Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 467 cholecystectomies (performed between 13. 6. 1990 and 12. 9. 1991) 278 were done by laparoscopy (196 women, 82 men; mean age 53 [18-86] years). Contraindications to a laparoscopic procedure were acute cholecystitis, severe chronic cholecystitis with adhesions, abnormal clotting and suspected gallbladder carcinoma. In 31 patients (11.1%) the initial laparoscopic cholecystectomy was continued as a conventional cholecystectomy, usually because of unclear conditions in severe chronic cholecystitis. Mean duration of hospital stay was 6.3 days for the laparoscopic procedure compared with 11.5 days for the conventional one. Complications occurred in four patients (in 12 with the conventional method): one occlusion (by clip) of the common bile duct, one bile leak, one bleeding and one pneumothorax, requiring re-operation in three patients. There were no deaths (compared with two in the conventional group). Assuming correct indications, laparoscopic cholecystectomy is a sparing method for the treatment of cholecystolithiasis.
 ...
PMID:[Laparoscopic cholecystectomy. Initial experiences and results in 278 patients]. 153 48

Laparoscopic cholecystectomy is a genuine alternative to open cholecystectomy. Acute cholecystitis, chronic cholecystitis with adhesions and gallbladder cancer are absolute, and bile duct stones in rare situations and previous surgery relative contraindications. Ultrasound and intravenous cholecysto-cholangio-tomography are obligatory preoperative investigations. Over 14 months we performed 253 laparoscopic cholecystectomies. Mortality was 0%. Relaparotomy was necessary in 3 of 4 complications (injury of the common bile duct, bile leak and hemorrhage), the reoperation rate is 1.18%. The fourth complication was a pneumothorax after injury of the diaphragm with the electrohook. Conversion to open cholecystectomy was necessary in 10.7%, usually after severe chronic cholecystitis with adhesions. The length of hospitalization was 11 days after open cholecystectomy and could be reduced to 6.5 days after laparoscopic cholecystectomy. With similar results concerning mortality and reoperation rate, the advantages of laparoscopic cholecystectomy are reduced postoperative pain, a shorter recovery time, shorter hospitalization and a better cosmetic result.
 ...
PMID:[Laparoscopic cholecystectomy--experiences and results with a new surgical technique]. 153 83

We report a case of gastric heterotopia in the gallbladder of an 18-year-old man. Symptoms of acute cholecystitis are characteristic in patients under 20 years old, while older patients present with chronic cholecystitis and gallstones. The heterotopic mucosa results either in a mass, a polyp, or a multiloculated gallbladder. Twenty-eight other cases of gastric heterotopia in the gallbladder or cystic duct have been reported. In only three was it associated with peptic ulceration. Treatment is cholecystectomy. Heterotopic gastric mucosa has been described throughout the length of the gastrointestinal tract from the oral cavity to the rectum. Curiously, it is extremely rare in the gallbladder, where it has the propensity for causing symptoms of acute cholecystitis, particularly in the young. We report a case of this condition in which there was a separate loculus lined by gastric epithelium.
 ...
PMID:Gastric heterotopia in the gallbladder. Case report and review of literature. 159 99

This study analyzed the first 100 laparoscopic cholecystectomies performed at a university teaching hospital by a single surgeon. Patients presented with chronic cholecystitis (92), acute cholecystitis (5), acalculus cholecystitis (2), and asymptomatic cholelithiasis (1). The operative time ranged from 59 minutes to 185 minutes (mean: 110 minutes). Cholangiography was performed in 88 patients, and common bile duct stones were discovered in 3. Choledocholithiasis was managed successfully through the cystic duct in all cases. Two procedures were converted to open cholecystectomy. Operative complications included ductal injury in one patient, bile leak in two, wound cellulitis in four, and atelectasis in one. Ninety-seven patients were released within 24 hours after surgery. Mean hospital charges for laparoscopic cholecystectomy were $828 less than the cost incurred for open cholecystectomy. These early results support the view that laparoscopic cholecystectomy is a safe, cost-effective method for performing cholecystectomy with a remarkable improvement in patient recovery time.
 ...
PMID:Results of laparoscopic cholecystectomy in a university hospital. 167 Feb 28

It is shown that in acute cholecystitis patients versus chronic cholecystitis ones and donors, the total glutathione in blood is lower while the activity of glutathione metabolism enzymes in red blood cells inhibited. Enzymological findings correlate with clinical symptoms of intoxication. Surgery aggravates disturbed activity of the enzymes. Conventional conservative therapy is not effective in normalizing the enzymes activity either. A good therapeutic response can be achieved by a directed transport of antibiotics in autologous blood ghosts which promotes recovery of normal activity of glutathione metabolism enzymes, routine glutathione level, early stabilization of hepatocytic membranes beneficial for surgical patients.
 ...
PMID:[Glutathione levels and the activity of the enzymes of glutathione metabolism in erythrocytes of patients with acute cholecystitis]. 176 54

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.
 ...
PMID:[Characteristics of manifestations of calculous cholecystitis in men]. 177 47

Laparoscopic cholecystectomy removes the gallbladder through three or four puncture wounds in the abdominal wall. The technique reduces the recuperative time to full activity, from as long as 4 wk to as little as 3 days, compared with conventional cholecystectomy. We herein present our initial experience with this procedure. In this series of 111 laparoscopic cholecystectomies, there were no mortalities and only one morbidity. Thirty-nine patients (35%) had a history of prior abdominal surgery. Fourteen underwent laparoscopic lysis of adhesions. Intraoperative cholangiograms were performed in 24 patients (21%), demonstrating choledocholithiasis in three. Two of the three patients underwent postoperative endoscopic retrograde cholangiopancreatography (ERCP); in the other, laparoscopic common bile duct exploration was performed. In each case, the common bile duct (CBD) was completely cleared of stones. Incidental laparoscopic appendectomy was also performed in three patients. The average time for completion of laparoscopic cholecystectomy in cases of chronic cholecystitis was 40 min. If the gallbladder was acutely inflamed, the procedure took a mean of 126 min. This series had a higher percentage of patients (19%) with acute cholecystitis then previously reported; therefore, the 2% conversion rate in this series emphasizes the broad applicability of the technique. The average length of stay in the hospital was 1.4 days, and patients returned to work in about 7 days.
 ...
PMID:Laparoscopic cholecystectomy: 111 consecutive cases. 183 57

Laparoscopic cholecystectomy has been developed as an alternative to open cholecystectomy for the treatment of symptomatic cholelithiasis. A collaborative study of 261 patients undergoing laparoscopic cholecystectomy at three Texas institutions was performed to determine the effectiveness and safety of this technique. There were 65 males and 196 females with a mean age of 49 years (range 17-94 years). Acute cholecystitis was present in 38 patients and chronic cholecystitis in 223 patients. Mean length of surgery was 80 minutes (20 min to 4 hr). Fifteen patients were converted to the open technique intraoperatively due to bleeding, adhesions, or difficulty of dissection. There were no perioperative deaths and morbidity was 3% including urinary retention, small bowel obstruction, arrhythmia, wound infection, and bile leakage. There were no common duct injuries. Hospitalization ranged from outpatient surgery to 7 postoperative days with a mean of 1.2 days. We conclude that laparoscopic cholecystectomy can be performed safely and with low morbidity and offers shorter hospitalization and postoperative recovery.
 ...
PMID:Laparoscopic cholecystectomy: a multicenter study. 183 1

Various diagnostic imaging studies have been employed in the past year to evaluate the normal and abnormal biliary ductal system. Variations in the normal ductal drainage of the left lobe of the liver, in which the right lateral hepatic duct drained into the left hepatic duct, were studied because of the implications for the surgical resection of the left lobe. Choledochal cysts have been studied in adults using endoscopic retrograde cholangiopancreatography to evaluate the abnormal junction between the common bile duct and pancreatic duct and the long dilated common channel. An ultrasound study indicated that children with choledochal cysts also may have intrahepatic duct dilatation. An increased incidence of malignancy has been noted in adults with choledochal cysts, and their appearance on ultrasound, CT, and cholangiography were described. Cystic fibrosis produces abnormalities of the biliary tree, extrahepatic strictures, and more interestingly, intrahepatic ductal dilatation and abnormal contour without strictures. The usefulness of the preoperative ultrasonographic evaluation of the biliary tract in Oriental cholangiohepatitis was stressed. Bile duct abnormalities in fascioliasis were also noted on CT scans. Patterns of abnormality in the CT appearance of the thickened, contrast-enhanced, extrahepatic bile ducts were elucidated. Focal concentric, focal excentric, diffuse concentric, and diffuse excentric ducts were seen with various forms of pancreatic disease, choledocholithiasis, and various forms of cholangitis. An enhanced, thick-walled duct indicates disease, but is a nonspecific finding. Chronic cholecystitis was found to produce false-positive cholescintigram results in patients with suspected acute cholecystitis, but only in those with severe degrees of chronic cholecystitis. The results of multicenter trials using extracorporeal biliary lithotripsy in the United States have been published. They are somewhat disappointing and do not confirm the original excellent results reported in Germany for treatment of gallbladder stones. Much interest has been focused on the use of expandable metallic stents for the treatment of benign and malignant biliary obstruction. Preliminary data suggest good patency rates for benign lesions. Patency rates for malignant lesions are similar to those of previously available plastic stents.
 ...
PMID:Diagnostic and interventional procedures for the biliary tract. 185 80

The utility of morphine-augmented cholescintigraphy was reviewed in 32 patients with suspected acute cholecystitis. All patients were administered 2 mg morphine sulfate intravenously when the gallbladder failed to visualize 30 minutes into the study, and imaging continued for up to 60 minutes. Sensitivity for detection of acute cholecystitis was 93% (13 out of 14). Specificity was 78% (14 out of 18). Three of four false-positives occurred in the setting of prolonged fasting and chronic cholecystitis. Cumulative experience suggests that the technique is diagnostically equivalent to imaging for up to 4 hours and that specificity remains incomplete in the setting of prolonged fasting, chronic cholecystitis and other conditions known to affect conventional cholescintigraphy.
 ...
PMID:Morphine-augmented cholescintigraphy in acute cholecystitis. A satisfactory alternative to delayed imaging. 186 50


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>