Cholangiography
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Cholangiography
Cholangiography is the imaging of the bile duct (also known as the biliary tree) by x-rays and an injection of contrast medium. __TOC__ Types There are at least four types of cholangiography: # Percutaneous transhepatic cholangiography (PTC): Examination of liver and bile ducts by x-rays. This is accomplished by the insertion of a thin needle into the liver carrying a contrast medium to help to see blockage in liver and bile ducts. # Endoscopic retrograde cholangiopancreatography (ERCP). Although this is a form of imaging, it is both diagnostic and therapeutic, and is often classified with surgeries rather than with imaging. # Primary cholangiography (or ''perioperative''): Done in the operation room during a biliary drainage intervention. # Secondary cholangiography: Done after a biliary drainage intervention. In both cases fluorescent fluids are used to create contrasts that make the diagnosis possible. Cholangiography has largely replaced the previously used method of intravenou ...
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Percutaneous Transhepatic Cholangiography
Percutaneous transhepatic cholangiography, percutaneous hepatic cholangiogram (PTHC) is a radiological technique used to visualize the anatomy of the biliary tract. A contrast medium is injected into a bile duct in the liver, after which X-rays are taken. It allows access to the biliary tree in cases where endoscopic retrograde cholangiopancreatography has been unsuccessful. Initially reported in 1937, the procedure became popular in 1952. Uses Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla. In this rendezvous technique, the guidewire is then pulled into duodenoscope and a small blade is slid over the guidewire into the CBD and perform surgeries on a specific bile ...
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Bile Duct
A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It joins the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct which then opens into the intestine. Structure 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. It opens into the part of the intestine called the duodenum via the ampulla of Vater. Segments The biliary tree (see below) is the whole network of various sized ducts branching through the liver. The path is as follows: Bile canaliculi → Canals of Hering → interlobular bile ducts → intrahepatic bile ducts → left and right hepatic ducts ''merge to form'' → common hepatic duct ''exits live ...
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X-rays
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 Picometre, picometers to 10 Nanometre, nanometers, corresponding to frequency, frequencies in the range 30 Hertz, petahertz to 30 Hertz, exahertz ( to ) and energies in the range 145 electronvolt, eV to 124 keV. X-ray wavelengths are shorter than those of ultraviolet, UV rays and typically longer than those of gamma rays. In many languages, X-radiation is referred to as Röntgen radiation, after the German scientist Wilhelm Röntgen, Wilhelm Conrad Röntgen, who discovered it on November 8, 1895. He named it ''X-radiation'' to signify an unknown type of radiation.Novelline, Robert (1997). ''Squire's Fundamentals of Radiology''. Harvard University Press. 5th edition. . Spellings of ''X-ray(s)'' in English include the variants ''x-ray(s)'', ''xray(s)'', and ''X ray(s)''. The most familiar use of X-ra ...
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Liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it is located in the quadrant (anatomy), right upper quadrant of the abdomen, below the thoracic diaphragm, diaphragm. Its other roles in metabolism include the regulation of Glycogen, glycogen storage, decomposition of red blood cells, and the production of hormones. The liver is an accessory digestive organ that produces bile, an alkaline fluid containing cholesterol and bile acids, which helps the fatty acid degradation, breakdown of fat. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver which is later moved to the small intestine to complete digestion. The liver's highly specialized biological tissue, tissue, consisting mostly of hepatocytes, regulates a w ...
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Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject a contrast medium into the ducts in the biliary tree and pancreas so they can be seen on radiographs. ERCP is used primarily to diagnose and treat conditions of the bile ducts and main pancreatic duct, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP can be performed for diagnostic and therapeutic reasons, although the development of safer and relatively non-invasive investigations such as magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound has meant that ERCP is now rarely performed without therapeutic intent. Medical u ...
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Primary Cholangiography
Primary or primaries may refer to: Arts, entertainment, and media Music Groups and labels * Primary (band), from Australia * Primary (musician), hip hop musician and record producer from South Korea * Primary Music, Israeli record label Works * ''Primary'' (album) by Rubicon (2002) * "Primary" (song) by The Cure * "Primary", song by Spoon from the album ''Telephono'' Other uses in arts, entertainment, and media * Primaries or primary beams, in E. E. Smith's science-fiction series ''Lensman'' * ''Primary'' (film), American political documentary (1960) Computing * PRIMARY, an X Window selection * Primary data storage, computer technology used to retain digital data * Primary server, main server on the server farm Education * Primary education, the first stage of compulsory education * Primary FRCA, academic examination for anaesthetists in the U.K. * Primary school, school providing primary education Mathematics * ''p''-group of prime power order * Primary decompositi ...
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Secondary Cholangiography
Secondary may refer to: Science and nature * Secondary emission, of particles ** Secondary electrons, electrons generated as ionization products * The secondary winding, or the electrical or electronic circuit connected to the secondary winding in a transformer * Secondary (chemistry), a term used in organic chemistry to classify various types of compounds * Secondary color, color made from mixing primary colors * Secondary mirror, second mirror element/focusing surface in a reflecting telescope * Secondary craters, often called "secondaries" * Secondary consumer, in ecology * An obsolete name for the Mesozoic in geosciences * Secondary feathers, flight feathers attached to the ulna on the wings of birds Society and culture * Secondary (football), a position in American football and Canadian football * Secondary dominant in music * Secondary education, education which typically takes place after six years of primary education ** Secondary school, the type of school at the secon ...
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Fluorescent
Fluorescence is the emission of light by a substance that has absorbed light or other electromagnetic radiation. It is a form of luminescence. In most cases, the emitted light has a longer wavelength, and therefore a lower photon energy, than the absorbed radiation. A perceptible example of fluorescence occurs when the absorbed radiation is in the ultraviolet region of the electromagnetic spectrum (invisible to the human eye), while the emitted light is in the visible region; this gives the fluorescent substance a distinct color that can only be seen when the substance has been exposed to UV light. Fluorescent materials cease to glow nearly immediately when the radiation source stops, unlike phosphorescent materials, which continue to emit light for some time after. Fluorescence has many practical applications, including mineralogy, gemology, medicine, chemical sensors (fluorescence spectroscopy), fluorescent labelling, dyes, biological detectors, cosmic-ray detection, vacuu ...
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Intravenous Cholangiography
Intravenous cholangiography is a form of cholangiography that was introduced in 1954. Overview The intravenous cholangiogram or IVC is a radiologic (x-ray) procedure that is used primarily to look at the larger bile ducts within the liver and the bile ducts outside the liver. The procedure can be used to locate gallstones within these bile ducts. IVC also can be used to identify other causes of obstruction to the flow of bile, for example, narrowings (strictures) of the bile ducts and cancers that may impair the normal flow of bile. Procedure To do an IVC, an iodine-containing dye (meglumine ioglycamate) is injected intravenously into the blood. The liver then removes the dye from the blood and excretes it into the bile. The iodine is sufficiently concentrated as it is secreted into the bile that it does not need to be further concentrated by the gallbladder to outline the bile ducts and any gallstones that may be there. The gallbladder is not always seen on an IVC, as the iodine ...
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Magnetic Resonance Cholangiopancreatography
Magnetic resonance cholangiopancreatography (MRCP) is a medical imaging technique. It uses magnetic resonance imaging to visualize the biliary and pancreatic ducts non-invasively. This procedure can be used to determine whether gallstones are lodged in any of the ducts surrounding the gallbladder. Uses MRCP has been slowly replacing endoscopic retrograde cholangiopancreatography (ERCP) as investigation of choice. MRCP is highly accurate in diagnosing the biliary system, pancreatic duct and accessing surrounding solid organs. Several advantages offered by MRCP is its non-invasive nature, less costly, requires less examination time when compared to ERCP (30 minutes), fewer staff required, and does not require any ionising radiation. MRCP is used to diagnose gallstones. It can also diagnose choledochal cysts very reliably. Besides providing information regarding the biliary system, MRCP also provides information regarding surrounding solid organs and blood vessels, thus useful for ...
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Projectional Radiography
Projectional radiography, also known as conventional radiography, is a form of radiography and medical imaging that produces two-dimensional images by x-ray radiation. The image acquisition is generally performed by radiographers, and the images are often examined by radiologists. Both the procedure and any resultant images are often simply called "X-ray". Plain radiography or roentgenography generally refers to projectional radiography (without the use of more advanced techniques such as computed tomography that can generate 3D-images). ''Plain radiography'' can also refer to radiography without a radiocontrast agent or radiography that generates single static images, as contrasted to fluoroscopy, which are technically also projectional. Equipment X-ray generator Projectional radiographs generally use X-rays created by X-ray generators, which generate X-rays from X-ray tubes. Grid An anti-scatter grid may be placed between the patient and the detector to reduce the quanti ...
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Hepatology
Hepatology is the branch of medicine that incorporates the study of liver, gallbladder, biliary tree, and pancreas as well as management of their disorders. Although traditionally considered a sub-specialty of gastroenterology, rapid expansion has led in some countries to doctors specializing solely on this area, who are called hepatologists. Diseases and complications related to viral hepatitis and alcohol are the main reason for seeking specialist advice. More than two billion people have been infected with hepatitis B virus at some point in their life, and approximately 350 million have become persistent carriers. Up to 80% of liver cancers can be attributed to either hepatitis B or hepatitis C virus. In terms of mortality, the former is second only to smoking among known agents causing cancer. With more widespread implementation of vaccination and strict screening before blood transfusion, lower infection rates are expected in the future. In many countries, however, overall ...
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