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Post cholecystectomy syndrom

Donato F Altomare, Maria T Rotelli, Nicola Palasciano
Patients with gallstones are often affected by alimentary disorders contributing to the onset of gallstones disease. Cholecystectomy can have nutritional and metabolic consequences in the short-term (diarrhea, abdominal pain and bloating) and in the long-term (increased Body Mass Index with metabolic syndrome, gastritis, liposoluble vitamin deficiency). Pathogenic mechanisms behind these disturbances are reviewed and the need for an early post-operative nutritional intervention based on low-lipid, high-fibers diet, is highlighted...
May 17, 2017: Current Medicinal Chemistry
Abdulrahman Saleh Al-Mulhim
Impairment of gastric emptying is well recognized in patients with diabetes mellitus. The aim of this study was to investigate the influencing factors for gastroparesis syndrome development after laparoscopic cholecystectomy in diabetic patients. This is a case-control study. Clinical data were collected retrospectively for 462 diabetic patients who underwent laparoscopic cholecystectomy from 2008 to 2013. We retrospectively analyzed the incidence of gastroparesis syndrome, clinical features, course of disease, and risk factors...
March 2017: Updates in Surgery
Tyler J Loftus, Scott C Brakenridge, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Frederick A Moore, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Phillip A Efron, Alicia M Mohr
BACKGROUND: For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes. METHODS: We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014...
May 2017: World Journal of Surgery
Federico Bolado, Enrique de-Madaria
Acute pancreatitis (AP) is a potentially serious disease whose incidence is on the increase. Pancreas divisum does not meet the required criteria to be considered an aetiological factor. Sphincter of Oddi dysfunction may be another cause of idiopathic AP. Less invasive methods cannot replace Sphincter of Oddi manometry in diagnosis. Almost half of patients with systemic inflammatory response syndrome develop organ failure, but the mechanisms involved are not completely understood. Obesity is a risk factor for severity in AP; the cause could be the presence of free unsaturated fatty acids, which have pro-inflammatory activity...
September 2016: Gastroenterología y Hepatología
Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
December 2016: Expert Review of Gastroenterology & Hepatology
Eleni-Aikaterini Nagorni, Georgios Kouklakis, Alexandra Tsaroucha, Soultana Foutzitzi, Nikos Courcoutsakis, Konstantinos Romanidis, Konstantinos Vafiadis, Michael Pitiakoudis
BACKGROUND: Laparoscopic cholecystectomy is the gold standard treatment of gallbladder disease. Post-cholecystectomy syndrome is a severe postoperative complication which can be caused by multiple mechanisms and can present with multiple disorders. The wide use of laparoscopy induces the need to understand more clearly the presentation and pathophysiology of this syndrome. Post-cholecystectomy Mirizzi syndrome is one form of this syndrome and, according to literature, this is the first report that clearly describes it...
May 27, 2016: Journal of Medical Case Reports
Laura Lorenzon, Gianluca Costa, Giulia Massa, Barbara Frezza, Francesco Stella, Genoveffa Balducci
PURPOSE: Cholecystectomy, which is one of the most common surgical procedures, is also performed in the emergency setting. A number of risk scores have been introduced in recent studies; moreover, over the last few years literature has focused on surgical patients with frailty syndrome. The aim of the present study is to evaluate whether frailty syndrome and the risk scores are correlated with morbidity, post-operative hospital stay and the ICU admission rate following emergency cholecystectomy...
January 2017: Surgery Today
P B Cotton, G H Elta, C R Carter, P J Pasricha, E S Corazziari
The concept that motor disorders of the gallbladder, cystic duct and sphincter of Oddi can cause painful syndromes is attractive and popular, at least in the USA. However, the results of commonly performed ablative treatments (cholecystectomy and sphincterotomy) are not uniformly good. The predictive value of tests that are often used to diagnose dysfunction (dynamic gallbladder scintigraphy and sphincter manometry) is controversial. Evaluation and management of these patients is made difficult by the fluctuating symptoms and the placebo effect of invasive interventions...
February 19, 2016: Gastroenterology
Wen Feng, Dong Yue, Lu ZaiMing, Liu ZhaoYu, Li Wei, Guo Qiyong
BACKGROUND: Hemobilia following laparoscopic cholecystectomy (LC) can occur in the early or late postoperative course and poses a diagnostic and therapeutic challenge. PURPOSE: To assess computed tomography (CT) findings and clinical outcomes after transcatheter arterial embolization (TAE) in patients presenting with hemobilia following LC. MATERIAL AND METHODS: Fourteen patients treated for hemobilia following LC were included in the study...
January 2017: Acta Radiologica
Pervin Gokay, Sevinc Tastan, Mehmet Emin Orhan
AIMS AND OBJECTIVES: This study aimed to compare the efficiency of the STOP-BANG and Berlin Obstructive Sleep Apnoea Syndrome questionnaires for evaluating potential respiratory complications during the perioperative period. BACKGROUND: Questionnaires that are used to determine obstructive sleep apnoea risk are not widely used for surgical patients. Among the questionnaires that are commonly used for obstructive sleep apnoea screening, it remains unclear whether the STOP-BANG or Berlin Obstructive Sleep Apnoea Syndrome questionnaire is more effective in terms of ease of use, usage period and diagnosis of surgical patients with obstructive sleep apnoea risk...
May 2016: Journal of Clinical Nursing
Pradeep Chowbey, Anil Sharma, Amit Goswami, Yusuf Afaque, Khoobsurat Najma, Manish Baijal, Vandana Soni, Rajesh Khullar
BACKGROUND: Incomplete gallbladder removal following open and laparoscopic techniques leads to residual gallbladder stones. The commonest presentation is abdominal pain, dyspepsia and jaundice. We reviewed the literature to report diagnostic modalities, management options and outcomes in patients with residual gallbladder stones after cholecystectomy. MATERIALS AND METHODS: Medline, Google and Cochrane library between 1993 and 2013 were reviewed using search terms residual gallstones, post-cholecystectomy syndrome, retained gallbladder stones, gallbladder remnant, cystic duct remnant and subtotal cholecystectomy...
October 2015: Journal of Minimal Access Surgery
Jon S Thompson, Rebecca A Weseman, Fedja A Rochling, Elizabeth Lyden, Wendy J Grant, Luciano M Vargas, Alan N Langnas, David F Mercer
BACKGROUND: Recently, an association has been proposed between cholecystectomy and various liver diseases. Our aim was to determine whether cholecystectomy in short bowel patients influences the risk of liver disease. METHODS: We reviewed 422 adults: 182 underwent cholecystectomy prior to short bowel, 102 after developing short bowel, and 138 patients still had the gallbladder in place. RESULTS: Compared to pre and post short bowel, gallbladder patients were significantly less likely to have obesity (18 % and 21 % vs 9 %), central line infections (59 % and 69 % vs 46 %), intestine <60 cm (30 % and 39 % vs 26 %), and require parenteral nutrition >1 year (72 % and 77 % vs 64 %)...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
A S Leontiev, A G Korotevich, R V Repnikova, M V Merzliakov, G A Safronova, S V Arkhipova, A A Faiev
The article presents the results of endoscopic and laboratory analyses of bile in 90 patients after mini-invasive cholecystectomy The significant amount of endoscopic diagnosed alterations in the area of major duodenal papilla that amounted to 64.4% of examined patients and also occurrence of micro-cholelithiasis and insoluble precipitates in analyzed bile of 83.3% of patients. The derived data testifies necessity of application of pre-operational endoscopic diagnostic of alterations in the area of major duodenal papilla and in post-operative period as well completing it by analysis of native bile preparation...
June 2015: Klinicheskaia Laboratornaia Diagnostika
Kazutaka Tanaka, Tamie Takenami, Junko Hari, Haruka Kaneko, Tomoe Fujita, Hirotsugu Okamoto
A 41-year-old woman with concomitant severe obesity, obstructive sleep apnea syndrome, and asthma was scheduled for endoscopic cholecystectomy. She was 165.8 cm tall and weighed 141.2 kg, with BMI of 51.4. We were concerned with difficulty in ventilation and intubation at the time of anesthesia induction and intra- and post-operative ventilatory failure. After sedation with fentanyl and droperidol together with intraoral local anesthesia with lidocaine (Xylocaine Viscous), the intubating laryngeal mask (ILMA) was inserted while awake, and after the confirmation of adequate ventilation, the bronchoscope was inserted into the guide...
April 2015: Masui. the Japanese Journal of Anesthesiology
Rigved Gupta, Gaurav Kochhar, Ashok Kumar, Sudipta Saha, Manoj Andley, Rahul Pusuluri, Gyan Saurabh, Ajay Kumar
BACKGROUND AND AIM: Postoperative gastroesophageal reflux (GER) is one of the causes of post-cholecystectomy syndrome (PCS). Reports studying the effect of cholecystectomy on GER show conflicting results and only a few studies have used the more sensitive technique of combined impedance-pH monitoring. This study aimed to study the effect of laparoscopic cholestectomy on GER (acid/non-acid reflux) using impedance-pH monitoring. METHODS: Sixty three consecutive patients of symptomatic cholelithiasis were evaluated...
October 2014: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Kyudon Chung, Seunguk Bang, Yoona Kim, Hyuntae Chang
We present the first reported case of a patient with intraoperative hypoglycemia, with no predisposing factors, that was indicative of post-hepatectomy liver failure due to liver injury. A 56-year-old man was hospitalized to undergo left lateral segmentectomy, cholecystectomy and T-tube choledocholithotripsy due to calculi in the intrahepatic and common bile ducts. His medical history was unremarkable. Three hours after surgery initiation, his glucose level decreased from 84 mg/dL to below detectable levels...
February 2016: Journal of Anesthesia
S-Q Yi, K Ren, M Kinoshita, N Takano, M Itoh, N Ozaki
Sphincter of Oddi dysfunction is one of the most important symptoms in post-cholecystectomy syndrome. Using either electrical or mechanical stimulation and retrogradely transported neuronal dyes, it has been demonstrated that there are direct neural pathways connecting gall bladder and the sphincter of Oddi in the Australian opossum and the golden hamster. In the present study, we employed whole-mount immunohistochemistry staining to observe and verify that there are two different plexuses of the extrahepatic biliary tract in Suncus murinus...
June 2016: Anatomia, Histologia, Embryologia
Yalin Kong, Gang Zhao, Yifeng Li, Dongqing Wen, Hui Zhang, Xiaojun He, Yuying Zhen, Hongyi Zhang
Aviation-related mechanism may exist in the post-cholecystectomy syndrome (PCS) of aircrew patients. The aim of this study was to test this hypothesis on vivo rabbit model and to explore the mechanism by using a novel telemetric method. We constructed a bile duct-to-intestinal bridge bypass on 30 rabbits, with a telemetry implant attached to the Oddi's sphincter. Then a telemetric recording system was used to record the biliary pressure fluctuation through the subcutaneous bridge and the changes of electromyography of the Oddi's sphincter under different +Gz acceleration...
2015: International Journal of Clinical and Experimental Medicine
Suzanne J Di Sano, Nicholas B Bull
Laparoscopic subtotal cholecystectomy is a technique that is becoming increasingly prevalent in modern surgery. It avoids the cystic duct and artery where acute or chronic cholecystitis prevents a safe laparoscopic dissection of these structures. There are numerous reports of symptomatic cystic duct remnants after subtotal cholecystectomy in the literature on post-cholecystectomy syndrome. We present a case report of a 62-year-old man who underwent emergent laparoscopic subtotal cholecystectomy complicated by the development of a persistent, controlled bile leak...
February 2, 2015: Journal of Surgical Case Reports
Anna C Weiss, Tazo Inui, Ralitza Parina, Alisa M Coker, Garth Jacobsen, Santiago Horgan, Mark Talamini, David C Chang, Bryan Sandler
INTRODUCTION: As the popularity of a laparoscopic Roux-en-Y Gastric Bypass (RYGB) surpassed that of an open approach, practice of concomitant cholecystectomy declined. Low rates of gallbladder disease following RYGB and high complication rates of concomitant cholecystectomy have been published, but these population-based studies have lacked long-term outcomes and survival data. STUDY DESIGN: The California Office of Statewide Health Planning and Development longitudinal database was queried for patients who underwent RYGB with or without cholecystectomy between 1995 and 2009...
November 2015: Surgical Endoscopy
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