PubMed · 14821906
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M K McGRATH. 1951. Gallbladder surgery.. https://pubmed.ncbi.nlm.nih.gov/14821906/
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An increasing incidence of liver and biliary tract diseases brings about an increasing necessity of their precise diagnosis. The procedure of estimation of gallbladder volume seems to be useful in ultrasonic examination of gallbladder motility and is widely applied in human medicine all over the world. The methods estimating gallbladder volume can be divided into two groups. The first group comprises the application of rather simple formulas approximating the actual gallbladder shape to the given geometric solid. These methods are precise when the actual gallbladder shape is at least roughly similar to the approximated solid. The second group is more uniform methods since their precision is principally not dependent on the gallbladder shape. The aim of this article was the description and comparison of more or less known methods ascribed to the both groups. Among the methods of the first group, one of the firstly applied and less precise methods usually lowering the results is the method approximating the gallbladder shape to a cone. More common and precise is the ellipsoid method, but this method sometimes also approximates the gallbladder shape not very accurately. The other methods approximating the gallbladder shape to a barrel, cylinder, sphere, trapezoid or frustum of cone and the modifications of some of these methods like the method of cone and ellipsoid, are comparable with the ellipsoid method. The planimetric group of the methods can be included into the second group and in these methods the calculation of the area of the organ longitudinal image is followed by estimation of the organ's volume. Other validated methods are: the random points method based on the known group of mathematical methods (Monte Carlo) representing practically one ofplanimetric methods, the commonly used sum-of-cylinder method and the Simpson method. The reported data indicate that Simpson method is currently the most accurate method estimating the gallbladder volume while the planimetric and sum-of-cylinder methods are believed to be also accurate. The applied method estimating gallbladder volume should be selected in the manner that guarantees its possibly maximal accuracy.
This report describes a rare autopsy case of death due to gallbladder injury. The victim was a 63-year-old man, with a clinical history of liver cirrhosis and alcohol abuse. The postmortem examination revealed fatal hemoperitoneum from traumatic gallbladder avulsion. Related injuries were observed in the right hypochondriac region. Normal distended gallbladder, liver cirrhosis and alcohol abuse were considered to be the predisposing factors. The gradual development of bleeding from the small vessels of the gallbladder and the liver bed may have caused extensive hemoperitoneum.
BACKGROUND: The congenital anomaly pancreaticobiliary maljunction (PBM) is considered to be a precancerous disease. PBM carcinogenesis is believed to be an accumulation of gene abnormalities, but the early events causing PBM carcinogenesis are still unclear. In the present study, telomerase activity and Bcl-2 expression in the gallbladder mucosa of PBM and non-PBM gallbladders were investigated. METHODS: The operative gallbladder materials were from five control cases, two cases of non-PBM gallbladder cancer, three of PBM gallbladder cancer, and three of non-neoplastic PBMs. Multiple sampling was performed from each gallbladder. The studies performed were: (1) immunohistochemistry of p53, Ki-67, and Bcl-2; (2) survey of k-ras point mutations; and (3) measurement of telomerase activity in each sample. RESULTS: In the cases of non-PBM cancer, abnormalities from the above studies were detected only in the cancerous lesions. Normal-appearing mucosa did not show Bcl-2 expression or telomerase activity. However, in the cases of PBM cancer, normal-appearing mucosa showed telomerase activity and Bcl-2 expression, but did not show p53, Ki-67, or k-ras abnormalities. In the non-neoplastic PBM, all samples showed Bcl-2 expression, and many showed telomerase activity. CONCLUSIONS: Bcl-2 expression and activation of telomerase are probably early events causing carcinogenesis of the PBM gallbladder mucosa. They might be important factors causing carcinogenesis associated with chronic inflammation.