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PubMed1988

Cholecystitis and cholelithiasis.

Cholelithiasis and cholecystitis, with their complications, remain major health problems in the United States. At this time, cholecystectomy is the treatment of choice for all patients with symptomatic gallstones and those with acute cholecystitis, except those who are too ill to undergo surgery. Present therapeutic options may be summarized as follows: Asymptomatic patients and those with flatulence and dyspepsia who have gallstones should be observed. Those who have symptoms of biliary pain, gallstone-induced pancreatitis, or common duct stones should have corrective surgery. Those who refuse surgery or who aren't surgical candidates might be treated with dissolution therapy. Dissolution of gallstones with chemical agents and extracorporeal shock-wave lithotripsy show some promise. We need a better understanding of the etiology and formation of gallstones to address the disease from a preventive standpoint and reduce the incidence of cholelithiasis and cholecystitis, and their complications.

Acute Disease↗
PubMed1987

[Cholelithiasis in childhood. Apropos of 4 cases].

Authors review four patients diagnosed of cholelithiasis during between 1976-1986. They emphasize the importance of abdominal ultrasonography as the technic of first choice when cholelithiasis is suspected, due to its' harmlessness and diagnostic reliability. They recommend surgical treatment even in asymptomatic cases to avoid possible complications derived from a passive attitude.

Adolescent↗
PubMed1987

Should cholecystectomy be done en passant for asymptomatic cholelithiasis?

The management of asymptomatic gallstones discovered during abdominal surgery is controversial. Should cholecystectomy be performed en passant? The authors report a 4-year survey of 109 patients with asymptomatic cholelithiasis who underwent surgery for other abdominal conditions: colorectal (31), gastric (24), vascular (20), gynecologic (21) and miscellaneous (13). Cholelithiasis was established preoperatively by ultrasonography in 52 of 55 examinations (95%). In the other 54, the gallstones were discovered at operation. Cholecystectomy was performed in 78 patients and in 31 the gallbladder was left in place. In the former group, 11 (14%) had complications, 2 being attributable to the cholecystectomy. Intraoperative cholangiograms were obtained in 43 and led to common-bile-duct explorations in 8. Common-bile-duct stones were found in seven. In the non-cholecystectomized group, three died postoperatively and three were lost to follow-up. Twelve of the remaining 25 are still asymptomatic and 13 have had symptoms: 7 underwent cholecystectomy (4 for acute cholecystitis) between 2 weeks and 11 months after the initial laparotomy. Because of the low morbidity and the relatively high number of cholecystectomies that were subsequently necessary, the authors recommend cholecystectomy en passant unless there is a specific contraindication. They also recommend ultrasonography before major gastrointestinal or vascular surgery in order to plan for cholecystectomy.

Adult↗
PubMed1985

Cholelithiasis in sickle cell disease: a cholecystographic and ultrasonographic evaluation in Nigerians.

A prospective study designed to establish the incidence of gallstones among 48 Nigerian homozygous sickle cell disease patients was made using oral cholecystography and grey-scale ultrasonography. The age range was 2 to 35 years with a mean of 16 years. The youngest patient with gallstones was a 51/2-year-old boy. Gallstones were demonstrated on cholecystosonography in 12 of 48 patients (25%). The incidence of cholelithiasis was 7.7% in children 10 years or younger and 31.4% in patients above this age. There was no correlation between the incidence of cholelithiasis and serum bilirubin on one hand and positive history of abdominal pain on the other. Screening of patients over 15 years for gallstones is suggested with a view to performing elective cholecystectomy in patients who subsequently become symptomatic.

Adolescent↗
PubMed1977

Incidence of cholelithiasis after truncal and selective vagotomy.

In order to establish the incidence of cholelithiasis after vagotomy, the patients operated upon in the period January 1st 1966, to December 31st 1971, were reexamined. The incidence of cholelithiasis was 12% after truncal and 2.4% after selective vagotomy, thus complications involving the gall bladder are more frequent after truncal than after selective vagotomy.

Cholelithiasis↗
PubMed1967

Cholelithiasis and cholecystitis in childhood.

Six cases of cholecystitis and cholelithiasis confirmed by x-ray examination and surgical operation were observed in a ten-year period. Due to the wide variability in signs and symptoms in children, cholecystitis and cholelithiasis can be diagnosed only with a high degree of clinical suspicion and roentgenological examination. Gallbladder disease is uncommon in childhood but should be considered in children with vague abdominal pains or bouts of unexplained jaundice. If a normal appendix is found at laparotomy in the "acute abdomen," the surgeon would be wise to palpate other specific organs within the abdomen, including the liver and gallbladder. The treatment of choice is cholecystectomy. The prognosis for recovery is excellent if there is no complicating systemic disease.

Adolescent↗
PubMed1984

Cholelithiasis in children in a Chinese hospital: report of 52 cases.

Over a period of 22 years (1958-1980), 52 children with cholelithiasis were treated in the Hunan Medical College Hospital in Ghangsha, China. Enteric helminthiasis is a common endemic disease in China and the countries of the Far East. Common in this region also is biliary ascariasis, which can precipitate an abdominal emergency in children. Both these conditions make differentiation of primary acute cholecystitis from the acute cholecystitis that is a complication of biliary ascariasis difficult in children. But, whatever the etiology of the disease, cholelithiasis was confirmed in all 52 children, an incidence of 1:62.4 the frequency of this disease in adults, or eight times higher than that which occurs in Western countries. Table 1 shows the distribution according to sex and age in our patients.

Adolescent↗
PubMed1984

[Leukocyte alkaline phosphatase in acute, chronic and exacerbated cholecystitis complicated and uncomplicated by cholelithiasis].

The leukocyte alkaline phosphatase was determined in 101 patients with acute and chronic exacerbated cholecystitis, complicated and non-complicated cholelithiasis. Enhanced enzyme activity was established in the inflammatory diseases of the gallbladder and biliary ducts, that was normalized with the effective treatment. No essential alterations were established in case of non-complicated cholelithiasis.

Adolescent↗
PubMed1984

[Cytochemical study of glycogen and peroxidase in acute and chronic exacerbated cholecystitis uncomplicated and complicated by cholelithiasis].

Glycogen content and peroxidase activity in 101 patients with acute, chronic exacerbated cholecystitis and noncomplicated cholelithiasis were investigated. An increase of the indices was established in case of inflammatory diseases of gallbladder and biliary ducts, being parallel to the severity of the pathological process. The values were normalized with the successful treatment. No essential deviations from the normal values were found in the non-complicated cholelithiasis.

Adolescent↗
PubMed1978

Accuracy of oral cholecystography in cholelithiasis.

The accuracy of oral cholecystograms in the detection of cholelithiasis was assessed by comparing 100 patients who were examined both roentgenographically and by ultrasonography of the gallbladder. All normal oral cholecystograms had normal ultrasonography of the gallbladder. This study supports previous reviews indicating that the reliability of cholecystography in cholelithiasis is in the 98% range.

Cholecystography↗
PubMed1980

Carcinoma of the gallbladder. Its relation to cholelithiasis and to the concept of prophylactic cholecystectomy.

Two hundred and thirteen cases of carcinoma of the gallbladder are reviewed with special reference to the presence or absence of symptoms of cholelithiasis. The majority of the patients (58%) had no history of cholelithiasis. Only one patient out of ten (11%) had gallstones known to have existed for more than a year, and the rest of the patients had a short history. A marked decrease in the cholecystectomy rate did not seem to affect the incidence of carcinoma over a period of eight years (1969--1976). Therefore cholecystectomy as prophylaxis against carcinoma does not seem to be justified. The only way to improve the prognosis of carcinoma of the gallbladder is to reduce the time between the onset of symptoms and surgery. The relative risk of carcinoma is ten times greater than symptoms and signs of cholecystitis are recorded and increases markedly beyond the age of sixty. Early surgery in these groups is recommended.

Aged↗
PubMed1982

[Cholelithiasis after stomach resection?].

The prevalence of all forms of cholelithiasis in patients suffering from peptic ulceration and following partial gastric resection has been examined on the basis of analysing 28 204 autopsies from 1953 to 1979. The review of the post-mortem reports proves considerable gallstone incidence of 30,84% in the above mentioned groups of patients. There was no statistic difference with regard to the prevalence of gallstone formation in the collective as a whole, in the ulcer group or the group with partial gastric resection. Our results obtained confirm the invalidity of the term "postresection-cholelithiasis."

Adolescent↗
PubMed1981

[Cholelithiasis and peptic ulcer surgery. Personal experience (author's transl)].

In veiw of the interest represented by the possible development of cholelithiasis after peptic ulcer surgery, the authors report their results in 848 patients undergoing surgery for peptic ulcer, 521 were followed up in order to determine whether the biliary complication developed and in how many cases. They conclude that their results showed nothing which might support the possibility of the development of cholelithiasis after any from of surgery for peptic ulcer.

Adolescent↗
PubMed1994

[CHolelithiasis in Burkina Faso (apropos of 44 cases operated on at NHC YO].

The authors relate 44 cases of cholelithiasis, operated on between 1986 and 1990 at the General and digestive Surgery Unit of the National Hospital Center YALGADO OUEDRAOGO of Ouagadougou. They established a progressive increase in the frequency of this affection thanks to the echographic diagnosis. The patients average age is 35 years old and paradoxically, the sex-ratio is for men. It is about lithiasis with some predominant pigment constituent, located in the vesicule area in 98% of the cases, associated in 18% with a localization in the common bile duct. The clinical symptomology is atypic. But the complicated forms with acute cholelithiasis, or with a big cholostasis liver and dilatation of the common bile duct, are not rare. The preoperative cholangiography is not used. All this resulting in frequent surgical procedures on the common bile duct. Anyway, the therapeutic results are satisfactory: the surgery death rate is 2.27% and there are few complications.

Adult↗
PubMed1995

[Current problems in the diagnosis, treatment and prevention of cholelithiasis in flight personnel].

In 50% of afflicted pilots, cholelithiasis is asymptotic and develops with the minimum anatomicomorphological changes of the biliary system. An early diagnostics of cholelithiasis in the pilots will enable one to treat them timely with the aim of returning the pilots to flying activity in the future. The introduction of nonsurgical treatment methods into the clinical practice with an application of distance shock-wave cholelithotripsy will elevate the percentage of pilots returning to flying activities. A need for developing domestic special devices for cholelithotripsy is ripe.

Aerospace Medicine↗
PubMed1994

[Cholelithiasis in the south of Madagascar (47 cases)].

47 cases (14 men and 33 women) of cholelithiasis were described in a southern district of Madagascar. Ultrasonography was used for diagnosis. In most cases, calculi were numerous. In this study, risk factors correlated with cholelithiasis were not found.

Adolescent↗