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Khanduri S, Parashari UC, Agrawal D, Bhadury S. Ascariasis of gallbladder: a rare case report and a review of the literature. Trop Doct 2013; 44:50-2. [PMID: 24253312 DOI: 10.1177/0049475513512637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ascariasis of the gallbladder is a very rare presentation. We report a case of a 15-year-old boy who presented with complaints of pain in the abdomen, vomiting, pruritus, and fever on-and-off for 10 days. On radiological examination, an ultrasonography of the abdomen showed a dilated gallbladder with multiple linear echogenic, tubular, parallel lines inside the lumen of the gallbladder, common bile duct and intrahepatic biliary radicles. The zigzag and coiling movement of a worm was noted in the lumen of the gallbladder on real time B-mode ultrasonography. The patient was successfully treated with an anthelminthic drug. On follow up no evidence of the worm was noted in the gallbladder or common bile duct lumen.
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Ozturk MA, Kalayci M, Oyan B. Gallbladder perforation related to bevacizumab. Clin Res Hepatol Gastroenterol 2013; 37:e117-8. [PMID: 23684575 DOI: 10.1016/j.clinre.2013.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 04/09/2013] [Indexed: 02/04/2023]
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Juul Nielsen LB, Schultz NA, Hasselby JP, Wettergren A. [Benign gallbladder polyp is a rare cause of haemobilia]. Ugeskr Laeger 2013; 175:2117-2118. [PMID: 24011211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Haemobilia can present with gastrointestinal bleeding, biliary colic and jaundice. Causes include trauma, iatrogenic causes, calculi, inflammation, vascular malformations and neoplasms. Benign gallbladder polyp is a very rare cause. A 63-year-old male with suspected gallbladder cancer due to the results from ultrasound scanning and computed tomography presented with epigastric pain, vomiting, weight loss, dizziness, sweating, fatigue, black stool and low haemoglobin level. Gastroscopy and colonoscopy were normal. Surgery revealed a gallbladder with inflammation, fibrosis, haemorrhage, blood clot and a 2 cm pedunculate polyp with no signs of dysplasia or malignant invasion.
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Lindholm EB, Alberty JB, Hansbourgh F, Upp JR, Lopoo J. Hyperkinetic gallbladder: an indication for cholecystectomy? Am Surg 2013; 79:882-884. [PMID: 24069981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Cholecystectomy may benefit children with biliary colic without stones on ultrasound (US) or low ejection fraction on cholecystokinin-hepatobiliary iminodiacetic acid (CCK-HIDA) scan. Children with symptomatic biliary colic and abnormal HIDA scan, specifically those with high ejection fractions, may benefit from cholecystectomy. All patients younger than 18 years old undergoing cholecystectomy from 2008 to 2012 in our practice were reviewed. Patients with a negative US and CCK-HIDA ejection fractions 80 per cent or greater were included in the study. Patient data were extracted from charts, whereas postoperative symptoms were obtained by phone interviews. Of 174 patients who underwent cholecystectomy, 12 (7%) met study criteria. All patients (12 of 12) had evidence of cholecystitis on the final pathology note. All 11 patients contacted had relief of colic after gallbladder removal with a mean follow-up of 16 months. A subset of pediatric patients with high ejection fractions on CCK-HIDA and symptomatic biliary colic may have symptomatic relief with cholecystectomy.
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Kim BS, Joo SH, Joh JH, Yi JW. Laparoscopic cholecystectomy in patients with anesthetic problems. World J Gastroenterol 2013; 19:4832-4835. [PMID: 23922485 PMCID: PMC3732860 DOI: 10.3748/wjg.v19.i29.4832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/13/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
Laparoscopic cholecystectomy is a standard operation for benign gallbladder disease. As experience with laparoscopic cholecystectomy has increased, the procedure has become possible in patients with anesthetic problems. Patients with ankylosing spondylitis or severe kyphosis represent a challenging group to anesthesiologists and laparoscopic surgeons since these diseases are associated with difficult intubation, restrictive ventilatory defects, and cardiac problems. The relatively new approach of awake fiberoptic intubation is considered to be the safest option for patients with anticipated airway difficulties. Laparoscopic cholecystectomy is usually performed under general anesthesia but considerable difficulties in anesthetic management are encountered during laparoscopic surgery; for example, hemodynamic instability may develop in patients with cardiopulmonary dysfunction due to pneumoperitoneum and position changes during the operation. Nonetheless, regional anesthesia can be considered as a valid option for patients with gallbladder disease who are poor candidates for general anesthesia due to cardiopulmonary problems. We report three cases of laparoscopic cholecystectomy successfully performed in patients with anesthetic problems that included cardiopulmonary disease, severe kyphosis, and ankylosing spondylitis.
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Bayram C, Valenti L, Miller G. Gallbladder disease. AUSTRALIAN FAMILY PHYSICIAN 2013; 42:443. [PMID: 23826592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Gallbladder disease (GBD) is a common cause of upper abdominal pain. Prevalence of GBD increases with age, and is more common in women than men. United States population prevalence estimates indicate that 17% of women and 8% of men have GBD. Although common, it is often asymptomatic. We analysed data collected in the BEACH (Bettering the Evaluation and Care of Health) program from January 2010 to December 2012 to describe general practitioners' management of GBD when it is an 'active' clinical problem.
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Yoshioka M, Watanabe G, Uchinami H, Miyazawa H, Abe Y, Ishiyama K, Hashimoto M, Nakamura A, Yamamoto Y. Diffusion-weighted MRI for differential diagnosis in gallbladder lesions with special reference to ADC cut-off values. HEPATO-GASTROENTEROLOGY 2013; 60:692-698. [PMID: 24046830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND/AIMS We retrospectively evaluated the usefulness of the apparent diffusion coefficient (ADC) measured from high-b value diffusion-weighted imaging (DWI) of magnetic resonance imaging for the differential diagnosis of gallbladder lesions among patients with cancer, adenoma and inflammatory disease. METHODOLOGY Forty patients with gallbladder lesions (22 patients with cancer, 7 patients with adenoma, and 11 patients with inflammatory disease) were enrolled in this study. All patients underwent high-b value DWI, and the ADC value was measured. The cut-off values were determined by receiver operating characteristic analysis. RESULTS The ADC values of gallbladder cancers (1.31±0.57x10-3 mm2/s) were smallest and those of adenomas (2.66±0.43x10-3 mm2/s) were largest among the diseases. Inflammatory diseases took a middle position (1.97±0.54x10-3 mm2/s) between them. There were significant differences among the 3 groups of diseases (p<0.05). The cut-off value within ADC values to discriminate cancer from the other diseases was 1.64x10-3 mm2/s (accuracy 87.5%), and that to discriminate adenoma was 2.25x10-3 mm2/s (accuracy 90.0%). CONCLUSIONS The ADC values measured from high-b value DWI would be useful for the differential diagnosis of gallbladder lesions.
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Park EJ, Lee HS, Lee SH, Chun HJ, Kim SY, Choi YK, Ryu HJ, Shim KW. Association between metabolic syndrome and gallbladder polyps in healthy Korean adults. J Korean Med Sci 2013; 28:876-80. [PMID: 23772152 PMCID: PMC3678004 DOI: 10.3346/jkms.2013.28.6.876] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 04/01/2013] [Indexed: 12/20/2022] Open
Abstract
The goal of this study was to evaluate the association between gallbladder (GB) polyps and metabolic syndrome. A total of 5,685 healthy subjects were included, and 485 of these subjects had GB polyps and 744 had metabolic syndrome. In this study, metabolic syndrome was diagnosed according to standards suggested by the AHA/NHLBI ATP III 2005, and abdominal obesity (≥ 90 cm in men and ≥ 85 cm in women for Korean) was diagnosed according to standards set forth by the Korean Society for Study of Obesity. Biphasic logistic regression adjusted for age and gender was used to evaluate the association between metabolic syndrome and GB polyps. Subjects who were male (OR, 1.493; 95% CI, 1.11-2.00) and hepatitis B suface Ag (HBsAg) positive (OR, 1.591; 95% CI, 1.06-2.38) were significantly more likely to have GB polyps. The metabolic syndrome group had a higher risk of GB polyps (OR, 1.315; 95% CI, 1.01-1.69) than the group without metabolic syndrome. In conclusion, subjects who were HBsAg positive and male appear to be associated with the risk of GB polyps. The presence of metabolic syndrome also appears to be associated with the risk of GB polyps in Koreans.
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Arikanoglu Z, Taskesen F, Aliosmanoglu I, Gul M, Gumus H, Celik Y, Tas I, Keles A, Girgin S. Continuing diagnostic and therapeutic challenges in gallbladder polyps. Am Surg 2013; 79:446-448. [PMID: 23574862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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60
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Priya H, Anshul G, Alok T, Saurabh K, Ranjit N, Romesh L, Deborshi S. Emergency cholecystectomy and hepatic arterial repair in a patient presenting with haemobilia and massive gastrointestinal haemorrhage due to a spontaneous cystic artery gallbladder fistula masquerading as a pseudoaneurysm. BMC Gastroenterol 2013; 13:43. [PMID: 23452779 PMCID: PMC3599389 DOI: 10.1186/1471-230x-13-43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 02/26/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Haemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis. Here we report a case of haemobilia manifesting as massive gastrointestinal haemorrhage in a patient without any prior history of biliary surgery or intervention and present a brief review of literature. CASE PRESENTATION A 22 year old male admitted with history suggestive of acute cholecystitis subsequently developed waxing waning jaundice and recurrent episodes of upper gastrointestinal bleed. Endoscopy showed an ulcer in the first part of duodenum with a clot, no active bleed was visible. Angiography was suggestive of a ruptured pseudoaneurysm in the vicinity of the right hepatic artery probably originating from the cystic artery. Coil embolization was tried but the coil dislodged into the right branch of hepatic artery distal to the site of pseudoaneurysm. Review of angiographic video in light of operative findings demonstrated a fistulous communication between cystic artery and gallbladder as the cause, a simultaneous cholecystoduodenal fistula was also noted. Retrograde cholecystectomy, closure of cholecystoduodenal fistula and right hepatic arteriotomy with retrieval of the endo-coil and hepatic arterial repair was performed. CONCLUSION Fistula between the cystic artery and gallbladder has been commonly reported to occur after laparoscopic cholecystectomy. Spontaneous fistulous communication, i.e. in the absence of any prior trauma or intervention, between cystic artery and gallbladder is rare with very few reports in literature. Aetiopathogenesis of the disease, in the context of current literature is reviewed. The diagnostic dilemma posed by the confounding finding of an ulcer in the duodenum, the iconic video angiographic depiction as also the therapeutic challenge of a failed embolization with consequent microcoil migration and primary hepatic arterial repair in the emergency situation is discussed.
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Rejab H, Guirat A, Ellouze S, Trigui A, Mizouni A, Triki H, Boudaouara T, Beyrouti MI. Primitive gallbladder tuberculosis: a case report with review of the literature. Ann Ital Chir 2013; 84:1-3. [PMID: 23416311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gallbladder tuberculosis is an exceedingly rare disease. A correct preoperative diagnosis of Gallbladder tuberculosis is difficult, and it may be confused with different gallbladder diseases. We present a new case of a patient who underwent surgery with the preoperative diagnosis of cholelithiasis. Diagnosis of gallbladder tuberculosis was obtained with the histological examination of the frozen section.
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62
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Gupta N, Arora MP. Single-incision laparoscopic cholecystectomy. Singapore Med J 2012; 53:856. [PMID: 23268165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg 2012; 16:2011-25. [PMID: 22986769 PMCID: PMC3496004 DOI: 10.1007/s11605-012-2024-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 08/15/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND Gallbladder disease is common and, if managed incorrectly, can lead to high rates of morbidity, mortality, and extraneous costs. The most common complications of gallstones include biliary colic, acute cholecystitis, common bile duct stones, and gallstone pancreatitis. Ultrasound is the initial imaging modality of choice. Additional diagnostic and therapeutic studies including computed tomography, magnetic resonance imaging, magnetic resonance cholangiopancreatography, endoscopic ultrasound, and endoscopic retrograde cholangiopancreatography are not routinely required but may play a role in specific situations. DISCUSSION Biliary colic and acute cholecystitis are best treated with early laparoscopic cholecystectomy. Patients with common bile duct stones should be managed with cholecystectomy, either after or concurrent with endoscopic or surgical relief of obstruction and clearance of stones from the bile duct. Mild gallstone pancreatitis should be treated with cholecystectomy during the initial hospitalization to prevent recurrence. Emerging techniques for cholecystectomy include single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery. Early results in highly selected patients demonstrate the safety of these techniques. The management of complications of the gallbladder should be timely and evidence-based, and choice of procedures, particularly for common bile duct stones, is largely influenced by facility and surgeon factors.
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Arslan ED, Hakbilir O, Uyanik B, Oztürk B, Kaya E, Oztürk D. Gallbladder volvulus. J PAK MED ASSOC 2012; 62:965-966. [PMID: 23139986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gallbladder volvulus or torsion; is an uncommon cause of acute abdomen and occurs by rotation of the gallbladder on its mesentery. The entity commonly misdiagnosed as cholecystitis before laparatomy, although it has some critical findings that alert physician for correct diagnosis. A 47 years old male patient admitted to our emergency department with right upper quadrant pain, and then progressed through abdominal rigidity indicating acute abdomen, was subjected to laparatomy. At surgery; gangrenous and rotated gallbladder was observed and cholecystectomy was performed. Early diagnosis and prompt surgical treatment is mandatory to lower the complications of this entity. Clinical signs and radiographic studies should guide physicians for proper diagnosis of gallbladder torsion.
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Marangoni G, Hakeem A, Toogood GJ, Lodge JPA, Prasad KR. Treatment and surveillance of polypoid lesions of the gallbladder in the United Kingdom. HPB (Oxford) 2012; 14:435-40. [PMID: 22672544 PMCID: PMC3384872 DOI: 10.1111/j.1477-2574.2012.00471.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The increase in the routine use of abdominal imaging has led to a parallel surge in the identification of polypoid lesions in the gallbladder. True gallbladder polyps (GBP) have malignant potential and surgery can prevent or treat early gallbladder cancer. In an era of constraint on health care resources, it is important to ensure that surgery is offered only to patients who have appropriate indications. The aim of this study was to assess treatment and surveillance policies for GBP among hepatobiliary and upper gastrointestinal tract surgeons in the UK in the light of published evidence. METHODS A questionnaire on the management of GBP was devised and sent to consultant surgeon members of the Association of Upper Gastrointestinal Surgeons (AUGIS) of Great Britain and Ireland with the approval of the AUGIS Committee. It included eight questions on indications for laparoscopic cholecystectomy and surveillance based on GBP (size, number, growth rate) and patient (age, comorbidities, ethnicity) characteristics. RESULTS A total of 79 completed questionnaires were returned. The vast majority of surgeons (>75%) stated that they would perform surgery when a single GBP reached 10 mm in size. However, there was a lack of uniformity in the management of multiple polyps and polyp growth rate, with different surveillance protocols for patients treated conservatively. CONCLUSIONS Gallbladder polyps are a relatively common finding on abdominal ultrasound scans. The survey showed considerable heterogeneity among surgeons regarding treatment and surveillance protocols. Although no randomized controlled trials exist, national guidelines would facilitate standardization, the formulation of an appropriate algorithm and appropriate use of resources.
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Meybodi F, Eslick GD, Cox MR. Image of the month. Gallbladder volvulus. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 2012; 147:677-678. [PMID: 22802068 DOI: 10.1001/archsurg.147.7.677-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Yamamoto S, Tsukamoto T, Kanazawa A, Shimizu S, Mikamori M, Fujiwara Y, Nagahara H, Xiang Z, Sakurai K, Inoue K. Lymphoid hyperplasia detected as a single mass in the gallbladder: report of a case. Surg Today 2012; 42:1244-7. [PMID: 22699402 DOI: 10.1007/s00595-012-0219-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 10/16/2011] [Indexed: 11/26/2022]
Abstract
We herein report a case of lymphoid hyperplasia of the gallbladder that showed unique images on computed tomography and ultrasonography. A 42-year-old female was referred to our hospital for evaluation and treatment of a gallbladder tumor. Ultrasonography and computed tomography showed a mass in the wall of the gallbladder neck, without typical findings of benign or malignant tumors. The serum levels of tumor markers, such as carcinoembryonic antigen, carbohydrate antigen 19-9, alpha-fetoprotein, and cytokeratin 19 fragment, were all within normal limits. Laparoscopic cholecystectomy was therefore performed. There were no stones in the gallbladder. Macroscopically, the submural tumor had a clear border without a capsule and a cystic portion. Its cut surface was grayish white. Microscopically, many lymph follicles with germinal centers were recognized in the subserosal layer. The lymphocytes were morphologically normal. We diagnosed lymphoid hyperplasia with chronic cholecystitis. Lymphoid hyperplasia of the gallbladder is extremely rare.
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Jyou M, Minami H. [Q & A. Acute cholecystitis in a 13-year-old boy?]. NIHON SHOKAKIBYO GAKKAI ZASSHI = THE JAPANESE JOURNAL OF GASTRO-ENTEROLOGY 2012; 109:977-981. [PMID: 23139944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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70
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Balent E, Plackett TP, Lin-Hurtubise K. Cholecystocolonic fistula. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2012; 71:155-157. [PMID: 22787563 PMCID: PMC3372787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The cholecystocolonic fistula is an atypical variant of biliary disease. When presenting with symptomatic disease, surgical treatment with cholecystectomy, fistula takedown and possible colonic resection are indicated, however the role of surgery in asymptomatic patients, especially those deemed higher risk is less clear. Herein we present a case of an incidentially discovered asymptomatic cholecystocolonic fistula in a higher risk surgical patient managed nonoperatively. The presentation and treatment options for this disease are discussed in relation to their application to this patient.
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Chang SKY, Tan SSY, Kok YO. Early experience in single-site laparoscopic cholecystectomy. Singapore Med J 2012; 53:377-380. [PMID: 22711035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Laparoscopic cholecystectomy is currently the gold standard for removal of symptomatic gallbladders. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of single-incision laparoscopic cholecystectomy (SILC). We report our early experience with SILC and assess its feasibility and safety. METHODS A prospective study was conducted of the first 100 patients who presented with complaints of biliary colic and underwent laparoscopic cholecystectomy via the single-port technique at our institution. SILC was performed via a single-port device such as a flexible umbilical port that could accommodate up to three surgical instruments. The port was inserted into a transumbilical incision around 15-20 mm long. Data on operative details and postoperative outcomes were collected and evaluated. RESULTS The mean operation time was 67.8 minutes. Six patients needed conversion, requiring extra 5-mm ports to complete the surgery. No serious intraoperative complications, such as bile duct injury or bile leakage, were encountered. Cosmesis from the scar hidden within the umbilical fold was excellent. CONCLUSION Our initial results of single-port laparoscopic cholecystectomy are promising, with no complications being seen in this early series. However, the drawbacks include the higher cost of equipment and a steeper learning curve. Further evaluation is required to assess the risks and benefits of this approach when compared with conventional laparoscopic cholecystectomy.
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Casasanta M, Mello M, Aghazarian S, Zapas J. Cholecystenteric fistula: the spectrum of disease and treatment modalities. Am Surg 2012; 78:E267-E269. [PMID: 22691324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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73
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Casasanta M, Mello M, Aghazarian S, Zapas J. Cholecystenteric fistula: the spectrum of disease and treatment modalities. Am Surg 2012; 78:E267-E269. [PMID: 22546101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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74
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Sato A, Hashimoto M, Sasaki K, Matsuda M, Watanabe G. Elevation of pancreatic enzymes in gallbladder bile associated with heterotopic pancreas. A case report and review of the literature. JOP : JOURNAL OF THE PANCREAS 2012; 13:235-238. [PMID: 22406610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT This is the first report associating heterotopic pancreas in the gallbladder and elevated pancreatic enzymes in bile. CASE REPORT A 60-year-old woman underwent abdominal ultrasonography at a medical check-up, revealing a nodular protrusion at the neck of the gallbladder. It seemed likely to be a lymph node, but we could not exclude the possibility of gallbladder cancer. In order to make a correct diagnosis, laparoscopic cholecystectomy was successfully performed. Pathological examination revealed heterotopic pancreatic tissue in the gallbladder wall. In addition, we detected elevated levels of amylase and lipase in gallbladder bile. CONCLUSIONS Preoperative diagnosis of heterotopic pancreas in the gallbladder is difficult. However, an increase of pancreatic enzymes in gallbladder bile may potentially play an important role in the occurrence of acalculous cholecystitis and biliary cancer. We need more accumulation of cases to know the true significance of this anomaly.
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Târcoveanu E, Vasilescu A, Georgescu S, Filip V, Vlad N. [The porcelain gallbladder-laparoscopic approach]. Chirurgia (Bucur) 2012; 107:246-251. [PMID: 22712357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A long time porcelain gallbladder was considered a relative contraindication to laparoscopic cholecystectomy, because of a high incidence of gallbladder cancer. From 12,000 patients underwent cholecystectomy in First Surgical Clinic of Iasi, 5 (0.04%) patients had porcelain gallbladder. All patients underwent ultrasound examen. Patients with porcelain gallbladder were classified as Type I to II according to preoperative ultrasound findings: three cases with porcelain gallbladder type I and two cases with porcelain gallbladder type II (in one case we found associated gallbladder carcinoma). We describe a three cases with porcelain gallbladder type I (complete calcification of gallbladder wall) treated by laparoscopic approach. Laparoscopic cholecystectomy was difficult because of adhesions and problems with grasping the thick gallbladder wall, but the postoperative course was uneventful. The histopathologic result of the specimen established the diagnosis of porcelain gallbladder type I and no cancer in the calcified wall of the gallbladder. We conclude based on cases presented and the literature review, although there is a high conversion rate, that patients with a type I porcelain gallbladder should be considered for laparoscopic cholecystectomy using a preoperative selection based on the ultrasound findings.
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Woods KS, Brisson BA, Defarges AMN, Oblak ML. Congenital duplex gallbladder and biliary mucocele associated with partial hepatic cholestasis and cholelithiasis in a cat. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2012; 53:269-273. [PMID: 22942442 PMCID: PMC3280779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 6-year-old neutered male domestic shorthair cat was presented for acute onset of vomiting. Exploratory laparotomy identified a duplex gallbladder and left cholecystectomy was performed. Histopathology confirmed biliary mucocele and hepatic cholestasis. While rare, biliary mucoceles should be considered as a differential diagnosis for feline extrahepatic bile duct obstruction.
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77
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Alam MS, Bin Khalid QS, Zeeshan M, Haider Z. Portal biliopathy. J PAK MED ASSOC 2012; 62:177-180. [PMID: 22755387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Portal biliopathy (PB) is a rare disorder, which mostly presents as sub-clinically. It occurs most commonly due to idiopathic extrahepatic portal vein obstruction. We present three cases having features of portal biliopathy secondary to portal hypertension. Our first case did not have a prior history of chronic liver disease while next two patients had previous history of chronic liver disease resulting in portal hypertension. Cavernous transformation of the portal vein due to extrahepatic portal vein obstruction is not infrequent but biliary obstruction in association with this disorder is distinctly uncommon. Proper case management is very important as prolonged biliary duct obstruction can lead to the development of ascending cholangitis or later on secondary biliary cirrhosis.
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Petrovic M, Radoman I, Artiko V, Stojkovic M, Stojkovic M, Durutovic D, Zuvela M, Matic S, Antic A, Palibrk I, Milovanovic A, Milovanovic J, Galun D, Radovanovic N, Bobic-Radovanovic A, Sobic D, Obradovic V. Gallbladder motility disorders estimated by non-invasive methods. HEPATO-GASTROENTEROLOGY 2012; 59:13-16. [PMID: 22260820 DOI: 10.5754/hge11286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND/AIMS The aim is to compare the radionuclide (DC) and ultrasonographic (US) method in the assessment of gallbladder (GB) motility. METHODOLOGY The study was performed in 15 controls (C), 10 patients with acute cholecystitis (AC), 20 patients with chronic acalculous cholecystitis (CAC), 26 patients with chronic cholecystitis with calculosis (CCC) as well as in 15 patients with GB dyskinesia (D). GB emptying period (EP), ejection fraction (EF) and ejection rate (ER) were estimated with dynamic cholescintigraphy (DC) and US. RESULTS The DC and US finding in the patients with AC was typical in all the patients, i.e. GB was not visualized at all on DC, while on US, stone was visible in the cystic duct. There were significant differences (p<0.05) between the EF and ER values obtained between C and the three groups of patients CAC, CCC and D, using both methods. However, there were no significant differences in EF, EP and ER values among CAC, CCC and D (p>0.05). There was also high correlation between the results obtained with both methods in all the groups of patients studied. CONCLUSIONS The results obtained by both methods are valuable for the assessment of GB motility. Although there are no significant differences and there is a high correlation between the values, radionuclide method is more precise, because it can register motility continuously.
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79
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Jain BK, Prasad D, Mohanty D, Garg PK, Diwaker P, Agarwal V. Gallbladder perforation: a great masquerader. Am Surg 2012; 78:E30-E32. [PMID: 22273300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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80
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Cheng HT, Wu CI, Hsu YC. Spontaneous cholecystocutaneous fistula managed with percutaneous transhepatic gallbladder drainage. Am Surg 2011; 77:E285-E286. [PMID: 22273199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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81
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Derıcı H, Kamer E, Kara C, Ünalp HR, Tansuğ T, Bozdağ AD, Nazli O. Gallbladder perforation: clinical presentation, predisposing factors, and surgical outcomes of 46 patients. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2011; 22:505-512. [PMID: 22234758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND/AIMS We aimed to investigate the clinical features and the relation between patient characteristics and the different types of gallbladder perforation and to determine the predisposing factors. MATERIAL AND METHODS The medical records of 478 patients who received urgent surgical treatment with the diagnosis of acute cholecystitis and underwent urgent surgery in our clinics between January 1997 and November 2008 were reviewed retrospectively. The demographic data of patients, time elapsed from the onset of the symptoms to the time of surgery, comorbidity status, American Society of Anesthesiologists classification, laboratory data, imaging results, surgical procedures, postoperative complications, and postoperative length of stay of the patients were analyzed. RESULTS There were 46 (9.6%) patients with the diagnosis of gallbladder perforation. Morbidity and mortality occurred in 15 (32.6%) and 7 (15.2%) patients, respectively. Advanced age, male gender, fever >38°C, high white blood cell count, and presence of cardiovascular comorbidity were found to be significant risk factors for gallbladder perforation. CONCLUSIONS While early diagnosis and early surgical intervention are the keys to managing gallbladder perforation, we suggest that patients having the above-mentioned clinical features should be carefully investigated.
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Shaw A, Smith B, Inglis C, Howlett D. A man with intra-abdominal calcification. BMJ 2011; 343:d5322. [PMID: 21917841 DOI: 10.1136/bmj.d5322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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83
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Klimis T, Roukounakis N, Kafetzis I, Mouziouras V, Karantonis I, Andromanakos N. Heterotopic pancreas of the gallbladder associated with chronic cholecystitis and high levels of amylasuria. JOP : JOURNAL OF THE PANCREAS 2011; 12:458-460. [PMID: 21904070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT Heterotopic pancreas of the gallbladder is an extremely rare entity, especially when pancreatic tissue appears histologically with an exclusively exocrine structure. CASE REPORT We report the case of a 35-year-old man who presented with symptoms of acalculous gallbladder disease with high levels of amylasuria. Immunohistochemical analysis of the surgical specimen of the cholecystectomy revealed pancreatic tissue at the gallbladder wall. CONCLUSIONS Heterotopic pancreatic tissue is a rare pathological finding in the gallbladder. It requires consideration and sensitization in the differential diagnosis of acalculous gallbladder disease, which can explain hyperamylasuria in cases of unknown origin.
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84
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Compoginis JM, Alexander M. Gallbladder agenesis with concurrent, solitary, intrahepatic biliary duct cyst. Am Surg 2011; 77:E202-E203. [PMID: 21944610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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85
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86
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Catani M, De Milito R, Romagnoli F, Mingazzini P, Silvestri V, Usai V, Romeo V, Modini C. Ectopic liver nodules: a rare finding during cholecystectomy. G Chir 2011; 32:255-258. [PMID: 21619777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The ectopic liver (or choristoma) is a rare condition found during autopsy or abdominal exploration for various indications. The authors report two cases of ectopic liver found during laparoscopic cholecystectomy for acute cholestytis. The ectopic liver tissue has been reported to develop in several sites as thoracic cavity, gastrohepatic ligament, adrenal glands, pancreas, esophagus and, above all, gallbladder. The Authors review the literature and report their experience as a contribution to the knowledge of this rare pathological entity.
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87
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Ögredici Ö, Erb S, Langer I, Pilo P, Kerner A, Haack HG, Cathomas G, Danuser J, Pappas G, Tarr PE. Brucellosis reactivation after 28 years. Emerg Infect Dis 2011; 16:2021-2. [PMID: 21122256 PMCID: PMC3294561 DOI: 10.3201/eid1612.100678] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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88
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Bagnato C, Lippolis P, Zocco G, Galatioto C, Seccia M. Uncommon cause of acute abdomen: volvulus of gallbladder with necrosis. Case report and review of literature. Ann Ital Chir 2011; 82:137-140. [PMID: 21682104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Gallbladder volvulus is a rare condition which can mimic an acute cholecystitis. This condition is characterized from a rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. Preoperative diagnosis is difficult. This is an acute surgical emergency that must be treated with immediate detorsion and cholecystectomy. We report a case of acute gallbladder torsion in an elderly man and review the clinical aspects of the disease in the context of the available literature.
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89
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Shukla RM, Roy D, Mukherjee PP, Saha K, Mukhopadhyay B, Mandal KC, SahaBasu K, Barman SS. Spontaneous gall bladder perforation: a rare condition in the differential diagnosis of acute abdomen in children. J Pediatr Surg 2011; 46:241-3. [PMID: 21238677 DOI: 10.1016/j.jpedsurg.2010.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/22/2010] [Accepted: 09/17/2010] [Indexed: 01/29/2023]
Abstract
Gallbladder perforation is very rare in children and almost exclusively is a complication of cholecystitis, which accompanies severe inflammation of the gallbladder with or without cholelithiasis. Here we present 4 cases of spontaneous gall bladder perforation, which should be kept in mind as a condition for inclusion in the differential diagnosis of an acute abdomen in children.
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90
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Bugosen Tannous M, Tagle Arróspide M, Huerta-Mercado Tenorio J, Scavino Levy Y. [Gallbladder polyps: Clinical and pathological features in Cholecystectomy patients in the Anglo American clinic in the period of 1999-2007]. REVISTA DE GASTROENTEROLOGIA DEL PERU : ORGANO OFICIAL DE LA SOCIEDAD DE GASTROENTEROLOGIA DEL PERU 2011; 31:32-37. [PMID: 21544154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To describe the clinical and anatomopathologic characteristics of gallbladder polyps found in patients who underwent cholecystectomy at Clinica Anglo Americana for the 1999-2007 period. MATERIALS AND METHODS Descriptive and retrospective study that started at Pathology Department where patients with anatomopathologic finding of gallbladder polyps who underwent cholecystectomy for the 1999-2007 period were selected. Clinical records were reviewed to take ultrasonographic, anatomopathologic and clinical characteristics, which were included and studied in a data base in Microsoft Excel. RESULTS Gallbladder polyps were found in 172 (10%) of 1707 gallbladders that were analized. Cholesterolosic polyps were found in 95.4% of the cases, 4% were adenomas and 0.6% were hyperplasic polyps. Gallbladder polyps ≥ 10 mm were found in 32,25% of the cases. A 90% of these polyps were cholesterolosic and a 10% were adenomas. No malign polyps were found in this study. CONCLUSIONS The vast majority of gallbladder polyps, including the ≥ 10 mm group, were cholesterolosic. The physician decision to remove the gallbladder must be individualized and discussed with each patient, considering gallbladder polyp characteristics such as size and growth rate of the lesion.
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91
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Mispakhov GB, Borisov AE, Akimov VP, Nazarenko AA. [Specific features of medico-diagnostic strategy for cholesterosis of the gallbladder]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 2011; 170:25-28. [PMID: 21674929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The work shows the incidence, criteria of the diagnosis and indications for surgical treatment of patients with cholesterosis of the gallbladder. An analysis of the results of examination and treatment of 3426 patients with diseases of the gallbladder has shown that the ultrasonic method of diagnostics allows detection of the cholesterosis form and determination of treatment strategy.
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92
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Gucev ZS, Pop-Jordanova N, Calovska V, Tasic V, Slavevska N, Laban N, Noli MC, Lepori MB, Loudianos G. Acute Gallbladder Hydrops and Arthritis: unusual initial manifestations of Wilson's Disease (WD): Case Report. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2011; 32:307-315. [PMID: 22286624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Wilson disease (WD) is an autosomal recessive disorder, in which copper is deposited in the liver, brain, cornea and kidneys. The clinical presentation is variable, with fully expressed disease manifesting cirrhosis, neurologic damage and Kayser-Fleischer (K-F) ring on the cornea. A 24-year-old patient developed right upper quadrant pain with a palpable mass and a swelling of the right talocrural articulation. X-rays were uneventful, but the routine examination of hepatic enzymes discovered a 6-8 fold increase in SGPT, SGOT and AST. Antibodies for hepatitis B, C were normal, as well as the ANA, ANCA, antimytochondrial and anti-smooth muscle antibodies. Ultrasound of the abdomen revealed extremely dilated hepatic, cystic ducts as well as gallbladder. A large, oedematous gallbladder with yellow green bile was removed, the liver was found to be cirrhotic, but as the operative bleeding was abundant a biopsy was not done. Serum ceruloplasmin was low [0.160 g/l (normal 0.204-0.407)], serum copper 12.7 µmol/l (11.0-24.4), transaminasis: always very high, in the last months normal/slightly elevated. Urine copper: 1.0 µmol/24 h (>9.44). As first seen the proband had tremor, dysarthria, dystonia and K-F ring on the cornea. After 10 months of treatment with penicillamine his transaminases normalized, the tremor, dysarthria, dystonia initially got worse and then ameliorated. The coagulation times are ameliorated, but not yet normalized. Mutational analysis has shown that the proband is homozygote for c.3207 C->A, p.H1069Q while his parents are heterozygotes. His sister is a healthy non-carrier. In brief, we describe an unusual presentation of WD, with gallbladder hydrops and talocrural arthritis in a patient with complete clinical manifestations of the disease.
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93
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Iudina TM, Iakimova LV, Ermolenko NS. [Experience of the conservative treatment of the gallbladder cholesterosis in children]. EKSPERIMENTAL'NAIA I KLINICHESKAIA GASTROENTEROLOGIIA = EXPERIMENTAL & CLINICAL GASTROENTEROLOGY 2011:93-97. [PMID: 21560398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Gallbladder cholesterosis (GBC) was described more than 150 years ago, but so far the disease remains unknown. With respect to children's age appear solitary works. The introduction of modern pediatric practice of the intrascopic research methods enabled us to objectively identify the pathological changes in the gallbladder wall. Many years of experience studying gallstone disease has shown that almost a third of children cholelithiasis combined with gallbladder cholesterosis. However, until cholecystectomy the last one was diagnosed in only 10% of children. Meanwhile, our experience in children observing with GBC showed that conservative therapy effective in childhood. The aim of this study was to demonstrate the clinical example of the possibility of conservative treatment of gallbladder cholesterosis in children.
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94
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Richmond BK. Response to: Laparoscopic cholecystectomy is safe and effective for the treatment of biliary dyskinesia in the pediatric population. Am Surg 2010; 76:1426. [PMID: 21265362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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95
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Spaziani E, Petrozza V, Di Filippo A, Picchio M, Ceci F, Miraglia A, Moretti V, Briganti M, Greco E, Pattaro G, De Angelis F, Salvadori C, Stagnitti F. [Gallbladder polypoid lesions. Three clinical cases with difficult diagnosis and literature review]. G Chir 2010; 31:439-442. [PMID: 20939951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Gallbladder polypoid lesions occur in 1.3%-6.9% of cases. The preoperative diagnosis between benign, malignant and potentially malignant lesions is difficult. Therefore it is not possible any. PATIENTS AND METHODS The Authors describe three cases. The case 1 was a gallbladder diffuse adenomyomatosis; the ultrasound and the CT were of little help in defining preoperatively the nature and the gravity of the thickening. Case 2 was an adenomyomatosis of the fundus: the ultrasound examinations were not able to establish preoperatively lesion's nature, site and dimensions. In the case 3, ultrasounds showed polypoid lesions and calculi concrections not found in colecistectomy. DISCUSSION The ultrasound is the most widely used diagnostic tool in the evaluation of gallbladder polypoid lesions; its accuracy is only 66%. CT, which has an accuracy level of 75%, must be carried out there is any possibility of malignant degeneration of the polyp. If doubts persist, a MR, 93% accuracy, is indicated. In selected cases, PET can be of further help. CONCLUSIONS The preoperative diagnosis of the nature of gallbladder polypoid lesions is "difficult" and this justifies the lack of consensus on treatment. However, the adenoma-carcinoma sequence, widely discussed in literature, can justifies to the use of CT, MR, PET and surgical treatment after an ultrasound examination.
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96
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Corazziari ES, Cotton PB. [Disorders of gallbladder and sphincter of Oddi]. REVISTA DE GASTROENTEROLOGIA DE MEXICO 2010; 75:472-479. [PMID: 21169117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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97
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Al-Shraim M, Rabie ME, Elhakeem H, Kandeel A, Shah MT, Jamil S. Pancreatic heterotopia in the gallbladder associated with chronic cholecystitis: a rare combination. JOP : JOURNAL OF THE PANCREAS 2010; 11:464-466. [PMID: 20818117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
CONTEXT Pancreatic heterotopia is a rare pathologic entity, previously reported in the stomach, duodenum and jejunum. It is mostly asymptomatic and rarely gives rise to complications. Localization of pancreatic heterotopia in the gallbladder is extremely rare and can be associated with cholecystitis or cholecystolithiasis. CASE REPORT We herein describe a case of a 39-year-old man who presented with biliary type pain with ultrasonographic evidence of a gallbladder polyp. Laparoscopic cholecystectomy was performed with uneventful recovery. Pathologic examination of the gallbladder detected a heterotopic focus of pancreatic tissue in its wall, associated with chronic cholecystitis with no gallstones. CONCLUSION Pancreatic heterotopia of the gallbladder is a very rare entity with unknown clinical significance. Awareness of this condition may facilitate its recognition which may shed more light on its clinical significance.
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Ruangsin S, Jaroonrach V, Petpichetchian C, Puttawibul P, Sunpaweravong S, Chewatanagongun S. Establishment the cost-effectiveness through set criteria of laparoscopic cholecystectomy. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND = CHOTMAIHET THANGPHAET 2010; 93:789-793. [PMID: 20649057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To assess the set criteria of laparoscopic cholecystectomy (LC) in reducing the length of hospital stay (LOHS), and total treatment expenditure. MATERIAL AND METHOD The measurement outcomes were prospectively analyzed through the medical record, and self questionnaire of the patients. RESULTS During the 1-year trial, a total of 122 patients were scheduled for LC. Among these, 85 cases had met the set criteria of low risk clients of both preoperative indicator of a) American Society of Anesthesiologists (ASA) class 1 or 2, and postoperative indicators of b) no surgical drainage, and c) no immediate complication, while 37 cases were excluded due to ASA class 3 or 4, and various reasons. Distributed by the duration of hospital stay, the patients were classified in to three groups; group A was overnight hospital stay, 15 of 85 subjects (17.6%), group B was short hospital stay (within 3 days), 51 of 85 subjects (60.0%), and group C was long hospital stay (more than 3 days), 19 of 85 subjects (22.4%). The mean length of hospital stay (LOHS) was 24 +/- 1.61 hours in group A, 55 +/- 11.16 in group B, and 108 +/- 21.59 in group C, while the average total expenditure was 531.22 +/- 111.09, 665.5 +/- 133.35 and 812.33 +/- 158.62, respectively. For the overnight hospital stay group, the LOHS and the total treatment expenditure was significantly lower the other groups (p < 0.001). The majority of the overnight hospital stay group had rated the patient satisfaction as excellent. CONCLUSION The set criteria of laparoscopic cholecystectomy (LC) are helpful and establish the cost-effectiveness in terms of reduction of LOHS and total treatment expenditure.
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Soufi M, Benamer S, Chad B. [Pseudotumoral gallbladder tuberculosis]. Rev Med Interne 2010; 32:e32-3. [PMID: 20646794 DOI: 10.1016/j.revmed.2009.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 08/05/2009] [Accepted: 11/24/2009] [Indexed: 11/17/2022]
Abstract
Gallblader tuberculosis is uncommon and may mimic a neoplasia. We report a 55-year-old man who presented with fever and abdominal pain compatible with cholecystitis. Abdominal ultrasound and computed tomographic scan showed a tumoral aspect of the bottom of the gallbladder and invasion of adjacent liver. Diagnosis of pseudo-tumoral gallbladder tuberculosis was obtained with the histologic examination of surgical sampling. Disease course was uneventful with appropriate antituberculous therapy.
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100
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Suliman E, Palade R, Voiculescu D, Simion G. [Porcelain gallbladder--diagnostic and therapeutic features]. Chirurgia (Bucur) 2010; 105:431-434. [PMID: 20726316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Porcelain gallbladder (PG) is a rare entity. It's frequently associated with cholecyst lithiasis (90%). Diagnosis is established based on imaging assays (simple abdominal radiography, ultrasound and/or abdominal CT). Pathologically is an extensive process of calcification of the gallbladder wall. The literature mentioned strongly PG association with cancer of the gallbladder. Therefore laparoscopic cholecystectomy was formally contraindicated. We present two cases of PG laparoscopically operated and with this occasion we review particular aspects of diagnosis and treatment of the disease.
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