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https://www.readbyqxmd.com/read/28224465/long-term-outcomes-following-percutaneous-cholecystostomy-tube-placement-for-treatment-of-acute-calculous-cholecystitis
#1
Donna Marie L Alvino, Zhi Ven Fong, Colin J McCarthy, George Velmahos, Keith D Lillemoe, Peter R Mueller, Peter J Fagenholz
INTRODUCTION: Percutaneous cholecystostomy tube (PCT) placement is considered a safe alternative to cholecystectomy for the treatment of acute calculous cholecystitis (ACC), but data regarding long-term outcomes following PCT are limited. METHODS: We retrospectively reviewed our institutional experience of patients undergoing PCT for ACC between 1997 and 2015. Recurrent biliary events were defined as cholecystitis, cholangitis, or gallstone pancreatitis. RESULTS: PCT was placed for 288 patients with ACC...
February 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28186337/impaired-intestinal-cholecystokinin-secretion-a-fascinating-but-overlooked-link-between-celiac-disease-and-cholesterol-gallstone-disease
#2
REVIEW
Helen H Wang, Min Liu, Xiaodan Li, Piero Portincasa, David Q-H Wang
BACKGROUND: Celiac disease is a chronic, small intestinal, immune-mediated enteropathy caused by a permanent intolerance to dietary gluten in genetically predisposed individuals. Clinical studies have found that intestinal cholecystokinin secretion and gallbladder emptying in response to a fatty meal are impaired before celiac patients start the gluten-free diet (GFD). DESIGN: However, it was never really appreciated whether celiac disease is associated with gallstones because there were very few studies investigating the mechanism underlying the impact of celiac disease on the pathogenesis of gallstones...
February 10, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28185534/effect-of-inhibition-of-intestinal-cholesterol-absorption-on-the-prevention-of-cholesterol-gallstone-formation
#3
Piero Portincasa, David Q-H Wang
BACKGROUND: Cholesterol cholelithiasis is a multifactorial hepatobiliary disease. METHODS: Interactions between genetic and environmental factors play a critical role in biliary cholesterol homeostasis and its imbalance enhances cholelithogenesis. RESULTS: In patients developing symptoms or complications of gallstone disease, laparoscopic cholecystectomy is recommended for treatment of gallstones. In a subgroup of patients with small, radiolucent pure cholesterol gallstones, the hydrophilic bile acid, ursodeoxycholic acid (UDCA) is still considered only pharmacological therapy able to induce oral litholysis...
February 9, 2017: Medicinal Chemistry
https://www.readbyqxmd.com/read/28145001/treatment-with-the-natural-fxr-agonist-chenodeoxycholic-acid-reduces-clearance-of-plasma-ldl-whilst-decreasing-circulating-pcsk9-lipoprotein-a-and-apolipoprotein-c-iii
#4
M Ghosh Laskar, M Eriksson, M Rudling, B Angelin
BACKGROUND: The natural farnesoid X receptor (FXR) agonist chenodeoxycholic acid (CDCA) suppresses hepatic cholesterol and bile acid synthesis and reduces biliary cholesterol secretion and triglyceride production. Animal studies have shown that bile acids downregulate hepatic LDL receptors (LDLRs); however, information on LDL metabolism in humans is limited. METHODS: Kinetics of autologous (125) I-LDL were determined in 12 male subjects at baseline and during treatment with CDCA (15 mg kg(-1) day(-1) )...
February 1, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28141556/ultrasound-measurement-of-the-gallbladder-wall-thickness-in-the-assessment-of-the-risk-of-conversion-from-elective-laparoscopic-cholecystectomy-to-open-surgery-olkusz-county-experience
#5
Dariusz Kania
: The aim of the study was to assess the risk of intraoperative difficulties, conversion and biliary-intestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gall-bladder wall thickness. MATERIAL AND METHODS: A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χ2) independence test was used, and the results were interpreted for the significance threshold of α = 0...
December 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28138229/risk-factors-for-gallbladder-contractility-after-cholecystolithotomy-in-elderly-high-risk-surgical-patients
#6
Tao Wang, Hao Luo, Hong-Tao Yan, Guo-Hu Zhang, Wei-Hui Liu, Li-Jun Tang
OBJECTIVE: Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia. METHODS: To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28118676/short-term-outcome-of-total-clipless-laparoscopic-cholecystectomy-for-complicated-gallbladder-stones-in-cirrhotic-patients
#7
Mohamed I Kassem, Ehab M Hassouna
BACKGROUND: Cirrhotic patients have been known to be more affected with gallstones than their non-cirrhotic counterparts; since laparoscopy was introduced, it has been generally approved as the standard approach for cholecystectomies with the exception of end-stage cirrhosis. The purpose of this study was to evaluate the safety and efficacy of clipless laparoscopic cholecystectomy using the harmonic scalpel in complicated cholelithiasis in cirrhotic patients. METHODS: This prospective study was conducted on 62 cirrhotic patients presenting to the Gastrointestinal Surgery Unit in Alexandria Main University Hospital with complicated gallstones between March 2013 and March 2016...
January 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28110901/-gastrointestinal-bleeding-and-delirium-challenges-in-the-diagnosis-of-gallstone-ileus-a-case-report-and-review-of-literature
#8
Francisco Aguilar-Espinosa, José Luis Gálvez-Romero, Jesús Falfán-Moreno, Gustavo Adolfo Guerrero-Martínez, Facundo Vargas-Solís
BACKGROUND: Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. CLINICAL CASE: A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia...
January 19, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28104896/the-role-of-endoscopic-biliary-drainage-without-sphincterotomy-in-gallstone-patients-with-cholangitis-and-suspected-common-bile-duct-stones-not-detected-by-cholangiogram-or-intraductal-ultrasonography
#9
Hyeon Jeong Goong, Jong Ho Moon, Yun Nah Lee, Hyun Jong Choi, Seo-Youn Choi, Moon Han Choi, Min Jin Kim, Tae Hoon Lee, Sang-Heum Park, Hae Kyung Lee
Background/Aims: Treatment for cholangitis without common bile duct (CBD) stones has not been established in patients with gallstones. We investigated the usefulness of endoscopic biliary drainage (EBD) without endoscopic sphincterotomy (EST) in patients diagnosed with gallstones and cholangitis without CBD stones by endoscopic retrograde cholangiopancreatography (ERCP) and intraductal ultrasonography (IDUS). Methods: EBD using 5-F plastic stents without EST was performed prospectively in patients with gallstones and cholangitis if CBD stones were not diagnosed by ERCP and IDUS...
January 20, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28088462/activation-of-the-hypoxia-inducible-factor-1-alpha-subunit-pathway-in-steatotic-liver-contributes-to-formation-of-cholesterol-gallstones
#10
Yoichiro Asai, Tetsuya Yamada, Sohei Tsukita, Kei Takahashi, Masamitsu Maekawa, Midori Honma, Masanori Ikeda, Keigo Murakami, Yuichiro Munakata, Yuta Shirai, Shinjiro Kodama, Takashi Sugisawa, Yumiko Chiba, Yasuteru Kondo, Keizo Kaneko, Kenji Uno, Shojiro Sawada, Junta Imai, Yasuhiro Nakamura, Hiroaki Yamaguchi, Kozo Tanaka, Hironobu Sasano, Nariyasu Mano, Yoshiyuki Ueno, Tooru Shimosegawa, Hideki Katagiri
BACKGROUND AND AIMS: Hypoxia inducible factor 1 alpha subunit (HIF1A) is a transcription factor that controls the cellular response to hypoxia and is activated in hepatocytes of patients with non-alcoholic fatty liver disease (NAFLD). NAFLD increases risk for cholesterol gallstone disease by unclear mechanisms. We studied the relationship between HIF1A and gallstone formation associated with liver steatosis. METHODS: We performed studies with mice with inducible disruption of Hif1a in hepatocytes, via a Cre adenoviral vector (iH-HIFKO mice), and mice without disruption of Hif1a (control mice)...
January 11, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#11
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28071655/effectiveness-of-guideline-recommended-cholecystectomy-to-prevent-recurrent-pancreatitis
#12
Ayesha Kamal, Eboselume Akhuemonkhan, Venkata S Akshintala, Vikesh K Singh, Anthony N Kalloo, Susan M Hutfless
OBJECTIVES: Cholecystectomy during or within 4 weeks of hospitalization for acute biliary pancreatitis is recommended by guidelines. We examined adherence to the guidelines for incident mild-to-moderate acute biliary pancreatitis and the effectiveness of cholecystectomy to prevent recurrent episodes of pancreatitis. METHODS: Individuals in the 2010-2013 MarketScan Commercial Claims & Encounters database with a hospitalization associated with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes of 577...
January 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28054294/treatment-of-common-bile-duct-stones-in-gastric-bypass-patients-with-laparoscopic-transgastric-endoscopic-retrograde-cholangiopancreatography
#13
Nina A Frederiksen, Louise Tveskov, Frederik Helgstrand, Lars Naver, Andrea Floyd
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Various techniques to access the biliary tree have been described. The techniques are characterised by complexity and varying results. The aim of the present study was to assess both feasibility and outcome of laparoscopic-assisted transgastric ERCP in patients with gastric bypass...
January 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28051233/giant-staghorn-common-bile-duct-calculus
#14
Mohamed Salah Jarrar, Mohamed Habib Ben Hadj Khalifa, Rafik Ghrissi, Imed Ben Mansour, Fehmi Hamila, Amine Elghali, Rached Letaief
Background - Stones in common bile duct are defined as 'large' if they are more than 15 mm in size. There are very few reports which describe a giant stone measuring 5 cm or more and exceptionally a staghorn calculus in the common bile duct. Purpose - The purpose is to report a new rare case of giant staghorn gallstone and discuss the diagnostic approach and therapeutic possibilities. Case report - We report a case of a giant staghorn common bile duct calculus in a 65-year-old patient. Its removal required 2 operations and an endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy...
July 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28051219/incidental-gallbladder-cancer-diagnosed-on-cholecystectomy-specimens-a-study-of-30-cases
#15
Sana Ben Slama, Rym Ennaifer, Dhouha Bacha, Rached Bayar, Saadia Bouraoui, Lassaad Gharbi, Ahlem Lahmar
Background - The gallbladder cancer is a rare cancer with poor prognosis. The association with gallstone disease is the main risk factor of this cancer. Aim - Describe the demographics, clinic-pathologic and therapeutic management of incidentally gallbladder cancer diagnosed on cholecystectomy specimens. Methods - retrospective study including 30 cases of gallbladder cancer incidentally detected on cholecystectomy specimens. Results - The incidence of gallbladder cancer incidentally discovered was 0.83%. The sex ratio M/F was 0...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28044954/haemobilia-a-rare-cause-of-upper-gastro-intestinal-bleeding
#16
Daniel Ion, Carmen Iuliana Mavrodin, Mihai Bogdan Șerban, Tudor Marinescu, Dan Nicolae Păduraru
Haemobilia is a rare cause of upper gastrointestinal bleeding that consists of haemorrhage within the biliary tree. Most cases of haemobilia are due to iatrogenic cause, laparoscopic or open cholecystectomy, abdominal trauma, gallstones, hepatic tumours, vascular aneurism. We present the case of a male patient admitted in the surgery department for epigastric and right hypochondria pain, nausea and vomiting. Open cholecystectomy was performed with a trans-cystic tube drainage. Postoperative outcome was favourable but with a continuous decrease in haemoglobin level...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28035552/small-gallstone-size-and-delayed-cholecystectomy-increase-the-risk-of-recurrent-pancreatobiliary-complications-after-resolved-acute-biliary-pancreatitis
#17
Sung Bum Kim, Tae Nyeun Kim, Hyun Hee Chung, Kook Hyun Kim
INTRODUCTION: Acute biliary pancreatitis (ABP) is a severe complication of gallstone disease with considerable mortality, and its recurrence rate is reported as 50-90% for ABP patients who do not undergo cholecystectomy. However, the incidence of and risk factors for recurrent pancreatobiliary complications after the initial improvement of ABP are not well established in the literature. The aims of this study were to determine the risk factors for recurrent pancreatobiliary complications and to compare the outcomes between early (within 2 weeks after onset of pancreatitis) and delayed cholecystectomy in patients with ABP...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#18
REVIEW
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27990758/factor-analysis-of-recurrent-biliary-events-in-long-term-follow-up-of-gallstone-pancreatitis
#19
Ji Min Lee, Woo Chul Chung, Hea Jung Sung, Yeon-Ji Kim, Gun Jung Youn, Yun Duk Jung, Sooa Choi, Eun Jung Jeon
OBJECTIVE: Recurrent attacks after acute gallstone pancreatitis (GSP) are a substantial problem with associated morbidity and mortality. The recommended therapies for recurrent attacks are cholecystectomy and endoscopic sphincterotomy (EST). This study aimed to evaluate the long-term results of cholecystectomy and EST after clinical improvement of GSP. METHODS: A consecutive series of patients who were admitted with GSP between January 2003 to December 2014 were analyzed...
December 18, 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27990011/retrospective-analysis-of-canine-gallbladder-contents-in-biliary-sludge-and-gallbladder-mucoceles
#20
Shinya Mizutani, Shidow Torisu, Yasuyuki Kaneko, Shushi Yamamoto, Shinsuke Fujimoto, Benedict Ong Huai Ern, Kiyokazu Naganobu
The pathophysiology of canine gallbladder diseases, including biliary sludge, gallbladder mucoceles, and gallstones, is poorly understood. This study aimed to evaluate the composition of gallbladder contents and bacterial infection of the gallbladder in order to elucidate the pathophysiology of biliary sludge and gallbladder mucoceles. A total of 43 samples of canine gallbladder contents (biliary sludge, 21 and gallbladder mucoceles, 22) were subjected to component analysis by infrared spectroscopy, and the resultant infrared spectra were compared with that of swine mucin...
December 17, 2016: Journal of Veterinary Medical Science
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