المؤلفون: Ángel Calderón, Ana Capelastegi, Victor Orive, Luis Bujanda, Arsenio Martinez, José Luis Cabriada, Mari M. Calvo, Iñaki Heras

المصدر: Journal of Clinical Gastroenterology. 34:233-236

مصطلحات موضوعية: Male, medicine.medical_specialty, Gallbladder Diseases, Gallbladder Stone, Sensitivity and Specificity, Cholangiography, Cholelithiasis, Bile, Humans, Medicine, Prospective Studies, Biliary sludge, Prospective cohort study, Aged, Ultrasonography, Magnetic resonance cholangiopancreatography, medicine.diagnostic_test, business.industry, Gallbladder, Ultrasound, Gastroenterology, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Female, Radiology, business

الوصف: Ultrasonography (US) is currently the reference technique for evaluating gallbladder pathology. The aim of this study was to prospectively determine the diagnostic efficacy of magnetic resonance cholangiography (MRCP) in evaluating the gallbladder, as compared with US. The study included 80 patients (mean age, 69.3 years; male-to-female ration, 1.3:1) who underwent prospective US and MRCP; 5 patients in whom MRCP was contraindicated were excluded. In all cases, US was performed before MRCP. Ultrasound was the reference technique for evaluating MRCP sensitivity and specificity. Magnetic resonance cholangiopancreatography provided good image quality in 65 patients (81.2%) and poor image quality in 15 (mostly because of poor patient cooperation). Artefacts did not influence visualization of the gallbladder or evaluation of the background pathology. The sensitivity of MRCP in diagnosing gallbladder stones (43 patients; 97.7%) was comparable to US (44 patients). In contrast, MRCP diagnosed biliary sludge or microlithiasis in 13 patients, versus 5 in the case of US. Magnetic resonance cholangiopancreatography is a good technique for diagnosing cholelithiasis and biliary sludge. However, its high cost, contraindications, and the need for patient cooperation limit the use of the technique in routine clinical gallbladder studies. Magnetic resonance cholangiopancreatography could contribute to the diagnosis of microlithiasis, provided that future studies confirm its greater sensitivity versus US.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::83d0dacea5a968eeeec8060bc80184f4Test
https://doi.org/10.1097/00004836-200203000-00007Test

المؤلفون: Jürgen F. Riemann, Henning E. Adamek, Weber J

المصدر: Journal of Clinical Gastroenterology. 13:395-400

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Gallbladder Stone, Lithotripsy, Extracorporeal, Cholelithiasis, Transducers, Pressure, medicine, Humans, Aged, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, Gallbladder, Gastroenterology, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Evaluation Studies as Topic, Cholecystitis, Pancreatitis, Female, Cholecystectomy, business, Follow-Up Studies

الوصف: Between January and May 1989, 65 patients with symptomatic gallbladder stones were treated with extracorporeal piezoelectric lithotripsy (EPL) and supplementary dissolution therapy with oral bile acids. In 98% of the patients, fragmentation of stones was achieved. On average, each patient received 3.18 treatments. In addition to attacks of colic and asymptomatic changes in laboratory parameters, one hematoma of the gallbladder and one of the liver were observed, together with pancreatitis and cholecystitis in two patients each. During the follow-up period, three patients developed symptomatic bile duct stones. An endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy was performed on four occasions, while one female patient had to undergo urgent cholecystectomy for inflammation of the gallbladder and empyema. Six months after the initial treatment, 36 (55%) patients were free of stones, while the stone-free rate after 12 months was 64.5% (41 of 65). Ninety percent of the patients with a solitary stone less than or equal to 2 cm in diameter became stonefree within a year. Extracorporeal piezoelectric lithotripsy is clearly a feasible procedure for the treatment of certain gallstone patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0698a4e10138da53bdbbb55dcd8e44a9Test
https://doi.org/10.1097/00004836-199108000-00007Test

المؤلفون: Mark Topazian, James M. Crawford, John H. Sinard, Kristin Landi

المصدر: Journal of clinical gastroenterology. 36(4)

مصطلحات موضوعية: Adult, Male, Pathology, medicine.medical_specialty, medicine.medical_treatment, Gallbladder disease, Gallbladder Diseases, Gallbladder Stone, Gastroenterology, Risk Assessment, Sensitivity and Specificity, Calculi, Sampling Studies, chemistry.chemical_compound, Predictive Value of Tests, Internal medicine, medicine, Cholecystitis, Bile, Humans, Biliary Tract, Aged, Cholesterol, business.industry, Gallbladder, Gallstones, Middle Aged, medicine.disease, medicine.anatomical_structure, chemistry, Pancreatitis, Child, Preschool, Cholecystectomy, Female, Microscopy, Polarization, business, Crystallization

الوصف: Background Biliary crystal morphology is best described in patients with gallbladder stones, but most patients undergoing bile collection for microscopy have a clinical diagnosis of acalculous gallbladder disease. We investigated the morphology of biliary crystals in such patients. Study Bile was obtained for polarizing microscopy from fresh cholecystectomy specimens of patients with a clinical diagnosis of acalculous or calculous gallbladder disease. Slides for microscopy were prepared by touch contact with bile in freshly opened gallbladder specimens, and following aspiration of gallbladder bile through a 5-French cannula. Results Bile was examined from five patients with a clinical diagnosis of acalculous gallbladder disease and five patients with known gallstones. Needle-like cholesterol crystals predominated in most patients without gallstones, whereas plate-like and dot-like crystals were more common in patients with gallstones. All three crystal types were seen in most patients. Crystal morphology was not affected by aspiration of bile through a 5-French cannula. Conclusions Birefringent needles and dots should be recognized as cholesterol crystals during bile microscopy. These crystal morphologies may predominate in some patients with a clinical diagnosis of acalculous gallbladder disease.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aac1349de3c403769d6d7a09d1066d8cTest
https://pubmed.ncbi.nlm.nih.gov/12642747Test

المؤلفون: Ernesto Cobos, Nahum Méndez-Sánchez, Ernesto Roldan-Valadez, Miguel A. Tanimoto, Misael Uribe

المصدر: Journal of clinical gastroenterology. 25(3)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Hypercholesterolemia, Gallbladder Stone, Gastroenterology, Body Mass Index, chemistry.chemical_compound, Cholelithiasis, Internal medicine, medicine, Humans, Obesity, Risk factor, Aged, business.industry, Cholesterol, Incidence (epidemiology), Gallbladder, Gallbladder Disorder, Middle Aged, medicine.anatomical_structure, chemistry, Cholecystectomy, Female, business, Body mass index

الوصف: High levels of cholesterol have been associated with certain gallbladder disorders such as cholesterolosis and gallstone disease. Furthermore, obesity is considered the main risk factor for cholesterol gallstone disease. We investigated the incidence of cholesterolosis in patients with and patients without gallbladder stones (GS). We reviewed the clinical records of patients with gallstone disease and other gallbladder disorders who had consecutive cholecystectomy during a 5-year period. We recorded demographic data, sex, age, serum cholesterol levels, and body mass index. The diagnosis of cholesterolosis was made macroscopically and microscopically. A total of 636 patients were included in this study: 446 with and 190 without GS. Cholesterolosis was more frequent in patients without GS (p < 0.01). However, hypercholesterolemia occurred more frequently in patients with GS (p < 0.001). Obese patients with GS had higher percentages of cholesterolosis and hypercholesterolemia than did eutrophic patients (p < 0.01 and p < 0.05, respectively). We suggest that cholesterolosis in the human gallbladder is not necessarily associated with gallstone disease and high plasma cholesterol levels.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1feabcca862ae2c923eb168dab7a50e3Test
https://pubmed.ncbi.nlm.nih.gov/9412968Test

المؤلفون: Usha Venkatachalam, Rakesh K. Tandon, Pramod Kumar Garg

المصدر: Journal of clinical gastroenterology. 20(4)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Gallstones, Gallbladder Stone, Gastroenterology, chemistry.chemical_compound, Emergency surgery, Internal medicine, Medicine, Humans, Aged, Cholangiopancreatography, Endoscopic Retrograde, Endoscopic retrograde cholangiopancreatography, Common bile duct, medicine.diagnostic_test, business.industry, Cholesterol, Bile duct, Gallbladder, Middle Aged, Surgery, medicine.anatomical_structure, chemistry, Obstructive jaundice, Female, business

الوصف: Common bile duct stones are usually associated with stones in the gallbladder. During the period 1989-1991, however, we encountered 17 patients with common bile duct (CBD) stones without gallbladder stones who had presented with obstructive jaundice and cholangitis. Their ages ranged between 30 and 72 years ; 10 were female and seven male. Five of them had a deceptive presentation and were initially mis-diagnosed as having a malignant lesion. It was endoscopic retrograde cholangiopancreatography that correctly diagnosed the presence of CBD stones in all 17 patients. Therapeutic sphincterotomy led to subsidence of cholangitis in 16 patients and retrieval of stones in 13 of them. Three patients required nasobiliary decompression because stones could not be retrieved. One patient required emergency surgery due to flare-up of cholangitis. Cholesterol concentration of the retrieved stones was 70-92% of the dry weight. Thus, these 17 patients formed a distinct subgroup who had cholesterol CBD stones with stoneless gallbladder, and five of these 17 patients had presentations mimicking malignant lesions.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::81e8416e8c2f25dbf95b7bbfbdd57b99Test
https://pubmed.ncbi.nlm.nih.gov/7665818Test