scholarly journals Penetration of ciprofloxacin and fleroxacin into biliary tract.

1996 ◽  
Vol 40 (3) ◽  
pp. 787-791 ◽  
Author(s):  
C E Edmiston ◽  
E C Suarez ◽  
A P Walker ◽  
M P Demeure ◽  
C T Frantzides ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Gallbladder Wall ◽  
Chronic Cholecystitis ◽  
Sample Collection ◽  
Tissue Penetration ◽  
Once Daily ◽  
Two Agents

Forty patients with chronic cholecystitis or cholelithiasis were prospectively randomized for therapy with either ciprofloxacin or fleroxacin to study the penetration of these two agents into gallbladder tissue, plasma, and bile. Patients received a 3-day course of ciprofloxacin (500 mg twice a day) or fleroxacin (400 mg once daily) and were subdivided into four groups reflecting intraoperative sample collection at 4, 7, 14, and 25 to 26 h following the last quinolone dose. Mean concentrations in plasma for ciprofloxacin and fleroxacin at 4 and 25 to 26 h postdose were 2.5 and 10 micrograms/ml and 0.3 and 1.8 micrograms/ml, respectively. The concentrations of ciprofloxacin and fleroxacin in bile and gallbladder wall tissue at 25 to 26 h postdose were 4.5 and 8.6 micrograms/ml and 1.2 and 4.4 micrograms/ml, respectively. Both agents demonstrate rapid tissue penetration with persistence at levels appropriate for treatment of biliary pathogens.

scholarly journals Tissue penetration of moxifloxacin into human gallbladder wall in patients with biliary tract infections

2009 ◽  
Vol 64 (5) ◽  
pp. 1091-1095 ◽  
Author(s):  
M. C. Ober ◽  
T. Hoppe-Tichy ◽  
J. Koninger ◽  
O. Schunter ◽  
H.-G. Sonntag ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Gallbladder Wall ◽  
Tissue Penetration ◽  
Human Gallbladder ◽  
Tract Infections

scholarly journals Physiology and Pathophysiology of the Biliary Tract: The Gallbladder and Sphincter of Oddi—A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Jose Behar
Keyword(s):  
Biliary Tract ◽  
Bile Salts ◽  
Standard Treatment ◽  
Sphincter Of Oddi ◽  
Chronic Cholecystitis ◽  
Gallbladder Motility ◽  
Hepatic Bile ◽  
Biliary Pain ◽  
Pain Affect ◽  
Upper Abdominal

The biliary tract collects, stores, concentrates, and delivers bile secreted by the liver. Its motility is controlled by neurohormonal mechanisms with the vagus and splanchnic nerves and the hormone cholecystokinin playing key roles. These neurohormonal mechanisms integrate the motility of the gallbladder and sphincter of Oddi (SO) with the gastrointestinal tract in the fasting and digestive phases. During fasting most of the hepatic bile is diverted toward the gallbladder by the resistance of the SO. The gallbladder allows the gradual entry of bile relaxing by passive and active mechanisms. During the digestive phase the gallbladder contracts, and the SO relaxes allowing bile to be released into the duodenum for the digestion and absorption of fats. Pathological processes manifested by recurrent episodes of upper abdominal pain affect both the gallbladder and SO. The gallbladder motility and cytoprotective functions are impaired by lithogenic hepatic bile with excess cholesterol allowing the hydrophobic bile salts to induce chronic cholecystitis. Laparoscopic cholecystectomy is the standard treatment. Three types of SO dyskinesia also cause biliary pain. Their pathophysiology is not completely known. The pain of types I and II usually respond to sphincterotomy, but the pain due to type III usually does not.

Significance of Preoperative Ultrasound Measurement of Gallbladder Wall Thickness

2007 ◽  
Vol 73 (9) ◽  
pp. 926-929 ◽  
Author(s):  
James Majeski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Wall Thickness ◽  
Open Cholecystectomy ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Chronic Cholecystitis ◽  
Entire Series ◽  
Calculous Cholecystitis ◽  
Gallbladder Ultrasound

Evaluation of patients with signs and symptoms of biliary tract disease usually includes ultrasound assessment of the gallbladder. Does measurement of the thickness of the gallbladder wall yield any significant information to the clinical surgeon? The records of all my patients undergoing cholecystectomy since 1990 were reviewed. The entire series consists of 401 consecutive patients, in whom 388 procedures were completed laparoscopically, with 14 patients requiring conversion to an open cholecystectomy. Each patient's preoperative evaluation included a gallbladder ultrasound, which included measurement of the diameter of the gallbladder wall. The entire series of cholecystectomies was evaluated according to the ultrasound measured diameter of the gallbladder wall. A thin gallbladder wall was less than 3 mm in diameter. A thick gallbladder wall was 3 mm or greater in diameter. Of the 401 consecutive patients who underwent cholecystectomy for symptomatic gallbladder disease, 86 (21.5%) were removed laparoscopically for acalculous disease. Eleven per cent of patients with acalculous cholecystitis had acute cholecystitis and 89 per cent had chronic cholecystitis. Every patient with either a thin or thick gallbladder wall with acalculous cholecystitis had a successful laparoscopic cholecystectomy. Three-hundred fifteen patients had a laparoscopic cholecystectomy for calculous cholecystitis. In patients with calculous cholecystitis, 28.3 per cent had acute cholecystitis and 71.7 per cent had chronic cholecystitis. The gallbladder wall was found to be greater than 3 mm in 38 per cent of patients with acute calculous cholecystitis and greater than 3 mm in 41 per cent of patients with chronic calculous cholecystitis. One-hundred, forty-two patients, out of a series total of 401, had a gallbladder wall thickness greater than 3 mm by preoperative sonography and 14 of these patients (10%) required conversion to an open cholecystectomy. A preoperative gallbladder ultrasound evaluation for symptomatic cholecystitis, which documents a thick gallbladder wall (≥3 mm) with calculi, is a clinical warning for the laparoscopic surgeon of the potential for a difficult laparoscopic cholecystectomy procedure which may require conversion to an open cholecystectomy procedure.

scholarly journals Ectopic Pancreatic Tissue Adherent to the External Gallbladder Wall

2018 ◽  
Vol 12 (1) ◽  
pp. 170-175 ◽  
Author(s):  
Ioannis M. Koukourakis ◽  
Meltem S. Perente Memet ◽  
Maria Kouroupi ◽  
Konstantinos Simopoulos
Keyword(s):  
Young Women ◽  
Gallbladder Wall ◽  
Pancreatic Tissue ◽  
Chronic Cholecystitis ◽  
Tissue Type ◽  
Pathological Examination ◽  
Fatty Tissue ◽  
Abdominal Symptoms ◽  
Ectopic Pancreatic Tissue

Heterotopic pancreatic tissue can be found in the gastrointestinal tract, with the stomach and small bowel being the most common sites of localization. The gallbladder is seldom affected. Here, we report 2 cases of ectopic pancreas within the fatty tissue adherent to the organ wall. Both cases concerned young women (31 and 36 years old) who were treated with a laparoscopic cholecystectomy due to persistent abdominal symptoms thought to be related to chronic cholecystitis. Pathological examination revealed the presence of ectopic pancreatic tissue type 1.

Case 3.4

2014 ◽  
pp. 140-140
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Chronic Hepatitis ◽  
Venous Pressure ◽  
Gallbladder Wall ◽  
Hepatic Disease ◽  
Chronic Cholecystitis ◽  
Wall Thickening ◽  
Physiologic Mechanism ◽  
Gallbladder Wall Thickening

32-year-old man with chronic hepatitis C and recent elevation of liver enzyme levels Axial SSFSE (Figure 3.4.1) and fat-suppressed SSFP (Figure 3.4.2) images demonstrate marked diffuse thickening of the gallbladder wall. Hepatitis with marked gallbladder wall thickening Gallbladder wall thickening is associated with a large number of pathologic conditions, including cirrhosis, acute and chronic cholecystitis, ascites, hypoalbuminemia, viral hepatitis, chronic renal failure, and heart failure. The physiologic mechanism responsible for diffuse gallbladder thickening in the presence of systemic or diffuse hepatic disease is uncertain but probably is related to elevated portal venous pressure or decreased intravascular osmotic pressure, or both....

Diurnal variation in urine nitrogen and creatinine concentrations from lactating cows grazing ryegrass-dominant pasture in autumn and late spring–summer

2017 ◽  
Vol 57 (7) ◽  
pp. 1297 ◽  
Author(s):  
G. P. Cosgrove ◽  
A. Jonker ◽  
K. A. Lowe ◽  
P. S. Taylor ◽  
D. Pacheco
Keyword(s):  
Diurnal Variation ◽  
Urine Volume ◽  
Late Spring ◽  
Urine Samples ◽  
Creatinine Ratio ◽  
Sample Collection ◽  
N Losses ◽  
Total N ◽  
Once Daily ◽  
N Concentration

In dairy production systems based on grazed pasture, urine patches are the main source of nitrogen (N) losses via leaching and gaseous emission pathways. The volume and N concentration of urine influences the amount of N in a urine patch. We conducted systematic urine sampling to determine the diurnal variation in concentrations of N and creatinine (a proxy for urine volume), and the N : creatinine ratio, to identify the sampling required for accurately estimating the daily mean concentrations of N and creatinine. Nine groups (n = 6) of multiparous Friesian and Friesian × Jersey cows in autumn (220 ± 26 days-in-milk, milked twice daily) and nine groups (n = 6) in late spring–summer (228 ± 24 days-in-milk, milked once daily) were sequentially withdrawn from the farm herd at approximately weekly intervals and each group was offered a fresh allocation of ryegrass-dominant pasture twice daily after milking for 3 days (including at the equivalent time in the afternoon in late spring–summer when they were milked once daily). For each of the 18 different groups of cows, individual urine samples were collected on Day 3 at 1100 hours, 1500 hours (afternoon milking), 1800 hours and 0700 hours (the following morning milking), and, subsequently, analysed for total N and creatinine concentrations. In autumn, urine-N concentrations were higher (P = 0.0002) at 1800 hours (5.8 g N/L) than they were at 1500 hours or 0700 hours (mean of 4.2 g N/L). In late spring–summer, the concentrations were higher (P < 0.001) at 1100 hours (8.0 g N/L) than they were at 1500 hours, 1800 hours or 0700 hours (mean of 6.3 g N/L). The urine N : creatinine ratio was 214 mol/mol in autumn and 148 mol/mol in late spring–summer, but did not vary among sampling times during the day. The highest concentrations of N were in urine samples collected ~3 h post-allocation of fresh feed when cows had grazed actively and consumed the majority of the herbage available. For accurate estimates of the daily mean urine N concentration, sample collections should be timed to encompass this diurnal variation. For the N : creatinine ratio, which was more stable through the day, the timing of sample collection is less important for estimating a daily mean.

scholarly journals On the diagnosis of chronic cholecystitis and the clinical significance of some methods for the study of bile

2021 ◽  
Vol 43 (3) ◽  
pp. 17-19
Author(s):  
A. L. Landa ◽  
A. A. Krylov ◽  
G. A. Trofimov A. Trofimov
Keyword(s):  
Clinical Significance ◽  
Biliary Tract ◽  
Chronic Cholecystitis

The problems of liver and biliary tract pathology occupy a prominent place among the problems attracting special attention of clinicians.

scholarly journals The biliary continuum: an up-to-date look at biliary tract diseases

2021 ◽  
pp. 122-134
Author(s):  
I. V. Maev ◽  
D. S. Bordin ◽  
T. A. Ilchishina ◽  
Yu. A. Kucheryavyy
Keyword(s):  
Biliary Tract ◽  
Gallstone Disease ◽  
Smooth Muscles ◽  
Chemical Properties ◽  
Subsequent Development ◽  
Gastrointestinal Diseases ◽  
Chronic Cholecystitis ◽  
Biliary System ◽  
Clinical Aspects ◽  
Biliary Pain

In  the  structure of  gastrointestinal diseases, the  pathology of  the  hepatobiliary system currently ranks second in  frequency of occurrence. The stages of diseases of the biliary system can be combined into the so-called “biliary continuum”, when one patient has a consistent development of pathogenetically related diseases of the biliary tract. The progressive course of functional motility disorders of the biliary tract gradually leads to the development of organic pathology, including chronic cholecystitis, the subsequent development of gallstone disease and possible postcholecystectomy complications. Among the diseases of the biliary system, one of the most frequently used diagnoses is chronic cholecystitis. The development of chronic cholecystitis is associated with repeated attacks of acute inflammation or prolonged irritation of large gallstones. The clinical aspects of chronic cholecystitis and other pathologies included in the the «biliary continuum» largely depends on concomitant dyskinesia. There are several directions for the treatment of pathologies of the biliary system: diet therapy, medication, endoscopic and surgical treatment. According to the latest guidelines, the most important direction in modern therapy of diseases of the biliary system is the restoration of the motility of the biliary tract and the normalization of the physicochemical properties of bile. The central place in the treatment of diseases of the “biliary continuum” is given to antispasmodic drugs. The administration of antispasmodics is recommended in order to relieve biliary pain and dyspeptic symptoms caused by spasm of smooth muscles, as well as to control the inflammatory process due to a decrease in the release of pro-inflammatory substances. This article describes in detail the importance of the recovery of the biliary tract motor activity and the improvement of the physico-chemical properties of bile acids.

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