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https://www.readbyqxmd.com/read/28809620/pancreatitis-in-a-high-hiv-prevalence-environment
#1
Frank Anderson, Sandie R Thomson
BACKGROUND: Acute pancreatitis is common in HIV-positive individuals in reports from regions with a low incidence of HIV infection. This association has not been reported in areas with a high incidence of HIV infection. OBJECTIVE: To examine the prevalence and outcomes of HIV-associated acute pancreatitis in a high HIV prevalence environment, and trends over the period May 2001 - November 2010. METHODS: The records of patients admitted with acute pancreatitis from 2001 to 2010 were reviewed, looking for HIV status, CD4 counts and medications at presentation...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28809384/the-impact-of-cholecystectomy-after-endoscopic-sphincterotomy-for-complicated-gallstone-disease
#2
B Joseph Elmunzer, Mohamed Noureldin, Katherine A Morgan, David B Adams, Gregory A Coté, Akbar K Waljee
OBJECTIVES: Cholecystectomy after endoscopic sphincterotomy (ES) is associated with improved outcomes compared to ES alone, however randomized trials have included mainly fit surgical candidates. Our objective was to assess the impact of cholecystectomy after ES among elderly patients, in whom the perceived risks of surgery may be increased and the prevailing bias may be to defer cholecystectomy. METHODS: We performed adjusted analyses comparing clinical outcomes in patients ≥65 years of age who did and did not undergo follow-up cholecystectomy after endoscopic sphincterotomy for choledocholithiasis, ascending cholangitis, or gallstone pancreatitis...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28808520/gallstone-ileus-dilemma-in-the-management
#3
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/28803891/cholecystectomy-decreased-the-recurrent-cholangitis-after-clearance-of-bile-duct-stones-by-ercp-in-patients-with-gallstone-related-cholangitis
#4
Tseng-Shing Chen, Xi-Hsuan Lin, Yen-Ling Peng, Jiing-Chyuan Luo, Yung-Tai Chen, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: This study assessed whether cholecystectomy can decrease recurrent cholangitis and all-cause mortality in patients who received endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and successful clearance of bile duct (BD) stones after gallstone-related cholangitis. METHODS: We analyzed data from the National Health Insurance research database of Taiwan. Patients who had gallstone-related cholangitis and underwent successful endoscopic clearance of BD stones were eligible for enrollment...
August 10, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28801889/strategies-of-minimally-invasive-treatment-for-intrahepatic-and-extrahepatic-bile-duct-stones
#5
Zongming Zhang, Zhuo Liu, Limin Liu, Mengmeng Song, Chong Zhang, Hongwei Yu, Baijiang Wan, Mingwen Zhu, Zixu Liu, Hai Deng, Haiming Yuan, Haiyan Yang, Wenping Wei, Yue Zhao
Cholelithiasis is a kind of common and multiple diseases. In recent years, traditional laparotomy has been challenged by a minimally invasive surgery. Through literature review, the therapeutic method, effect, and complications of minimally invasive treatment of intrahepatic and extrahepatic bile duct stones by combining our practical experience were summarized as follows. (1) For intrahepatic bile duct stones, the operation may be selected by laparoscopic liver resection, laparoscopic common bile duct exploration (LCBDE), or percutaneous transhepatic cholangioscopy...
August 12, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28799434/metabolic-biomarkers-and-gallstone-disease-a-population-based-study
#6
Daniel Mønsted Shabanzadeh, Tea Skaaby, Lars Tue Sørensen, Jesper Eugen-Olsen, Torben Jørgensen
OBJECTIVES: The objectives for this study were to examine the associations between metabolic biomarkers of obesity including insulin resistance, vascular dysfunction, systemic inflammation, genetic susceptibility and ultrasound proven gallstone disease or cholecystectomy in a population-based cross-sectional study. MATERIAL AND METHODS: A total of 2650 participants were included, of whom 422 had gallstone disease. Associations between selected metabolic biomarkers and gallstone disease were estimated by multivariable logistic regression models and expressed as odds ratio (OR) and 95% confidence interval (CI)...
August 11, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28792589/early-definitive-treatment-rate-as-a-quality-indicator-of-care-in-acute-gallstone-pancreatitis
#7
R Green, S C Charman, T Palser
BACKGROUND: Early definitive treatment (cholecystectomy or endoscopic sphincterotomy in the same admission or within 2 weeks after discharge) of gallstone disease after a biliary attack of acute pancreatitis is standard of care. This study investigated whether compliance with early definitive treatment for acute gallstone pancreatitis can be used as a care quality indicator for the condition. METHODS: A retrospective cohort study was conducted using the Hospital Episode Statistics database...
August 9, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28790094/gallstone-ileus-of-the-duodenum-an-unexpected-presentation-of-bouveret-s-syndrome
#8
Neil Tindell, Kayla Holmes, David Marotta
This report describes a patient who presented with a large gallstone obstructing the duodenal bulb, with the chief complaint of acute on chronic abdominal pain. Classically, this is known as Bouveret's syndrome or a gallstone ileus of the duodenum. Our patient's current health status presented a challenge, with the presence of several comorbidities, particularly a large abdominal aortic aneurism. We chose an open procedure for this reason. The stone was removed through a laparotomy, and the cholecystoduodenal fistula that the stone used to pass into the small bowel was repaired...
August 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28782748/ileostomy-site-approach-for-adhesiolysis-and-laparoscopic-cholecystectomy-in-a-hostile-abdomen-a-novel-technique
#9
Deeplaxmi Purushottam Borle, Nikhil Agrawal, Asit Arora, Senthil Kumar, Tushar Kanti Chattopadhyay
INTRODUCTION: Gallstones are an etiological factor in 23%-54% of patients with acute pancreatitis. A small proportion of these patients will also have intestinal complications requiring necrosectomy with diverting loop ileostomy. Later, these patients require cholecystectomy and ileostomy reversal. Laparoscopic cholecystectomy is fraught with difficulty in these patients due to dense intra-abdominal adhesions, and many surgeons resort to an open approach. We describe a technique which takes advantage of the ileostomy site for initial access...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28781893/routine-cysticotomy-and-flushing-of-the-cystic-duct-in-patients-with-low-risk-of-common-duct-stones-can-it-be-beneficial
#10
Piera Leon, Fabiola Giudici, Antonio Sciuto, Francesco Corcione
BACKGROUND: Gallstone disease affects 15-20% of the general population and up to 20% of these patients present common bile duct stones. AIM: This observational study reports our experience on routine cysticotomy and flushing of the cystic duct in patients with low risk of common duct stones. MATERIALS AND METHODS: We analyzed 731 patients who underwent laparoscopic cholecystectomy between September 2013 and September 2015. RESULTS: Patients were preoperatively stratified on the clinical risk; those presenting with low preoperative risk of common bile duct stones were referred to undergo laparoscopic cholecystectomy and routine cysticotomy with bile duct flushing...
2017: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/28776457/-validation-of-ultrasound-examinations-performed-by-general-practitioners
#11
Karsten Lindgaard, Lars Riisgaard
OBJECTIVE: The aim of this study was to evaluate the diagnostic agreement when a general practitioner and subsequently a specialist (radiologist/gynecologist) performed point-of-care ultrasound examinations for certain abdominal and gynecological conditions of low to moderate complexity. DESIGN: A prospective study of inter-rater reliability and agreement. SETTING: Patients were recruited and initially scanned in general practice. The validation examinations were conducted in a hospital setting...
August 4, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28767582/gallstone-prevalence-and-risk-factors-in-patients-with-ulcerative-colitis-in-korean-population
#12
Yo Han Jeong, Kyeong Ok Kim, Ho Chan Lee, Se Hoon Sohn, Jung Woo Lee, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
This study aims to evaluate the prevalence, risk factors, and relative risk of gallstones and associated disease in patients with ulcerative colitis (UC). Medical records of 311 patients diagnosed with UC between January 2004 and February 2015 were reviewed retrospectively. To assess relative risk, 622 patients matched by age, sex, and body mass index were included as a control group. Gallstones were detected in 8% (25/311) of UC patients and in 3.9% (24/622) of the control group. Prevalence was significantly higher in the UC group (odds ratio [OR], 2...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28763814/three-modalities-on-common-bile-duct-exploration
#13
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/28761686/quality-of-life-and-psychological-and-gastrointestinal-symptoms-after-cholecystectomy-a-population-based-cohort-study
#14
Arne Talseth, Tom-Harald Edna, Kristian Hveem, Stian Lydersen, Eivind Ness-Jensen
OBJECTIVE: The study aims to examine gastrointestinal symptoms, quality of life and the risk of psychological symptoms after cholecystectomy. DESIGN: This is a prospective population-based cohort study based on the Nord-Trøndelag Health Study (HUNT) Norway. HUNT is a repeated health survey of the county population and includes a wide range of health-related items. In the present study, all 3 HUNT surveys were included, performed between 1984 and 2008. Selected items were scores on quality of life, the Hospital Anxiety and Depression Scale (HADS) and selected gastrointestinal symptoms...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28756832/erratum-in-erratum-to-recurrence-of-gallstone-disease-following-non-surgical-treatment-of-acute-cholecystitis-in-the-elderly-population-med-clin-barc-2017-149-3-139
#15
Ismael Mora-Guzmán, Marcello Di Martino, Elena Martín-Pérez
No abstract text is available yet for this article.
August 22, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28756146/two-year-experience-implementing-a-curriculum-to-improve-residents-patient-centered-communication-skills
#16
Amber W Trickey, Anna B Newcomb, Melissa Porrey, Franco Piscitani, Jeffrey Wright, Paula Graling, Jonathan Dort
OBJECTIVES: Surgery milestones from The Accreditation Council for Graduate Medical Education have encouraged a focus on training and assessment of residents' nontechnical skills, including communication. We describe our 2-year experience implementing a simulation-based curriculum, results of annual communication performance assessments, and resident evaluations. DESIGN: Eight quarterly modules were conducted on various communication topics. Former patient volunteers served as simulation participants (SP) who completed annual assessments using the Communication Assessment Tool (CAT)...
July 26, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28752146/acute-biliary-pancreatitis-in-cholecystectomised-patients
#17
Fatih Ciftci, Turgut Anuk
OBJECTIVE: The present study is an evaluation of cases of acute biliary pancreatitis that developed subsequent to cholecystectomy. METHODS: Total of 44 patients were assessed in this retrospective study. Demographic characteristics, severity of illness, time elapsed between cholecystectomy and development of pancreatitis, whether endoscopic sphincterotomy (ES) was performed, surgical procedure used, duration of hospitalization, and mortality data were recorded. RESULTS: Mean age of all patients was 60...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28750315/a-chip-off-the-old-block-a-case-report-of-gallstone-ileus-in-which-identification-of-a-facetted-stone-was-essential-in-preventing-re-laparotomy
#18
James O'Kelly, Paul Begg, David Anderson
Gallstone ileus is a rare presentation, accounting for 0.1% of cases of mechanical small bowel obstruction. Patients are often elderly with significant comorbidity. Treatment is based upon laparotomy and enterolithotomy. We present the case of a 75year old lady admitted as an emergency with a 4day history of small bowel obstruction. She was found on CT scan to have an impacted gallstone in the distal ileum. At operation, her impacted stone was removed through a proximal enterostomy. The stone however was found to have a squared off edge, raising the suspicion of a second fragment within the proximal small bowel lumen...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28745245/-bariatric-surgery-who-when-and-where-an-overview-for-the-referring-physician
#19
T C C Boerlage, Y I Z Acherman, S T Houweling, F Holleman, V E A Gerdes
- Bariatric surgery is performed in patients with a body mass index (BMI) > 40kg/m2, or BMI > 35 kg/m2 with obesity-related comorbidities. The Roux-en-Y gastric bypass and sleeve gastrectomy are the most frequently used procedures.- On average, patients have lost 25-27% of their original weight 10 years after surgery.- Obesity-related comorbidities improve dramatically in many patients following surgery. The effect is most noticeable in patients with diabetes mellitus type 2 and obstructive sleep apnoea syndrome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28743097/less-is-more-an-outcome-assessment-of-patients-operated-for-gallstone-ileus-without-fistula-treatment
#20
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)...
2017: International Journal of Surgery Case Reports
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