scholarly journals Incidental Gallbladder Cancer with the Laparoscopic Treatment in the MRI Era: An Experience at a Single Institution

2021 ◽  
Author(s):  
yong zhou ◽  
Wenzhang Zha ◽  
Xudong Wu ◽  
Rengen Fan
Keyword(s):  
Gallbladder Cancer ◽  
Histological Examination ◽  
Critical Role ◽  
Preoperative Imaging ◽  
Biliary Pancreatitis ◽  
Extensive Resection ◽  
Gallbladder Diseases ◽  
Magnetic Resonance Imaging Mri ◽  
Incidental Gallbladder Cancer ◽  
Mri Evaluation

Abstract Background: Magnetic resonance imaging (MRI) has been widely applied to the preoperative diagnosis of gallbladder diseases, among which laparoscopic cholecystectomy plays a critical role. Incidental gallbladder cancer (IGBC) is an unexpected guest of the patients who underwent cholecystectomy, forcing them to receive reoperation for complete resection. This study aimed to share our experience in pre-operative MRI evaluation and laparoscopic management of the IGBCs. Methods: Between January 2011 and January 2020, 7917 patients with gallbladder diseases and treated by laparoscopy were enrolled in this study. Results: A total of 49 patients were diagnosed as IGBCs. The incidence of IGBCs in polypoid lesions, biliary pancreatitis, cholecystitis, cholecystocholedocholithiasis and gallbladder stones was 0.42%, 1.19%, 0.62%, 1.20% and 0.49%, respectively. Moreover, 73.5% and 59.2% of the IGBCs had unremarkable preoperative imaging during the ultrasonographic and MRI evaluation respectively. Also, 14 of the patients were diagnosed as gallbladder cancer (GBC) via intraoperative histological examination, and 11 received laparoscopic extensive resection after cholecystectomy.Conclusion: The patients with biliary pancreatitis and cholecystocholedocholithiasis have a higher incidence of incidental gallbladder cancer. Preoperative MRI evaluation and intraoperative histological examination may help some incidental gallbladder cancers to achieve one-stage laparoscopic extensive resection.

scholarly journals Spilled gallstones during laparoscopic cholecystectomy

2014 ◽  
Vol 96 (5) ◽  
pp. e18-e20 ◽  
Author(s):  
J Ahmad ◽  
AIW Mayne ◽  
Y Zen ◽  
MB Loughrey ◽  
P Kelly ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Cancer ◽  
Histological Examination ◽  
Early Stage ◽  
Recurrent Pain ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Symptomatic Gallstones ◽  
Incidental Gallbladder Cancer

Introduction Incidental gallbladder cancer is found in 0.6–2.1% of patients undergoing laparoscopic cholecystectomy for symptomatic gallstones. Patients with Tis or T1a tumours generally undergo no further intervention. However, spilled stones during surgery may have catastrophic consequences. We present a case and suggest aggressive management in patients with incidental gallbladder cancer who had spilled gallstones at surgery. Case History A 37-year-old woman underwent a laparoscopic cholecystectomy for symptomatic gallstones, during which some stones were spilled into the peritoneal cavity. Subsequent histological examination confirmed incidental pT1a gallbladder cancer. Hepatopancreatobiliary multidisciplinary team discussion agreed on regular six-monthly follow-up. The patient developed recurrent pain two years after surgery. Computed tomography revealed a lesion in segment 6 of the liver. At laparotomy, multiple tumour embedded gallstones were found on the diaphragm. Histological examination showed features (akin to the original pathology) consistent with a metastatic gallbladder tumour. Conclusions This case highlights the potential for recurrence of early stage disease resulting from implantation of dysplastic or malignant cells carried through spilled gallstones. It is therefore important to know if stones were spilled during original surgery in patients with incidental gallbladder cancer following a laparoscopic cholecystectomy. Aggressive and early surgical management should be considered for these patients.

scholarly journals Incidental Gallbladder Cancer: Routine versus Selective Histological Examination After Cholecystectomy

2021 ◽  
Vol 07 (01) ◽  
pp. e22-e25
Author(s):  
Andrew Alabi ◽  
A D. Arvind ◽  
Nikhil Pawa ◽  
Shakir Karim ◽  
Jason Smith
Keyword(s):  
Gallbladder Cancer ◽  
Gallstone Disease ◽  
Papillary Adenocarcinoma ◽  
University Teaching ◽  
Histological Evaluation ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Potential Cost ◽  
Histopathological Evaluation ◽  
Incidental Gallbladder Cancer

Abstract Background Incidental gallbladder cancer is relatively rare, with an incidence ranging between 0.19 and 5.5% of all the cholecystectomies for benign disease, and carries a poor prognosis. Currently, in the literature, there appears to be some controversy about whether all gallbladder specimens should be sent for routine histopathology. The aim of this study was to investigate the need for either routine or selective histopathological evaluation of all gallbladder specimens following cholecystectomy in our institution. Methods The records of all patients who underwent a cholecystectomy (laparoscopic and open) for gallstone disease over a 5-year period (between January 2011 and January 2016) were reviewed retrospectively in a single university teaching hospital. Patients with radiological evidence of gallbladder cancer preoperatively were excluded. The notes of patients with incidental gallbladder cancer were reviewed and data were collected for clinical presentation and preoperative investigations including blood tests and radiological imaging. Results A total of 1,473 specimens were sent for histopathological evaluation, with two patients being diagnosed with an incidental gallbladder cancer (papillary adenocarcinoma in situ and moderately differentiated invasive adenocarcinoma [stage IIIa]). The incidence rate was 0.14%. All patients with incidental gallbladder cancer had macroscopically abnormal specimens. Conclusion Both patients in our study who were diagnosed with incidental gallbladder cancer had macroscopic abnormalities. A selective rather than routine approach to histological evaluation of gallbladder specimens especially in those with macroscopic abnormalities should be employed. This will reduce the burden on the pathology department with potential cost savings.

scholarly journals Robotic completion radical cholecystectomy for incidental gallbladder cancer

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S186
Author(s):  
J.M. Creasy ◽  
M.E. Lidsky ◽  
K.N. Shah ◽  
G.S. Herbert ◽  
P.J. Allen ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Radical Cholecystectomy ◽  
Incidental Gallbladder Cancer

scholarly journals Preoperative measurements on MRI in Chiari 1 patients fail to predict outcome after decompressive surgery

2021 ◽  
Author(s):  
Miro-Pekka Jussila ◽  
Juho Nissilä ◽  
Minna Vakkuri ◽  
Päivi Olsén ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
University Hospital ◽  
Resonance Imaging ◽  
Surgical Decision ◽  
Postoperative Mri ◽  
Before And After ◽  
Magnetic Resonance Imaging Mri ◽  
Surgical Decision Making ◽  
Mri Evaluation ◽  
Outcome Of Surgery

Abstract Background The purpose of our study was to research the parameters of magnetic resonance imaging (MRI) that would predict the outcome of surgery in patients with Chiari 1 malformation (CM1) and to evaluate changes in MRI parameters after surgery. Methods Fifty-one patients (19 children, 13 adolescents, and 19 adults) operated on due to CM1 in Oulu University Hospital between 2004 and 2018 were evaluated. Seventeen parameters were measured from the preoperative MRI and 11 from the postoperative MRI. The correlations between the MRI parameters and the clinical variables before and after surgery were analyzed. Results The majority (88.2%) of the patients had favorable surgical outcomes. Postoperatively, subjective symptoms improved in 88.6% of the patients and syringomyelia in 81.8%. The location of the cerebellar tonsils, when measured in relation to the C2 synchondrosis or the end plate, postoperatively moved cranially in 51.0% (n = 26), did not change in 27.4% (n = 14), and moved caudally in 21.6% (n = 11) of the patients. However, neither the location of the tonsils nor any other parameters measured from pre- or postoperative MRI correlated with the patients’ symptoms or surgical outcomes. Conclusions No specific parameters on preoperative MRI evaluation were predictive of the outcome of surgery, emphasizing clinical examination in surgical decision-making. Furthermore, the postoperative MRI parameters did not correlate with the surgical outcomes. Thus, routine postoperative imaging is suggested only for patients with preoperatively diagnosed syringomyelia or worsening of symptoms.

scholarly journals Unresectable Carcinoma Pancreas : Efficacy of Imaging in Diagnosing and Labeling them as ‘Unresectable’

2013 ◽  
Vol 12 (3) ◽  
pp. 23-26 ◽  
Author(s):  
Md Abdullah Al Farooq ◽  
MA Mushfiqur Rahman ◽  
Tania Tajreen ◽  
Eqramur Rahman ◽  
Md Minhajuddin Sajid ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pancreatic Carcinoma ◽  
Imaging Modality ◽  
Preoperative Imaging ◽  
Mri Imaging ◽  
Medical College ◽  
Magnetic Resonance Imaging Mri ◽  
Carcinoma Pancreas ◽  
Operative Findings ◽  
Better Than

Background: Carcinoma pancreas is being diagnosed increasingly with the help of conventional imaging like ultrasonography (USG), computerized tomography (CT) scan and magnetic resonance imaging (MRI).Imaging also gives the opportunity to assess resectability. In our country MRI and CT scan are not widely available and most of the pancreatic carcinoma is too advanced for curative surgical resection when diagnosed. These are unresectable carcinoma pancreas (UCP). Objectives: To evaluate the efficacy of imaging in diagnosing carcinoma pancreas and to assess resectability after comparing them with peroperative findings. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in Bangladesh Institute for Research and Rehabilitation in Diabetic Endocrine and Metabolic disorders (BIRDEM) hospital, Dhaka, Bangladesh from July 2004 to June 2006 (2 years). After laparotomy findings and histopathological confirmation 50 patients were labeled as UCP. Among 50 patients male were 28 & female patients were 22. Imaging modalities used before surgery was assessed and compared with per operative findings. USG were done in all patients and CTscan in 45 patients. MRI was done in 08 patients suspected clinically as pancreatic carcinoma where USG /CT scan had failed to reach a conclusion. Findings of the various imaging studies regarding diagnosis and unresectability were compared with per operative findings. Results: USG was able to diagnose 42 (84%) pancreatic carcinoma patients with unresectibility in 29 (69%). Forty five patients (90%) were diagnosed by CT scan and could label 38 (84.44%) as unresectable. MRI was 100% accurate to diagnose and label the entire 08 patient as unresectable carcinoma pancreas. Cumulative multimodal preoperative imaging was 91.33% accurate in diagnosing carcinoma pancreas and could tell the features of unresectibility in 73.59% patients. Conclusion: CT scan should be the primary imaging modality for diagnosing pancreatic carcinoma and its resectability. MRI is very promising for diagnosing and assessing UCP. Multimodal imaging is better than single imaging. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 23-26

scholarly journals Occlusal stabilization appliance: evaluation of its efficacy in the treatment of temporomandibular disorders

2004 ◽  
Vol 12 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Elisa Emi Tanaka ◽  
Emiko Saito Arita ◽  
Bunji Shibayama
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Temporomandibular Joint ◽  
Temporomandibular Disorders ◽  
Imaging Modality ◽  
Clinical Status ◽  
Signs And Symptoms ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Evaluation

Occlusal stabilization appliances or splints are the most widely employed method for treatment of temporomandibular disorders (TMD). Magnetic Resonance Imaging (MRI) is the most indicated imaging modality to evaluate the components of the temporomandibular joint (TMJ). Forty patients with signs and symptoms of temporomandibular disorders were treated with splints for a mean period of 12 months, comprising regular semimonthly follow-ups. After stabilization of the clinical status, occlusal adjustments and MRI evaluation were performed. It was concluded that the success of this kind of treatment are related to the total (70%) or partial improvement (22.5%) of painful symptomatology and to the functional reestablishment of the craniomandibular complex. The MRI allowed evaluation and also the conclusion that the splints provide conditions for the organism to develop means to resist to the temporomandibular disorders by means of elimination of several etiologic factors. Moreover, after treatment the patients are able to cope with disc displacements with larger or smaller tolerance.

scholarly journals Wrist Swelling in Kienböck's Disease

2018 ◽  
Vol 07 (05) ◽  
pp. 389-393
Author(s):  
Hirofusa Ichinose ◽  
Etsuhiro Nakao ◽  
Takaaki Shinohara ◽  
Masahiro Tatebe ◽  
Harumoto Yamada ◽  
...  
Keyword(s):  
Histological Examination ◽  
Resonance Imaging ◽  
Synovial Proliferation ◽  
Level Of Evidence ◽  
Kienböck’S Disease ◽  
Capsular Ligament ◽  
Kienböck's Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Common Manifestation ◽  
Kienbock’S Disease

Background and Purpose Wrist swelling is a frequent clinical manifestation of Kienböck's disease, but no study has reported the site and pathology of wrist swelling in this disease. The aim of this study is to elucidate the site and pathology of wrist swelling in Kienböck's disease. Materials and Methods Dorsal and palmar soft tissue thicknesses of the wrist were measured on standard lateral radiographs of the wrist in 26 patients with Kienböck's disease and 30 subjects without intra-articular lesion. Axial magnetic resonance imaging (MRI) views were examined to detect the site of swelling. The dorsal capsular ligament in three patients with Kienböck's disease underwent histological examination. Results Radiographic study confirmed dorsal wrist swelling in 24 of 26 (92%) patients examined compared with the contralateral unaffected wrists. MRI demonstrated thickening of the dorsal capsular ligament and extensor layer with synovial proliferation. Histological examination revealed nonspecific chronic inflammation. Conclusion Dorsal wrist swelling in Kienböck's disease is a common manifestation and constitutes a part of pathology of Kienböck's disease, although further study is required to clarify the relation between wrist swelling and etiology of Kienböck's disease. Level of Evidence This is a Level III study.

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