scholarly journals PTU-28 Factors associated with spontaneous passage of radiologically confirmed CBD stones through a virgin duodenal papilla

2021 ◽  
Author(s):  
Mohammed Gariballa ◽  
Hussam Ahmed ◽  
Rachael Wilkinson-Hall ◽  
Amer Al-Joudeh
Keyword(s):  
Duodenal Papilla ◽  
Factors Associated ◽  
Cbd Stones ◽  
Spontaneous Passage

scholarly journals Spontaneous Passage of Gallbladder Calculi-Facilitation by Endoscopic Sphincterotomy

HPB Surgery ◽  
1998 ◽  
Vol 11 (1) ◽  
pp. 23-26 ◽  
Author(s):  
B. C. Sharma ◽  
D. K. Agarwal ◽  
S. S. Baijal ◽  
V. A. Saraswat
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Cystic Duct ◽  
Endoscopic Sphincterotomy ◽  
Gallbladder Motility ◽  
Study Group ◽  
Cbd Stones ◽  
Narrow Angle ◽  
Spontaneous Passage ◽  
Age And Sex

After Endoscopic sphincterotopy (ES) gallbladder motility increases leading to expulsion of crystals and stones. But this is not a universal phenomenon. We evaluated cholangiographic findings in patients emptying their gallbladder after ES for common bile duct (CBD) stones. Cholangiographic features of twenty patients expelling gallbladder calculi after ES were studied. Controls included 20 age and sex matched patients with gallstones and CBD stones, who did not expel gallstones after ES. Of 20 cases in study group, 9 recovered more than 20 stones each in the stool within 7 days of ES. Repeat ERCP showed empty gallbladder in all, whereas CBD was full of stones in 11 of the 20 cases. In the study group, low insertion of the cystic duct was more common (10 vs 0, p<0.04), the cystic duct made a narrow angle (20±5° vs 50±10°, p<0.04) with CBD before insertion and cystic duct diameter was higher (5 mm vs 2.5 mm, p<0.04) as compared to controls. We conclude that in patients undergoing ES with intact gallbladder and small gallbladder calculi, spontaneous emptying of gallbladder calculi occurs, if cystic duct is wider, has low insertion and makes narrow angle with CBD before insertion.

Predictive factors associated with spontaneous passage of coins: A ten-year analysis of paediatric coin ingestion in Australia

2018 ◽  
Vol 113 ◽  
pp. 266-271 ◽  
Author(s):  
Narinder Singh ◽  
Jessica Chong ◽  
Joyce Ho ◽  
Shruti Jayachandra ◽  
Daron Cope ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Factors Associated ◽  
Spontaneous Passage

scholarly journals Factors related to the spontaneous passage of common bile duct stones through the papilla: a single-center retrospective cohort study

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110583
Author(s):  
Songming Ding ◽  
Shanjie Dong ◽  
Hengkai Zhu ◽  
Weilin Wu ◽  
Yiting Hu ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Clinical Laboratory ◽  
Demographic Data ◽  
Gamma Glutamyl Transpeptidase ◽  
Stone Size ◽  
Cbd Stones ◽  
Spontaneous Passage ◽  
Group A ◽  
Group B

Objective Common bile duct (CBD) stones can spontaneously pass through the papilla. This study explored factors associated with stone passage by comparing differences in the clinical features of stones retained in the CBD and excreted stones. Methods Data were retrospectively collected for all patients who were hospitalized in our center between March 2016 and May 2021 with clinical, laboratory, or imaging evidence of CBD stones. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP) and were classified into two groups: group A (stones extracted by ERCP, n = 86) and group B (stones discharged before ERCP, n = 15). Demographic data, biochemical and radiological findings were compared between the groups. Results Stone size (0.82 vs. 0.33 cm), and levels of total bilirubin (58.2 vs. 28.8 μmol/L), gamma-glutamyl transpeptidase (416.7 vs. 193.9 U/L), alkaline phosphatase (191.9 vs. 123.1 U/L), carbohydrate antigen 19-9 (603.7 vs. 37.2 U/mL), and α-L-fucosidase (37.4 vs. 22.6 U/L) were significantly higher in group A than in group B. Logistic regression analyses showed that stone size was the only factor significantly associated with spontaneous passage of CBD stones. Conclusions CBD stones less than 0.33 cm in size may be self-expelled through the papilla.

Factors associated with complete clearance of difficult common bile duct stones after temporary biliary stenting followed by a second ERCP: a multicenter, retrospective, cohort study

Endoscopy ◽  
2020 ◽  
Vol 52 (06) ◽  
pp. 462-468
Author(s):  
Dong Kee Jang ◽  
Sang Hyub Lee ◽  
Dong Won Ahn ◽  
Woo Hyun Paik ◽  
Jae Min Lee ◽  
...  
Keyword(s):  
Bile Duct ◽  
Clearance Rate ◽  
Plastic Stents ◽  
Biliary Stenting ◽  
Stone Size ◽  
Stone Clearance ◽  
Complete Clearance ◽  
Factors Associated ◽  
Cbd Stones ◽  
Male Patients

Abstract Background Although temporary endoscopic biliary stenting is considered effective for difficult common bile duct (CBD) stones, few studies have investigated the optimal conditions for complete stone clearance at the second endoscopic retrograde cholangiopancreatography (ERCP) after temporary biliary stenting. We aimed to evaluate factors associated with complete clearance. Methods Patients with difficult CBD stones (a large [≥ 20 mm] or multiple [≥ 3 sized ≥ 15 mm] CBD stones) were retrospectively enrolled from three institutions. Patients who underwent temporary biliary stenting at the first ERCP were analyzed. Double-pigtail plastic stents (7 or 10 Fr) were placed with the proximal ends above the stones. Complete clearance rate and stone size reduction at the second ERCP, and factors associated with complete clearance were evaluated using univariate and multivariate analyses. Results 85 patients were enrolled (mean age 74.5 years [SD 11.3]; 47 women). Stone size and CBD diameter significantly decreased during the interval. The overall complete stone clearance rate was 64.7 % (55/85) at the second ERCP. The mean stone size reduction was 5.6 mm (SD 6.8). In multivariate analysis, complete clearance rate was significantly lower in male patients, in patients aged > 80 years, and in stones > 25 mm initially, but was significantly higher when 7-Fr stents were placed and stone size was reduced by > 5 mm. Conclusion Use of 7-Fr rather than 10-Fr plastic stents was beneficial for complete clearance of difficult CBD stones after temporary biliary stenting; older male patients as well as patients with initial stones > 25 mm had a lower clearance rate.

scholarly journals Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Tawfik Khoury ◽  
Mohamed Adileh ◽  
Ashraf Imam ◽  
Yosef Azraq ◽  
Avital Bilitzky-Kopit ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Gamma Glutamyl Transferase ◽  
Cbd Stones ◽  
Spontaneous Passage ◽  
Group A ◽  
Group B ◽  
Glutamyl Transferase

Background. Common bile duct (CBD) stones are common. However, they are known to pass spontaneously, which obviates the need for ERCP. Aim. The aim of this study is to identify specific predictors for spontaneous passage of CBD stones. Methods. Data was retrospectively collected for all patients who were hospitalized with clinical, laboratory, or ultrasonographic evidence of choledocholithiasis and who underwent magnetic resonance cholangiopancreatography (MRCP) in Hadassah Medical Center between 2005 and 2011. The patients were classified into 4 groups: group A (positive MRCP and positive ERCP), group B (positive MRCP but negative ERCP), group C (positive MRCP but did not undergo ERCP), and group D (negative MRCP that did not undergo ERCP) for choledocholithiasis. All positive MRCP-groups (A+B+C) were further grouped together into group E. We compared groups A versus B and groups E versus D. Results. Comparing groups A versus B, only gamma-glutamyl transferase predicted spontaneous passage of stones from CBD, as the level was significantly higher in group A (677±12.1) versus group B (362.4±216.2) (P=0.023). Patients with small stone diameter (P=0.001), distal stones (P=0.05), and absence of intrahepatic dilatation (P=0.047) tend to pass their stones spontaneously. Comparing groups D versus E, it was found that male gender (P=0.03), older age (P<0.001), high levels of GGT (P=0.022), high levels of alkaline phosphatase (P=0.011), high levels of total bilirubin (P=0.007), and lower levels of amylase (P<0.001) are predictors for positive MRCP studies for CBD stones. Conclusion. Identification of specific predictors is important to avoid unnecessary invasive endoscopic intervention.

Stain contamination and embedding in electron microscopy

1986 ◽  
Vol 44 ◽  
pp. 50-53
Author(s):  
Hilton H. Mollenhauer
Keyword(s):  
Electron Microscopy ◽  
Information Retrieval ◽  
Epoxy Resins ◽  
Image Contrast ◽  
Sample Preservation ◽  
Factors Associated ◽  
Amount Of Information ◽  
Electron Microscopical ◽  
Contrast Information

Many factors (e.g., resolution of microscope, type of tissue, and preparation of sample) affect electron microscopical images and alter the amount of information that can be retrieved from a specimen. Of interest in this report are those factors associated with the evaluation of epoxy embedded tissues. In this context, informational retrieval is dependant, in part, on the ability to “see” sample detail (e.g., contrast) and, in part, on tue quality of sample preservation. Two aspects of this problem will be discussed: 1) epoxy resins and their effect on image contrast, information retrieval, and sample preservation; and 2) the interaction between some stains commonly used for enhancing contrast and information retrieval.

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