Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of cystic dilatation of the common bile duct is reported. Initially treated by Roux-Y cystojejunostomy, twenty five years after, the patient presented a cholecystitis. This patient was treated by cholecystectomy and a few months after by excision of the cyst with Roux-Y hepato-jejunostomy. This attitude is proposed to avoid the complications of the cystic dilatation of the common bile duct: secondary biliary cirrhosis, angiocholitis, and malignant degeneration.
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PMID:[Cystic dilatation of the common bile duct initially treated by cystojejunostomy and reoperation 25 years later because of infectious and lithiasic complications]. 271 30

Adult cystic fibrosis (CF) patients are increasingly diagnosed with hepatic cirrhosis, cholecystitis, and cholelithiasis. A continuing diagnostic problem is the early detection of cirrhosis prior to diffuse liver involvement. Sonography has been used in evaluating the pancreas, gallbladder, liver, and spleen in cystic fibrosis patients. We used a real-time mechanical sector scanner to study the portal veins in adult CF patients randomly selected from our CF population and correlated the portal vein diameters with liver function studies. A measurement greater than 12 mm was interpreted as a probable sign of portal hypertension. Of 21 patients studied, 14 had portal veins that measured greater than 12 mm, and 12 patients had (although not necessarily at the time of the exam) elevated serum alkaline phosphatase levels. Three patients had associated splenomegaly and thrombocytopenia, and 10 patients also exhibited cholelithiasis and abnormal gallbladders on sonography. Initial results indicate that portal vein measurement may be a sensitive indicator of early portal hypertension. Sonography may, thus, isolate patients at high risk for possible future complications. Serial sonograms can be performed easily in evaluating the progress of liver disease.
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PMID:Portal vein measurement by ultrasonography in patients with long-standing cystic fibrosis: preliminary observations. 354 Feb 61

Seventeen high-risk critically ill patients with suspected cholecystitis underwent percutaneous transhepatic cholecystostomy between 1981 and 1986 using Hawkins' needle guide system for gallbladder intubation. Acute cholecystitis was documented in 15 patients, including 1 with common bile duct obstruction. Two other patients had common bile duct obstruction secondary to metastatic cancer (one patient) and chronic pancreatic fibrosis (one patient). There was rapid resolution of the signs and symptoms of cholecystitis, sepsis, or both in 16 of the 17 patients. One critically ill patient with positive findings on blood culture and an organism resistant to triple antibiotic therapy died soon after percutaneous cholecystostomy. In the entire group of 17 patients, there was no evidence of bile leaks or other catheter complications. Six patients subsequently underwent successful cholecystectomy and two underwent common bile duct exploration without complications. One patient underwent cholecystojejunostomy, and in three patients, the catheter was removed with no sequelae of cholecystitis. Two remaining patients had the catheter in place and were awaiting operation at last follow-up. Three of four patients who died within 30 days of percutaneous transhepatic cholangiographic cholecystostomy died either from the terminal malignant condition (two patients) or from arrhythmia (one patient with cirrhosis). This review suggests that percutaneous cholecystostomy is a safe and effective procedure for resolving acute cholecystitis in high-risk patients. In addition, the technique of percutaneous transhepatic cholangiographic cholecystostomy appears well suited for percutaneous dissolution of stones, sclerosis of the gallbladder, or both in selected high-risk critically ill patients.
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PMID:Percutaneous cholecystostomy for acute cholecystitis in high-risk patients. 379 87

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

The biliary excretion of cefoperazone in experimental animals, and humans, was investigated. Biliary excretion of cefoperazone in rats, rabbits, dogs, and monkeys was always higher than that of cephazolin. Biliary excretion was markedly reduced in experimentally-produced liver cirrhosis in rats. Comparing the biliary excretion of cefoperazone and cephazolin in a crossover study in patients, the excretion of cefoperazone was shown to be much higher than that of cephazolin. In clinical studies in 116 patients with biliary tract infections such as cholecystitis, cholangitis, and liver abscess, cefoperazone was effective in 90 (78%). The incidence of side effects was low. In conclusion, cefoperazone was considered to be effective in treating biliary tract infections because of its broad antibacterial spectrum and high penetration into bile.
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PMID:Clinical experience with cefoperazone in biliary tract infections. 645 83

Forty-eight patients with alcoholic cirrhosis and absence of patent infection were assessed for asymptomatic bacteriemia and endotoxemia. 280 blood cultures have been performed and 190 serum samples collected for study by two different methods of the limulus test (LT). Bacteriemia was found in 7 blood cultures from 3 patients. In these patients, occult infection was demonstrated in each case (cholecystitis, ulcerated rectal adenocarcinoma, cutaneous infection). Sixteen LT from 14 patients were positive initially. Only one LT remained positive after control by two different methods. These results suggest that in patients with alcoholic cirrhosis and in the absence of patent infection: 1) bacteriemia is an infrequent feature and, if present, explained by other causes than cirrhosis. 2) LT is negative in systemic blood when rigorous controls are performed, and endotoxemia cannot be substantiated by this test.
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PMID:[Do latent bacteremia and endotoxinemia exist in cirrhotics? A study of 48 patients]. 687 64

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

Several properties of estradiol (E2)-binding cytosol macromolecules in the liver of females with cholecystitis and of males with hepatic cirrhosis were studied by means of comparatively delicate methods of free- and bound hormone separation. E2-binding macromolecules with Stokes' radius of approximately 5 nm were found in the hepatic samples under study, formed with E2 complexes, similar to estrogen receptors, according to hormonal specificity of affinity and stability. Protein, similar to a specific estrogen-binding protein of the rat and guinea pig liver, was not found in the preparations examined.
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PMID:[Identification of estrogen-binding proteins in the human liver]. 715 72

Gallbladder and extrahepatic bile duct operations merit special consideration in cirrhotic patients. During the past 15 years at Strong Memorial Hospital, 33 cirrhotic patients have undergone cholecystectomy or an operation for bile duct obstruction. Of the 21 patients with cirrhosis subjected to cholecystectomy for cholecystitis and cholelithiasis, nine had uncomplicated courses. Included in this group was one patient in whom the intrahepatic portion of the gallbladder was deliberately not resected. The other 12 patients (57%) had excessive intraoperative bleeding and required transfusion of three or more units of blood. One patient required additional exploratory surgery and antifibrinolytic therapy to control bleeding. In an additional group, only one of seven patients whose gallbladder was removed during a portal decompressive procedure bled excessively from the liver bed. A third group of five patients, including four with secondary biliary cirrhosis who underwent operations on the bile duct for obstruction, had massive intraoperative bleeding (greater than 5 U). Four of the five exsanguinated, and the remaining patient died of sepsis. A more conservative approach toward elective cholecystectomy in the cirrhotic patient is indicated. If an operation is performed, increased bleeding should be anticipated; extensive intrahepatic dissection should be avoided. Intraoperative infusion of vasopressin and an antifibrinolytic agent should be considered.
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PMID:Biliary tract surgery and cirrhosis: a critical combination. 728 Sep 97

The levels of serum secretory component (SC) were measured in 147 patients with digestive disease. Decreased levels were found patients with acute hepatitis, HBs-antigen associated chronic hepatitis, HBs-antigen associated liver cirrhosis and hepatoma. Normal levels were observed in patients with diabetes mellitus, gastric cancer and colonic carcinoma. Elevated levels were found in patients with cholecystitis, obstructive jaundice and acute pancreatitis. The serum SC level in almost all disease groups showed no correlation with immunoglobulin levels.
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PMID:Studies on secretory component in digestive disease. III. Levels of serum secretory component in digestive disease. 743 18


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