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T Løtveit

Publications and source records attributed to T Løtveit.

27 records · Page 2Linked to original sources

The composition of biliary calculi in patients with juxtapapillary duodenal diverticula.

Biliar calculi from 32 patients with juxtapapillary duodenal diverticula were analyzed by quantitative infrared spectroscopy. In 22 of the patients the calculi were classified as pigment stones and in 10 as cholesterol stones. Calcium bilirubinate was the main component in the pigment stones, with a median value of 45%; the median cholesterol content was 7.5%. In the cholesterol stones median calcium bilirubinate content was 1% and median cholesterol content 95.5%. Calcium carbonate was found in small amounts in only nine of the calculi. The findings support our theory that the pigment calculi in patients with juxtapapillary diverticula are caused by ascending infections to the bile ducts with intestinal beta-glucuronidase-producing bacteria. Beta-glucuronidase will split the conjugated bilirubin in bile into glucuronic acid and unconjugated bilirubin, which in turn combine with calcium to form insoluble calcium bilirubinate.

Adult↗

Biliary pigment and cholesterol calculi in patients with and without juxtapapillary duodenal diverticula.

The occurrence of pigment and cholesterol calculi was studied in 45 patients with concrements in the gallbladder but no calculi in the common or intrahepatic bile ducts. Twenty-one of the patients had juxtapapillary duodenal diverticula diagnosed by duodenoscopy. Twenty-four patients had no diverticula. The classification of the calculi as pigment stones or cholesterol stones was based on quantitative determination of the cholesterol contents. Calculi with a cholesterol content of less than 25% were classified as pigment stones; calculi with a cholesterol content of more than 25% were classified as cholesterol stones. All pigment stones had a cholesterol content of less than 20%. With the exception of four patients the cholesterol content was over 70% in all cholesterol stones. Twelve of the 21 patients with were classified as pigment stones; calculi with a cholesterol content of more than 25% were classified as cholesterol stones. All pigment stones had a cholesterol content of less than 20%. With the exception of four patients the cholesterol content was over 70% in all cholesterol stones. Twelve of the 21 patients with were classified as pigment stones; calculi with a cholesterol content of more than 25% were classified as cholesterol stones. All pigment stones had a cholesterol content of less than 20%. With the exception of four patients the cholesterol content was over 70% in all cholesterol stones. Twelve of the 21 patients with diverticula had pigment stones, whereas only 1 of the 24 patients without diverticula had pigment calculi, a difference that was statistically significant (p less than 0.01).

Adult↗

Studies of the choledocho-duodenal sphincter in patients with and without juxta-papillary duodenal diverticula.

The function of the choledocho-duodenal sphincter was studied in 16 patients, 8 with juxta-papillary duodenal diverticula. All patients had calculi in the gallbladder. The common bile duct was normal. At cholecystectomy two catheters were introduced into the common bile duct through the stump of the cystic duct and fixed in place. The examinations were performed when the patients had recovered from the operation. One catheter was connected to a pressure transducer, the other was used for saline infusions. Pressure in the common duct was recorded before infusion and at constant infusion rates of 3,6, and 12 ml/min. The muscular tone, the contractile activity, and the total rhythmic variations of the sphincter during infusions were all significantly less in patients with diverticula than in the controls without diverticula. The findings indicate that there is a dysfunction of the choledochoduodenal sphincter in patients with juxta-papillary duodenal diverticula. This may in part be responsible for the high incidence of biliary calculi in patients with duodenal diverticula.

Aged↗

Comparison of endoscopic retrograde and intravenous cholangiography in diagnosis of biliary calculi.

The results of endoscopic retrograde cholangiography (E.R.C.) and intravenous cholangiography (I.V.C.) were compared in patients undergoing surgery for biliary calculi. E.R.C. gave a significantly higher rate of correct diagnosis of gallbladder calculi (p = 0.026) and common bileduct calculi (p = 0.002) than I.V.C. Biliary stones may thus frequently be present in patients with a normal I.V.C. and E.R.C. may reduce the rate of diagnostic errors in patients with symptoms of biliary disease.

Cholangiography↗