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cholecystectomy acute pancreatitis

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https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-following-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#1
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 following PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) following PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a three-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27888858/novel-findings-in-the-management-of-acute-pancreatitis
#2
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
https://www.readbyqxmd.com/read/27847668/large-bowel-obstruction-a-delayed-complication-of-severe-gallstone-pancreatitis
#3
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/27796634/cholecystectomy-reduces-recurrent-pancreatitis-and-improves-survival-after-endoscopic-sphincterotomy
#4
Shih-Hao Young, Yen-Ling Peng, Xi-Hsuan Lin, Yung-Tai Chen, Jiing-Chyuan Luo, Yen-Po Wang, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: The aim of this study was to assess whether cholecystectomy can decrease the recurrent pancreatitis in the elderly patients who received endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) and successful clearance of bile duct (BD) stones after gallstone-related acute pancreatitis. METHODS: We analyzed data from National Health Insurance Research Database of Taiwan. Elderly patients (age ≧70 years old) who had gallstone-related acute pancreatitis and underwent successful EST with BD stones clearance were eligible for enrollment...
October 27, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27793575/unrecognized-necrosis-at-same-admission-cholecystectomy-for-pancreatitis-increases-organ-failure-and-infected-necrosis
#5
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/27747128/pancreaticopleural-fistula-causing-massive-right-hydrothorax-and-respiratory-failure
#6
Esther Ern-Hwei Chan, Vishalkumar Girishchandra Shelat
Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging, particularly magnetic resonance cholangiopancreatography, aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27700180/acute-biliary-pancreatitis-focus-on-recurrence-rate-and-costs-when-current-guidelines-are-not-complied
#7
Tim Ragnarsson, Roland Andersson, Daniel Ansari, Ulf Persson, Bodil Andersson
BACKGROUND: International guidelines recommend cholecystectomy within 2-4 weeks after mild-moderate acute biliary pancreatitis (ABP) to prevent recurrence. We aimed to investigate the compliance to guidelines concerning early cholecystectomy and the associated costs. METHODS: Admissions for ABP 2011-2013 were retrospectively reviewed. Classification was made according to the revised Atlanta classification. Treatment, time to surgery and recurrence, as well as cost analysis for both in-hospital costs and loss of production was performed...
October 4, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27678352/management-of-patients-after-recovering-from-acute-severe-biliary-pancreatitis
#8
REVIEW
Georgia Dedemadi, Manolis Nikolopoulos, Ioannis Kalaitzopoulos, George Sgourakis
Cholelithiasis is the most common cause of acute pancreatitis, accounting 35%-60% of cases. Around 15%-20% of patients suffer a severe attack with high morbidity and mortality rates. As far as treatment is concerned, the optimum method of late management of patients with severe acute biliary pancreatitis is still contentious and the main question is over the correct timing of every intervention. Patients after recovering from an acute episode of severe biliary pancreatitis can be offered alternative options in their management, including cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy, or no definitive treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27663692/how-does-cholecystectomy-influence-recurrence-of-idiopathic-acute-pancreatitis
#9
Claire L Stevens, Saleh M Abbas, David A K Watters
BACKGROUND: Idiopathic acute pancreatitis is diagnosed in approximately 10-30 % of cases of acute pancreatitis. While there is evidence to suggest that the cause in many of these patients is microlithiasis, this fact has not been translated into a resource efficient treatment strategy that is proven to reduce recurrence rates. The aim of this study was to examine the value of prophylactic cholecystectomy following an episode of acute pancreatitis in patients with no history of alcohol abuse and no stones found on ultrasound...
December 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27660206/intrahepatic-biliary-duct-branching-patterns-cystic-duct-anomalies-and-pancreas-divisum-in-a-tertiary-referral-center-a-magnetic-resonance-cholangiopancreaticographic-study
#10
Ankur Gupta, Praveer Rai, Vivek Singh, Rakesh Kumar Gupta, Vivek Anand Saraswat
BACKGROUND: Knowledge about anatomic variations in intrahepatic biliary ducts (IHBD) is relevant for performing biliary drainage and for avoiding bile duct injury during cholecystectomy and liver resections. Low insertion of cystic duct (LICD) is a common anatomic variant. Pancreas divisum is the commonest congenital anomaly of pancreas; it has been causally linked with recurrent acute pancreatitis (RAP). METHODS: Magnetic resonance cholangiopancreaticography (MRCP) images of 500 consecutive patients were reviewed for anatomic variants of IHBD, cystic duct, and pancreatic duct...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27556900/nationwide-assessment-of-trends-in-choledocholithiasis-management-in-the-united-states-from-1998-to-2013
#11
Michael W Wandling, Eric S Hungness, Emily S Pavey, Jonah J Stulberg, Ben Schwab, Anthony D Yang, Michael B Shapiro, Karl Y Bilimoria, Clifford Y Ko, Avery B Nathens
Importance: There are currently 2 widely accepted treatment strategies for patients presenting to the hospital with choledocholithiasis. However, the rate of use for each strategy in the United States has not been evaluated, and their trends over time have not been described. Furthermore, an optimal management strategy for choledocholithiasis has yet to be defined. Objective: To evaluate secular trends in the management of choledocholithiasis in the United States and to compare hospital length of stay between patients with choledocholithiasis treated with endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy (ERCP+LC) vs laparoscopic common bile duct exploration with laparoscopic cholecystectomy (LCBDE+LC)...
August 24, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27530927/outcomes-of-early-versus-delayed-cholecystectomy-in-patients-with-mild-to-moderate-acute-biliary-pancreatitis-a-randomized-prospective-study
#12
Shir Li Jee, Razman Jarmin, Kin Foong Lim, Krishnan Raman
BACKGROUND: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate. METHODS: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group...
August 13, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27517163/cost-effectiveness-of-same-admission-versus-interval-cholecystectomy-after-mild-gallstone-pancreatitis-in-the-poncho-trial
#13
D W da Costa, L M Dijksman, S A Bouwense, N J Schepers, M G Besselink, H C van Santvoort, D Boerma, H G Gooszen, M G W Dijkgraaf
BACKGROUND: Same-admission cholecystectomy is indicated after gallstone pancreatitis to reduce the risk of recurrent disease or other gallstone-related complications, but its impact on overall costs is unclear. This study analysed the cost-effectiveness of same-admission versus interval cholecystectomy after mild gallstone pancreatitis. METHODS: In a multicentre RCT (Pancreatitis of biliary Origin: optimal timiNg of CHOlecystectomy; PONCHO) patients with mild gallstone pancreatitis were randomized before discharge to either cholecystectomy within 72 h (same-admission cholecystectomy) or cholecystectomy after 25-30 days (interval cholecystectomy)...
August 12, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27509701/multidetector-computed-tomography-evaluation-of-post-cholecystectomy-complications-a-tertiary-care-center-experience
#14
Ujjwal Gorsi, Pankaj Gupta, Naveen Kalra, Mandeep Kang, Rajinder Singh, Rajesh Gupta, Vikas Gupta, Niranjan Khandelwal
OBJECTIVE: To evaluate the role of multidetector computed tomography (CT) and CT angiography (CTA) in post cholecystectomy complications. METHODS: A retrospective analysis of data from December 2012 to August 2014 was performed. Eight hundred sixty consecutive patients with history of cholecystectomy (laparoscopic or open) were evaluated. After exclusion of 645 patients with normal imaging, analysis for post cholecystectomy complications was performed in 215 patients...
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
https://www.readbyqxmd.com/read/27508070/gallstones-new-insights-into-an-old-story
#15
REVIEW
Evan Tiderington, Sum P Lee, Cynthia W Ko
Gallstones, particularly cholesterol gallstones, are common in Western populations and may cause symptoms such as biliary colic or complications such as acute cholecystitis or gallstone pancreatitis. Recent studies have allowed for a better understanding of the risk of symptoms or complications in patients with gallstones. In addition, newer data suggest an association of gallstones with overall mortality, cardiovascular disease, gastrointestinal cancers, and non-alcoholic fatty liver disease. Knowledge of appropriate indications and timing of cholecystectomy, particularly for mild biliary pancreatitis, has gradually accumulated...
2016: F1000Research
https://www.readbyqxmd.com/read/27498585/pancreatitis-in-pregnancy-etiology-diagnosis-treatment-and-outcomes
#16
Padmavathi Mali
BACKGROUND: Acute pancreatitis in pregnancy is a rare and dangerous disease. This study aimed to examine the etiology, treatment, and outcomes of pancreatitis in pregnancy. METHOD: A total of 25 pregnant patients diagnosed with pancreatitis during the period of 1994 and 2014 was analyzed retrospectively. RESULTS: The pregnant patients were diagnosed with pancreatitis during a period of 21 years. Most (60%) of the patients were diagnosed with pancreatitis in the third trimester...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27444192/readmissions-due-to-acute-biliary-edematous-pancreatitis-in-patients-without-cholecystectomy
#17
Eva Barreiro Alonso, Alejo Mancebo Mata, Pilar Varela Trastoy, María Pipa Muñiz, Eduardo López Fernández, Rafael Tojo González, Mónica García Espiga, Rosa García López, José Martín Pérez Pariente, Francisco Javier Román Llorente
AIMS: Analyzing the readmission of patients with acute biliary edematous pancreatitis (ABEP) without cholecystectomy despite a previous episode of mild acute gallstone pancreatitis or lithiasic cholecystitis. Calculating the health costs associated with the non-performance of cholecystectomy. MATERIAL AND METHODS: Prospective observational study conducted at a tertiary hospital from July to November 2014. The study has consecutively included inpatients suffering from ABEP who: a) had suffered a previous episode of mild acute gallstone pancreatitis or cholecystitis at least 2 weeks before readmission; and b) had not undergone cholecystectomy despite the lack of contraindications...
August 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27387334/post-laparoscopic-cholecystectomy-mirizzi-syndrome-induced-by-polymeric-surgical-clips-a-case-report-and-review-of-the-literature
#18
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...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27381691/predictive-factors-of-difficult-procedure-in-octogenarians-undergoing-elective-laparoscopic-cholecystectomy-a-single-center-experience
#19
F Guida, L Monaco, M Schettino, R Porfidia, G Iapicca
AIM: To assess the feasibility and safety of laparoscopic cholecystectomy (LC) in very elderly patients with particular attention to the predicitive factors of difficulty. PATIENTS AND METHODS: All patients aged ≥ 80 undergoing elective LC for lithiasis at our institution since 1st January 2015 to 31st December 2015 were included in the study. Exclusion criteria were: a) acute cholecystitis; b) biliary pancreatitis; c) biliary tract neoplasms; d) urgent procedure...
March 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27371265/role-of-ercp-in-patients-with-idiopathic-recurrent-acute-pancreatitis
#20
REVIEW
Piyush Somani Md, Udayakumar Navaneethan Md
Recurrent acute pancreatitis (RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. RAP is differentiated from chronic pancreatitis based on the presence of a normal morphological appearance of the pancreas between episodes. RAP can be due to a variety of etiologies including common bile duct stones or sludge, sphincter of Oddi dysfunction (SOD), pancreas divisum (PD), anomalous pancreaticobiliary junction, genetic mutations, and alcohol related. In approximately 30 % of patients, the etiology of RAP is unclear and the term "idiopathic" is used...
September 2016: Current Treatment Options in Gastroenterology
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