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https://www.readbyqxmd.com/read/28808520/gallstone-ileus-dilemma-in-the-management
#1
Girish D Bakhshi, Rajesh G Chincholkar, Jasmine R Agarwal, Madhukar R Gupta, Prachiti S Gokhe, Amogh R Nadkarni
Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28763814/three-modalities-on-common-bile-duct-exploration
#2
Yong Zhou, Xu-Dong Wu, Wen-Zhang Zha, Ren-Gen Fan, Biao Zhang, Yong-Hua Xu, Cheng-Lin Qin, Jing Jia
Background Choledocholithiasis can be managed by transcystic (TC) and transduct (TD) stone extraction or using cholangioscopy through the left hepatic duct orifice (LHD). Objective The aim of this study is to evaluate the safety and effectiveness of common bile duct exploration through the TC approach, TD approach, and LHD approach for choledocholithiasis, with a specific emphasis on the TC and LHD approaches versus the TD approach. Methods Between January 2011 and June 2014, a total of 172 choledocholithiasis patients accompanied by cholecystitis and/or left intrahepatic gallstones were scheduled for laparoscopic or open common bile duct (CBD) exploration using cholangioscopy through the CBD (TD group: n = 72), cystic duct (TC group: n = 63), or LHD orifice (LHD group: n = 37)...
August 1, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28743097/less-is-more-an-outcome-assessment-of-patients-operated-for-gallstone-ileus-without-fistula-treatment
#3
Dario Tartaglia, Sohail Bakkar, Lorenzo Piccini, Jessica Bronzoni, Luigi Cobuccio, Andrea Bertolucci, Christian Galatioto, Massimo Chiarugi
BACKGROUND: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome. MATERIALS AND METHODS: Patients with a diagnosis of GI were reviewed. Two groups were identified: patients who underwent a definitive biliary procedure with relieving the intestinal obstruction (group 1/G1) and those who did not have a definitive biliary procedure (group 2/G2)...
July 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28741196/how-safe-is-performing-cholecystectomy-in-the-oldest-old-a-15-year-retrospective-study-from-a-single-institution
#4
Matteo Novello, Davide Gori, Salomone Di Saverio, Matteo Bianchin, Lorenzo Maestri, Francesco Vito Mandarino, Giuseppe Cavallari, Bruno Nardo
BACKGROUND: Globally, the number of people aged 80 years or over, the "oldest old," is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in-hospital mortality up to 30 days postoperatively...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28733744/comparison-of-one-stage-laparoscopic-cholecystectomy-combined-with-intra-operative-endoscopic-sphincterotomy-versus-two-stage-pre-operative-endoscopic-sphincterotomy-followed-by-laparoscopic-cholecystectomy-for-the-management-of-pre-operatively-diagnosed-patients
#5
Chester Tan, Omar Ocampo, Raymund Ong, Kim Shi Tan
BACKGROUND: Laparoscopic cholecystectomy (LC) for symptomatic gallstone disease is one of the most common surgical procedures. Concomitant common bile duct (CBD) stones are detected with an incidence of 4-20% and the ideal management is still controversial. The frequent practice is to perform endoscopic sphincterotomy pre-operatively (POES) followed by LC, to allow subsequent laparoscopic or open exploration if POES fails. However, POES has shown different drawbacks such as need for two hospital admissions, need of two anesthesia inductions, higher rate of pancreatitis, and longer hospital stay...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28725301/review-of-infectious-etiology-of-acute-pancreatitis
#6
REVIEW
Prashanth Rawla, Sathyajit S Bandaru, Anantha R Vellipuram
While gallstones and alcoholism are widely known to be the most common causative agents of acute pancreatitis, about 10% of cases are thought to be caused by infectious microorganisms. These microorganisms include viruses (e.g. mumps, Coxsackie B, and hepatitis), bacteria (e.g. Mycoplasma pneumoniae and leptospirosis), and parasites (e.g. Ascaris lumbricoides, Fasciola hepatica, and hydatid disease). Each organism causes acute pancreatitis through diverse mechanisms. The review is primarily conducted in an attempt to provide a better understanding of the possibility of acute pancreatitis presenting as a complication relating to these organisms, and the aim is to guide future diagnoses, management, and predictions of complications...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28719397/obesity-and-pancreatitis
#7
Biswajit Khatua, Bara El-Kurdi, Vijay P Singh
PURPOSE OF REVIEW: The obesity pandemic poses a unique set of problems for acute pancreatitis - both by increasing acute pancreatitis incidence, and worsening acute pancreatitis severity. This review explores these associations, underlying mechanisms, and potential therapies. RECENT FINDINGS: We review how the obesity associated increase in gallstones, surgical, and endoscopic interventions for obesity management, diabetes, and related medications such as incretin-based therapies and hypertriglyceridemia may increase the incidence of acute pancreatitis...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28690774/utility-of-routine-blood-tests-after-elective-laparoscopic-cholecystectomy-for-symptomatic-gallstones
#8
Offir Ben-Ishay, Marina Zeltser, Yoram Kluger
AIM: To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related complications. METHODS: Charts of all patients undergoing elective laparoscopic cholecystectomy from January 2013 through December 2014 were reviewed retrospectively for demographics, indication for surgery, operative course and outcome. In our institution the decision to perform postoperative blood analysis is left for the discretion of the surgeon, therefore we had the possibility to compare the results of those who had blood analyses results to those who did not...
June 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28679321/case-report-an-unwanted-leftover-after-laparoscopic-cholecystectomy
#9
Eline Stroobants, Peter Cools, Francis Somville
BACKGROUND: A 72-year-old female patient with a history of laparoscopic cholecystectomy presented at the gastroenterology consultation with intermittent complaints of abdominal pain since two months in the right hemi abdomen. METHODS: Imaging discovered a subhepatic abscess. Explorative surgery showed multiple gallstones as the cause of the abscess. A brief literature study was conducted and after a thorough selection based on title and abstract, we ended up with 14 articles...
July 6, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28645922/management-of-high-grade-dysplasia-of-the-cystic-duct-after-cholecystectomy
#10
Maitham A Moslim, Andrew Tang, Gareth Morris-Stiff
High-grade dysplasia (HGD) of the cystic duct margin without evidence of concurrent malignancy is a rare occurrence. We present a case of a 36-year-old woman who developed gallstone pancreatitis and subsequently underwent a laparoscopic cholecystectomy. On histopathology, she was found to have HGD at the cystic duct margin. Following evaluation, she underwent excision of the cystic duct remnant with no malignancy being present on final pathology. We present this case to discuss the management of cystic duct dysplasia in the absence of gallbladder malignancy...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#11
Olivier Windisch, Toni Raffoul, Catrina Hansen, Jean-Louis Frossard, Philippe Morel, Léo Bühler
Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. Except endoscopic removal of gallstone for biliary origin, treatment remains symptomatic and focuses on fluid resuscitation, effective antalgia and adapted management of nutrition. This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28621510/laparoscopic-cholecystectomy-for-acute-cholecystitis-an-analysis-of-early-versus-delayed-cholecystectomy-and-predictive-factors-for-conversion
#12
Joel C Goh, Jarrod K Tan, Janice W Lim, Iyer G Shridhar, Krishnakumar Madhavan, Alfred W Kow
BACKGROUND: There is an increasing preference for early laparoscopic cholecystectomy (ELC) as compared to delayed LC (DLC) in the management of acute cholecystitis (AC). Conversion to open cholecystectomy (LOC) remains an important outcome. We aim to compare ELC and DLC outcomes and identify LOC predictors. METHODS: Retrospective analysis of 466 patients who underwent LC for AC from June 2010 - June 2015 was performed. Patients were divided into ELC and DLC groups, defined as LC performed within 7 days and between 4 to 24 weeks of symptom onset respectively...
June 16, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28614581/clinical-biochemical-and-genetic-characterization-of-north-american-patients-with-erythropoietic-protoporphyria-and-x-linked-protoporphyria
#13
Manisha Balwani, Hetanshi Naik, Karl E Anderson, D Montgomery Bissell, Joseph Bloomer, Herbert L Bonkovsky, John D Phillips, Jessica R Overbey, Bruce Wang, Ashwani K Singal, Lawrence U Liu, Robert J Desnick
Importance: Autosomal recessive erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare photodermatoses presenting with variable degrees of painful phototoxicity that markedly affects quality of life. The clinical variability, determinants of severity, and genotype/phenotype correlations of these diseases are not well characterized. Objective: To describe the baseline clinical characteristics, genotypes, and determinants of disease severity in a large patient cohort with EPP or XLP...
August 1, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28611568/two-anomalies-in-one-a-rare-case-of-an-intrahepatic-gallbladder-with-a-cholecystogastric-fistula
#14
Mohammad F Ali, David Friedel, Galina Levin
The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder - the second most common ectopic location of the gallbladder - is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28611560/gallstone-ileus-caused-by-cholecystocolonic-fistula-and-gallstone-impaction-in-the-sigmoid-colon-review-of-the-literature-and-novel-surgical-treatment-with-trephine-loop-colostomy
#15
James W O'Brien, Lucy-Anne Webb, Luke Evans, Chris Speakman, Irshad Shaikh
Gallstone ileus is an uncommon cause of intestinal obstruction and occurs following the formation of a cholecystoenteric fistula, permitting passage of gallstones into the gastrointestinal tract. Impaction of a gallstone in the sigmoid colon is rare and is usually at sites of previous colonic disease. Definitive management can be challenging due to the advanced age and co-morbidity usually seen in this group of patients. We describe a patient successfully managed with on-table endoscopy and, under local anaesthetic, the formation of a left iliac fossa trephine loop colostomy, permitting an enterolithotomy to deliver the stone whilst accommodating for severe pre-existing distal sigmoid diverticular disease...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28604381/miniinvasive-surgical-interventions-in-management-of-cholelithiasis-a-retrospective-study
#16
Mamuka R Gurgenidze, Merab A Kiladze, Zurab A Beriashvili, Teimuraz U Tabucadze, Giorgi A Datuashvili
The aim of the present study is to analyze outcomes after laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) for gallstone disease and determine the algorithm of treatment for different groups of patients according to the age, severity of disease and comorbid conditions. This is a multicenter retrospective review of 2997 patients who underwent LC or MC between January 1, 2002 and December 31, 2008. The patients were categorized into LC (1479) and MC (1518) groups. When preoperative examination data were not reliable, we performed abdominal wall lifting with the retractors to visualise abdominal cavity with laparoscope during minilaparotomy...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28603611/subtotal-laparoscopic-cholecystectomy-influences-the-rate-of-conversion-in-patients-with-difficult-laparoscopic-cholecystectomy-case-series
#17
W E Abdelrahim, Kamal E Elsiddig, A A Wahab, M Saad, H Saeed, E A G Khalil
OBJECTIVES: This study aimed to show that subtotal laparoscopic cholecystectomy (SLC) is a safe procedure that reduces the rate of conversion in patients with difficult laporoscopic cholecystectomies in resource-meagre settings. PATIENTS AND METHODS: Following informed consent, patients with gallstones reporting to Atbara Medical Centre, Atbara, Northern Sudan from February 2012 to July 2013 were managed laparoscopically except those with choledocholithiasis. SLC was done for patients with difficult cholecystectomy and obscured Callot's triangle...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28599581/changing-management-of-gallstone-related-disease-in-pregnancy-a-retrospective-cohort-analysis
#18
Jonas Hedström, Johan Nilsson, Roland Andersson, Bodil Andersson
OBJECTIVES: Gallstone-related disease is the second most common non-obstetric cause, following appendicitis, for acute abdomen in pregnancy. This study aimed to investigate treatment strategies, changes over time and outcome. MATERIALS AND METHODS: All consecutive patients with symptomatic gallstone-related disease during pregnancy admitted to Skane University hospital in Lund and Malmö 2001-2015 were analysed retrospectively. Information regarding the patient, pregnancy and fetus/child was recorded...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597677/endoscopic-management-of-afferent-loop-syndrome-caused-by-enteroliths-and-anastomotic-stricture-a-case-report
#19
Ana Rita Alves, Nuno Almeida, Margarida Ferreira, Luís Tomé
Afferent loop syndrome (ALS) is a rare complication of Billroth-II gastrojejunostomy. Causes of afferent loop obstruction include adhesions, internal hernias, intestinal strictures or malignancy. Obstruction caused by enteroliths is rare and usually requires surgery. We present the case of a 90-year-old man with a Billroth-II performed 50 years earlier and three acute pancreatitis. He presented with acute abdominal pain, without signs of pancreatitis. Upper digestive endoscopy revealed a punctiform anastomotic stricture of the afferent loop...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28586152/right-upper-quadrant-pain-ultrasound-first
#20
Margarita V Revzin, Leslie M Scoutt, Joseph G Garner, Christopher L Moore
Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis...
June 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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