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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ascarids in the biliary tract may cause cholecystitis, pancreatitis and obstruction of the common bile ducts. We retrospectively evaluated clinical features, radiographic findings and surgical treatment of 15 patients. Obstructive jaundice in eight patients (53.3%), acute cholecystitis in five patients (33.3%), and chronic calculous cholecystitis in two patients (13.3%) had been shown in our series. In four of the patients with obstructive jaundice signs of acute cholangitis were observed. Of 15 patients, two had hepatic abscess besides biliary ascariasis and one had hydatid cyst. In our series, all of the patients were operated on. Choledochotomy and primary closure were performed on six patients (40%), choledochoduodenostomy on six patients (40%), T-tube drainage on two patients (13.3%) and only cholecystectomy on one patient (6.6%). No mortality was determined in our patients.
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PMID:Biliary ascariasis in fifteen patients. 164 42

Of 2,000 patients who underwent cholecystectomy between 1965-1984, 457 had their common bile ducts explored and of these 126 had choledochoduodenostomies. There were 70 women and 56 men and a third were over 70 years old. Forty-three also had acute cholecystitis or pancreatitis, and 73 had an increased serum concentration of bilirubin. Of the 126, 103 had stones in the common duct, and 16 had benign strictures of the sphincter of Oddi. Morbidity included wound infections in 18 (14%) and bile discharge from the drain for over 14 days in four (3%). Five patients died (4%), and they were all over 70 years old. Ninety-seven of 103 patients followed-up over 1-19 years were symptom free (94%). Two patients required re-operation for a narrow anastomosis. Three patients developed a "sump" syndrome; two were treated with antibiotics, and the third responded to endoscopic sphincterotomy. Choledochoduodenostomies should be considered during operation for benign biliary disease, when stones or a stricture in the common bile duct are anticipated.
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PMID:Choledochoduodenostomy an important surgical tool in the management of common bile duct stones. A review of 126 cases. 168 77

The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation.
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PMID:[Erroneous laparotomy in emergency surgery]. 177 33

Analysis of the features of calculous cholecystitis in 522 females and 106 males showed that acute cholecystitis takes a course which is more severe and acute in males than in females. Its gangrenous forms were encountered more often in males, which was an indication for more frequent emergency operations. In males the process was complicated by obstructive jaundice more frequently. In females acute cholecystitis was attended more frequently by peritonitis and was often combined with pancreatitis. Chronic cholecystitis also had some distinguishing features. Chronic indurative pancreatitis and hydrops of the gallbladder were encountered more often in females. The mortality in the abnormality was higher among males.
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PMID:[Characteristics of manifestations of calculous cholecystitis in men]. 177 47

The examination of 411 patients with diagnosis of acute cholecystitis (AH) and pancreatitis (AP) showed that 14% of the examinees had malignant or benign affections of the upper portion of the gastrointestinal tract. AH and AP were noted to occur frequently in combination with duodenal ulcer. As for gastric ulcer, it often simulates the above diseases.
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PMID:[The role of esophagogastroduodenoscopy in the differential diagnosis of acute cholecystitis and acute pancreatitis in diseases of the upper gastrointestinal tract]. 180 9

Percutaneous drainage has become, during the last ten years, the treatment of choice of abdominal abscesses. From January 1986 to January 1990, 205 patients have been treated in our department for an abdominal collection. In this prospective work we have realised percutaneous drainage in every patients who would have been operated, according to the classical indications. In 28 patients (acute cholecystitis), the indication has been elective because of the surgical risk, depending to the age (mean 80 years). We have treated 67 intra abdominal collections (34 post operative), 39 pseudocysts of the pancreas, 40 liver collections (18 abscesses); and we have done 37 biliary drainages. 15% of the patients showed communication of the collection with the digestive tract. Mortality was less than 5%. Half of these deaths occurred during the evolution of necrotic pancreatitis. 78% of the patients have been cured by the percutaneous drain. The other patients have been operated upon but the drainage facilitated the operation. In our experience percutaneous drainage is a secure technique and every abdominal surgeon would be able to practice this technique.
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PMID:[Ultrasound-guided percutaneous drainage of intraperitoneal fluid collections. An experience of a surgical team with 205 patients]. 181 26

The authors describe 11 cases of acute abdomen they observed during a two-year period mainly after abdominal operations. The male/female ratio was 6:5, the mean age 59 years with a range from 20 to 75 years. The mean period which had elapsed after the primary operation was 18.5 days. The authors describe four cases with ileus due to adhesions, three cases of volvulus of the small intestine, a stress ulcer, gangrenous appendicitis, acute cholecystitis and adnexitis. In general it is assumed that the most frequent acute abdomen during the post operative period is ileus due to adhesions, postoperative pancreatitis or stress ulcers are less frequent. Extremely rarely the cause of complaints is inflammatory acute abdomen of a different nature which is an unexpected finding during surgical revision. It is dangerous due to the atypical course and the fact that symptoms are masked by manifestations of the receding postoperative state. In the literature the aetiopathogenesis of such rare conditions is most frequently associated with impaired tissue perfusion due to an inadequate blood flow, general tissue hypoxia due to hypovolaemia, protracted postoperative shock, rigid vascular walls which are incapable of adequate reaction to acute deviations of circulatory demands. Despite this these conditions develop more rarely than corresponds to the coincidence of these general relatively frequent adverse factors. Severe immunosuppression is also observed much more frequently in surgical patients than these rare complications. The authors observed the incidence of these cases of acute abdomen at a ratio of 1:2000 which corresponds roughly to data in published work. Seeking the solution in immunity disorders does not explain this problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acute abdomen as a postoperative complication]. 182 40

Laparoscopic cholecystectomy is on the way to become the procedure of choice for treatment of uncomplicated cholelithiasis. First experiences are summarized: Within the first year after introduction 139 patients, 100 women and 39 men, have been treated by this novel technique. 33 open cholecystectomies were carried out in the same period. In addition to simple cholecystolithiasis 11 patients had prior biliary pancreatitis and/or sphincterotomy because of choledocholithiasis, 16 patients had suffered before from acute cholecystitis, 3 patients were operated on with the diagnosis of acute cholecystitis and 3 patients underwent simultaneous laparoscopic intervention. Seven times the laparoscopic procedure had to be converted into an open one because of intraoperative complications, twice because of a lesion to the common bile duct, three times because of intractable bleeding, once because of obscure anatomic conditions and once because of a technical failure in establishing the pneumoperitoneum. Four postoperative complications could be treated conservatively. In the average, patients complained about pain for 2 days, stayed in the hospital 4.4 days and assumed their usual activity after 13 days. An extension of indications for laparoscopic cholecystectomy should be sought stepwise according to gained experience. The problem of technical training of surgeons persists and must be solved in priority.
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PMID:[Laparoscopic cholecystectomy. Results and experiences 1 year following introduction of a new surgical technique (139 cases)]. 183 Dec 86

Three hundred seventy-five consecutive patients underwent laparoscopic cholecystectomy from September 1989 to January 1991. Three hundred forty-one (91%) presented on an elective basis, and the remaining 34 patients (9%) were admitted for acute cholecystitis (24), gallstone pancreatitis (9), and cholangitis (1). Of the 375 patients, 20 were converted to laparotomy and cholecystectomy, for an overall success rate of 95% for patients undergoing laparoscopic cholecystectomy. Three hundred nineteen patients (90%) were discharged within 24 hours of surgery. Operative cholangiography was completed in 141 patients, showing choledocholithiasis in five (managed by postoperative endoscopic retrograde cholangiopancreatography [ERCP] in 4, common bile duct exploration [CBDE] in 1). Two retained stones (0.9%) were detected in 214 patients not undergoing cholangiography. Three patients (0.8%) were reoperated on because of perioperative complications. Overall morbidity for patients undergoing laparoscopic cholecystectomy was 3.5%. Major complications (0.6%) included a single common hepatic duct injury and a delayed cystic duct leak at 10 days. Minor complications occurred in 11 patients (2.9%). The single perioperative death (0.3%) was due to a myocardial infarction on postoperative day 3, after an otherwise uncomplicated laparoscopic procedure. Laparoscopic cholecystectomy appears to offer significant advantages to patient recovery, and these data suggest that it can be performed with an efficacy, morbidity rate, and mortality rate similar to those of open cholecystectomy.
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PMID:Laparoscopic cholecystectomy. Experience with 375 consecutive patients. 183 46

In the first year from October 1990 since starting the procedure 65 laparoscopic cholecystectomies were carried out on one surgical service. There were 4 planned open cholecystectomies and 8 laparoscopic procedures converted during the same period: 7 of these were in the first 3 months with only 1 of the last 53 being opened. Surgery was carried out during the same admission in 22 patients presenting as emergencies: acute cholecystitis (9), colic (6), pancreatitis (3), jaundice (4). Two patients had later laparotomies for complications; one patient bled from the umbilical stab and with ongoing peritonism had a pelvic haematoma drained on day 5 and a second was opened following a bile leak caused by a displaced cystic duct clip--both recovered uneventfully. Peroperative cholangiography was performed in 13 patients; 2 were positive (15%) and had ERCP papillotomy 3 days post op without complication. One patient who presented with pancreatitis had ERCP performed post-op without incident. Seven patients had laparoscopic cholecystectomy following papillotomy for common duct stones. The gallbladder was extracted per umbilicus in 45 (3 wound infections) and per right subcostal stab in 20 (no infections). Mean hospital stay was 48 hours (1-4 days) in uncomplicated cases. In conclusion, the learning curve is associated with higher conversion rates. Extraction through pliable hypochondrial muscles is easier and may be safer and less traumatic. Perioperative endoscopic papillotomy is safe and effective for choledochal stones.
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PMID:Endoscopic management of common duct stones with laparoscopic cholecystectomy. 183 42


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