The bifid pancreas: a rare anatomical variation
| Autor: | Richard E. Rogers, Bruce R. Heare, J. Marc Shabot, R D Halpert |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Pathology Transhepatic approach Gallbladder Fundus business.industry Gallbladder Operative mortality Pancreatic Ducts Gastroenterology Computed tomographic Abdominal wall medicine.anatomical_structure Fundus (uterus) medicine Humans Female Radiology Nuclear Medicine and imaging Radiology Pancreas business Aged |
| Zdroj: | Gastrointestinal Endoscopy. 36:60-61 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/s0016-5107(90)70926-1 |
| Popis: | course extremely difficult. Early reports have suggested that percutaneous cholecystostomy performed under sonographic guidance may be helpful in managing these patients by reducing operative mortality. Subsequent elective cholecystectomy may be carried out when indicated, following stabilization of the patient's condition. However, cases have been reported in which this technique was associated with significant bile leakage forcing an operation. Warren et al. after reviewing the computed tomographic findings in 100 consecutive patients, found that ultrasound-guided percutaneous cholecystostomy by direct transperitoneal puncture of the gallbladder fundus was possible in only 17% of cases. Such an approach was limited due to interposition of bowel or liver between the gallbladder fundus and the skin entry site. A transhepatic approach adds the risks of intraperitoneal hemorrhage and hemobilia. The laparoscopic approach offers the advantage of bringing the fundus of the gallbladder in contact with the parietal peritoneum, potentially decreasing the risk of bile leakage. If the colon is found to be interposed between the gallbladder and the abdominal wall |
| Databáze: | OpenAIRE |
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