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)

Ten cases of xanthogranulomatous cholecystitis are presented, 5 women and 5 men, from a total of 439 cholecystectomies (2.2%). In 50% of cases the clinical course was consistent with acute cholecystitis; in 30%, gallbladder cancer was suspected preoperatively; and in 70% of cases cancer was suspected during surgery but intraoperative biopsies showed no malignancy. Definitive pathological findings included early carcinoma of the gallbladder in two patients, and a cholecystocolic fistula in one patient. A perforated gallbladder was found in one patient. The incidence of postoperative septic complications was 18.1%, a figure that doubles that of elective biliary surgery in our hospital.
 ...
PMID:[Xanthogranulomatous cholecystitis]. 148 86

The most certain symptomatic manifestation of gallstones is episodic upper abdominal pain. Characteristically, this pain is severe and located in the epigastrium and/or the right upper quadrant. The onset is relatively abrupt and often awakens the patient from sleep. The pain is steady in intensity, may radiate to the upper back, be associated with nausea and lasts for hours to up to a day. Dyspeptic symptoms of indigestion, belching, bloating, abdominal discomfort, heartburn and specific food intolerance are common in persons with gallstones, but are probably unrelated to the stones themselves and frequently persist after surgery. Many, if not most, persons with gallstones have no history of pain attacks. Persons discovered to have gallstones in the absence of typical symptoms appear to have an annual incidence of biliary pain of 2-5% during the initial years of follow-up, with perhaps a declining rate thereafter. Gallstone-related complications occur at a rate of less than 1% annually. Those whose stones are symptomatic at discovery have a more severe course, with approximately 6-10% suffering recurrent symptoms each year and 2% biliary complications. The far higher rates of symptom development reported in a few studies raise the possibility that these incidence estimates may be too low. The best predictors of future biliary pain are a history of pain at the time of diagnosis, female gender and possibly obesity. The risk of acute cholecystitis appears to be greater in those with large solitary stones, that of biliary pancreatitis in those with multiple small stones, and that of gallbladder cancer in those with large stones of any number. Drugs that inhibit the synthesis of prostaglandins may now be the treatment of choice in patients with gallstones who are suffering acute pain attacks. Persistent dyspeptic symptoms occur frequently following cholecystectomy. A prolonged history of such symptoms prior to surgery and evidence of significant psychological distress appear to be the best predictors of unsatisfactory outcome.
 ...
PMID:Symptoms of gallstone disease. 148 6

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

Although endoscopic retrograde cholangiopancreatography is the technique of choice for examining the biliary tract when ultrasonography does not demonstrate dilated ducts, the transhepatic cholangiopancreatogram was shown to be useful when endoscopic retrograde cholangiopancreatography fails. On cholangiography, ultrasonography, and CT, clonorchiasis and cryptosporidiosis were found to have duct dilatation and contour irregularity, and in some patients, papillary stenosis. The value of cholangiography in determining the prognosis and appearance of primary sclerosing cholangitis and in diagnosing Klatskin tumor was examined. Patients with high-grade extrahepatic strictures, diffuse intrahepatic strictures, and marked intrahepatic dilatation had decreased survival. The preoperative cholangiogram diagnosis of Klatskin tumor was found to be accurate in only two-thirds of cases. In patients with liver transplantation who had dilatation of both donor and native extrahepatic bile ducts and abnormal liver function tests, but no evidence of anastomotic stricture, malfunction of the sphincter of Oddi was suggested as a possible cause. The sonographic features of acute gallbladder disease were evaluated and striations in the thickened gallbladder wall were shown not to be a specific sign for acute cholecystitis. Also, the ultrasonographic diagnosis of early gallbladder carcinoma was not accurate enough, but ultrasonography was reaching a sensitivity of 70% to 80% for advanced gallbladder cancer.
 ...
PMID:Imaging of the biliary tract. 158 Nov 35

Cholecystectomy is indicated in the presence of gallbladder trauma, gallbladder cancer, acute cholecystitis, and other complications of gallstones. More controversial are the indications for elective cholecystectomy. To properly determine the indications for elective cholecystectomy, the risk of the operation (taking into account the age and comorbid factors of the individual patient) must be weighed against the risk of complications and death without operation (taking into account the symptomatic status of the individual and the functional status of the gallbladder). Cholecystectomy (or some other form of gallstone therapy) is indicated in most patients with symptomatic cholelithiasis--especially those with non-functioning gallbladders. Cholecystectomy is not indicated in most patients with asymptomatic stones.
 ...
PMID:What are the indications for cholecystectomy? 240 88

We are reporting 35 cases of gallbladder cancer in elderly people. 9 of them (25.7%) were operated with the diagnosis of acute cholecystitis. We point out the high incidence of the association of acute cholecystitis and gallbladder cancer, being the cholelithiasis a predominant factor in the pathogenesis of cancer. Considering that we found gallbladder cancer in 6.1% of the cholecystectomies, we advise to perform the surgical treatment in all the patients suffering of cholelithiasis.
 ...
PMID:[Acute cholecystitis and cancer of the gallbladder in the aged]. 383 62

From 1969 to 1982 there has been a continuous decrease in the cholecystectomy rate in the county of Stockholm, Sweden, from 265 per 100.000 population to 105. The change is greatest among young females. During the same period there has been a two-fold increase in gallbladder cancer. Although the total number of cases with common bile duct stones have decreased, they have increased in relation to the number of cholecystectomies. A similar trend is true for cases with and operations for acute cholecystitis. From 1970 to 1982 there has been a fairly constant number of cholecystographies and ultra sound scans of the biliary tract indicating that the diagnostic efforts have been unchanged, at least quantitatively. However, cases with positive diagnosis have decreased especially among young females. It is concluded that the decreased cholecystectomy rate in the county of Stockholm can be explained by a simultaneous decrease of the prevalence of gallstones, at least among the young, and a decrease of operations among those who have gallstones.
 ...
PMID:Changes in gallstone morbidity in a community with decreasing frequency of cholecystectomies. A statistical study of the county of Stockholm, Sweden, 1969-1982. 639 Oct 54

The suprahepatic region is a rare ectopic location of the gallbladder. It usually combines with right lobe anomaly of the liver. Here we report two unusual cases of suprahepatic gallbladder with agenesis or hypogenesis of the right lobe of the liver and biliary cancer. A patient with a gallbladder tumor was admitted to our emergency room with acute cholecystitis and liver abscess. Imagining examinations and operation confirmed the suprahepatic position of gallbladder, agenesis of the right lobe, and dissemination of gallbladder cancer. In the patient with cholangiocarcinoma, CT scans and percutaneous transhepatic cholangiography documented the presence of a hilar tumor and hypogenesis of the right lobe. Both of these patients died from biliary tract cancer soon after operation.
 ...
PMID:Suprahepatic gallbladder and right lobe anomaly of the liver in patients with biliary cancers. 758 23

Recent studies have indicated that solitary or multiple gallstones may differ with respect to the conditions favoring their formation, such as nucleation time. We examined the clinical, histological and laboratory characteristics of symptomatic gallstone disease in a series of 125 consecutive patients with either solitary (n = 33) or multiple (n = 92) cholesterol gallstones undergoing cholecystectomy. The nature of biliary pain was found to differ in the two groups. Histological diagnoses of acute cholecystitis and gallbladder cancer was more frequent in the patients with multiple stones, and cholesterolosis in those with solitary stones. Furthermore, the stone cholesterol content was higher in the solitary stone group than in the multiple stone group. Morbid complications such as cholangitis and pancreatitis were rare and occurred only in the multiple stone group. The results support the view that gallbladder disease presents histological evidence of biliary complications more often in patients with multiple cholesterol stones than in those with solitary stones.
 ...
PMID:Characteristics of symptomatic gallbladder disease in patients with either solitary or multiple cholesterol gallstones. 795 50

Laparoscopic cholecystectomy is the treatment of choice for gallstones. A formal contraindication is gallbladder cancer. However, in a great number of cases, this is a previously unsuspected intraoperative finding, and sometimes its first appearance is in acute cholecystitis. We present the case of 67-year-old woman, which presented an unsuspected carcinoma of the gallbladder that developed abdominal wall implants at the umbilical and left hypocondrium site. The success of LC favors the observation of cases similar to that described in this article. Surgeons who operate using laparoscopic techniques should bear this possibility in mind and practice an extemporaneous biopsy at the slightest suspicion of malignancy, and, if it is confirmed, the operation should be continued as an open one.
 ...
PMID:Unsuspected carcinoma of the gallbladder. A laparoscopic dilemma. 819 62


1 2 3 4 5 Next >>