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Query: UMLS:C0008325 (cholecystitis)
 3,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The physiology and pathophysiology of the sphincter of Oddi are poorly understood. The relationships of functional disorders of the sphincter to biliary and pancreatic disease and of organic lesions of the papilla to pancreatic inflammatory disease are subjudice to say the least. The efficacy of sphincter section in the treatment of chronic pancreatitis is unproved. Section of the sphincter may be necessary to treat biliary tract pathology but its use should not be routine or indiscriminative since, there is morbidity as well as mortality. Finally, the price of sphincterotomy is: 1. hemorrhage; 2. duodenal perforation; 3. pancreatic duct damage--a. acute pancreatitis; b. chronic pancreatitis; 4. sphincter incompetence--a. common duct regurgitation--cholangitis; b. pancreatic duct regurgitation--pancreatitis; 5. sphincter stenosis--obstructive jaundice; 6. stasis cholecystitis; 7. diarrhea; 8. morbidity 10%; 9. mortality 1.9%.
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PMID:The sphincter of Oddi, sphincterotomy and biliopancreatic disease. 39 44

The authors studied the site of draining operations on the biliary tract in 160 patients with biliary pancreatitis. Among 64 patients with chronic pancreatitis 41 (64.1%) were subjected to various draining operations on the biliary system, one patient died. In a group of 96 patients with acute biliary cholecystitis 47 (48.8%) underwent internal drainage of the biliary tract and 49 (51.1%) patients were treated by external drainage. Four patients died. The late-term results were studied in 25 patients of each group: in group 1 the results were good in 22, satisfactory in 2, and poor in 1 patient; in group 2 the respective results were encountered in 19, 4, and 2 patients. The authors claim that various draining operations on the common bile duct are conductive to improvement of the immediate and late-term results of treatment of various forms of biliary pancreatitis.
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PMID:[Draining surgery of the main biliary tract in the surgical treatment of chronic and acute pancreatitis]. 177 54

The author describes the results of examining 120 patients with chronic recurrent pancreatitis, 110 patients with chronic non-calculous cholecystitis and 70 patients with duodenal ulcer to detect the abdominocardial syndrome (ACS). Shows the rate and the most characteristics complaints of patients with the indicated syndrome, gives the detailed characterization of the main clinical manifestations of the ACS. Provides the data on microcirculation and ECG studies at the polyclinical stage and results of studying myocardial contractility, peripheral hemodynamics and immunological parameters under inpatient conditions. Notes the greatest degree of changes among patients with chronic pancreatitis and cholecystitis associated with the ACS.
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PMID:[The abdominocardial syndrome. Detection and treatment before hospitalization]. 205 8

As many as 352 patients with different gastroenterological pathology (ulcer disease, chronic gastritis, chronic pancreatitis and cholecystitis) were examined under clinical conditions. Intracavitary pressure and gastric and duodenal motility were recorded on a "Salyut" polygraph with the aid of a tube of original design. It has been discovered that intracavitary pressure in the stomach and duodenum is biphasic in nature and that it may change not only in different diseases but also at different motility types. The changes discovered should be taken into account in administering adequate therapy.
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PMID:[Changes in the intracavitary pressure in the stomach and duodenum with different types of motility]. 233 19

Disseminated cytomegalovirus (CMV) infection occurs predominantly in immunocompromised hosts. Symptomatic CMV cholecystitis and pancreatitis are quite rare, and, to our knowledge, there are no reports of these occurring simultaneously. We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. At surgery, cholecystitis and pancreatitis were found, and a cholecystectomy was performed. The patient developed disseminated intravascular coagulation, eventual sepsis, and multiorgan failure. At autopsy, widespread disseminated CMV infection was found, with CMV-associated foci of acute inflammation and necrosis in the pancreas and in the surgically resected gallbladder. A review of our autopsy files revealed only one renal transplant patient with CMV inclusions and chronic pancreatitis. No pancreatitis was seen in 27 patients with acquired immunodeficiency syndrome. Cytomegalovirus should be considered as a possible cause of pancreatitis and cholecystitis in immunocompromised patients.
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PMID:Disseminated cytomegalovirus infection presenting with acalculous cholecystitis and acute pancreatitis. 255 45

Patients with chronic pancreatitis and complicated calculous cholecystitis are known to have considerable disturbances of the immune status of the organism. The complex of preoperative management and postoperative treatment of such patients should include drugs mainly influencing the cell immunity indices.
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PMID:[Clinico-immunologic status and postoperative course of patients with chronic pancreatitis and complicated cholecystitis]. 387 31

An easy, safe, and definitive operation for the "difficult gallbladder" is described and has been termed subtotal cholecystectomy. Eighteen patients underwent subtotal cholecystectomy during a 30-month period, which constitutes approximately 7% of cholecystectomies performed at our institution. The indications were cholecystitis with severe fibrosis or inflammatory changes that prevented safe dissection in Calot's triangle in 11 patients and portal hypertension in seven patients (liver cirrhosis [two patients] and segmental portal hypertension caused by chronic pancreatitis [five patients]) to prevent massive blood loss from the gallbladder bed. The operation entails leaving the posterior wall of the gallbladder attached to the liver and securing the cystic duct at its origin from within the gallbladder with a purse string technique. The latter obviates the need for dangerous dissection in Calot's triangle. Control of bleeding from the remaining gallbladder edge is greatly facilitated by the use of a running suture after each stage of piecemeal excision of the gallbladder. All patients survived the operation and wound infection occurred in only two patients (11%). One patient required a laparotomy 1 month after surgery for adhesive small bowel obstruction related to the remaining gallbladder wall and site of a liver biopsy. No patients have so far developed postcholecystectomy symptoms (median follow-up 12.2 months; range 3 to 31 months). Subtotal cholecystectomy is a definitive operation that prevents recurrent gallstone formation, as no residual diseased gallbladder mucosa is left in continuity with the biliary system. It provides a simple, safe option in patients in whom cholecystectomy could be hazardous.
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PMID:Subtotal cholecystectomy: for the difficult gallbladder in portal hypertension and cholecystitis. 389 43

Comparative examination of the material obtained from 133 cadavers of patients dying after operations for chronic pancreatitis, pancreonecrosis, and cholecystitis as well as dying suddenly with other diseases (control) was carried out. Stereoscopic microscopy was used to study the internal relief of the mucous membrane of the ampulla and ducts of the major duodenal papilla (MDP), and their step-wise histological examination was performed. From 1 to 10 valves were found in 98% of the control cases. Inflammatory diseases of the gall bladder and pancreas were found to be accompanied by morphological changes in the valve apparatus of MDP. In acute cholecystitis and pancreatitis, edema of the valves and their inflammatory infiltration developed. Courvoisier's gallbladder and chronic recurrent pancreatitis with the duration of the disease up to 3 years resulted in hypertrophic changes in the valves. A disease of longer duration (from 3 to 7 years) was accompanied by deforming changes in the valves with possible subsequent complete atrophy of the valvular apparatus.
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PMID:[Internal topography of the greater duodenal papilla in cholecystitis and pancreatitis]. 666 Oct 75

Alcohol-induced chronic pancreatitis involving the head of pancreas may have profound effects on the hepatobiliary system. The natural history, complications, and management of the syndrome are presented, using selected cases to emphasize important features. Chronic pancreatitis can cause mechanical obstruction to both the distal common bile duct and the proximal pancreatic duct. In the common bile duct this will result in proximal dilatation above the stenosis with bile stasis. Possible sequelae are ascending cholangitis, cholecystitis, biliary calculi formation, and secondary biliary cirrhosis. The mechanical effects of stricture of the proximal pancreatic duct may exacerbate pancreatic dysfunction. The clinicopathological spectrum of chronic pancreatitis with biliary obstruction encompasses three clinical types--"transient," "recurrent", and "persistent." The widespread effects of the syndrome are evident from the involvement of pancreas, proximal pancreatic duct, papilla of Vater, liver, peripheral biliary tree, common bile duct, gallbladder, and reticuloendothelial system. Essential to management is surgery which should be considered when there is objective evidence of obstruction to the common bile duct. Choledochoduodenostomy is the preferred type of operation. If dilatation is mild and jaundice transient, conservative therapy with careful observation is advocated.
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PMID:Chronic pancreatitis and the hepatobiliary system. 713 42

This is the first description of the detection of pancreatic adenocarcinoma peritoneal metastasis by established radiolabeled polymerase chain reaction (PCR) based Ki-ras mutational analysis. The present study evaluates both routine cytology and Ki-ras mutational analysis in the detection of peritoneal micrometastases in 24 subjects with pancreatic adenocarcinoma compared to seven control cases of chronic pancreatitis and seven control cases of cholecystitis. Locoregional extension, vascular invasion, and distal metastases were confirmed in 21/24 (88%) of the subjects with pancreatic adenocarcinoma by compute tomography, angiography, endosonography, or laparoscopy. The most common site of histologically confirmed extrapancreatic involvement was the vasculature (29%), followed by the liver (25%), duodenum (17%), peritoneum (17%), and lymph nodes (12%). Peritoneal lavage cytology was positive in 3/24 (12%) cases of pancreatic carcinoma while Ki-ras codon 12 mutational analysis was positive in 2/24 (8%). Two histologically confirmed cases of peritoneal metastases were not detected by either methodology, while peritoneal lavage cytology detected malignant cells in one case with histologically confirmed lymph node metastasis.
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PMID:Peritoneal exfoliative cytology and Ki-ras mutational analysis in patients with pancreatic adenocarcinoma. 749 64


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