Billiary tree includes the ductal parts which contains bile. Thus there are two main divisions; intra hepatic and extra hepatic.
Cholecystectomy –Cholecystectomy is a commonly performed surgical procedure. Laparoscopic cholecystectomy is the standard procedure in most patients. Symptomatic gallstones; either due to acute or chronic inflammation or biliary colic are the usual indications. Biliary colic usually present with right sided recurrent pain. Chronic cholecystitis usually gives rise to symptoms to gastritis. Acute cholecystitis the pain is associated with fever.Laparocsopic cholecystectomy is done with three or four small cuts made in the abdominal wall. Surgery can take usually around one to one and half hours. Most patients are discharged in the following day.
Choledochal cyst –Choledochal cysts are abnormal dilatation in the biliary tree without a significant distal obstruction. They present with abdominal discomfort pain or fever and occasionally jaundice. These carry a risk of malignancy towards the latter part of life. Due to this surgical excision and reconstruction of the biliary drainage system is recommended in them.
Bile duct injuries -Bile duct injuries has become a serious concern in laparoscopic cholecystectomy Proper training and extreme care can make the risk of this unfortunate complication negligible. According to literature the incidence is around 0.05%. the degree of injury can vary from simple bile leak to complete damage of the bile duct. North Colombo center gets many referrals with bile duct injuries. We perform immediate repair compared to delayed approach in some canters.
Tumours in the biliary tree –Commonest type of cancer in the biliary tree are cholangiocarcinoma. They are very aggressive type of a cancer. Usual presentation is yellow discoloration of eyes without pain. Surgical resection is the best treatment in them as it gives a chance of cure. All the other treatment are intended to relieve symptom.