scholarly journals Acute Cholecystitis and Cholelithiasis Developed after Esophagectomy

2003 ◽  
Vol 17 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Mitsuo Tachibana ◽  
Shoichi Kinugasa ◽  
Hiroshi Yoshimura ◽  
Dipok Kumar Dhar ◽  
Shuhei Ueda ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Gallbladder Disease ◽  
Gallstone Disease ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Abdominal Ultrasonography ◽  
Gallbladder Polyps ◽  
Number Of Patients ◽  
History Of

BACKGROUND: Although the prevalence of gallstone disease after gastrectomy is reported to be high, its prevalence after esophagectomy is scarcely reported.MATERIALS AND METHODS: Gallbladder disease following an esophagectomy was prospectively evaluated in 237 patients with esophageal cancer by abdominal ultrasonography twice a year up to five years postoperatively. The median follow-up period was 18.6 months.RESULTS: One patient (0.4%) developed acute acalculous cholecystitis postoperatively, and 13 patients (5.5%) developed gallstone disease during the follow-up period. Nine (69%) of these 13 patients developed gallstone disease within two years, and another two patients developed the disease three years after esophagectomy. Another patient developed gallbladder debris at 35 months postoperatively, and one developed gallbladder polyps at 33 months. Seven of the 13 patients with gallstone disease underwent cholecystectomy between 13 and 125 months after esophagectomy: two developed acute cholecystitis; two had associated common bile duct stones; the remaining three patients had upper abdominal pain. Nine of the 13 patients who developed gallstone disease showed a history of alcoholism, whereas only 81 of 224 patients without gallstone disease had a similar history (P<0.05).CONCLUSION: A certain number of patients with esophageal carcinoma and a history of alcoholism develop cholelithiasis within three years after esophagectomy, and subsequently undergo cholecystectomy during the follow-up period.

scholarly journals Two Cases of Acute Cholecystitis and Symptomatic Choledocholithiasis in Two Women Less than 40-Years-of-Age with Hormonal Intrauterine Devices

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Helen M. Shields ◽  
Hasrat Sidhu
Keyword(s):  
Family History ◽  
Acute Cholecystitis ◽  
Gallbladder Disease ◽  
Gallstone Disease ◽  
Positive Family History ◽  
Controlled Study ◽  
Women Patients ◽  
Intrauterine Devices ◽  
History Of ◽  
Clinical Risks

Levonorgestrel uterine implants are accepted as a safe and efficacious method of contraception. One of the two major health side effects in a large controlled study of subcutaneous hormonal implants with levonorgestrel was a significant increase in gallbladder disease. Gallbladder hypomotility is recognized as a side effect of the levonorgestrel (progesterone). We recently saw on a Gastroenterology Consult Service, two women under 40-years-of-age who had been transferred from outside hospitals with acute cholecystitis with symptomatic choledocholithiasis. Both required Endoscopic Retrograde Cholangiopancreatography and sphincterotomies in addition to laparoscopic cholecystectomies. Both had hormonal (levonorgestrel-releasing) intrauterine devices in place for contraception. Although one patient had a family history of gallstones, the other did not. Both were nonobese, young women patients. We were struck by the coincidence of seeing two such patients. Few articles in the medical literature detail the clinical risks of gallstone disease in patients with hormonal (levonorgestrel-releasing) intrauterine devices. Our experiences with these two patients led us to believe that patients with risk factors for gallstone disease, such as a positive family history, ethnic predisposition, or obesity, should be warned of possible problems, not only with gallbladder disease, but also of common duct stones.

scholarly journals Factors Influencing Failure to Undergo Interval Cholecystectomy After Percutaneous Cholecystostomy Among Patients With Acute Cholecystitis: a Retrospective Study

2021 ◽  
Author(s):  
Yao Peng ◽  
Zhihui Chang ◽  
Zhaoyu Liu
Keyword(s):  
Acute Cholecystitis ◽  
Acalculous Cholecystitis ◽  
Albumin Level ◽  
Percutaneous Cholecystostomy ◽  
Factors Influencing ◽  
Effective Treatment Modality ◽  
Risk Patients ◽  
History Of ◽  
Grade Iii

Abstract Background: Percutaneous cholecystostomy (PC) with interval cholecystectomy is an effective treatment modality in high-risk patients with acute cholecystitis. However, some patients still fail to undergo interval cholecystectomy after PC, with the reasons rarely reported. Hence, this study aimed to explore the factors that prevent a patient from undergoing interval cholecystectomy.Methods: Data from patients with acute cholecystitis who had undergone PC from January 1, 2017, to December 31, 2019, in our hospital were retrospectively collected. The follow-up endpoint was the patient undergoing cholecystectomy. Patients who failed to undergo cholecystectomy were followed up every three months until death. Univariate and multivariate analyses were performed to analyze the factors influencing failure to undergo interval cholecystectomy. A nomogram was used to predict the numerical probability of non-interval cholecystectomy.Results: In total, 205 participants were identified, and 67 (32.7%) patients did not undergo cholecystectomy during the follow-up period. Multivariate analysis revealed that Tokyo guidelines 2018 (TG18) grade III status (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.27–11.49; p=0.017), acalculous cholecystitis (OR: 4.55; 95% CI: 1.59–12.50; p=0.005), albumin level <28 g/L (OR: 4.15; 95% CI: 1.09–15.81; p=0.037), and history of malignancy (OR: 4.65; 95% CI: 1.62–13.37; p=0.004) were independent risk factors for a patient’s failure to undergo interval cholecystectomy. Among them, history of malignancy showed the highest predictor point on the nomogram for predicting non-interval cholecystectomy.Conclusions: TG18 grade III status, acalculous cholecystitis, severe hypoproteinemia, and history of malignancy are the factors influencing failure to undergo cholecystectomy after PC in patients with acute cholecystitis.

scholarly journals Natural history of acalculous biliary symptoms

2013 ◽  
Vol 95 (7) ◽  
pp. 511-514 ◽  
Author(s):  
AM Warwick ◽  
F Bintcliffe ◽  
E Wu ◽  
D Stell
Keyword(s):  
Natural History ◽  
Gallbladder Disease ◽  
Biliary Disease ◽  
Biliary Pain ◽  
Abdominal Ultrasonography ◽  
Small Minority ◽  
Radiological Criteria ◽  
Biliary Pathology ◽  
History Of

Introduction The radiological criteria for the diagnosis of gallbladder disease rely largely on the detection of calculi using ultrasonography. Patients may, however, suffer symptoms typical of biliary pain without detectable gallstones. The aim of this study was to identify a cohort of patients presenting with recurrent episodes of biliary symptoms in the absence of identifiable pathology on ultrasonography and to record the outcome of subsequent imaging investigations. Methods Records of patients having abdominal ultrasonography during a four-month period in 2006 were accessed retrospectively and those with symptoms suggesting biliary disease were identified. Radiology records were reviewed over a five-year follow-up period to identify patients undergoing further imaging for recurrent biliary symptoms and outcomes were recorded. Results A total of 512 patients had ultrasonography for investigation of symptoms consistent with biliary disease. Almost half (41.2%) of these were found to have gallbladder pathology on ultrasonography and 4.7% of patients went on to have further investigations for similar symptoms without achieving a diagnosis. The median age of this group was 47 years and 75% of these patients were female. During the follow-up period, 2.6% of patients with biliary symptoms and initially normal ultrasonography developed gallstones and in 1.3% pancreatitis was demonstrated on imaging. Conclusions A small minority of patients who present with biliary symptoms and have no abnormality on ultrasonography present with recurrent symptoms or develop significant biliary pathology. These patients should be identified by interview at routine follow-up visits and further investigations should be considered.

scholarly journals Factors influencing failure to undergo interval cholecystectomy after percutaneous cholecystostomy among patients with acute cholecystitis: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Yao ◽  
Zhihui Chang ◽  
Zhaoyu Liu
Keyword(s):  
Acute Cholecystitis ◽  
Acalculous Cholecystitis ◽  
Albumin Level ◽  
Percutaneous Cholecystostomy ◽  
Factors Influencing ◽  
Effective Treatment Modality ◽  
Risk Patients ◽  
History Of ◽  
Grade Iii

Abstract Background Percutaneous cholecystostomy (PC) with interval cholecystectomy is an effective treatment modality in high-risk patients with acute cholecystitis. However, some patients still fail to undergo interval cholecystectomy after PC, with the reasons rarely reported. Hence, this study aimed to explore the factors that prevent a patient from undergoing interval cholecystectomy. Methods Data from patients with acute cholecystitis who had undergone PC from January 1, 2017 to December 31, 2019 in our hospital were retrospectively collected. The follow-up endpoint was the patient undergoing cholecystectomy. Patients who failed to undergo cholecystectomy were followed up every three months until death. Univariate and multivariate analyses were performed to analyze the factors influencing failure to undergo interval cholecystectomy. A nomogram was used to predict the numerical probability of non-interval cholecystectomy. Results Overall, 205 participants were identified, and 67 (32.7%) did not undergo cholecystectomy during the follow-up period. Multivariate analysis revealed that having a Tokyo Guidelines 2018 (TG18) grade III status (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.27–11.49; p = 0.017), acalculous cholecystitis (OR: 4.55; 95% CI: 1.59–12.50; p = 0.005), an albumin level < 28 g/L (OR: 4.15; 95% CI: 1.09–15.81; p = 0.037), and a history of malignancy (OR: 4.65; 95% CI: 1.62–13.37; p = 0.004) were independent risk factors for a patient’s failure to undergo interval cholecystectomy. Among them, the presence of a history of malignancy exhibited the highest influence in the nomogram for predicting non-interval cholecystectomy. Conclusions Having a TG18 grade III status, acalculous cholecystitis, severe hypoproteinemia, and a history of malignancy influence the failure to undergo cholecystectomy after PC in patients with acute cholecystitis.

scholarly journals Conservative Management of Gallstone Disease in the Elderly Population: Outcomes and Recurrence

2019 ◽  
Vol 109 (3) ◽  
pp. 205-210
Author(s):  
I Mora-Guzmán ◽  
M Di Martino ◽  
AC Bonito ◽  
VV Jodra ◽  
SG Hernández ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Survival Curve ◽  
Gallbladder Disease ◽  
Gallstone Disease ◽  
Operative Management ◽  
Index Admission ◽  
Consecutive Series ◽  
Early Cholecystectomy ◽  
Non Operative Management

Background & Aims: The prevalence of gallstone disease increases with age, being early cholecystectomy the most accepted treatment in the vast majority of patients in order to prevent complications and recurrence. The aim of this study is to determine the recurrence rate and its possible predictors after initial non-operative management. Materials and Methods: We reviewed a consecutive series of patients, older than 65 years, admitted for a gallstone-related disease and treated with a non-operative management between January 2010 and December 2013. We analyzed comorbidities, clinical data, diagnosis, management, recurrence, and its treatment. Median follow-up after the discharge was 2 years. Recurrence was analyzed by a Kaplan–Meier survival curve. Possible recurrence’s predictors were analyzed. Results: The study included 226 patients. Mean age was 80.4 ± 7.2 years, 127 (56%) were female. The main causes of index hospitalization were acute cholecystitis (58%) and biliary pancreatitis (18.1%). After 2 years of follow-up, the recurrence rate was 39.8%; mean time to recurrence was 255.2 ± 42.1 days, 81% of patients recurred within 1 year. Bile duct disease implied a higher recurrence rate than the gallbladder disease group (52% vs 33%, p < 0.001). Subjects with two or more diagnoses during index admission presented higher recurrence rate (32% vs 49%, p < 0.001). Conclusion: More than a third of elderly patients could present a recurrence within 2 years after initial non-operative management. Early cholecystectomy should be considered at index admission in order to prevent recurrence.

Percutaneous Cholecystectomy in the Intensive Care Patient

1998 ◽  
Vol 13 (2) ◽  
pp. 78-84
Author(s):  
John P. Mcgahan
Keyword(s):  
Intensive Care ◽  
Acute Cholecystitis ◽  
Intensive Care Patient ◽  
Acalculous Cholecystitis ◽  
Care Patient ◽  
Definitive Treatment ◽  
Acute Acalculous Cholecystitis ◽  
Percutaneous Cholecystostomy ◽  
Diagnostic Dilemma ◽  
Definitive Therapy

The diagnosis of acute cholecystitis in the intensive care patient is often problematic. While most patients with acute cholecystitis present with fever, increased white count, or symptomatology pertaining to the gallbladder, occasionally these patients may be comatose and often present a diagnostic dilemma. Surgical cholecystectomy is the treatment of choice for acute cholecystitis, but this therapy carries with it a high mortality rate in the desperately ill patient. Thus surgical cholecystostomy has been advocated as a temporizing procedure to be performed until these patients stabilize. More recently percutaneous cholecystostomy, performed at the patient's bedside under ultrasound guidance, has been successfully performed using small-size catheters. This is a low-risk temporizing procedure when performed by well-trained personnel. In fact, percutaneous cholecystostomy has been shown to be a definitive treatment in patients with acute acalculous cholecystitis. Patients with calculous cholecystitis may require more definitive therapy, such as cholecystectomy. Presented is a review of the development and the current applications of percutaneous cholecystostomy in intensive care patients with suspected acute cholecystitis.

scholarly journals Acalculous Acute Cholecystitis in Previously Healthy Children: General Overview and Analysis of Pediatric Infectious Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Dimitri Poddighe ◽  
Matteo Tresoldi ◽  
Amelia Licari ◽  
Gian Luigi Marseglia
Keyword(s):  
Infectious Diseases ◽  
Acute Cholecystitis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pediatric Population ◽  
Acalculous Cholecystitis ◽  
Clinical Aspects ◽  
Acute Acalculous Cholecystitis ◽  
Healthy Children ◽  
General Overview

Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder, which does not appear to be associated with the presence of gallstones. AAC is estimated to represent more than 50% of cases of acute cholecystitis in the pediatric population. Although this pathology was initially described in critically ill patients, actually most pediatric cases have been observed during several infectious diseases. Particularly, here we reviewed pediatric infectious acute acalculous cholecystitis and analyzed the pathophysiological and clinical aspects of bacterial and viral forms.

scholarly journals Acute acalculous cholecystitis on a COVID-19 patient: a case report

2020 ◽  
Author(s):  
Edoardo Mattone ◽  
Maria Sofia ◽  
Elena Schembari ◽  
Valentina Palumbo ◽  
Rosario Bonaccorso ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gastrointestinal Symptoms ◽  
Acalculous Cholecystitis ◽  
Gallbladder Wall ◽  
Acute Acalculous Cholecystitis ◽  
Surgical Risk ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Vascular Insufficiency ◽  
High Surgical Risk

Abstract Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

scholarly journals Evaluation of General, Pathological, and Radiological Features of Male Breast Cancer

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Fariba Zarei ◽  
Fereshte Bagheri ◽  
Amin Dehdashtian ◽  
Majid Akrami
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Male Breast Cancer ◽  
Medical Records ◽  
Male Breast ◽  
Treatment Modalities ◽  
Time Interval ◽  
Number Of Patients ◽  
History Of

Background: Male breast cancer (MBC) is an infrequent disease and a scarcely researched topic. Since the incidence of male breast cancer is increasing and so far, management advices have been concluded from results of trials in female patients, there has been a growing interest in this field of research. Objectives: In this study, we aimed to evaluate the general, radiological and pathological features of MBC patients. Patients and Methods: We retrospectively reviewed the medical records of MBC patients who had been referred to breast clinic, Shahid Motahari in Shiraz, Iran, between 2005 and 2018. Data regarding general characteristics of patients such as demographic information, age, and also past history of any cancer, family history of breast cancer, mammogram and ultrasound findings, stage, size and location of tumor, histopathology of tumor, metastasis, treatment modalities and follow-up time were attained by reviewing medical records. Results: Fifty-one patients with MBC were included with the mean age of 58.4 years. Invasive ductal carcinoma was the most prevalent pathologic type. By use of the Kaplan Meier survival estimate, survival probability of patients for each time interval after diagnosis was calculated. There was a decline over time until about 85 months after diagnosis when it reached a plateau state above 50%. Age, human epidermal growth factor receptor 2 (HER2) and metastasis showed to lower the survival time by increasing the hazard ratio. Only 13 patients had mammography and 22 had an ultrasound, which are less than 50% of the total number of patients. Conclusions: This study showed that there is still unfulfilled need to evaluate MBC in order to find the best management guidelines such as screening in high risk populations, diagnosis, treatment, and follow-up. Risk factor evaluation, survival time, and diagnostic radiologic modalities have not been well assessed in MBC so far.

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