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Risk factors for conversion of laparoscopic cholecystectomy.

BACKGROUND: Conversion during laparoscopic cholecystectomy has adverse effects on operating time, postoperative morbidity and hospital costs … minal or cardiac surgery,as well as pain, fever, a high white blood cell count, ultrasound signs of cholecystitis at hospitalization. Intraoperative variables were: adhesiolysis, associated hepatic biopsy. RESULTS: Twenty-five operations were converted (conversion rate: 2.76%). Factors significantly associated with conversion were: age over 60 years, diabetes, …

A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain.

OBJECTIVES: Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain. MATERIALS AND METHODS: … ,021 patients (mean age 47; 55% female) were appendicitis (284; 28%), diverticulitis (118; 12%) and cholecystitis (52; 5%). The sensitivity of CT in detecting appendicitis and diverticulitis was significantly higher than that of ultrasound: 94% versus 76% (p < 0.01) and 81% versus 61% (p = 0.048), respectively. For cholecystitis, the sensitivity of both was 73% …

Single-incision laparoscopic cholecystectomy in a pediatric population: a preliminary report.

Laparoscopic cholecystectomy has become a standard procedure for treatment of gallbladder diseases. The operation is performed through a fou … a diagnosis of symptomatic cholelithiasis. Two patients had gallstone pancreatitis, three had acute cholecystitis, and one had a hydropic gallbladder. Two patients had an intraoperative cholangiogram performed. Average operating room time was 97.5 +/- 34.5 minutes (range, 65 to 145 minutes). There were no intraoperative complications. All patients had minimal ( …

Is early laparoscopic cholecystectomy safe after the "safe period"?

BACKGROUND: Early laparoscopic cholecystectomy (ELC) in acute cholecystitis improves hospital stay and outcome. Operative difficulty is said to increase with delay, and surgery is usually advised within 3 days of presentation. It can be difficult to accommodate all these patients within 3 days; this study evaluates results within and after this "safe period." MATERIALS AND METHODS: In total, 137 patients (male:female 45:92) presenting as an emergency due to acute cholecystitis over 45 months from August 1, 2003, who then underwent ELC with an on-table cholangiogram (OTC) or laparoscopic ultra…

Preoperative complications of gallstones and their relevance to treatment and prognosis: experience with 451 cases.

Of 451 patients with cholelithiasis, 273 suffered from 396 preoperative complications; the common ones were acute cholecystitis (n = 120), jaundice (n = 135), and acute pancreatitis (n = 52). Of the 195 patients under the age of 50 years 48% had complications, compared with 70% of the 256 above the age of 50 years. For acute cholecystitis and acute pancreatitis, an interval cholecystectomy was carried out 3-6 wk after initial conservative treatment. Except in the 33 cases with obstructive jaundice of indeterminate etiology (n = 15) or jaundice associated with uncontrollable cholangitis (n = 18…

[Endoscopic papillotomy in preserved gallbladder].

Endoscopic papillotomy was attempted in 60 high risk patients (mean age 76 years) with complications of common bile duct stones and preserve … had a short transient bout of jaundice and cholangitis respectively. Three patients developed acute cholecystitis with subsequent empyema. Four out of five complications occurred within one month and in three of them the cystic duct was occluded at papillotomy. In summary, treatment of common bile duct stones by endoscopic papillotomy appears to be justified in …

Bile peritonitis associated with gastric dilation-volvulus in a dog.

This report describes a case of septic peritonitis and gall bladder rupture in German shepherd dog that developed 7 d after surgical treatment for gastric dilation-volvulus. Histological examination confirmed gall bladder necrosis, secondary to an acute ischemic event. Postoperative acute necrotizing cholecystitis has not been a previously reported complication in dogs.

[Morphofunctional characteristics of endocrine gastric cells in chronic biliary pancreatitis].

Clinicoendoscopic morphological and morphofunctional studies in 50 patients with chronic cholecystitis and 50 patients with chronic biliary pancreatitis have demonstrated that morphometric analysis of the antral stomach endocrine cells secreting melatonin, neurotensin and somatostatin can be used in addition to standard laboratory and device methods for differentiation chronic biliary pancreatitis with biliary pathology.

Intestinal obstruction diagnosed by cholescintigraphy.

Radionuclide cholescintigraphy provides useful information about the dynamics of bile flow through the liver, gallbladder, bile ducts, and intestines. Besides helping to diagnose acute cholecystitis, it may provide other meaningful information to effectively alter the patient's management. Preoperative diagnosis of intestinal obstruction was made on routine cholescintigraphy and was proved subsequently at surgery.

Hepatobiliary imaging of common bile duct obstruction by a hydronephrotic kidney.

A patient with intermittent right upper quadrant abdominal pain thought to represent acute cholecystitis had common bile duct obstruction due to an enlarged right renal pelvis. A Tc-99m-HIDA scan provided the first clue to the diagnosis. The case reinforces the value of cholescintigraphy in diagnosing pathology outside the biliary system.

Volvulus of the gallbladder: laparoscopic detorsion and removal.

A 73-year-old woman who presented with symptoms of acute cholecystitis was found to have a gangrenous gallbladder wrapped in three complete rotations around its pedicle. Detorsion and removal of the gallbladder were accomplished laparoscopically. Our review of the literature found no other case in which this degree of torsion was successfully treated laparoscopically.

[Method of punction transcutaneous cholecystostomy and device for accomplishment].

The author has developed a mode of punctional transcutaneous cholecystostomy--under ultrasound scanning control and the device for its accomplishment. The mode and the device provide increase of safety of the operation and the possibility of usage of ultrasound scanning without special punctional transducer. The results of clinical application of the developed method and the device in patients with acute cholecystitis are effective.

Gallbladder volvulus.

A case of torsion of the gallbladder is presented. This is a rare condition that occurs more frequently in elderly females, it is associated with anatomical variants related to abnormal fixation of the gallbladder to the liver bed. It is usually diagnosed at laparotomy and treatment consists of cholecystectomy. This condition should be suspected in elderly females with acute cholecystitis or acute abdominal pain of unknown origin.

[Cholelithiasis from the surgeon's view point].

Patients with silent gallstones and without other severe diseases should be operated on as well as patients with complications of gallstones like perforation, jaundice and obstructive bowel disease caused by stones. In case of acute cholecystitis medical treatment stands first. During operation cholangiography is performed. In choledocholithiasis we prefer choledochoscopy with a rigid instrument.

Vasculitis of the gallbladder in a 70-year-old man with giant cell (temporal) arteritis.

A patient with giant cell (temporal) arteritis developed acute cholecystitis related to vasculitis. Histopathologically, the vasculitic lesions in the gallbladder resembled polyarteritis nodosa. In addition to demonstrating the rare occurrence of vasculitis of the gallbladder in a patient with giant cell arteritis, this case points out the inadequacies of currently used criteria to separate the various forms of arteritis.

The correlation between postoperative complications of ERCP and quality of life after discharge in patients with choledocholithiasis.

BACKGROUND: The treatment of choledocholithiasis by endoscopic retrograde cholangiopancreatography (ERCP) is a difficult endoscopic procedur … uding 18 cases (9.3%) of hyperamylase, 11 cases (5.7%) of acute pancreatitis, and 5 cases (2.6%) of cholecystitis. There were 4 cases (2.1%) of gastrointestinal bleeding. The SF-36 scores in the complication group were significantly lower than those in the non-complication group across various dimensions, including bodily pain (BP), general health (GH), vitalit …

Role of Cholecystectomy After Endoscopic Sphincterotomy in the Management of Choledocholithiasis in High-risk Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care … ral secondary outcomes including difference in development of acute pancreatitis, biliary colic and cholecystitis, cholangitis and recurrent jaundice, nonbiliary adverse events, and length of hospital stay. Risk ratios (RR) were calculated for categorical variables and difference in means was calculated for continuous variables. These were pooled using random e …

Association of BDNF and BMPR1A with clinicopathologic parameters in benign and malignant gallbladder lesions.

BACKGROUND: Neurotrophic factors such as brain derived neurotrophic factor (BDNF) are synthesized in a variety of neural and non-neuronal ce … nd BMPR1A expression of gallbladder adenocarcinoma, peritumoral tissues, adenoma, polyp and chronic cholecystitis were Immunohistochemically determined. RESULTS: BDNF expression was significantly higher in gallbladder adenocarcinoma than in peritumoral tissues, adenoma, polyps and chronic cholecystitis samples. However, BMPR1A expression was significantly lowe …

The cholecystokin provocation HIDA test: recreation of symptoms is superior to ejection fraction in predicting medium-term outcomes.

BACKGROUND: The (99m) technetium labelled hepato imino diacetic acid (HIDA) scan is widely used in the investigation of patients with typica … adders were delivered intact for histological assessment and all but one showed evidence of chronic cholecystitis. At each postoperative visit, approximately 2 weeks following the procedure, all patients reported resolution of symptoms. After a mean of 18.7 ± 12.1 months symptom recurrence had been noted in only one of 42 (2.4%). CONCLUSIONS: The CCK HIDA scan …

Под обманом: скрытый случай острого гепатита.

Вирусная инфекция острого гепатита А обычно выявляется на основе тщательной истории пациента в сочетании с химией печени и вирусной серологией. Диагноз может быть отсрочен, когда клиническая картина затуманена другой, кажется, более неотложным представлением патологии с пересекающимися чертами. Здесь мы описываем случай с молодой женщиной, у которой был острый калькуляционный холецистит с сопутствующим острым гепатитом А вирусным инфекцией.

Совпадение в аннотации оригинала
Acute hepatitis A virus infection is routinely identified through a thorough patient history in conjunction with liver chemistries and viral … erlapping features. Here, we describe the case of a young female who presented with acute calculous cholecystitis with concurrent acute hepatitis A virus infection.