Gallstone disease

Gallstone disease is common with clinical presentations including biliary colic, cholecystitis, and obstructive jaundice. Acute cholangitis and pancreatitis are other complications. Ultrasound scan and MRCP as well as endoscopic ultrasound are investigation modalities. Medical treatment of gallstones with ursodeoxycholic acid is discussed as well as laparoscopic cholecystectomy with its risks and benefits. The prevalence of bile duct stones is around 10–20%. Strategies for investigation and management are discussed, including ERCP and laparoscopic bile duct exploration.

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Is Preoperative Evaluation of the Biliary Tree Necessary in Uncomplicated Gallstone Disease?

Scandinavian Journal of Surgery ◽

10.1177/145749690509400108 ◽

2005 ◽

Vol 94 (1) ◽

pp. 31-33 ◽

Cited By ~ 8

Author(s):

J. Järhult

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Statistical Difference ◽

Preoperative Evaluation ◽

Gallstone Disease ◽

Common Bile Duct Stones ◽

Biliary Tree ◽

Control Group ◽

Bile Duct Stones ◽

Intravenous Cholangiography

Aim: To analyse if preoperative radiology is of value in patients with uncomplicated gallstone disease. Material: 312 patients intended for laparoscopic cholecystectomy were randomly allocated to undergo preoperative radiology (intravenous cholangiography or magnetic resonance cholangiography) or to a control group. Intraoperative cholangiography was not used routinely in either group. Results: There was no bile duct injury and no difference in complication frequency between the two groups. The incidence of common bile duct stones was 3,8 % within the first postoperative year with no statistical difference between the two groups. Conclusions: Routine preoperative evaluation of the bile tree seems unnecessary before laparoscopic cholecystectomy in patients with uncomplicated gallstone disease.

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Primary Choledocholithiasis 15 Years Postcholecystectomy

Case Reports in Medicine ◽

10.1155/2020/3265010 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Michael Simon ◽

Irfan Nazir Hassan ◽

Dhanasekaran Ramasamy ◽

David Wilson

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Common Bile Duct ◽

Standard Treatment ◽

Case Reports ◽

Gallstone Disease ◽

The Elderly ◽

Western Society ◽

Bile Duct Stones ◽

Symptomatic Gallstones

Gallstone disease is extremely prevalent in the western society with laparoscopic cholecystectomy (LC) being the standard treatment for patients with symptomatic gallstones. The prevalence of common bile duct (CBD) stones with concomitant gallstones increases with age from 8–15% in patients <60 years of age and up to 60% in the elderly. There have been only a few case reports of postcholecystectomy bile duct stones occurring more than 10 years following surgery in the literature. Most of these reports describe the presence of stones within the gallbladder/cystic duct remnant or secondary to migrating surgical clips.

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Biochemical Prediction of Acute Cholangitis and Symptomatic Bile Duct Stones by Gallstone Hepatitis

HPB Surgery ◽

10.1155/1995/51915 ◽

1995 ◽

Vol 8 (4) ◽

pp. 267-273 ◽

Cited By ~ 4

Author(s):

M. Isogai ◽

K. Hachisuka ◽

A. Yamaguchi ◽

A. Hori

Keyword(s):

Bile Duct ◽

Early Stage ◽

Gallstone Disease ◽

Acute Cholangitis ◽

False Negative ◽

Serum Transaminase ◽

Bile Duct Stones ◽

Risk Patients ◽

Clinical Concept ◽

Selection Of

We have adopted the clinical concept of gallstone hepatitis indicated by marked serum transaminase elevation due to an acute inflammatory liver cell necrosis in the early stages of gallstone impaction in the bile duct as clinical and biochemical criteria for identifying high-risk patients for acute cholangitis or bile duct stones causing symptoms (symptomatic bile duct stones, SBDS).One hundred and fifty-eight (80.2%) of 197 patients with acute gallstone disease and concomitant elevation of serum transaminase (gallstone hepatitis) underwent emergency treatment, either surgery (138 patients) or percutaneous transhepatic biliary drainage (PTBD)/endoscopic sphincterotomy (ES) (20 patients). One hundred and forty-two (89.9%) and 67 (42.4%) were confirmed to have SBDS and acute cholangitis, respectively, in the early stage of the disease. The majority of the patients who had no bile duct stones identified at surgery had either biliary pancreatitis or multiple small stones in the gallbladder. They were assumed to have migrating stones or false negative operative cholangiograms.In conclusion, gallstone hepatitis indicates that SBDS and acute cholangitis are probable, and facilitates rapid selection of patients for urgent biliary tract exploration in patients with acute gallstone disease.

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Efficacy of laparoscopic common bile duct exploration combined with laparoscopic cholecystectomy for treatment of common bile duct stones with mild to moderate acute cholangitis

World Chinese Journal of Digestology ◽

10.11569/wcjd.v23.i22.3614 ◽

2015 ◽

Vol 23 (22) ◽

pp. 3614

Author(s):

Ying Li

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Common Bile Duct ◽

Acute Cholangitis ◽

Common Bile Duct Stones ◽

Common Bile Duct Exploration ◽

Bile Duct Stones

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Unusual Clinical Presentation of Hemobilia with Recurrent Vasovagal Episodes

Case Reports in Gastroenterology ◽

10.1159/000479311 ◽

2017 ◽

Vol 11 (3) ◽

pp. 554-558 ◽

Cited By ~ 2

Author(s):

Abhinav Tiwari ◽

Tariq Hammad ◽

Himani Sharma ◽

Khola Qamar ◽

Mohammad Saud Khan ◽

...

Keyword(s):

Abdominal Pain ◽

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Obstructive Jaundice ◽

Blood Vessel ◽

Gastrointestinal Bleeding ◽

Clinical Presentation ◽

Unusual Presentation ◽

Biliary Colic ◽

Classic Triad

Hemobilia is caused by the abnormal connection between a blood vessel and the bile duct, which is usually iatrogenic and caused by hepatobiliary procedures. The classic triad of hemobilia includes biliary colic, obstructive jaundice, and gastrointestinal bleeding. We present the case of an 80-year-old man who had laparoscopic cholecystectomy complicated by hemobilia. He had an unusual presentation of hemobilia in the form of transient vasovagal episodes in addition to abdominal pain and hematochezia.

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