scholarly journals Study of histopathological spectrum of gallbladder in cholecystectomy specimens

2019 ◽  
Vol 7 (2) ◽  
pp. 593
Author(s):  
Gomathi Srinivasan ◽  
A. Sagaya Inba Sekar
Keyword(s):  
Acalculous Cholecystitis ◽  
Female Gender ◽  
Chronic Cholecystitis ◽  
Cholesterol Stone ◽  
Patient History ◽  
Pigment Stone ◽  
Medical College ◽  
Predominant Type ◽  
Calculous Cholecystitis ◽  
Number Of Males

Background: Cholecystitis is one of the most common indications for abdominal surgery. Routine examination of gallbladder grossly and microscopically shows lot of interesting findings. This study aims to quantify the various outcomes of routine gallbladder examination following cholecystectomy procedure.Methods: All clinical details and data from case sheet and patient history are collected and analysed for all the patients who underwent cholecystectomy surgery in the Department of General Surgery, Govt. Omandurar Medical College, Chennai, from August 2017 to August 2018. The Study period of this study was from August 2017 to August 2018. Three sections each from neck, body and fundus taken. Tissues were processed in automated tissue processor and paraffin blocks made. Statistical analysis of the data was done.Results: Total number of specimens received were 36. And among the cases the number of females were 33 and the number of males were 3. The number of cases of calculous cholecystitis were 31 and the number of cases with pigment stones were 26, number of cases with cholesterol stone were 2 and the number of cases with mixed stones were 3. The number of cases of acalculous cholecystitis were 5. The number of cases of cholecystectomy by laproscopy were 30 whereas the number of cases of cholecystectomy by open procedure were 6. Chronic cholecystitis was seen in 34 cases and chronic cholecystitis with stones was seen in 29 cases and chronic cholecystitis without stones was seen in 5 cases and Acute on chronic cholecystitis with pigment stone was seen in 1 case and xanthogranulomatous cholecystitis with pigment stone was seen in 1 case.Conclusions: The risk factors for developing chronic cholecystitis was seen in female gender. The predominant histomorphological pattern seen in this study group is chronic calculous cholecystitis. And the predominant type of stone found in this study is pigment stone compared to mixed and cholesterol stone.

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 Histopathologic Features of 1000 Cholecystectomy Specimens

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Mahsa Ahadi ◽  
Tahmineh Mollasharifi ◽  
Behrang Kazeminezhad ◽  
Mitra Abdolahi ◽  
Amir Sadeghi ◽  
...  
Keyword(s):  
Invasive Carcinoma ◽  
Precancerous Lesions ◽  
Cholesterol Stone ◽  
Histopathological Analysis ◽  
Female Ratio ◽  
Gallbladder Diseases ◽  
Predominant Type ◽  
Male Female Ratio ◽  
One Year ◽  
Calculous Cholecystitis

Background: One of the most common gastrointestinal surgeries is cholecystectomy. Gallstones are the major causes of cholecystectomy and induce various histopathologic changes. Gallbladder carcinoma is rare with poor prognosis. Metaplasic changes in gallbladder epithelium are considered precancerous lesions. Objectives: This study aimed at revealing the spectrum of histopathological patterns of gallbladder diseases in cholecystectomy specimens. Methods: A total of 1004 gallbladder H & E stained slides of cholecystectomy specimens over one year were studied. Histopathological evaluation was done by 6 pathologists in terms of variables. Results: In our study, the male: female ratio was 1:2.1. The age of patients varied from 17 to 96 years with a mean age of 49.1 years. The mean age of patients with gallstones was 47.52 years and was more common in women. Cholesterol, pigmented, and mixed stones were reported in 58.36%, 39.03%, and 2.6% of gallstones, respectively. The most common histological morphology was chronic calculous cholecystitis (61.18%). The incidence of metaplasia and invasive carcinoma was 19.55% and 0.2%, respectively. Conclusions: In this study, histopathological analysis of gallbladder diseases in the cholecystectomy specimens revealed that chronic calculous cholecystitis was the most common histologic finding. Gallstones were found more commonly in women and cholesterol stone was the predominant type. Pyloric metaplasia was the most frequent type of metaplasia. The rate of invasive carcinoma is compatible with those reported in the literature. Routine histopathological analysis of the cholecystectomy specimens will help to detect incidental carcinoma and precursors of malignancy.

scholarly journals Prevalence of different types of gallstone in the patients with cholelithiasis at Kathmandu Medical College, Nepal

1970 ◽  
Vol 7 (3) ◽  
pp. 268-271 ◽  
Author(s):  
SB Pradhan ◽  
MR Joshi ◽  
A Vaidya
Keyword(s):  
Gallstone Disease ◽  
Health Care Expenditure ◽  
College Teaching ◽  
Clinical Findings ◽  
Brown Pigment ◽  
Cholesterol Stone ◽  
Pigment Stone ◽  
Medical College ◽  
Female Predominance ◽  
Different Types

Background: Gallstone disease known as cholelithiasis is the most common digestive surgical disorder and account for an important part of health care expenditure. Attempt was made to analyse the gallstone for typing depending upon the composition. Aims & objectives: The main objective of this study was to see the prevalence of different types of gallstone in Nepal and to correlate them with the clinical findings. Materials & methods: Gallstones of 80 different patients who underwent cholecystectomy for cholelithiasis were collected from 20th January 2005 to 16th May 2006 in Department of Pathology, Kathmandu Medical College Teaching Hospital. Detailed history was taken. Stones were analyzed with chemical and enzymatic methods using clinical spectrophotometer. Results & conclusion: The most commonly involved age group for cholelithiasis (32.5%) is found to be 30-39 years with a female predominance (M: F=1:3.2). Cholelithiasis was found more commonly among non-vegetarian with the vegetarian: non-vegetarian ratio 1:9. Mixed type stone was found to be the most common type of stone comprising 78.75%, followed by cholesterol stone 12.5%, Brown pigment stone 7.5% and Black pigment stone 1.25%.Key words: Gallbladder; cholelithiasis; Gallstone DOI: 10.3126/kumj.v7i3.2736 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 268-271

scholarly journals Online Learning in the Face of COVID-19 Pandemic: Assessment of Students’ Satisfaction at Chitwan Medical College of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 40-47
Author(s):  
K. Sharma ◽  
G. Deo ◽  
S. Timalsina ◽  
A. Joshi ◽  
N. Shrestha ◽  
...  
Keyword(s):  
Online Learning ◽  
Student Satisfaction ◽  
Virus Disease ◽  
Female Gender ◽  
Weak Links ◽  
Online Classes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College ◽  
Students Satisfaction

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners’ satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners’ dimensions, technological characteristics, instructors’ characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students’ overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners’ dimension score [aOR: 1.27, p<0.001] were the significant predictors of students’ satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students’ satisfaction and better outcomes.

Acute Acalculous Cholecystitis after Gastrointestinal Surgery

2012 ◽  
Vol 78 (2) ◽  
pp. 220-224 ◽  
Author(s):  
Lya Crichlow ◽  
Sarah Walcott-Sapp ◽  
Joshua Major ◽  
Bernard Jaffe ◽  
Charles F. Bellows
Keyword(s):  
Postoperative Period ◽  
Medical Center ◽  
English Literature ◽  
Gastrointestinal Surgery ◽  
Acalculous Cholecystitis ◽  
Acute Acalculous Cholecystitis ◽  
Left Hemicolectomy ◽  
High Level ◽  
Calculous Cholecystitis ◽  
Colorectal Procedures

Acute acalculous cholecystitis has been identified as a rare but potentially devastating entity after trauma, and burns, as well as in critically ill patients, and in the postoperative period. Gastrointestinal surgery is most frequently implicated in postoperative acute acalculous cholecystitis, especially after gastric and colorectal procedures. Review of the English literature identified 28 articles reporting 76 cases of acute acalculous cholecystitis after gastrointestinal operations, which included a case from Tulane University Medical Center of a 64-year-old man who developed postoperative acute acalculous cholecystitis after elective left hemicolectomy. A total of 52.4 per cent of the patients developed gangrenous acute acalculous cholecystitis, with a mortality rate of 21.1 per cent, much higher than that reported in postoperative calculous cholecystitis. This emphasizes the need for a high level of suspicion and early detection in the postoperative period to avoid devastating consequences.

scholarly journals Clinical Relationship between Steatocholecystitis and Gallbladder Contractility Measured by Cholescintigraphy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Chang Seok Bang ◽  
Yong Sub Lee ◽  
Jai Hoon Yoon ◽  
Youn Jeong Kim ◽  
Jin Bong Kim ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Teaching Hospital ◽  
Multivariable Analysis ◽  
Acalculous Cholecystitis ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Gallbladder Stone ◽  
Gallbladder Contractility ◽  
Clinical Relationship ◽  
Calculous Cholecystitis

Objective.Contractility of gallbladder is known to be decreased in fatty gallbladder diseases. However, clinical estimation data about this relationship is still lacking. The aim of this study was to investigate the association between steatocholecystitis and contractility of gallbladder.Methods.Patients with cholecystitis (steatocholecystitis versus nonsteatocholecystitis) who underwent cholescintigraphy before cholecystectomy were retrospectively evaluated in a single teaching hospital of Korea. The association of steatocholecystitis with contractility of gallbladder, measured by preoperative cholescintigraphy, was assessed by univariable and multivariable analysis.Results.A total of 432 patients were finally enrolled (steatocholecystitis versus nonsteatocholecystitis; 75 versus 357, calculous versus acalculous cholecystitis; 316 versus 116). In the multivariable analysis, age (OR: 0.94, 95% CI: 0.90–0.99,P=0.01) and total serum cholesterol (OR: 1.02, 95% CI: 1.01–1.04,P=0.04) were related to steatocholecystitis in patients with acalculous cholecystitis. Only age (OR: 0.97, 95% CI: 0.94–0.99,P=0.004) was significantly related to steatocholecystitis in patients with calculous cholecystitis. However, ejection fraction of gallbladder reflecting contractility measured by cholescintigraphy was not related to steatocholecystitis irrespective of presence of gallbladder stone in patients with cholecystitis.Conclusion.Ejection fraction of gallbladder measured by cholescintigraphy cannot be used for the detection or confirmation of steatocholecystitis.

PIXE ANALYSIS OF GALLSTONES

2005 ◽  
Vol 15 (03n04) ◽  
pp. 147-152 ◽  
Author(s):  
T. R. RAUTRAY ◽  
V. VIJAYAN ◽  
M. ASHOK ◽  
J. V. KENNEDY ◽  
V. JAYANTHI ◽  
...  
Keyword(s):  
Trace Elements ◽  
Minor Element ◽  
Southern Region ◽  
Cholesterol Stone ◽  
Eastern Region ◽  
Accelerator Facility ◽  
Pixe Analysis ◽  
Pigment Stone ◽  
Human Gallstone ◽  
A Minor

Particle Induced X-ray Emission (PIXE) technique has been used to determine the trace elements present in fourteen representative human gallstone samples collected from eastern region (Orissa) and thirteen representative samples collected from southern region (Chennai) of India. PIXE irradiation of the samples has been carried out by using the 3 MV tandem type horizontal pelletron accelerator facility at Institute of Physics, Bhubaneswar with proton beam of energy 3 MeV. In the present investigation, twenty one trace elements like S , Cl , K , Ca , Ti , V , Cr , Mn , Fe , Ni , Cu , Zn , As , Se , Br , Rb , Sr , Y , Zr , Mo and Pb have been estimated in all the three types of gallstones viz. cholesterol stone, mixed stone and pigment stone. While sulphur in cholesterol stones in the eastern region was less than that of the southern region, sulphur was present as a minor element in the pigment stones of both the regions. Less concentration of copper in the gallstones from eastern region is another interesting observation. The lower values of copper in the patients of eastern region may be due to different types of food habits. The concentrations of all the elements in the southern region pigment stones have higher values than that of the eastern region. Moreover, the concentrations of Fe and Mo in cholesterol stone and pigment stone samples in southern region have also higher values than in eastern region. The current PIXE study is of its first kind in this eastern region of India.

scholarly journals A Pattern of Age-related Macular Degeneration

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Suprada Pokhrel ◽  
O K Malla ◽  
C L Pradhananga ◽  
S N Joshi
Keyword(s):  
Macular Degeneration ◽  
College Teaching ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Increased Risk ◽  
Number Of Individuals

Introduction: Age related macular degeneration is a disorder of the macula most often clinicallyapparent affecting central vision and is one of the leading causes of blindness in the populationabove 50 years. The aim of this study is to determine clinical profi le of AMD in Nepalese presentingto a Teaching Hospital in Kathmandu.Methods: It was a hospital-based cross-sectional study. The subjects included in the study were thosepresenting to the Ophthalmology department of Kathmandu Medical College Teaching Hospitalfrom July 2007- Dec 2007.The total number of individuals included in the study were 402 and totalnumber of eyes were 804.Results: AMD was observed in 5.2% out of 402 subjects of 40 years and above age group withprevalence increasing with age. The prevalence of AMD was 0.7% within 40-50 years of age-groupindividuals increasing to 2.6% in 51-60 years, 6.5% in 61-70 years and to 19.3% among subjectsabove 71 years. This study revealed that the prevalence of AMD in females was higher with femalepreponderance in ratio of 2.5:1. 52.5 % AMD subjects in our study had visual impairment with 6/24-6/60 vision and 15% had vision <3/60-PL. Our study revealed statistically signifi cant increased riskfor AMD with aging (p=0.00). Increased risk was observed in female gender and diabetics though theOdds ratio (OR) was statistically insignifi cant (p=>0.01).Conclusions: Prevalence of AMD in Nepalese presenting to Kathmandu Medical College TeachingHospital was 5% with female preponderance in ratio of 2.5:1. Aging showed statistically signifi cantincreased risk for AMD development in this study.Key Words: Age-related macular degeneration, blindness, Nepalese, prevalence

scholarly journals Prevalence of subclinical hypothyroidism in metabolic syndrome: our experience from Karnataka

2021 ◽  
Author(s):  
Praveen R. Badri ◽  
Tanveer Ahmed ◽  
Anant Arunrao Takalkar
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
General Medicine ◽  
Female Gender ◽  
Iodine Intake ◽  
Overt Hypothyroidism ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
And Gender

Background: Metabolic syndrome is a collection of factors which can increase the risk of heart disease, stroke and diabetes. Subclinical hypothyroidism is a state of mild thyroid failure. There are few factors which increase the risk for developing subclinical hypothyroidism such as female gender, advanced age and greater dietary iodine intake. Subclinical hypothyroidism as it is more common than overt hypothyroidism. Objectives were to study prevalence of subclinical hypothyroidism in patients of metabolic syndrome and its association with demographic and clinical parameters.Methods: This cross-sectional observational study was conducted on patients attending General Medicine OPD and in-patients admitted at Navodaya Medical College and Hospital, Raichur including 103 cases of metabolic syndrome. The data was analyzed using statistical package for the social sciences (SPSS) 24.0 version.Results: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 9 (29%) and majority were females i.e., 17 (54.8%). We did not find any association between Subclinical hypothyroidism and gender (p>0.05). Prevalence of overweight in our study among SCH was 35.5% compared to 18.1% of normal patients. Elevated levels of TG were observed in 64 i.e., 62.1%, elevated TC 23.3%, elevated levels of LDL in 30.1% patients.Conclusions: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 29% and majority were females i.e., 17 (54.8%). We did not find any association between subclinical hypothyroidism and body mass index (BMI) in our study.

Comparing clinical outcomes of image-guided percutaneous transperitoneal and transhepatic cholecystostomy for acute cholecystitis

2020 ◽  
pp. 028418512095982
Author(s):  
Joseph R Kallini ◽  
Deven C Patel ◽  
Nikhil Linaval ◽  
Edward H Phillips ◽  
Richard J Van Allan
Keyword(s):  
Clinical Outcomes ◽  
Multivariable Analysis ◽  
Bile Leak ◽  
Acalculous Cholecystitis ◽  
Catheter Placement ◽  
Percutaneous Cholecystostomy ◽  
Post Procedure ◽  
The Mean ◽  
Calculous Cholecystitis ◽  
Mean Time

Background Percutaneous cholecystostomy is performed by interventional radiologists for patients with calculous/acalculous cholecystitis who are poor candidates for cholecystectomy. Two anatomical approaches are widely utilized: transperitoneal and transhepatic. Purpose To compare the clinical outcomes of transperitoneal and transhepatic approaches to cholecystostomy catheter placement. Material and Methods From December 2007 to August 2015, 165 consecutive patients (97 men, 68 women) underwent either transperitoneal (n = 89) or transhepatic (n = 76) cholecystostomy at a single center. Indications were calculous cholecystitis (n = 21), acalculous cholecystitis (n = 35), hydrops (n = 1), gangrenous cholecystitis (n = 1), and other cholecystitis (n = 107). The most common high-risk co-morbidities were sepsis (n = 53) and cardiac (n = 11). Outcomes were compared using univariate and multivariable analysis. Results Post-procedure outcomes included tube dislodgement (transperitoneal [n = 6] and transhepatic [n = 3], P = 0.44), bile leak (transperitoneal [n = 5], transhepatic [n = 1], P = 0.14), gallbladder hemorrhage (transperitoneal [n = 2]; transhepatic [n = 3], P = 0.52), duodenal fistula (transperitoneal [n = 0], transhepatic [n = 1], P = 0.27), repeat cholecystostomy (transperitoneal [n = 1], transhepatic [n = 3], P = 0.27), and repeat cholecystitis requiring separate admission (transperitoneal [n = 6], transhepatic [n = 10], P = 0.15). All complications were Common Terminology Criteria for Adverse Events grade <3. Twenty transperitoneal patients underwent post-procedure cholecystectomy: 13 laparoscopic, three open, and four unclear/outside records. The mean time from cholecystostomy to operation was 38 days (range 3–211 days). Twenty-three transhepatic patients underwent cholecystectomy: 14 laparoscopic, eight open, and one unclear/outside records, with the mean time from cholecystostomy being 98 days (range 0–1053 days). One transhepatic and three transperitoneal patients died during admission. Conclusion There were no significant differences in short-term complications after transperitoneal and transhepatic approaches to percutaneous cholecystostomy catheter placement.

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