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Biomedical subjects

G Edlund

Publications and source records attributed to G Edlund.

At least 19 recordsLinked to original sources
PubMed1993

Cholescintigraphy and biochemical tests in cholecystitis--an evaluation with discriminant analysis.

The biochemical values of 76 patients with suspected cholecystitis were subjected to discriminant analysis. The final diagnoses, i.e. acute cholecystitis, chronic cholecystitis and non-biliary disease, were used as the grouping variable. Cholescintigraphy identified patients with acute cholecystitis. Routine preoperative biochemical tests were found to be of limited value. Only alkaline phosphatase was of help in predicting common-duct stones, especially in patients with acute cholecystitis. The conclusion is that many biochemical tests presently in common use could as well be dispensed with.

Acute Disease↗
PubMed1990

Acute cholecystitis in the elderly.

After a controlled randomized trial, the management of patients with acute cholecystitis was changed from delayed to early cholecystectomy. The results obtained in 125 consecutive patients some years before the trial and in 144 consecutive patients after the trial were compared. All patients were 70 years or older. The comparison confirmed that early cholecystectomy reduces morbidity and mortality. Early cholecystectomy for acute cholecystitis in the elderly is strongly recommended.

Acute Disease↗
PubMed1990

Cholescintigraphy versus infusion cholecystography in acute cholecystitis.

Patients with the clinical diagnosis of acute cholecystitis were studied with intravenous cholecystography and cholescintigraphy. The two examinations alternated in a random order. The final diagnosis was ascertained by surgery in most patients. Either cholecystography or cholescintigraphy could be used in the diagnostics of patients with suspected acute cholecystitis. The methods have about the same accuracy. However, cholescintigraphy is performed more easily and more rapidly than intravenous cholecystography.

Acute Disease↗
PubMed1988

Ultrasonic nonvisualization of the gallbladder in emphysematous cholecystitis. Case report.

In a patient with suspected acute cholecystitis, ultrasonography-although repeated-failed to visualize the gallbladder. Corresponding to the gallbladder fossa there was an area of high-density echoes casting a shadow posteriorly, but the examination was considered inconclusive because the gallbladder was not visualized. Plain abdominal radiographs established the diagnosis of acute emphysematous cholecystitis.

Acute Disease↗
PubMed1984

Acute cholecystitis and thiazides.

Drugs purchased by a random sample (17 000) of the population of Jämtland county, Sweden, are continuously monitored. Patients who had been admitted to the county's only hospital with acute cholecystitis and who were part of this sample were studied, and controls matched for age and sex were drawn from the sample. The purchase of thiazides and other drugs prescribed to the patients with acute cholecystitis was compared with that of the controls. The estimated relative risk of developing acute cholecystitis in patients who had purchased thiazides in the year before admission to hospital, as compared with those who had not, was 2.1 (95% confidence limit 1.1-3.9). As it has been reliably reported that the use of thiazides is not itself associated with cholelithiasis, the association found between thiazides and cholecystitis suggests that thiazides may increase the risk of acute cholecystitis developing in a patient with gall stones.

Acute Disease↗
PubMed1983

Function of liver, gallbladder and sphincter of Oddi after major surgery studied by computer-assisted cholescintigraphy and real-time ultrasonography.

Patients with normal gallbladders were subjected to computer-assisted Tc-HIDA cholescintigraphy at fixed intervals after major surgery. Hepatic time--activity curves showed that hepatic excretion of the material was first reduced and later a reduction of hepatic uptake followed. The gallbladder responded first by dilatation and reduction of motility and later by delay in or even absence of visualization. Postoperative dilatation was confirmed with real-time ultrasonography. No tracer passed into the duodenum in the early postoperative stage indicating spasm of the sphincter of Oddi. Healthy volunteers were studied with and without morphine and with and without a 24 h fast. The sphincter of Oddi closed after morphine but not after fasting. Transient non-visualization of the gallbladder after surgery makes the diagnosis of postoperative cholecystitis more difficult.

Aged↗
PubMed1983

Jaundice in acute cholecystitis without common duct stones.

Patients with acute cholecystitis without common duct stones were studied pre- and postoperatively with 99mTc-HIDA scintigraphy. The resulting hepatic time-activity curves were analyzed. Preoperative serum bilirubin levels were closely correlated with hepatic discharge but not with hepatic uptake of the radiopharmaceutical. Cholecystectomy resulted in prompt improvement of hepatic discharge but did not affect uptake. In acute as well as in chronic cholecystitis cholangiograms taken before removal of the gallbladder were compared with those taken after. In acute cholecystitis the former view frequently showed medial displacement of the biliary tract and incomplete filling of its proximal part. Displacement of the duct was also apparent in comparisons of pre- and postoperative scintigrams. Jaundice in acute cholecystitis is due to reduced excretion which may be caused by pressure on the ducts by the distended gallbladder.

Acute Disease↗
PubMed1982

Transient nonvisualization of the gallbladder by Tc-99m HIDA cholescintigraphy in acute pancreatitis: concise communication.

In five of seven patients with acute pancreatitis, Tc-99m HIDA scintigraphy failed to visualize the gallbladder. In all five patients the gallbladder was later found to be normal and in three of them normal filling was obtained at a repeat examination performed after the attack had subsided. Transient nonvisualization of the gallbladder in acute pancreatitis is probably due to disturbed motility of the biliary tree.

Acute Disease↗
PubMed1981

Early versus delayed cholecystectomy: the effect of a change in management.

After a controlled trial, conservative treatment followed by delayed operation was replaced by early operation as the treatment of choice for acute cholecystitis. Results before and after this change were compared. The comparison confirmed that early cholecystectomy leads to more rapid recovery and to less time spent in hospital. There was no significant difference between the two procedures in the duration of operation and the incidence of wound infection. Early operation caused fewer biliary fistulas and was accompanied by a lower mortality.

Acute Disease↗
PubMed1981

Randomized trial of drainage after cholecystectomy. Suction vaersus static drainage through a main wound versus a stab incision.

One hundred eighty-four patients who underwent biliary surgery were randomly allocated to four groups arranaed in a 2 by 2 design. In 92 patients the drain was brought out through the wound and in the other 92 through a stab incision. In half of the patients in each group the drain was connected to a suction system and in the other half to a sterile bag. Suction was found to impair rather than enhance intraperitoneal drainage. In patients who underwent elective cholecystectomy and early operation for acute cholecystitis, the amount of discharge was more than twice as large when suction was omitted than when it was applied. After common duct operations the amount of discharge was very large and there was little difference in cases with and without suction. Prolonged drainage, static or suction, resulted in an increase in the serum haptoglobin level. Analysis of out data suggested that after a few days the drain starts to act as a traumatic stimulus. No difference was found between cases with the drain brought out through a stab incision and those with the drain brought out through the main wound. A number of studies have ascertained the superiority of closed to open drainage. The results of the present trial lead us to recommend that after biliary surgery the closed us to recommend that after biliary surgery the closed drain should not be connected to a suction apparatus and that after elective cholecystectomy the drain should preferably be removed after a few days.

Adult↗
PubMed1981

Sump drainage versus static drainage after cholecystectomy.

Sump drainage was compared with closed static drainage in a randomized trial using a restricted sequential plan. Sump drains were converted into static drains by closing the air-vent tubes and by omitting suction. Sump drains so converted evacuated more intraperitoneal fluid during the first 24 hours after cholecystectomy than did drains in which the sump was functioning. For drainage after cholecystectomy, the sump drain is inferior to the passive drain in a closed circuit.

Cholecystectomy↗