cystic duct

胆嚢管

WordNet

1. press or wedge together; pack together
2. a forceful consequence; a strong effect; "the book had an important impact on my thinking"; "the book packs a wallop" (同)wallop
3. the striking of one body against another
4. a continuous tube formed by a row of elongated cells lacking intervening end walls
5. an enclosed conduit for a fluid
6. a bodily passage or tube lined with epithelial cells and conveying a secretion or other substance; "the tear duct was obstructed"; "the alimentary canal"; "poison is released through a channel in the snakes fangs" (同)epithelial duct, canal, channel
7. of or relating to or resembling a cyst
8. of or relating to a normal cyst (as the gallbladder or urinary bladder)
9. a closed sac that develops abnormally in some body structure

PrepTutorEJDIC

1. 〈U〉〈C〉(…の…に対する)衝突,衝撃《+『of』+『名』+『against』(『on』,『upon』,『with』)+『名』》 / 〈C〉(…の…に対する)影響(influence)影響力《+『of』+『名』+『on』(『upon, against』)+『名』》
2. 送水管;(建物・船などの)通気管;(地下ケーブルなどの)ダクト / (体液を運ぶ)導管,(植物が水・空気を運ぶ)導管
3. 胞嚢(ほうのう)性の
4. 胞嚢(ほうのう)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/07/27 17:20:49」(JST)

wiki en

[Wiki en表示]

Cystic duct
1: Right lobe of liver 2: Left lobe of liver 3: Quadrate lobe of liver 4: Round ligament of liver 5: Falciform ligament 6: Caudate lobe of liver 7: Inferior vena cava 8: Common bile duct 9: Hepatic artery 10: Portal vein 11: Cystic duct 12: Hepatic duct 13: Gallbladder
Latin	ductus cysticus
Gray's	p.1198
Artery	cystic artery

1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen.
13. Esophagus. 14. Stomach. Small intestine: 15. Duodenum, 16. Jejunum
17. Pancreas: 18: Accessory pancreatic duct, 19: Pancreatic duct.
20–21: Right and left kidneys (silhouette).

The anterior border of the liver is lifted upwards (brown arrow). Gallbladder with Longitudinal section, pancreas and duodenum with frontal one. Intrahepatic ducts and stomach in transparency.

The cystic duct is the short duct that joins the gallbladder to the common bile duct. It usually lies next to the cystic artery. It is of variable length. It contains 'spiral valves of Heister,' which do not provide much resistance to the flow of bile.

Function

Bile can flow in both directions between the gallbladder and the common hepatic duct and the (common) bile duct.

In this way, bile is stored in the gallbladder in between meal times. The hormone cholecystokinin, when stimulated by a fatty meal, promotes bile secretion by increased production of hepatic bile, contraction of the gall bladder, and relaxation of the Sphincter of Oddi.

Clinical significance

Gallstones can enter and obstruct the cystic duct, preventing the flow of bile. The increased pressure in the gallbladder leads to swelling and pain. This pain, known as biliary colic, is sometimes referred to as a gallbladder "attack" because of its sudden onset.

During a cholecystectomy, the cystic duct is clipped two or three times and a cut is made between the clips, freeing the gallbladder to be taken out.

Postoperative Cystic Duct Stump Leaks (CDSL)

This is a leak from the cystic duct stump in post cholecystectomy patients. It was rarely reported in open cholecystectomy patients. Since the advent of laparoscopic cholecystectomy the incidence of CDSL has increased with one study doing it to occur in 0.1 to 0.2% of patientss Cystic duct stump leak is the commonest cause of bile leak and technical morbidity according to one study. The cause may be not related the presence of emergency laparoscopic cholecystecomies as one study showed that only 46.6% of CDSL occurred with acute cholecystitis.

Theories of the CDSL include:

1. Cystic duct displacement:

1a. Improper firing can cause the clip to displace as one study showed clipless cystic ducts after placement of 2 cystic duct clips.

1b. Cystic duct displacement could be due to abnormal cystic duct morphological features. This could place constrictions which thus could lead to improper firing. A solution is to suture the duct or as last resort leave a T tube or Jackson-pratt drain intraoperatively.

2. Necrosis of cystic duct stump proximal to clip: This would occur proximal to the applied clip. Necrosis may be secondary to electrocautery creating a phenomenon called "clip-coupling" in which excessive electrocautery near the clips, conducted via the metal in the clips, causes necrosis of the proximal cystic duct

3. Ischemic necrosis secondary to devascularization: One study showed that blood flow can be disrupted from dissecting. One study showed a pseudoaneurysm of the right hepatic artery causing vascular disrupting blood supply to the cystic duct. A solution is dividing the cystic artery distally.

4. Increased biliary pressure: This can be due to a retained common bile duct stone creating pressure in the biliary tree. This may be the most rare causes of CDSL.

CDSL Presentation

CDSL presents 3 to 4 days after operation with right upper quandrant pain, followed by nausea, vomiting, and fever. High WBC is described in 68% of patient. Liver function tests can be highly variable.

Diagnosis and Treatment of CDSL

Initial test is ultrasonography to screen out biloma, ascites, or retained stones. Computed tomgraphy has a high sensitivity approaching 100% for detecting leaks. The most successful imaging is from ERCP. ERCP has the additional value of allowing for treatment which often consists of sphincterotomy with common bile duct stenting.

See also

• Accessory bile duct

Additional images

• Digestive system diagram showing the cystic duct

• The gall-bladder and bile ducts laid open.

• The portal vein and its tributaries.

• Cystic duct.Visceral surface of liver.

References

External links

• cystic+duct at eMedicine Dictionary
• Anatomy figure: 38:06-03 at Human Anatomy Online, SUNY Downstate Medical Center - "The gallbladder and extrahepatic bile ducts."
• Anatomy photo:38:14-0106 at the SUNY Downstate Medical Center - "Stomach, Spleen and Liver: The Gallbladder and the Bile System"
• liver at The Anatomy Lesson by Wesley Norman (Georgetown University) (liverinferior, biliarysystem)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 成人における胆嚢機能障害 functional gallbladder disorder in adults
• 2. 急性胆嚢炎：病因、臨床的特徴、および診断 acute cholecystitis pathogenesis clinical features and diagnosis
• 3. 成人における合併症のない胆石症 uncomplicated gallstone disease in adults
• 4. 腹腔鏡下胆嚢摘出術の合併症 complications of laparoscopic cholecystectomy
• 5. オッディ括約筋機能不全の臨床症状よび診断 clinical manifestations and diagnosis of sphincter of oddi dysfunction

English Journal

• Acute acalculous cholecystitis due to breast cancer metastasis to the cystic duct.

• Hashimoto M1, Koide K2, Arita M2, Kawaguchi K2, Tokunaga M2, Mikuriya Y2, Iwamoto T3.
• Surgical case reports.Surg Case Rep.2016 Dec;2(1):111. Epub 2016 Oct 12.
• BACKGROUND: Acute acalculous cholecystitis (AAC) is a relatively rare disorder of the gallbladder. Breast cancer recurrence more than 10 years after curative surgery is also infrequent.CASE PRESENTATION: Here, we report a case of a 59-year-old woman who presented with right flank pain. Her medical
• PMID 27730536

• A resected case of symptomatic acinar cell cystadenoma of the pancreas displacing the main pancreatic duct.

• Tanaka H1,2, Hatsuno T3, Kinoshita M3, Hasegawa K3, Ishihara H3, Takano N3, Shimoyama S3, Nakayama H3, Kataoka M3, Ichihara S4, Kanda M5, Kodera Y5, Kondo K3.
• Surgical case reports.Surg Case Rep.2016 Dec;2(1):39. doi: 10.1186/s40792-016-0166-1. Epub 2016 Apr 23.
• Acinar cell cystadenoma (ACA) of the pancreas has been newly recognized as an entity by the World Health Organization (WHO) definition (2010), and its pathogenesis has not been known adequately because of the rarity. Here, we report a case of a 22-year-old female who had been followed up for a cysti
• PMID 27108123

• Ciliated foregut cyst in the triangle of Calot: the first report.

• Al Beteddini OS1, Amra NK2, Sherkawi E3.
• Surgical case reports.Surg Case Rep.2016 Dec;2(1):20. doi: 10.1186/s40792-016-0147-4. Epub 2016 Feb 25.
• Ciliated foregut cysts are rare anomalies arising from remnants of aberrant embryological development. Around 100 reports on the presence of these congenital masses in the tracheobronchial tree, mediastinum, liver, pancreas and, rarely, the gallbladder have been described. In this article, the case
• PMID 26943696

Japanese Journal

• Bile duct injuries after laparoscopic cholecystectomy: 11-year experience in a tertiary center

• BioScience Trends 10(3), 197-201, 2016
• NAID 130005167349

• Historical control background incidence of spontaneous thyroid and parathyroid glands lesions of rats and CD-1 mice used in 104-week carcinogenicity studies

• Journal of Toxicologic Pathology 29(3), 201-206, 2016
• NAID 130005165776

• ガマ腫様の口底部腫脹を呈した顎下腺管閉鎖症の1例

• 日本口腔外科学会雑誌 62(5), 232-237, 2016
• NAID 130005165613

Related Links

• cystic duct - definition of cystic duct by Medical dictionary

cystic duct n. The duct that leads from the gallbladder and joins the hepatic duct to form the common bile duct. cystic duct, the duct through which bile from the gallbladder passes into the common bile duct. duct [dukt] a passage ...

• Cystic Duct - Human Anatomy: Learn All About the Human ...

The cystic duct is between two and four centimeters long. It lies between the gallbladder and the common bile duct. It transmits bile between ducts that are important for the digestion process and the gallbladder. Usually it's found ...

Related Pictures

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★リンクテーブル★

リンク元	「impact」「胆嚢管」
拡張検索	「cystic duct stump syndrome」
関連記事	「duct」「cystic」

「impact」

　　[★]

• n.

• 衝撃、打撃、衝突。影響、影響力

• vt.

• しっかり固定する。密着させる、詰め込む(into, in)。～に衝突する。強く打つ/たたく、たたきつける。～に強い衝撃/影響を与える。～に有害/不利な影響を与える、逆効果的である

• vi.

• 強い衝撃/影響を与える。強く当たる(on, against)。有害/不利な影響を与える。

cholecystitis is usually cased by a gallstone impacting in the cystic duct. ←("嵌入する"の意味で用いられている)

関

affect, effect, impaction, impinge, impulse, impulsive, influence, intrusion, invaginate, invagination, percussion

　 　 　 　

「胆嚢管」

　　[★]

英

cystic duct (KH,Z)

ラ

ductus cysticus

関

胆管系、総胆管、胆道

• 胆嚢頚部～総肝管・総胆管の合流部(三管合流部)をつなぐ管

「cystic duct stump syndrome」

　　[★] 胆嚢管断端症候群、胆嚢管遺残症

「duct」

　　[★]

• n.

• 管、(植物)導管

関

canal、conduit、ductal、ductus、meatus、pipe、tubal、tube、vas、vessel

　 　 　 　

「cystic」

　　[★]

• adj.

• 嚢胞性の