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antibiotics and choledocholithiasis

Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
Koy Min Chue, Jun Wei Bryan Aw, Sin Hui Melissa Chua, Zhaojin Chen, Shridhar Ganpathi Iyer, Krishnakumar Madhavan, Alfred Wei Chieh Kow
BACKGROUND: Single-staged laparoscopic common bile duct exploration (LCBDE) offers clear benefits in terms of cost and shorter hospitalization stays. However, a failed LCBDE requiring conversion to open surgery is associated with increased morbidity. This study reviewed the factors determining success of LCBDE, and created a predictive nomogram to stratify patients for the procedure. METHODS: A retrospective analysis of 109 patients who underwent LCBDE was performed...
April 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Maryam Razaghi, Elahe Tajeddin, Leila Ganji, Masoud Alebouyeh, Amir Houshang Mohammad Alizadeh, Amir Sadeghi, Mohammad Reza Zali
Escherichia coli is the species that is most frequently isolated from bile of patients with biliary tract diseases. This study was aimed to investigate any association between resistance and virulence properties of these isolates with occurrence of the diseases. A total of 102 bile samples were obtained from patients subjected to endoscopic retrograde cholangiopancreatography for different biliary diseases. Clinical data were collected and culture of the bile samples was done on selective media. Resistance of characterized Escherichia coli isolates to deoxycholate sodium (0-7%) and nineteen antibiotics was determined and PCR using 16 pairs of primers targeting stx1, stx2, exhA, eae, bfp, agg, pcvd432, lt, st, ipaH, pic, pet, ast, set, sen, and cdtB genes was done...
October 2017: Microbial Pathogenesis
Mohan Ramchandani, Partha Pal, D Nageshwar Reddy
Acute cholangitis is infectious disease of the biliary system and potentially can cause significant morbidity and mortality. With advances in intensive care, antibiotic therapy advances and endoscopic and other modalities of biliary drainage, mortality rates have significantly come down of late. Although most cases respond to antibiotics alone, definitive therapy is required later in most of the patients. Increased biliary pressure leads to biliovenous reflux of bacteria and purulent bile into the circulation leading to systemic inflammation and sepsis with subsequent organ dysfunction...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
David Lan Cheong Wah, Christopher Christophi, Vijayaragavan Muralidharan
BACKGROUND: Acute cholangitis, also known as ascending cholangitis, is a life-threatening systemic condition that results from a biliary tree infection and obstruction. Severe acute cholangitis was reported to have a mortality rate between 11 and 27% in the 1990s. This article is a literature review about acute cholangitis. Its aim is to review the latest literature about acute cholangitis and to discuss its pathogenesis, clinical presentation, diagnosis, prognosis, risk factors and treatment...
July 2017: ANZ Journal of Surgery
Saki Shimamoto, Akiko Tanaka, Keiichiro Tsuchida, Kazuko Hayashi, Teiji Sawa
An 85-year-old woman with a diagnosis of choledocholithiasis due to common duct stones gradually developed severe coagulation dysfunction over the course of 27 days after hospitalization. Initial clinical findings were fever, general malaise, and obstructive jaundice. She was treated with fasting, and received cephem antibiotics containing N-methyl-thio-tetrazole. Because the common duct stones were not removed endoscopically, cholecystectomy was scheduled. Coagulation on admission was normal, but gradually became impaired...
April 2016: Masui. the Japanese Journal of Anesthesiology
Christian Rupp, Konrad Bode, Karl Heinz Weiss, Gerda Rudolph, Janine Bergemann, Petra Kloeters-Plachky, Fadi Chahoud, Wolfgang Stremmel, Daniel Nils Gotthardt, Peter Sauer
The aim of this study was to determine the antibiotic susceptibility profiles of bacteria in bile samples and to analyze the clinical relevance of the findings as only limited information about risk factors for elevated frequence of bacterial and fungal strains in routinely collected bile samples has been described so far.A prospective cohort study at a tertiary care center was conducted. Seven hundred forty-four patients underwent 1401 endoscopic retrograde cholangiographies (ERCs) as indicated by liver transplantation (427/1401), primary sclerosing cholangitis (222/1401), choledocholithiasis only (153/1401), obstruction due to malignancy (366/1401), or other conditions (233/1401)...
March 2016: Medicine (Baltimore)
Dalila Gargouri, Asma Ouakaa-Kchaou, Asma Kochlef, Héla Elloumi, Norsaf Bibani, Dorra Trad, Mohamed Zili, Jamel Kharrat
BACKGROUND: Biliary obstruction together with bacterial colonization of the bile duct may lead to development of acute cholangitis. The reported incidence of infectious complications may reach up to 10%. Nevertheless, no antibiotic prophylaxis is administered routinely, prior to endoscopic therapeutic procedures. AIM: To investigate the presence and degree of biliary bacterial colonization during endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary obstruction...
October 2015: La Tunisie Médicale
Purvi P Patel, Shaun C Daly, Jose M Velasco
Acute cholecystitis is one of the most common surgical diagnoses encountered by general surgeons. Despite its high incidence there remains a range of treatment of approaches. Current practices in biliary surgery vary as to timing, intraoperative utilization of biliary imaging, and management of bile duct stones despite growing evidence in the literature defining best practice. Management of patients with acute cholecystitis with early laparoscopic cholecystectomy (LC) results in better patient outcomes when compared with delayed surgical management techniques including antibiotic therapy or percutaneous cholecystostomy...
October 18, 2015: World Journal of Hepatology
Vincent Zimmer, Frank Lammert
BACKGROUND: Acute bacterial cholangitis for the most part owing to common bile duct stones is common in gastroenterology practice and represents a potentially life-threatening condition often characterized by fever, abdominal pain, and jaundice (Charcot's triad) as well as confusion and septic shock (Reynolds' pentad). METHODS: This review is based on a systematic literature review in PubMed with the search items 'cholangitis' 'choledocholithiasis' 'gallstone disease' 'biliary infection', and 'biliary sepsis'...
June 2015: Viszeralmedizin
Mirko Muroni, Valeria Loi, François Lionnet, Robert Girot, Sidney Houry
INTRODUCTION: Prophylactic laparoscopic cholecystectomy remains controversial and has been discussed for selected subgroups of patients with asymptomatic cholelithiasis who are at high risk of developing complications such as chronic haemolytic conditions. Cholelithiasis is a frequent condition for patients with sickle cell disease (SCD). Complications from cholelithiasis may dramatically increase morbidity for these patients. Our objective was to evaluate the effectiveness of prophylactic cholecystectomy in SCD patients with asymptomatic gallbladder stones...
October 2015: International Journal of Surgery
Martín Guidi, Hui Jer Hwang, Cecilia Curvale, Gonzalo Souto, Julio De María, Fernando Ragone, Esteban Promenzio, Raúl Matano
INTRODUCTION: The American Society of Gastroenterology (ASGE) and the American College of Gastroenterolog (ACG) have established indicators to recognize high-quality studies in endoscopic retrograde cholagiopancreatography (ERCP). The indicators were: a) Pre-procedure: adequate indication, informed consent, assessment of the degree of difficulty of the procedure and antibiotic prophylaxis. b) Intraprocedure: cannulation, choledocholithiasis extraction and stents placement rates. c) Postprocedure: full documentation and complications rates...
March 2015: Acta Gastroenterologica Latinoamericana
Takashi Ishigaki, Tamito Sasaki, Masahiro Serikawa, Kenso Kobayashi, Michihiro Kamigaki, Tomoyuki Minami, Akihito Okazaki, Masanobu Yukutake, Yasutaka Ishii, Keiichi Kosaka, Teruo Mouri, Satoshi Yoshimi, Kazuaki Chayama
BACKGROUND/AIMS: The purpose of this study was to evaluate the relationship between prophylactic antibiotic use and complications following endoscopic retrograde cholangiopancreatography (ERCP). METHODOLOGY: We retrospectively evaluated 605 consecutive patients who underwent ERCP in our hospital between September 2009 and November 2011. The antibiotic group included patients who underwent their procedure before October 2010, while the control group included patients after October 1, 2010, who did not receive antibiotics...
March 2015: Hepato-gastroenterology
Cerine Jeanty, S Christopher Derderian, Jesse Courtier, Shinjiro Hirose
PURPOSE: Infantile cholelithiasis is a rare disease process, and management strategies are poorly defined. We therefore examined the risk factors, complications, and management of this disease at our institution. METHODS: We retrospectively reviewed infants with cholelithiasis diagnosed on ultrasound between 1997 and 2013. Details of the patient's medical history, presentation, imaging findings, laboratory values, and treatment were reviewed and analyzed. RESULTS: Over the 16-year period, 50 infants were evaluated for cholelithiasis...
August 2015: Journal of Pediatric Surgery
Farokh R Demehri, Hasan B Alam
Gallstone-related disease is among the most common clinical problems encountered worldwide. The manifestations of cholelithiasis vary greatly, ranging from mild biliary colic to life-threatening gallstone pancreatitis and cholangitis. The vast majority of gallstone-related diseases encountered in an acute setting can be categorized as biliary colic, cholecystitis, choledocholithiasis, and pancreatitis, although these diagnoses can overlap. The management of these diseases is uniquely multidisciplinary, involving many specialties and treatment options...
January 2016: Journal of Intensive Care Medicine
Takayuki Tanaka, Masashi Haraguchi, Hirotaka Tokai, Shinichiro Ito, Masachika Kitajima, Tsuyoshi Ohno, Shinya Onizuka, Keiji Inoue, Yasuhide Motoyoshi, Tamotsu Kuroki, Takashi Kanemastu, Susumu Eguchi
A 50-year-old male was examined at another hospital for fever, general fatigue and slight abdominal pain. He was treated with antibiotics and observed. However, his symptoms did not lessen, and laboratory tests revealed liver dysfunction, jaundice and an increased inflammatory response. He was then admitted to our hospital and underwent an abdominal computed tomography scan and magnetic resonance cholangiopancreatography (MRCP), which revealed common bile duct (CBD) stones. He was diagnosed with mild acute cholangitis...
May 2014: Case Reports in Gastroenterology
Dominik Grieb, Axel Feldkamp, Thomas Lang, Michael Melter, Christian Stroszczynski, Friedhelm Brassel, Dan Meila
We report the first case of a male child with both Caroli disease and vein of Galen malformation. The neonate presented to our department with congestive heart failure as a result of the intracranial arteriovenous high-flow shunt. Over time, several endovascular embolizations led to a complete angiographic occlusion of the shunt. Additionally, the diagnosis of Caroli disease was made at the age of 2 months. He developed choledocholithiasis necessitating endoscopic sphincterotomy and stone extraction. As a prolonged medical treatment he received ursodeoxycholic acid and antibiotics...
July 2014: Pediatrics
Liang Zhu, Hao Zeng, You-Xiang Chen, Nong-Hua Lu
Choledochocele, or type III choledochal cyst, is a rare congenital disease and is even less common among adults compared with children. In this case, a 75-year-old female was admitted to our hospital presented with epigastric pain and vomiting for one day. Abdominal computed tomography revealed dilated common bile duct, pancreatitis and peripancreatic effusion. The patient was treated with fasting, fluid resuscitation, anti-acid agents, somatostatin and antibiotics. Endoscopic retrograde cholangiopancreatography was employed for the further diagnosis of choledochocele, choledocholithiasis and biliary stenosis...
February 2015: Aging Clinical and Experimental Research
Brian C Sninsky, Priyanka D Sehgal, J Louis Hinshaw, John C McDermott, Stephen Y Nakada
BACKGROUND AND PURPOSE: We evaluated the efficacy of ureteroscopic therapy (electrohydraulic lithotripsy [EHL] and intraductal laser lithotripsy [ILL]) in patients with challenging biliary stones secondary to anatomic variations resulting from a previous surgical procedure, including liver transplantation. PATIENTS AND METHODS: A retrospective chart review was performed for all patients with previous surgical alteration of the gastrointestinal (GI) tract who underwent EHL or ILL via peroral or percutaneous access for choledocholithiasis by a single surgeon at our institution from 2000 to 2012...
July 2014: Journal of Endourology
Maddalena Zippi, Isabella De Felici, Roberta Pica, Giampiero Traversa, Giuseppe Occhigrossi
AIM: To evaluate the efficacy and safety of endoscopic balloon dilation (EBD) performed for common bile duct (CBD) stones. METHODS: From a computer database, we retrospectively analyzed the data relating to EBD performed in patients at the gastrointestinal unit of the Sandro Pertini Hospital of Rome (small center with low case volume) who underwent endoscopic retrograde cholangiopancreatography (ERCP) for CBD from January 1, 2010 to February 29, 2012. All patients had a proven diagnosis of CBD stones studied with echography, RMN-cholangiography and, when necessary, with computed tomography of the abdomen (for example, in cases with pace-makers)...
April 16, 2013: World Journal of Clinical Cases
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