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)

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.
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PMID:Suprahepatic gallbladder and right lobe anomaly of the liver in patients with biliary cancers. 758 23

Together with biliary drainage, which is an appropriate procedure for unresectable biliary cancer, biliary stent placement is used to improve symptoms associated with jaundice. Owing to investigations comparing percutaneous transhepatic biliary drainage (PTBD), surgical drainage, and endoscopic drainage, many types of stents are now available that can be placed endoscopically. The stents used are classified roughly as plastic stents and metal stents. Compared with plastic stents, metal stents are of large diameter, and have long-term patency (although they are expensive). For this reason, the use of metal stents is preferred for patients who are expected to survive for more than 6 months, whereas for patients who are likely to survive for less than 6 months, the use of plastic stents is not considered to be improper. Obstruction in a metal stent is caused by a tumor that grows within the stent through the mesh interstices. To overcome such problems, a covered metal stent was developed, and these stents are now used in patients with malignant distal biliary obstruction. However, this type of stent has been reported to have several shortcomings, such as being associated with the development of acute cholecystitis and stent migration. In spite of these shortcomings, evidence is expected to demonstrate its superiority over other types of stent.
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PMID:Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas. 1827 46

Gallstone disease is more common in the elderly. In this short review, we summarize guideline-based recommendations for the diagnosis and treatment of biliary diseases in elderly patients. Warning episodes of biliary colic represent a general indication for cholecystectomy to avoid stone-related complications. Elderly patients with mild and moderate acute cholecystitis should undergo urgent cholecystectomy. After endoscopic retrograde cholangiography and stone extraction as well as mild acute biliary pancreatitis, cholecystectomy should be performed during the same hospital admission. Since the elevated risk of gallstone carriers to develop biliary cancer increases with age, cholecystectomy also protects against cancer.
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PMID:[Biliary diseases in the elderly]. 2482 10

Objective Endoscopic gallbladder stenting (EGBS) is an alternative treatment option for high-risk surgical patients with acute cholecystitis. However, there are no reports focusing on EGBS in patients with concomitant unresectable cancer. The aim of this study was thus to evaluate EGBS in such patients. Methods Twenty-two consecutive patients with acute cholecystitis and unresectable cancer were enrolled between September 2010 and December 2014. Their median age was 74.5 years (range: 51-95). Thirteen patients were men and nine were women. The primary cancers of the patients were biliary tract cancer (9), pancreas cancer (9), lung cancer (2), gastric cancer (1), and colon cancer (1). The causes of cholecystitis were calculus cholecystitis (7), obstruction by malignant tumor (13), and obstruction by fully covered stent (2). Results EGBS was successfully performed in 17 patients (77.2%). The technical success rates for calculus cholecystitis, obstruction by malignant tumor, and obstruction by fully covered stent were 85.7% (6/7), 69.2% (9/13), and 100% (2/2), respectively. No complications were observed. Percutaneous transhepatic gallbladder drainage was conducted on two patients in whom EGBS had failed and then we performed EGBS by a rendezvous approach. Of the 19 patients in whom we finally deployed EGBS, the median follow-up period was 229 days (range: 14-880 days). A recurrence of acute cholecystitis occurred in three (15.7%) patients 14, 130, and 440 days after EGBS placement. The rates of recurrence of cholecystitis at one and two years were 10.5% and 18.7%, respectively. Conclusion Our study demonstrated that EGBS is a safe and effective method for acute cholecystitis in patients with concomitant unresectable cancer.
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PMID:Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer. 2725 45