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biliary, gallstones

Rishikesh Kalaria, Philip Abraham, Devendra C Desai, Anand Joshi, Tarun Gupta
BACKGROUND: To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression. METHODS: Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015. RESULTS: In the 97 patients included (mean age 47.2 [SD 16...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Thomas Peponis, Trine G Eskesen, Tomaz Mesar, Noelle Saillant, Haytham Ma Kaafarani, D Dante Yeh, Peter J Fagenholz, Marc A de Moya, David R King, George C Velmahos
BACKGROUND: Bile spillage (BS) occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. We hypothesized that BS increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy. STUDY DESIGN: Patients older than 18, who were admitted to an academic hospital for a laparoscopic (or laparoscopic converted to open) cholecystectomy from 05/2010 to 03/2017, were prospectively included. Open cholecystectomies were excluded...
March 1, 2018: Journal of the American College of Surgeons
Monjur Ahmed
Acute cholangitis is bacterial infection of the extra-hepatic biliary system. As it is caused by gallstones blocking the common bile duct in most of the cases, its prevalence is greater in ethnicities with high prevalence of gallstones. Biliary obstruction of any cause is the main predisposing factor. Diagnosis is established by the presence of clinical features, laboratory results and imaging studies. The treatment modalities include administration of intravenous fluid, antibiotics, and drainage of the bile duct...
February 15, 2018: World Journal of Gastrointestinal Pathophysiology
Luke Nugent, Palanichamy Chandran
Dropped gallstones, in addition to inadvertent damage to the biliary tree, is a complication seen in laparoscopic cholecystectomy (LC) far more frequently than the open procedure. It can result in symptomatic abscess formation, and given its relative rarity, can present a diagnostic challenge. We present the case of a lady whose dropped gallstone resulted in a peritoneo-cutaneous fistula, over 20 years on from her LC.
February 2018: Journal of Surgical Case Reports
Susan E Smith, Kelli A Rumbaugh
PURPOSE: Persistent elevation of prothrombin time (PT) and International Normalized Ratio (INR) values in a patient receiving daptomycin is reported. SUMMARY: A morbidly obese 51-year-old man was hospitalized for evaluation for surgical intervention for gallstone pancreatitis and biliary obstruction. Previously prescribed warfarin therapy was withheld due to suspected coagulopathy and an elevated INR (5.1), and warfarin reversal was initiated. After undergoing partial cholecystectomy on hospital day 6, the patient developed sepsis and was treated with i...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Xiaoxiao Fan, Lifeng He, P Asutosh Khadaroo, Daizhan Zhou, Hui Lin
RATIONALE: Duplication of the extrahepatic bile duct is an extremely rare congenital anomaly of the biliary system. PATIENT CONCERNS: A 44-year-old woman presented with a history of continuous upper abdominal pain and vomiting. DIAGNOSES: Magnetic resonance cholangiopancreatography (MRCP) disclosed diffuse dilatation of the intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) showed the presence of two extrahepatic bile ducts with calculus at the distal end of the CBD...
February 2018: Medicine (Baltimore)
S Fedele, P Lobascio, G Carbotta, G Balducci, R Laforgia, M G Sederino, M Minafra, A Delvecchio, N Palasciano
INTRODUCTION: Gallstone ileus is an uncommon condition of mechanical bowel obstruction caused by the passage of a gallstone into the bowel. It occurs more frequently in female patients older than 65 years and often for a biliary-enteric fistula. The pathognomonic features of gallstone ileus - the Rigler's triad - are pneumobilia, ectopic gallstone and bowel obstruction. Less commonly, a gallstone may enter the intestinal lumen through the common bile duct, after endoscopic retrograde cholangiopancreatography, and very rarely in colecistectomized patient...
November 2017: Il Giornale di Chirurgia
Reginald Del Pozo, Lorena Mardones, Marcelo Villagrán, Katia Muñoz, Susana Roa, Francisca Rozas, Valeska Ormazábal, Mirna Muñoz
BACKGROUND: It is known that some nutrients play an important role in the development of cholelithiasis. Cholesterol is carried by micelles and vesicles in the bile. During the first stage of gallstone formation, cholesterol crystals derive from thermodynamically unstable vesicles. AIM: To determine the effect of a high fat diet on blood lipids and bile composition, and its implication in the formation of gallstones. MATERIAL AND METHODS: Two groups of 15 BALB/c mice each, coming from the same litter, were treated with a control or with a high-fat diet (64% fat and 0...
September 2017: Revista Médica de Chile
Julie Vaynshtein, Gilbert Sabbag, Ilya Pinsk, Ilan Rahmani, Avraham Reshef
AIM: Biliary lithiasis is common in most western countries. Symptomatic patients will also have choledocholithiasis in 10% of the cases. For patients with intermediate probability of CBD stones, the recommended imaging studies are endoscopic ultrasound (EUS) or MRCP. This study aims to identify early factors that can be used as predictors for the presence of CBD stones, and by that to find which patient should undergo ERCP without an early EUS. METHODS: This is a retrospective cohort study including all patients who underwent EUS for suspected choledocholithiasis at the Soroka University Medical Center (SUMC) in the years 2009-2014...
February 8, 2018: Scandinavian Journal of Gastroenterology
F Su, E He, L Qian, Z Zhu, L Wei, Z Zeng, W Qu, R Xu, Z Yi
BACKGROUND: Preserving the donor's gallbladder during living donor liver transplantation (LDLT) is a better method for liver transplantation surgery, but not enough is known about gallbladder complications after the operation. METHODS: We retrospectively investigated postsurgical donor gallbladder complications in clinical LDLT with gallbladder preservation. The feasibility of retaining the gallbladder during liver graft procurement is discussed. Ninety-one donors with retained gallbladder after LDLT with the hepatic left lateral sectionectomy (from June 2013 to October 2015) were retrospectively analyzed...
January 2018: Transplantation Proceedings
Hee Seung Lee, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial...
2018: PloS One
Binit Sureka, Amar Mukund
Laparoscopic cholecystectomy is now considered the procedure of choice for uncomplicated symptomatic gallstone disease worldwide. Various biliary, vascular, gastrointestinal, neurological and local complications may be seen on imaging post surgery. Knowledge of these entities and imaging appearances is indispensable for the radiologist in today's era. We emphasize on the list of potential complications and imaging appearances of this surgical procedure.
October 2017: Indian Journal of Radiology & Imaging
Stella Pak, Damian Valencia, Brendan Sheehy, Uchenna Agbim, Yusuf Askaroglu, Christine Dee
Mirizzi syndrome, also known as extrinsic biliary compression syndrome, is a rare clinical entity in which the common bile duct is obstructed by compression by the impaction of one or more gallstones in the cystic duct or gallbladder infundibulum. This case illustrates an absolutely asymptomatic presentation of Mirizzi syndrome in a 62-year-old, otherwise healthy, woman. Mirizzi syndrome was treated with preemptive laparotomy cholecystectomy. The present case is exemplary for careful evaluation with the proper index of suspicion in establishment of preoperative diagnosis as well as prompt treatment prior to development of complications...
November 16, 2017: Curēus
Amrit K Kamboj, Victorio Pidlaoan, Mohammad H Shakhatreh, Alice Hinton, Darwin L Conwell, Somashekar G Krishna
Background and study aims : Endoscopic biliary intervention (BI) is often difficult to perform in patients with prior bariatric surgery (BRS). We sought to analyze outcomes of patients with prior BRS undergoing endoscopic and non-endoscopic BI. Patients and methods:  The Nationwide Inpatient Sample (2007 - 2011) was reviewed to identify all adult inpatients (≥ 18 years) with a history of BRS undergoing BI. The clinical outcomes of interest were in-patient mortality, length of stay (LOS), and total hospital charges...
January 2018: Endoscopy International Open
Lisa Ratanaprasatporn, Jennifer W Uyeda, Jeremy R Wortman, Ian Richardson, Aaron D Sodickson
Imaging of the gallbladder has a key role in the examination of patients with abdominal pain-especially pain localized to the right upper quadrant. Pathologic conditions that affect the gallbladder include cholelithiasis and associated complications such as acute and chronic cholecystitis, choledocholithiasis, gallstone pancreatitis, and cancer. Modalities used to image the gallbladder include ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging, and nuclear scintigraphy. US is the primary imaging modality used to evaluate entities suspected of being gallbladder disease, as it is both sensitive and specific for demonstrating gallstones, biliary duct dilatation, and inflammatory features...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Yoshihide Yamanashi, Tappei Takada, Hiroshi Suzuki
Westernization of dietary habits leads to an increase in lipid intake and is thought to be responsible for an increase in patients with dyslipidemia. It is a well-known fact that the impaired cholesterol homeostasis is closely related to the development of various lifestyle-related diseases such as fatty liver, diabetes, and gallstone as well as dyslipidemia leading to atherosclerosis and cardiovascular diseases such as heart attack and stroke. Therefore, appropriate management of cholesterol levels in the body is considered important in prevention and treatments of these lifestyle-related diseases and in addition, molecular mechanisms controlling plasma (and/or hepatic) cholesterol levels have been intensively studied...
2018: Biological & Pharmaceutical Bulletin
Eun-Ji Lee, Min Hee Kim, Ye-Ryung Kim, Joo-Won Park, Woo-Jae Park
Gallstone disease is one of the most prevalent and costly gastrointestinal disorders worldwide. Gallstones are formed in the biliary system by cholesterol secretions in bile, which result from excess cholesterol, a deficiency in bile salts or a combination of the two. The present study examined the effects of proteasome inhibition on gallstone formation using the proteasome inhibitors bortezomib (BT) and carfilzomib (CF). C57BL/6J mice were fed a lithogenic diet to generate gallstones and injected with BT or CF for 12 weeks...
December 15, 2017: International Journal of Molecular Medicine
Robert C Verdonk, Hanna Sternby, Alexandra Dimova, Povilas Ignatavicius, Peter Koiva, Anne K Penttila, Lucas Ilzarbe, Sara Regner, Jonas Rosendahl, Thomas L Bollen
OBJECTIVE: The most common aetiologies of acute pancreatitis (AP) are gallstones, alcohol and idiopathic. The impact of the aetiology of AP on the extent and morphology of pancreatic and extrapancreatic necrosis (EXPN) has not been clearly established. The aim of the present study was to assess the influence of aetiology on the presence and location of pancreatic necrosis in patients with AP. PATIENTS AND METHODS: We carried out a post-hoc analysis of a previously established multicentre cohort of patients with AP in whom a computed tomography was available for review...
March 2018: European Journal of Gastroenterology & Hepatology
Nilesh H Doctor, Vijay Waman Dhakre
A 59-year-old male patient presented with mild gallstone pancreatitis. He underwent laparoscopic cholecystectomy during the same admission, where we encountered a left-sided gall bladder (GB). This was managed during laparoscopic surgery by modifying the laparoscopic port positions, and we did not encounter any other variations in the biliary anatomy. Thorough knowledge regarding anatomical variations of the GB will help in managing rare cases and avoid injuries to vital structures.
December 13, 2017: BMJ Case Reports
Christophoros S Kosmidis, Georgios D Koimtzis, Maria S Kosmidou, Fotini Ieridou, Triantafyllia Koletsa, Katerina T Zarampouka, Eleni Georgakoudi, Isaac Kesisoglou
BACKGROUND There are different variations in the anatomy of the gallbladder. Congenital abnormalities of the gallbladder such as agenesis and hypoplasia are rare conditions and difficult to diagnose with imaging studies. Patients are usually asymptomatic or have symptoms that mimic gallstone disease. The diagnosis is often made intraoperatively and is established by histopathological examination. CASE REPORT We report a case of a 62-year-old male who had cholelithiasis symptoms and was falsely diagnosed with gallstone disease by abdominal ultrasound scan...
December 11, 2017: American Journal of Case Reports
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