Study of Relationship Between the Blood Supply of the Extrahepatic Bile Duct and Duct Supply Branches from Gastroduodenal Artery on Imaging and Anatomy

Abstract

Background:Liver transplantation has become the treatment of choice for patients with end-stage acute or chronic hepatic disease. Bile duct complications are common events after liver transplantation. The aim of this study was to evaluate the blood supply of the human bile duct and identify the underlying mechanisms of bile duct complications after liver transplantation.Methods:The duct supply branches from gastroduodenal artery and blood supply of extrahepatic bile duct system were re-evaluated through selective hepatic angiography from 600 patients. In addition, 33 cadavers were injected with latex casting material into the common hepatic artery, then the extrahepatic bile duct and the branches from the common hepatic artery were carefully dissected to visualize the gastroduodenal artery and its branching to the extrahepatic bile duct.Results:The bile duct artery arose from the branch of the gastroduodenal artery in 8.1% (49/600). Of these 49 individuals, the bile duct artery was supplied by the gastroduodenal artery (61.22%, 30/49), the proper hepatic artery (14.29%, 7/49), or both the gastroduodenal artery and the proper hepatic artery (24.49%, 12/49). In our study of 33 cadavers, the percentage that the bile duct artery arose from the gastroduodenal artery was 27.27%. The blood supply to the bile extrahepatic bile ducts was divided into different segments and formed longitudinal and arterial network anastomosed on the walls of the duct.Conclusions:There is a close relationship between the duct supply branches from gastroduodenal artery and the blood supplying patterns of the extrahepatic bile duct system. In liver transplant surgery, the initial part of the gastroduodenal artery is preferred to be preserved in the donor liver. It is of great significance to improve the success rate of operation and reduce complications.

Micro- and ultrastructural organization of the common bile duct wall during four-week opioid effect in the experiment

“…Холангіоцити становлять лише 3-5% від загальної кількості клітин печінки, але мають унікальну морфологію [8,9]. Широке використання наркотичних середників у клінічній практиці з метою отримання знеболювального та протизапального ефе-__________________________________________________________________________________ MORPHOLOGIA • 2020 • Том 14 • № 3 60 ктів вимагає комплексного морфологічного дослідження особливостей структурної організації органів за умов впливу опіоїдів [10][11][12]. Можна передбачити негативну дію опіоїдів на морфологічний стан жовчних проток.…”

Morphological features of the wall of common bile duct under the conditions of experimental opioid exposure

“…Opioids, in particular morphine, are often used to obtain an analgesic effect in patients with acute cholangitis [12]. However, in the professional literature there are only a few works devoted to the study of the mechanism of action of opioids [8]. Information on the effectiveness of opioids in the treatment of pathological conditions of the bile ducts is often contradictory.…”

Reply: Aberrant arteries—1 may be better than 2 for the liver, but maybe not the bile duct

“…Other options can be graft/recipient gastroduodenal artery or recipient splenic artery.Regarding the second issue, we would like to point out that the vascularization of the extrahepatic biliary tree is complex, variable, and multimodal, being provided by a continuous plexus whose tributary vessels arise from the right, left, and proper aHAs, as well as from pancreaticoduodenal, supraduodenal, gastroduodenal, and retroportal artery. [2][3][4][5] Meanwhile, the pathogenesis of biliary strictures is highly multifactorial, including surgical technique as well as size and length of biliary ducts. Therefore, we believe that drawing definitive conclusions taking in account only the preservation or not of aHAs may be currently hazardous.…”