm on the average. But there was a difference in the length and the breadth according to the quantity of bile. 7. The ramified angles of dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, ducts of papillary processes and caudate processes, dorsal and ventral ducts of right hepatic lobes and cystic ducts were 130-170, 160-200, 190-250, 240-300, 90-140, 320-350, 30-100, 270-330 and 240-300 degrees respectively.

• YAKHAK HOEJI
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• v.42 no.2
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• pp.181-186
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• 1998

This study was attempted to investigate the pharmacokinetics of cyclosporine (10mg/kg, oral) in rabbits with $CCI_4$ and bile duct ligation-induced hepatic disorder. The area under the curve (AUC) of blood cyclosporine concentration versus time was significantly increased ($CCI_4$-induced hepatic disorder. Elimination rate constant (Kel) was significantly decreased (p<0.05, p<0.01) in rabbits with $CCI_4$ and bile duct ligation-induced hepatic disorder. Volume of distribution (Vdss) and total body clearance (CLtot) were significantly decreased (p<0.01) in rabbits with $CCI_4$-induced hepatic disorder. But Vdss was significantly increased (p4-induced hepatic disorder were 874ng/ml and 2.71 hr, respectively. Cmax and Tmax values in rabbits with bile duct ligation were 105ng/ml and 2.834 hr, respectively. From results of this experiment. It is desirable to do therapeutic drug monitoring of cyclosporine for effective treatment when the cyclosporine is administered to patients with liver disorder m clinical practice.

• Journal of Veterinary Clinics
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• v.8 no.1
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• pp.71-80
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• 1991

Clinical signs, serum chemical values and histological findings of hepatic tissue after partial and complete obstruction of common bile duct in Korean goats were investigated. Abnormal clinical signs were not observed in partial obstruction of common bile duct, but in complete obstruction clinical signs such as jaundice, urine color change, were observed. Serum total bilirubin, total cholesterol, aspartate aminotransferase, sorbitol dehydrogenase, gamma glutamyltranspeptidase, and total protein values increased on the 1-4th day and then gradually decreased to normal level in partial obstruction. However, they tend to increase persistently by the 24th day in complete obstruction of common bileduct. Histologic features of hepatic tissue in partial obstruction were not changed as compared with normal hepatic tissue. On the other hand, in complete obstruction of common bite duct there were moderate bile duct proliferation in a portal area, rupture of bile canaliculi, phagocytosis of bile pigment by Kupffer cells, periportal fibrosis, intrahepatic bile stasis and hepatic cell necrosis.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.197-202
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• 1990

Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.231-234
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• 2017

Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

• Journal of Pharmaceutical Investigation
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• v.25 no.3
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• pp.193-204
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• 1995

In order to examine the effect of extrahepatic cholestasis induced by common bile duct ligation on the hepatic function, the pharmacokinetics of antipyrine and d-propranolol were investigated in rats. In addition, in an attempt to observe the degree of direct hepatic injury, light and electron microscopic observations and conventional pathologic test using serum were performed. Five days after common bile duct ligation, antipyrine(15 mg/kg) and d-propranolol(3 mg/kg) were intravenously administrated to the rats, respectively. The total clearances of antipyrine and d-propranolol were significantly(p<0.05) decreased. Because hepatic clearance of antipyrine poorly extracted by the liver and that of d-propranolol highly extracted by the liver are respectively dependent on the hepatic intrinsic clearance and the hepatic blood flow, it may be concluded that extrahepatic cholestasis following five days after common bile duct ligation decreased the hepatic intrinsic clearance and the hepatic blood flow. SGPT, SGOT, cholesterol, bilirubin(total bilirubin, direct bilirubin) and alkaline phosphatase were significantly increased(p<0.05). The proliferation of bile ducts was prominent, and degeneration and necrosis of hepatocytes were observed by light microscope. Also, ultrastructurally, bile canaliculi were containing the amorphous materials and losing microvilli, and SER and RER in hepatocytes were dilated and vacuolated.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.143-147
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• 1996

Spontaneous perforation of the bile duct in children is a very rare disorder. We experienced a 6 year-old girl with spontaneous perforation of the right hepatic duct. The patient was initially misdiagnosed as hepatitis because of elevation of liver enzyme and then as appendicitis because of fluid collection in the pelvic cavity demonstrated by ultrasonogram. A laparoscopic exploration was done and no abnormal findings were detected except bile-stained ascites. Peritoneal drainage was performed and the patients seemed to improve clinically. Abdominal pain, distention and high fever developed after removal of the drains. DISIDA scan showed a possible of bile leak into the peritoneal cavity. ERCP demonstrated free spill of dye from the right hepatic duct. At laparotomy, the leak was seen in the anterior wall of the right hepatic duct 2cm above the junction of the cystic duct and common hepatic duct. The perforation was linear in shape and 0.8cm in size. The patient underwent cholecystectomy, primary closure of the perforation and T-tube choedochostomy. We could not identify the cause of the perforation; however, the T-tube cholangiography taken on the 42nd postoperative day showed a little more dilatation of the proximal common bile duct compared with the cholangiography taken on the 14th day. Long-term follow-up of the patient will be necessary because of the possibility for further change of the duct.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.32-36
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• 2014

We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

• Journal of Trauma and Injury
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• v.29 no.3
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.65-69
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• 2008

A two-month-old baby had acholic stool, neonatal hyperbilirubinemia and congenital heart disease. Atresia of the hepatic duct was confirmed by open cholangiography, which showed a non-opacified intrahepatic bile duct. Liver biopsy and the Kasai operation were performed. Because the liver biopsy pathology revealed a paucity of intrahepatic bile ducts, the patient was diagnosed with the Alagille syndrome. We report the case of an infant diagnosed with the Alagille syndrome with atresia of the hepatic duct.