It can also diagnose gallbladder diseases, e.g. bile leaks of biliary fistulas. Overlapping presentation with primary biliary cholangitis and primary sclerosing cholangitis has been observed. Enzymatic hydrolysis is initiated by intraluminal processes requiring gastric, pancreatic, and biliary secretions. This also affects pipecuroniums metabolism by resisting hepatic uptake, metabolism, and biliary excretion. The definitive treatment for cholangitis is relief of the underlying biliary obstruction. The risk of biliary injury is more during laparoscopic cholecystectomy than during open cholecystectomy. Liver progenitor cells differentiate into two different cell types&colon; hepatocytes and biliary epithelial cells. In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage. If untreated, about 20% of people with biliary colic develop acute cholecystitis. CREST syndrome can be noted in up to 10% of patients with primary biliary cirrhosis. Timmy was diagnosed with biliary atresia upon birth. The bipotential hepatoblasts begin differentiating into biliary epithelial cells and hepatocytes. In acalculous cholecystitis, no stone is in the biliary ducts. UDCA has been used as medical therapy in gallstone disease (cholelithiasis) and for biliary sludge. There are isolated examples of biliary atresia in animals.