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gallstone management

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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
#1
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/28051219/incidental-gallbladder-cancer-diagnosed-on-cholecystectomy-specimens-a-study-of-30-cases
#2
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 M├ędicale
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#3
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/28012321/recurrent-spontaneous-pneumoperitoneum-a-surgical-dilemma
#4
Polly Estridge, Jacob A Akoh
INTRODUCTION: Spontaneous pneumoperitoneum describes free air within the peritoneal cavity in the absence of iatrogenic causes or a perforated viscus. This report describes a rare case in which despite raised inflammatory markers, a trial of conservative management proved adequate. CASE REPORT: AM is a 36-year old woman who presented multiple times with abdominal pain and radiologically proven pneumoperitoneum. Her medical history included self catheterisation and cerebrovascular stenosis (Moyamoya disease), asymptomatic gallstones, livedo reticularis and peptic ulceration...
November 29, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28009683/diabetes-mellitus-is-associated-with-mortality-in-acute-pancreatitis
#5
Ji Hye Huh, Hosung Jeon, Sun Min Park, EunHee Choi, Geun Sook Lee, Jae Woo Kim, Kyong Joo Lee
BACKGROUND AND AIM: Predicting severe pancreatitis is important for early aggressive management of patients with acute pancreatitis (AP). Despite the established role of diabetes mellitus (DM) in the risk of AP, the impact of DM on the clinical outcome in AP has not been fully elucidated. The objective of this study was to assess the risk of mortality and severity in AP among patients with type-2 DM. METHODS: Patients diagnosed with first attacks of AP were enrolled from January 2013 to June 2015...
December 22, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28008467/readmissions-after-laparoscopic-cholecystectomy-in-a-uk-district-general-hospital
#6
Olugbenga Awolaran, Tabitha Gana, Nehemiah Samuel, Kenneth Oaikhinan
INTRODUCTION: Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic gallstones and its practice as day case where possible is considered the standard over the last decade. However, readmission after surgery is recognised as a new problem. AIM: The aim of this cohort observational study was to investigate the readmission rate in a district general hospital and identify the causes of readmission in order to explore ways by which this can be reduced or managed more cost effectively...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27996365/laparoscopic-management-of-mirizzi-syndrome-without-dissection-of-calot-s-triangle
#7
Daisuke Koike, Yusuke Suka, Motoki Nagai, Yukihiro Nomura, Nobutaka Tanaka
BACKGROUND: Mirizzi syndrome (MS) is a rare complication of cholecystolithiasis that causes compacted gallstones and is often accompanied by severe inflammation of Calot's triangle. This study compared the use of laparoscopic surgery for MS without dissection of Calot's triangle with routine laparoscopic cholecystectomy (LC). METHODS: A total of 411 consecutive patients underwent laparoscopic surgery for benign gallbladder (GB) disease between January 2013 and December 2014...
December 20, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27981822/early-cholecystectomy-for-non-severe-acute-gallstone-pancreatitis-easier-said-than-done
#8
Simone Guadagni, Ismail Cengeli, Matteo Palmeri, Luca Bastiani, Andrea Bertolucci, Matteo Modesti, Christian Galatioto, Massimo Chiarugi
BACKGROUND: Laparoscopic cholecystectomy (LC) carried out within 3 days after an attack of non severe acute gallstone pancreatitis (NSAGP) is recommended to reduce hospital stay and overall costs. Aim of the study was to evaluate factors that may delay a timely surgical management of NSAGP and the consequences of this deviation. METHODS: We reviewed the charts of patients admitted for NSAGP and managed by LC during the last 14 years. 316 patients entered the study, 98 of whom underwent early LC...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27935909/exploring-the-diagnosis-and-management-of-bouveret-s-syndrome
#9
M Bhattarai, P Bansal, B Patel, A Lalos
Bouveret's syndrome is an unusual cause of gastric outlet obstruction secondary to gallstone impaction. It is so rare that it is commonly missed in clinical practice if it is not considered in differential diagnoses of intestinal obstruction more specifically in man who does not report the history of gall stone. Furthermore, there are no definitive guidelines on approach and management of this condition. We present a seventy eight year old man who developed acute abdominal symptoms due to impaction of a gallstone in the duodenum...
January 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27933137/gallstone-ileus-associated-with-impaction-at-meckel-s-diverticulum-case-report-and-literature-review
#10
Harveen K Lamba, Yiwen Shi, Ajita Prabhu
Gallstone ileus due to erosion of one or more gallstones into the gastrointestinal tract is an uncommon cause of small bowel obstruction. The site of impaction is usually distal ileum, and less commonly the jejunum, colon, duodenum, or stomach. We report a rare case of gallstone ileus with impaction at the proximal small bowel and at a Meckel's diverticulum (MD) in a 64-year-old woman managed with laparoscopic converted to open small bowel resections. Patient was discharged home in stable condition and remained asymptomatic at 6-mo follow up...
November 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27906430/recurrent-acute-pancreatitis-in-bowel-malrotation
#11
G Alessandri, A Amodio, L Landoni, N De' Liguori Carino, C Bassi
OBJECTIVE: Recurrent acute pancreatitis is an uncommon diagnosis in teenagers. Excluded alcohol and biliary stones, more prevalent aetiologies in these group of patients are genetic pancreatitis, pancreatic duct system abnormalities, neoplasia, traumas and congenital abnormalities of the duodenum such as duodenal duplication or diverticulum. Two reported cases of recurrent pancreatitis associated to midgut malrotation were described in English literature. Bowel malrotation is a difficult diagnosis in a teenager or a young adult and a common delay is documented...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27898355/gallstone-ileus-presenting-as-intussusception-a-case-report
#12
Rahul M Prasad, Katrina M Weimer, Arunkumar Baskara
BACKGROUND: Gallstone ileus is a complication of acute cholecystitis that accounts for 25% of bowel obstruction cases in the elderly. To our knowledge, only one other case of gallstone ileus presenting as intussusception has been reported in the literature, and involved non-operative management with an unfavorable outcome. CASE PRESENTATION: Here we report the case of 69year old woman presenting with symptoms of acute small bowel obstruction with a surgical history significant for cholecystectomy 30 years prior...
November 22, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-after-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#13
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography after PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) after PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a 3-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27885290/effectiveness-of-spinal-anaesthesia-versus-general-anaesthesia-for-open-cholecystectomy
#14
R B Kuju, Y Dongol, R Verma
BACKGROUND: Cholecystectomy is performed either as an open or a laparascopic route. Despite of a number of peri-operative and post-operative benefits of laparascopic cholecystectomy, the traditional and invasive open cholecystectomy is still in frequent practice for various reasons. Though general anaesthesia is regarded as the gold standard anaesthetic technique, alternatives to it such as spinal anaesthesia, with its advantages, outweighs general anaesthesia. Spinal anaesthesia, therefore, could be a safe and effective anaesthetic procedure over general anaesthesia for open cholecystectomy...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27847668/large-bowel-obstruction-a-delayed-complication-of-severe-gallstone-pancreatitis
#15
Neeraj Lal, John Whiting, Rahul Hejmadi, Sudarsanam Raman
Colonic complications are rare after acute pancreatitis but are associated with a high mortality. Possible complications include mechanical obstruction, ischaemic necrosis, haemorrhage, and fistula. We report a case of large bowel obstruction in a 31-year-old postpartum female, secondary to severe gallstone pancreatitis. The patient required emergency laparotomy and segmental bowel resection, as well as cholecystectomy. Presentation of obstruction occurs during the acute episode or can be delayed for several weeks...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27793575/unrecognized-necrosis-at-same-admission-cholecystectomy-for-pancreatitis-increases-organ-failure-and-infected-necrosis
#16
Wilson Tak-Yu Kwong, Santhi Swaroop Vege
BACKGROUND AND AIMS: Guidelines recommend same admission cholecystectomy (SAC) in the management of mild acute gallstone pancreatitis (AGP) with a recent randomized trial supporting this recommendation. However, the push for early cholecystectomy will lead a subset of patients with evolving, unrecognized necrotizing pancreatitis (NP) to undergo laparoscopic cholecystectomy (LC) with unknown consequences. With concerns about potentially serious outcomes, we studied the outcomes in patients with unrecognized NP who underwent SAC and identified predictors of unrecognized NP at the time of SAC...
October 21, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27780559/routine-intraoperative-cholangiography-is-unnecessary-in-patients-with-mild-gallstone-pancreatitis-and-normalizing-bilirubin-levels
#17
Xuan-Binh D Pham, Christian de Virgilio, Lutfi Al-Khouja, Michael C Bermudez, Alexander C Schwed, Amy H Kaji, David S Plurad, Steven L Lee, Robert S Bennion, Darin J Saltzman, Dennis Y Kim
BACKGROUND: The benefit of intraoperative cholangiography (IOC) is controversial in patients with gallstone pancreatitis whose bilirubin levels are normalizing. IOC with subsequent endoscopic retrograde cholangiopancreatography may lengthen duration of surgery and length of stay, whereas failure to clear the common bile duct may result in recurrent pancreatitis. METHODS: We performed a 6-year retrospective cohort analysis of consecutive adult patients with mild gallstone pancreatitis undergoing same-admission cholecystectomy at 2 university-affiliated medical centers...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27689452/financial-burden-secondary-to-delay-in-cholecystectomy-following-mild-biliary-pancreatitis
#18
Mohamed H Boshnaq, Nabeel Merali, Islam H El Abbassy, Sayed A Eldesouky, Mohamed A Rabie
AIM OF THE STUDY: The guidelines recommend that patients with mild gallstones pancreatitis should undergo a definitive management for gallstones during the same admission or within the next two weeks. The aim of this study was to estimate the financial cost resulting from a delay in surgical management following mild gallstones pancreatitis. This includes the costs of readmissions with biliary events and the subsequent investigations required during these admissions. MATERIALS AND METHODS: A retrospective analysis included patients with gallstone pancreatitis who were admitted to a district general hospital in the United Kingdom over one year...
September 30, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27669536/use-of-a-roth-net-platinum-universal-retriever-for-the-endoscopic-management-of-a-large-symptomatic-gallstone-causing-bouveret-s-syndrome
#19
Ankur Jindal, Cyriac Abby Philips, Kapil Jamwal, Shiv K Sarin
No abstract text is available yet for this article.
January 2016: Endoscopy
https://www.readbyqxmd.com/read/27667536/surgical-innovation-and-the-multiple-meanings-of-randomized-controlled-trials-the-first-rct-on-minimally-invasive-cholecystectomy-1980-2000
#20
Cynthia L Tang, Thomas Schlich
This article uses the case of the first randomized controlled trial (RCT) evaluating laparoscopic cholecystectomy to investigate the introduction of minimally invasive surgery in the 1990s and explore the meaning of RCTs within the context of the introduction of a new surgical technology. It thus brings together the history of the use of laparoscopic cholecystectomy to remove the gallbladder, and the history of the RCT, shedding light on particular aspects of both. We first situate the RCT in the context of the history of the various treatment options for gallstones, or cholelithiasis, then characterize the specific situation of the rapid, patient-driven spread of laparoscopic cholecystectomy, and in a next step describe how the local context of laparoscopic cholecystectomy as a new technology made it possible and desirable to conduct an RCT, despite numerous obstacles...
September 25, 2016: Journal of the History of Medicine and Allied Sciences
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