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Biliary dyskinesia

Vamsi V Alli, Jie Yang, Jianjin Xu, Andrew T Bates, Aurora D Pryor, Mark A Talamini, Dana A Telem
BACKGROUND: Since the introduction of laparoscopic cholecystectomy (LC), there has been continued evolution in technique, instrumentation and postoperative management. With increased experience, LC has migrated to the outpatient setting. We asked whether increased availability and experience has impacted incidence of and indications for LC. METHODS: The New York (NY) State Planning and Research Cooperative System longitudinal administrative database was utilized to identify patients who underwent cholecystectomy between 1995 and 2013...
September 7, 2016: Surgical Endoscopy
David H Rothstein, Carroll M Harmon
Biliary disease in children has changed over the past few decades, with a marked rise in incidence-perhaps most related to the parallel rise in pediatric obesity-as well as a rise in cholecystectomy rates. In addition to stone disease (cholelithiasis), acalculous causes of gallbladder pain such as biliary dyskinesia, also appear to be on the rise and present diagnostic and treatment conundrums to surgeons.
August 2016: Seminars in Pediatric Surgery
Neha Santucci, Sunny Z Hussain, Carroll M Harmon, Julie H Schiavo, Paul E Hyman
OBJECTIVES: Cholecystectomy rates for biliary dyskinesia in children are rising in the United States, but not in other countries. Biliary dyskinesia is a validated functional gallbladder disorder in adults, requiring biliary colic in the diagnosis. In contrast, most studies in children require upper abdominal pain, absent gallstones on ultrasound and an abnormal gallbladder ejection fraction (GBEF) on cholecystokinin-stimulated cholescintigraphy for diagnosis. We aimed to systematically review existing literature in biliary dyskinesia in children, determine the validity and reliability of diagnostic criteria, GBEF, and to assess outcomes following cholecystectomy...
July 28, 2016: Journal of Pediatric Gastroenterology and Nutrition
Keith K Lai, Hannah E Goyne, David Hernandez-Gonzalo, Kennon A Miller, Marion Tuohy, Gary W Procop, Laura W Lamps, Deepa T Patil
Cystoisospora belli, previously known as Isospora belli, is an obligate intracellular coccidian parasite that is most often associated with gastrointestinal disease in immunocompromised patients. In this study, we detail the clinicopathologic features of 18 cases of Cystoisospora infection affecting the gallbladder in immunocompetent individuals and compare them with a control group. Each case was reviewed for cholecystitis (none, acute, chronic), epithelial disarray, presence of intraepithelial lymphocytes (none, rare [≤5 per 20 epithelial cells], present [>5 per 20 epithelial cells]), architectural distortion, intramucosal eosinophilia, and mural thickening/serositis...
August 2016: American Journal of Surgical Pathology
Emily R Perito
No abstract text is available yet for this article.
July 2016: Journal of Pediatric Gastroenterology and Nutrition
Bryan K Richmond, Caresse Grodman, Jerri Walker, Scott Dean, Edward H Tiley, Roland E Hamrick, Kristen Statler, Mary Emmett
BACKGROUND: Despite widespread adoption by the surgical community, high-quality prospective data supporting the practice of laparoscopic cholecystectomy (LC) for the treatment of biliary dyskinesia (BD) are lacking. STUDY DESIGN: Adult patients meeting criteria for diagnosis of BD (Rome III symptoms, normal ultrasound, gallbladder ejection fraction < 38%) were randomized to either LC or a trial of nonoperative (NO) therapy with a low-dose neuromodulator (amitriptyline 25 mg/day)...
June 2016: Journal of the American College of Surgeons
Maria G Sacco Casamassima, Colin Gause, Jingyan Yang, Seth D Goldstein, Abhishek Swarup, Fizan Abdullah
PURPOSE: Limited data exists evaluating the extent of utilization and safety of outpatient laparoscopic cholecystectomy (LC) in children. The aim of this study was to investigate the safety of outpatient LC in the pediatric population utilizing a national surgical quality improvement database. METHODS: The National Surgical Quality Improvement Program-Pediatric (NSQIP-P) databases from 2012 and 2013 were queried to identify pediatric patients who underwent elective LC...
June 2016: Pediatric Surgery International
Patrick M Jones, Marc B Rosenman, Marian D Pfefferkorn, Frederick J Rescorla, William E Bennett
OBJECTIVES: Biliary dyskinesia is a common diagnosis that frequently results in cholecystectomy. In adults, most clinicians use a cut off value for the gallbladder ejection fraction (GBEF) of <35% to define the disease. This disorder is not well characterized in children. Our aim was to determine the relation between GBEF and gallbladder pathology using a large statewide medical record repository. METHODS: We obtained records from all patients of 21 years and younger who underwent hepatic iminodiacetic acid (HIDA) testing within the Indiana Network for Patient Care from 2004 to 2013...
July 2016: Journal of Pediatric Gastroenterology and Nutrition
Nicholas Ahn, Gary Signor, Tejinder Paul Singh, Steven Stain, Christine Whyte
BACKGROUND: Elective cholecystectomy is a high-volume, simple procedure, well suited for the development of a pediatric robotic surgery program. Surgical robot software, by "reversing" the surgeon's hands, simplifies single-site cholecystectomy through a single incision at the umbilicus. MATERIALS AND METHODS: Data were reviewed on the first nine children who had robotic cholecystectomy, with the Da Vinci® Surgical System (Intuitive Surgical Inc., Sunnyvale, CA) device, at our institution...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Anthony Gonzalez, Christian Hernandez Murcia, Rey Romero, Ernesto Escobar, Pedro Garcia, Gail Walker, Michelle Gallas, Eugene Dickens, Bruce McIntosh, William Norwood, Keith Kim, Jorge Rabaza, Don Parris
BACKGROUND: Recently, the robotic single-site platform has been used to ameliorate the difficulties seen in single-incision laparoscopic surgery (SILC) while preserving the benefits of standard laparoscopic cholecystectomy. The purpose of this study is to describe the clinical outcomes of a large series of single-incision robotic cholecystectomy (SIRC). METHODS: Medical records of consecutive patients who underwent SIRC were retrospectively reviewed. All procedures were performed by six surgeons at five different North American centers involved in the study...
July 2016: Surgical Endoscopy
Saif Dairi, Andrew Demeusy, Anne M Sill, Shirali T Patel, Gopal C Kowdley, Steven C Cunningham
BACKGROUND: The clinical significance of cholesterolosis has not been well established but there are some provocative, if not robust, studies of the role it may play in the pathophysiology of pancreatitis and biliary dyskinesia, as well as hypercholesterolemia. Our aim was to take advantage of a very large cholecystectomy (CCY) database to support or refute these potentially important reported associations. MATERIALS AND METHODS: A retrospective review of 6868 patients who underwent CCY from 2001-2013 was performed...
February 2016: Journal of Surgical Research
Amanda H Eckenrode, Joseph A Ewing, Jennifer Kotrady, Allyson L Hale, Dane E Smith
Patients with upper abdominal pain, nausea, and vomiting are often evaluated with ultrasound to diagnose symptomatic cholelithiasis or cholecystitis. With a normal ultrasound, a hepatobiliary iminodiacetic acid (HIDA) scan with ejection fraction (EF) is recommended to evaluate gallbladder function. The purpose of this study was to evaluate whether the HIDA scan with EF was appropriately utilized in considering cholecystectomy. Over 18 months, we performed 1533 HIDA scans with EF. After exclusion, 1501 were analyzable, 438 of whom underwent laparoscopic cholecystectomy...
July 2015: American Surgeon
Hideo Takahashi, Gavin A Falk, Michael Cruise, Gareth Morris-Stiff
A 47-year-old woman presented with a history of vague abdominal pain for several years, which worsened over the past 2 months, with pain more prominent in the right upper quadrant. She also had a history of peptic ulcer disease. The ultrasound scan of right upper quadrant revealed normal gallbladder and oesophagogastroduodenoscopy was unremarkable. A (99m)technetium labelled hepato iminodiacetic acid (HIDA) scan with cholecystokinin provocation demonstrated a decreased gallbladder ejection fraction (EF) of 32%...
2015: BMJ Case Reports
L M Nemtsov
RESULTS: Basal and stimulated serum CCK concentrations were not statistically significant differences (p > 0.05) with the control group in patients studied in the whole and in patients subgroups, formed by the diagnosis of biliary pathology and the character of gallbladder emptying. Increased stimulated CCK concentration was found in patients with symptomatic variants. Reduce of serum-cholecystokinin concentration growth (ACCK) after intake of Sorbitol was revealed in subgroup of patients with low-symptom variant...
2014: Experimental & Clinical Gastroenterology
H-D Allescher
Sphincter of Oddi dyskinesia is a functional disorder of the papillary region which can lead to clinical symptoms due to functional obstruction of biliary and pancreatic outflow. Based on the severity of the clinical symptoms the disorder can be graded into three types (biliary and pancreatic types I-III). The manometric diagnosis of this disorder using sphincter of Oddi manometry is hampered by the relatively high risk of pancreatitis after endoscopic retrograde cholangiopancreatography. Although papillary manometry is often carried out in North America, in Europe this is the exception rather than the rule...
June 2015: Der Internist
Justin B Mahida, Jason P Sulkowski, Jennifer N Cooper, Austin P King, Katherine J Deans, Denis R King, Peter C Minneci
BACKGROUND: Rates of cholecystectomy for biliary dyskinesia are rising. Our objective was to identify clinical determinants of symptom improvement in children undergoing cholecystectomy for biliary dyskinesia. METHODS: This retrospective cohort study included patients undergoing cholecystectomy for biliary dyskinesia from 2006-2013 who had their gallbladder ejection fraction (EF) measured by either cholecystokinin-stimulated hepatobiliary iminodiacetic acid scan and/or fatty meal ultrasound...
October 2015: Journal of Surgical Research
I A Makarov, N V Mokeeva, N A Lavreniuk, M L Vasil'evykh
Study of 462 patients with occupational pulmonary diseases revealed that hepatobiliary diseases are among concomitants of occupational COLD. Inflammatory changes in gallbladder and bile ducts with bile dyskinesia are first manifestations of such diseases developing early at chronic nonobstructive bronchitis stage. Shortly, hepatosteatosis adds to these disorders. Final stage of the pathologic process in some patients is bile stones or liver cirrhosis.
2014: Meditsina Truda i Promyshlennaia Ekologiia
Ines van Dooren, My El Abbes Faouzi, Kenn Foubert, Mart Theunis, Luc Pieters, Yahya Cherrah, Sandra Apers
ETNOPHARMACOLOGICAL RELEVANCE: Infusions of Herniaria hirsuta L., Herniaria glabra L. and Herniaria fontanesii J.Gay are well known in Moroccon folk medicine for the treatment of biliary dyskinesia, (uro)lithiasis or as a diuretic. Herniariae Herba which can contain H. glabra and H. hirsuta is known in Europe as an urological drug. AIM OF THE STUDY: To investigate the efficacy of a standardized infusion of Herniaria hirsuta against choleltihiasis, and evaluation of its genotoxicity...
July 1, 2015: Journal of Ethnopharmacology
Jennifer F Preston, Brian S Diggs, James P Dolan, Erin W Gilbert, Moshe Schein, John G Hunter
BACKGROUND: Our objective was to determine if cholecystectomy for biliary dyskinesia (BD) was performed more commonly in the United States than in 4 comparator countries around the world. METHODS: Using the Nationwide Inpatient Sample, we extracted and analyzed data for cholecystectomy from 1991 to 2011 using ICD-9 (International Classification of Diseases 9th Revision) procedure codes. To derive the number of cholecystectomies performed for BD, we used the ICD-9 code 575...
May 2015: American Journal of Surgery
Brian G A Dalton, Katherine W Gonzalez, Erol Marty Knott, Shawn D St Peter, Pablo Aguayo
BACKGROUND: Although the safety of same day discharge (SDD) after laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis (SC) and biliary dyskinesia (BD) in adults has been well documented in the literature, the same data in the pediatric population are lacking. We have recently instituted a protocol for SDD after LC for SC and BD, and this study is an analysis of our initial experience. METHODS: A retrospective chart review of all patients who underwent LC for BD and SC in our institution from January 2011-July 2014 was performed...
May 15, 2015: Journal of Surgical Research
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