Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008325 (cholecystitis)
 3,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laparoscopic cholecystectomy (LC) has rapidly gained wide acceptance in the United States. The applicability, safety and efficacy of this new procedure for the treatment of cholelithiasis in Taiwan, however, needs evaluation. We performed LC in 50 out of 98 cases of cholelithiasis at Cathay General Hospital from 28 December 1990 to 28 April 1991. We found that the applicability rate was 51%. The reasons for not selecting LC in the 48 open cases were: acute and gangrenous cholecystitis (13), common bile duct stones (11), concomitant intra-abdominal malignancy (5), intrahepatic stones (5), multiple upper abdominal incisions (4), pancreatitis or pancreatic abscesses (3) and other causes (7). In the LC group, there were 44 patients with symptomatic chronic calculus cholecystitis, 3 patients with acute calculus cholecystitis and 3 patients with gall bladder polyps. The age of the patients ranged from 27 to 79. There were 14 males and 36 females. All of the patients had a detailed preoperative workup including complete liver function test and sonographic examination of the hepatobiliary system. Additional pre-operative endoscopic retrograde cholangiopancreatographies were done in 3 and operative cholangiograms were done in another 3 to confirm the absence of common bile duct stones or to delineate anatomy. Although we encountered a few problems during the operations, such as severe adhesion, bleeding, difficult dissection, CO2 leakage, difficult insufflation, or large stones, all of the 50 patients completed the LC successfully without conversion to open cholecystectomy. The average operation time was 60 minutes, ranging from 30 to 135 minutes. Drain tubes were used in 7 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Laparoscopic cholecystectomy: the first 50 patients]. 168 93

Although laparoscopic cholecystectomy has become the surgical procedure of choice for most patients with cholecystitis, the safety of carbon dioxide (CO2) pneumoperitoneum during pregnancy has not been fully elucidated. Pregnancy causes many physiologic changes, resulting in compromised cardiac, pulmonary, and metabolic reserves. The use of CO2 pneumoperitoneum during laparoscopy may cause further physiologic stress to both the parturient and the fetus. A case of gasless laparoscopic cholecystectomy is presented. This procedure avoids potential risks of both absorbed CO2 and increased intraabdominal pressure.
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PMID:Gasless laparoscopic cholecystectomy in pregnancy. 761 44

An analysis of results of treatment of 85 patients subjected to planned operations for calculous cholecystitis and inguinal hernias with the application of high-energy CO2 and YAG laser, surgical scalpel was performed. For local treatment of the aseptic wounds radiation of semiconduction arsenide gallium laser "Uzor" was used. Results of the investigation suggest that laser infrared radiation promotes rapid liquidation of acute inflammatory symptoms, quicker healing and smooth course of the postoperative period. The method is recommended for wide introduction into clinical practice.
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PMID:[Laser radiation in the infrared range in the treatment of aseptic postoperative wounds]. 859 47

We have designed a new abdominal wall lifter for gasless laparoscopic surgery which consists of stainless steel rods and iron lifters. They elevate the abdominal wall up like a dome-type camping tent, which does not disturb any manipulation of scope or X-ray camera. We received a good view of the peritoneal cavity without CO2 gas insufflation in ten patients with cholecystitis. This will be helpful for general laparoscopic surgery or laparoscopic assisted surgery with the use of conventional forceps or extracorporeal suturing through a valveless trocar.
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PMID:Fishing-rod-type abdominal wall lifter for gasless laparoscopic surgery. 870 60

We report a case of anaerobic peritonitis with bowel emphysema, but no hollow organ perforations, following gallbladder removal for acute acalculous cholecystitis using a laparoscopic procedure in a diabetic patient. Management consisted of profuse peritoneal irrigation and zipper laparostomy. After a long postoperative period, the patient recovered without sequelae. The patient suffered typical acute cholecystitis with empyema and a diabetic status; anaerobial flora is frequent in these cases. The patient was operated on by means of a closed technique without contact with either air or oxygen. Moreover, CO2 injection into the peritoneal cavity with this technique, along with gallbladder rupture, created an ideal medium for anaerobial growth. We suggest that acalculous cholecystitis in diabetic patients could represent a contraindication for laparoscopic cholecystectomy; alternatively, open cholecystectomy should at least be considered when gallbladder rupture occurs during laparoscopy.
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PMID:Postoperative gangrenous peritonitis after laparoscopic cholecystectomy: a new complication for a new technique. 910 56

Sphincter of Oddi (SO) dysfunction as a potential cause of chronic acalculous cholecystitis (CAC) has not been studied in cases for which intraoperative SO manometry was used during laparoscopic cholecystectomy. In this study, we evaluated the effects of carbon dioxide pneumoperitoneum on laparoscopic transcystic SO manometry. In 27 patients with CAC, transcystic SO manometry had been attempted during laparoscopic cholecystectomy. The mean age of the patients was 46 years (range, 22-71). Complete manometric data sets were obtained in 18 patients. The mean SO pressure, phasic SO pressure, and phasic frequency were 35.4 +/- 29.1 mm/Hg versus 30.8 +/- 23.8 mm/Hg, 104.8 +/- 63.0 mm/Hg versus 73.6 +/- 34.6 mm/Hg, and 2.1 +/- 1.8 contractions/min versus 2.8 +/- 3.4 contractions/min with and without pneumoperitoneum, respectively. All differences were nonsignificant (P > 0.05). Two complications (7.4%) were observed: pancreatitis and jaundice. SO manometry is not affected by CO2 pneumoperitoneum. It may be used to study SO motility in patients with CAC.
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PMID:Laparoscopic transcystic sphincter of Oddi manometry is not affected by carbon dioxide pneumoperitoneum. 1144 49

Of all the striated muscles in the bodies of mammals, only the pelvic floor muscles, which include the levator ani (LA), have resting electric activity. The cause and function of this resting myoelectric activity are not exactly known. The current study investigated the effect of intraabdominal pressure (IAP) and visceral weight on the electromyographic (EMG) activity of the LA, seeking to elucidate its cause and function. A series of 18 subjects (12 women, 6 men, mean age 38.6 years) were subjected to laparoscopic cholecystectomy for calcular cholecystitis. Prior to cholecystectomy, the resting LA EMG and IAP were recorded with the patient in the recumbent and erect positions. During laparoscopic cholecystectomy, the IAP was elevated by CO2 insufflation in increments of 5 cm of H(2)O, and the LA EMG activity was recorded for the recumbent and vertical positions during inflation and after deflation at the end of the operation. In 5/18 patients in whom laparoscopic cholecystectomy was extended to open cholecystectomy, the IAP and LA EMG were also registered. The study also included histologic examination of the LA muscle from 15 cadavers (7 adults, 8 neonates). Levator ani EMG increased ( p < 0.05) on standing. At operation, IAP elevation was associated with a significant increase of LA EMG activity. On deflation, the IAP and LA EMG activity level returned to the pre-insufflation state. In open cholecystectomy, the IAP was zero and the LA EMG recorded no activity for the recumbent position, but there was an activity for the vertical position. Histologically, the lateral part of the LA in the adult cadavers consisted solely of skeletal muscle fibers. Proceeding medially, smooth muscle fibers started to appear and gradually increase until, at the midportion, the LA split into two layers, a deep layer consisting of smooth muscle fibers and a superficial layer consisting of skeletal fibers. In neonates, the LA was composed of purely skeletal muscle fibers. The LA EMG activity seems to be related to both the IAP and the visceral weight. It is probably attributable to the presence of smooth muscle bundles in the LA muscle. The LA EMG activity increased with the elevation of the IAP and visceral weight, which resulted in increased muscle tone to oppose the augmented pressure or weight. This effect seems to be mediated through the straining-levator reflex. A chronic increase of IAP or visceral overload is suggested to affect muscle integrity and function.
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PMID:Etiology of the resting myoelectric activity of the levator ani muscle: physioanatomic study with a new theory. 1260 57