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PubMed2004

Gallbladder and urinary tract precipitations associated with ceftriaxone therapy in children: a prospective study.

The incidence and outcome of gallbladder and urinary tract complications in children receiving ceftriaxone therapy were evaluated prospectively. The subjects were given intravenous ceftriaxone, 100 mg/kg/day, in two divided doses infused over 20-30-minute periods, for 5-14 days. Serial abdominal ultrasonography revealed gallbladder and urinary tract precipitations in five of 35 children, three of whom had gallbladder pseudolithiasis, one gallbladder sludge and one gallbladder pseudolithiasis and urinary bladder sludge. The children who had gallbladder sludge and gallbladder pseudolithiasis with urinary bladder sludge had abdominal pain, nausea and vomiting. Three children remained symptom-free. The gallbladder precipitations were found after 4-9 days of ceftriaxone therapy, and resolved completely 7-19 days after the end of treatment. The urinary tract precipitation was found on the 5th day after cessation of ceftriaxone therapy and resolved 7 days later. Ceftriaxone-associated gallbladder pseudolithiasis, gallbladder sludge and urinary bladder sludge usually resolve spontaneously and physicians should be aware of these complications so as to avoid unnecessary therapeutic procedures.

Adolescent↗

PubMed1976

[A photo-optical observation of gallbladder motility in dogs (author's transl)].

A photo-optical observation on gallbladder motility was made with the 16 mm cine-cholangiography. The subjects studied were thirty two mongrel dogs. The gallbladder was exposed by a short upper midline abdominal incision under pentothal anesthesia. Gallbladder bile was aspirated and contrast medium was given into the bladder, through a transhepatic route. The cine-cholangiography was done by an image intensifier at a speed of one frame every 2 to 4 seconds. The cinefilms taken were observed repeatedly by the screen projection at various speeds. The drawings were made by tracing the outline of the image of the gallbladder on each frame and were overlapped. Moreover, a contraction curve was made by the cholecystometry using of film motion analyzer in every case. At the same time bile flow into the duodenum was recorded to study a relationship between the gallbladder contraction and motility of the terminal common bile duct. The results obtained are as follows: 1. In a resting state any contraction of the gallbladder was not seen during 30 minutes, and a peristalsis-like movements of the neck portion was observed. However, there was not a relationship between the contraction curve of the gallbladder and the bile flow into the duodenum. 2. Immediately after giving Caerulein, the contrast medium injected into the gallbladder was rapidly discharged into the common bile duct by a peristalsis-like movement of the neck. The size of the gallbladder was markedly decreased into three fifths of the initial state three minutes after administration. At the same time contrast medium was continuously discharged into the duodenum. 3. After giving pilocarpine a marked contraction with forceful movement of the neck and body was observed, and the size of the gallbladder was decreased into three quarters ot the initial state. Bile discharge into the duodenum was markedly increased with an active open- and closing movement of the terminal common bile duct.

Animals↗

PubMed2001

Xanthogranulomatous cholecystitis mimicking gallbladder cancer: report of a case.

A 61-year-old woman was admitted to our hospital with abnormal findings of abdominal computed tomography. Whereas she had neither fever nor abdominal pain, a cholecystitis was suspected. Ultrasonography showed a mass in the gallbladder with several stones, and an unclear border between the gallbladder and liver. Computed tomography showed a large-mass in the gallbladder with findings that seemed to indicate hepatic invasion and para-aortic lymph node metastasis. On the basis of these findings, we made a diagnosis of gallbladder cancer associated with hepatic invasion and lymph node metastasis. We treated this gallbladder tumor by hepatic arterial infusion chemotherapy via catheter with cisplatin and 5-fluorouracil. Four weeks after administration of the anti-cancer drugs, the tumorous lesion of the gallbladder could not be detected by abdominal imagings, and the gallbladder wall revealed no irregular findings. During laparotomy, the gallbladder showed signs of chronic cholecystitis, and a cholecystectomy was performed. Findings of the resected specimens showed severe inflammation, fibrosis, and bleeding in the gallbladder wall with infiltration by many foamy cells. Histopathological diagnosis was xanthogranulomatous cholecystitis. We report here a case of xanthogranulomatous cholecystitis mimicking gallbladder cancer and review the literature.

Cholecystitis↗

PubMed2002

A case of gallbladder cancer associated with pancreaticobiliary maljunction.

We report a case of gallbladder cancer associated with pancreaticobiliary maljunction. The patient was a 60-year-old woman who consulted a local doctor because of discomfort in the right hypochondriac region. Abdominal ultrasonography (US) showed a gallbladder abnormality, and she was referred to Kurume University Hospital, where she was hospitalized for further study and surgery. Abdominal US revealed a sessile tumor with an irregular surface in the fundus of the gallbladder. The internal echo of the tumor was nonhomogeneous, and the structure of the gallbladder wall was partly torn. The common bile duct and the left intrahepatic bile duct were dilated. Abdominal computed tomography (CT) showed an elevated lesion with the same degree of imaging effect as that of the liver on the peritoneal side of the fundus of the gallbladder. The structure of the gallbladder was preserved, and the gallbladder was well demarcated from the surrounding tissue. No hepatic or lymph node metastases were noted. Endoscopic retrograde cholangiopancreatography (ERCP) visualized the pancreaticobiliary maljunction where the pancreatic duct joined the bile duct, entering an approximately 2-cm-long common channel. Dilatation of the common bile duct and intrahepatic bile ducts was observed and diagnosed as the IV-A type according to the Toya classification. Abdominal angiography in the arterial phase showed dilatation of the cystic artery and hyperplasia of vessels but no apparent encasement. In the venous phase, a deep-staining tumor was observed. From the above findings, we made a diagnosis of gallbladder cancer complicating pancreaticobiliary maljunction, and performed an operation. Since intraoperative US showed that the outermost layer of the gallbladder was in part ill-demarcated, we diagnosed the depth of penetration as ss, and performed cholecystectomy and bile duct resection and hepatic resection (S4a and S5), and lymphnode dissection (D2; dissection of groups 1 and 2 lymphnodes). The resected specimen grossly showed a papillomatous lesion with a cauliflower-like surface. The histopathologic diagnosis was papillary adenocarcinoma, depth ss, stage II. Tumor cells proliferated in a papillomatous pattern and were mostly confined to the muscular coat but partly infiltrated into the subserosal coat. In the diagnosis of pancreaticobiliary maljunction, it is crucial to consider complicating gallbladder cancer.

Biliary Tract↗

PubMed2004

Genomic determination of CR1 CD35 density polymorphism on erythrocytes of patients with gallbladder carcinoma.

AIM: To study the changes of quantitative expression, adhering activity and genomic density polymorphism of complement types in erythrocytes (CR1) of patients with gallbladder carcinoma and the related clinical significance. METHODS: Polymerase chain reaction (PCR), Hind III restriction enzyme digestion, quantitative assay of CR1 and adhering activity assay of CR1 in erythrocytes were used. RESULTS: The number and adhering activity of CR1 in patients with gallbladder carcinoma (0.738+/-0.23, 45.9+/-5.7) were significantly lower than those in chronic cholecystitis and cholecystolithiasis (1.078+/-0.21, 55.1+/-5.9) and healthy controls (1.252+/-0.31, 64.2+/-7.4) (P<0.01). The number and adhering activity of CR1 in patients with chronic cholecystitis and cholecystolithiasis (1.078+/-0.21, 55.1+/-5.9) were significantly lower than those in healthy controls (1.252+/-0.31, 64.2+/-7.4) (P<0.05). There was a positive correlation between quantitative expression and adhering activity of CR1 (r = 0.79, P<0.01). Compared with those on preoperative day (0.738+/-0.23, 45.4+/-4.9), the number and adhering activity of CR1 in patients with gallbladder carcinoma decreased greatly on the third postoperative day (0.310+/-0.25, 31.8+/-5.1) (P<0.01), and on the first postoperative week (0.480+/-0.25, 38.9+/-5.2) (P<0.01), but they were increased slightly than those on the preoperative day (P>0.05). The number and adhering activity of CR1 recovered in the second postoperative week(0.740+/-0.24, 46.8+/-5.9) (P<0.01) and increased greatly in the third postoperative week (0.858+/-0.35, 52.7+/-5.8) (P<0.01) in comparison with those on the preoperative day and in the first postoperative week. The number and adhering activity of CR1 of gallbladder carcinoma patients with infiltrating, adjacent lymphogenous and distant organ metastases were significantly lower than those of gallbladder carcinoma patients without them (P<0.01). No difference was observed between the patients with gallbladder carcinoma and healthy individuals in the spot mutation rate of CR1 density gene (chi(2) = 0.521, P>0.05). The distribution of expression was 67.8% in high expression genomic type, 24.8% in moderate expression genomic type, and 7.4% in low expression genomic type. The number and adhering activity of CR1 high expression genomic type gallbladder carcinomas (0.749+/-0.22, 42.1+/-6.2) were significantly lower than those of healthy individuals (1.240+/-0.29, 63.9+/-7.2), and were also significantly lower than those of healthy individuals (0.921+/-0.23, 54.8+/-7.1), but no difference was observed between the number and adhering activity of CR1 lower expression genomic type gallbladder carcinomas (0.582+/-0.18, 44.3+/-5.5) and those of healthy individuals (0.610+/-0.20, 45.8+/-5.7) (P>0.05). CONCLUSION: Defective expression of CR1 in gallbladder carcinoma is mostly acquired through central peripheral mechanisms. The changes in CR1 quantitative expression and adhering activity are consanguineously related to the development and metastasis in gallbladder carcinoma.

Adult↗

PubMed2002

Anatomical and functional study of localization of originating neurons of the parasympathetic nerve to gallbladder in rabbit brain stem.

The present study was to investigate the localization of preganglionic parasympathetic neurons of gallbladder in brain stem by anatomical and functional approaches. Male or female rabbits (n = 11) were anesthetized with sodium pentobarbital (30 mg/kg, i.v.). Cholera toxin B conjugated to horseradish peroxidase (CB-HRP) was injected into the gallbladder wall. Four days later, animals were re-anesthetized and perfused transcardially with paraformaldehyde solution in a 0.1 M phosphate buffer. The rabbit brain was then frozenly sectioned. The sections were processed for HRP label and stained with neutral red. Another group of rabbits (n = 54) were anesthetized by urethane (1 g/kg) after fasting for 18-24 hours, Gallbladder pressure (GP) was measured by inserting a frog bladder filled with normal saline into the gallbladder. Myoelectrical activity of the sphincter of Oddi (SO) was induced by a pair of copper electrodes. A glass tube (30 microm tip diameter) connected with a microsyringe was directed to the dorsal vagal complex (DVC) for microinjection. Majority of retrogradely labeled cells was found bilaterally in dorsal motor nucleus of the vagus nerve (DMV) throughout the length, except the rostral and caudal part. These cells were distributed in subnuclei parvicellularis or mediocellularis of DMV. Some labeled perikarya located in the medial subnucleus of the solitary tract (mNTS). Thyrotropin-releasing hormone (TRH, 1.3 mmol/L, 0.2 microl) microinjected into the rostral portion of the DVC (including DMV and NTS) enhanced the motility of gallbladder and SO. Microinjection of TRH at the middle part of DVC seldom induces excitatory effects on the gallbladder or SO. TRH microinjected into the caudal portion of the DVC elicited weaker response of gallbladder and SO than rostral portion. Our results indicated that DMV is one of the most important original nuclei of gallbladder's vagus nerves and mNTS may be also involved in the control of gallbladder's parasympathetic activity. Neurons that innervate the gallbladder distribute at most part of DVC, and are relatively dense at rostral and caudal position of DMV.

Animals↗

PubMed2003

[The roles of VEGF and C-myc in occurrence, development and metastasis of gallbladder carcinoma].

To investigate the relationship of the expression of vascular endothelial growth factor (VEGF) and C-myc with the occurrence, development and metastasis of gallbladder carcinoma, the expression levels of VEGF and C-myc in gallbladder carcinoma tissue (n = 30) and in normal gallbladder tissue (n = 20) were examined by immunochemistry. Results show that the positive rates of VEGF and C-myc in gallbladder carcinoma tissue were 80% and 63.3% respectively, and 45% and 25% respectively in normal gallbladder tissue. The positive rates of VEGF and C-myc were significantly higher in gallbladder carcinoma than in normal gallbladder tissue. The expression of VEGF and C-myc in gallbladder carcinoma related to the metastasis of gallbladder carcinoma. VEGF and C-myc play important roles in the occurrence, development and metastasis of gallbladder carcinoma.

Adult↗

PubMed1992

Human cholecystitis is associated with increased gallbladder prostaglandin I2 and prostaglandin E2 synthesis.

Microsomal prostanoid synthesis was compared in normal gallbladders removed during organ donation and inflamed gallbladders removed at cholecystectomy. Normal human gallbladder microsomes demonstrated low rates of conversion of [14C]arachidonic acid to total labeled prostanoids, which increased during 1 to 30 min of incubation. Normal human gallbladder microsomes converted labeled substrate to all primary prostaglandins without demonstration of a major product. Inflamed human gallbladder microsomes increased the rate of conversion of [14C]arachidonic acid to total labeled prostanoids two or three times over the levels demonstrated by normal gallbladder microsomes at all times of incubation (p < 0.01). The main prostanoids synthesized by the inflamed human gallbladder microsomes were prostaglandin E2 and 6-keto-prostaglandin F1 alpha, which were increased four times over the levels demonstrated by normal gallbladder microsomes (p < 0.01). These data showed that inflammation of the human gallbladder was associated with increased synthesis of gallbladder 6-keto-prostaglandin F1 alpha and prostaglandin E2.

6-Ketoprostaglandin F1 alpha↗

PubMed2004

Expression of the bacterial gene in gallbladder carcinoma tissue and bile.

BACKGROUND: The major causive factors of gallbladder carcinoma are very complex. Cholecystitis with gallstone was reported one of the most important factors. Many research revealed that cholecystitis or gallstone can give rise to epithelial hyperplasia of gallbladder mucusa or canceration secondarily. In this study, 46 patients were detected in order to find the relationship between infection of different bacteria and formation of gallbladder carcinoma. METHODS: Using the common gene primer of bacteria 16S ribosomal RNA (rRNA), we detected bacterial gene fragments of gallbladder carcinoma tissues in 46 patients by polymerase chain reaction (PCR). Relative bile was also detected by PCR in 18 patients who underwent operations, including U-tube drainage (1), right or left biliary tube drainage (4), radical cholecystectomy (9), and cholecystorrhaphy (4). The tissue fragments of gallbladder carcinoma from the remaining 28 patients were paraffin slices. RESULTS: The positive rate of bacterial DNA in gallbladder carcinoma tissue was 78.3% (36/46). The sequence of 16S ribosomal RNA gene fragments amplified by PCR was approximately 371 base pairs (bp). Multiple kinds of standard bacterial gene fragments obtained from 36 patients included Colibacillus, B.fragilis, Klebsiella, C.perfringens and Clostridium, with a positive rate of 78.3% (36/46). Among the 36 patients, 14 patients with gallbladder carcinoma received operation and their relative bile at operation was detected bacterial gene fragments with a positive rate of 77.8% (14/18). This result was close to that in gallbladder carcinoma tissues. CONCLUSIONS: Our results suggested that there might be a relationship between occurrence of gallbladder carcinoma and infection of different kinds of bacteria, especially anaerobic bacteria C.perfringens. This reminds us that the gallbladder mucosa stimulated by anaerobic and aerobic bacteria might be the principal cause for the development of carcinoma.

Adolescent↗

PubMed1989

Studies on neurotensin. I. Effects on gallbladder motility.

Effects of neurotensin (NT) on gallbladder contraction were examined both in vivo and in vitro. Cholecystokinin-octapeptide (CCK-8) was used to evaluate the methods used in this study and to compare the action of NT on the gallbladder. In In vivo studies, gallbladder contraction was monitored by strain-gauge force transducers implanted on the surface of the dog gallbladder. Bolus intravenous (IV) injection of NT at doses of 20 and 40 ng/kg caused gallbladder contraction of similar of magnitudes in terms of contractile force, while CCK-8 caused contraction dose-dependently. Continuous IV infusion of NT at doses of 250 and 500 ng/kg/hr, which resulted in an elevation of blood levels of NT comparable with those achieved by endogenous release, induced a transient gallbladder contraction. Both maximum contractile force and onset time of contraction were similar to both does of NT. In contrast, CCK-8 induced gallbladder contraction was sustained during infusion of CCK-8 and was dose-dependent for both maximum contractile force and onset time of contraction. NT-induced gallbladder contraction was completely abolished by atropine treatment. In In vitro studies of longitudinal rabbit gallbladder muscle strips, NT was ineffective, while CCK-8 caused a dose-dependent contraction. The present study shows that NT can stimulate gallbladder contraction in the dog via cholinergic pathways.

Animals↗

PubMed1986

Effects of age, gender and female sex hormones upon contractility of the human gallbladder in vitro.

Age, gender and female sex hormones are thought to influence contractility of the gallbladder. Surgically removed gallbladders with gallstones and mild chronic cholecystitis from three groups of patients (males and premenopausal and postmenopausal females) were studied. Strips were incubated in Krebs solution, in Krebs containing 0.2 per cent ethanol-propylene glycol solvent (solvent controls) or in Krebs solution containing progesterone (0.1, 1.0 and 10.0 micromolar) or 17-beta-estradiol (0.1 and 1.0 micromolar). Concentration response curves were obtained for acetylcholine and octapeptide of cholecystokinin and the maximum contraction and median effective dose values were recorded. Steroid receptor levels in the wall of the gallbladder were also estimated. In gallbladders from males, the sensitivity to acetylcholine increased significantly with age. However, in gallbladders from premenopausal women, there was a significant decrease in sensitivity to acetylcholine and cholecystokinin with age. Progesterone (1 and 10 micromolar) reduced the spontaneous rhythmic contractions of the strips by 35 +/- 8 and 65 +/- 8 per cent, respectively, and also reduced the maximum contraction of gallbladders from postmenopausal females to acetylcholine. Estradiol-17 beta had no effect upon the contractility of the gallbladder. The results of additional studies showed that the human gallbladder is estrogen and progesterone receptor negative. The sensitivity of the gallbladder to neurohormonal stimulation varies with age and gender. These results indicate that short term exposure to female sex hormones has an inhibitory effect upon gallbladder contractility. The inhibitory effects of short term exposure to progesterone seen in this study are probably nonspecific in nature.

Acetylcholine↗

PubMed1985

Effect of aging on gallbladder contraction and release of cholecystokinin-33 in humans.

The objective of this study was to examine the effect of aging on gallbladder contraction and cholecystokinin (CCK) release, as well as on the correlation between the two in humans who are free of gallbladder disease. Twenty-nine human volunteers were divided into a young group of 14 individuals (ages 22 to 42 years, median age 32 years) and an older group of 15 individuals (ages 60 to 84 years, median age 66 years). In the study each person in both groups was given corn oil (Lipomul), 1.5 ml/kg, by mouth after an overnight fast. Blood was collected for measurement of CCK-33 by radioimmunoassay before and at intervals after ingestion of Lipomul. Simultaneous measurements of gallbladder volume were obtained by real-time varian ultrasonography. Both fasting and fat-stimulated concentrations of CCK in plasma were significantly higher in the older individuals than in the younger volunteers. The 60-minute integrated measurement of CCK release was significantly increased in the older people as compared with the young. Both fasting and maximally contracted gallbladder volumes were equal in the older and younger groups. The rate of emptying of the gallbladder was equal in both age groups, but the gallbladders of older people appeared to show an earlier initiation of contraction. The highly significant correlation of gallbladder contraction with levels of CCK was similar in both age groups, but the sensitivity of the gallbladder to CCK in the older people was significantly decreased. In conclusion, both fasting and fat-stimulated plasma levels of CCK increase with aging. The sensitivity of the gallbladder muscle to stimulation by CCK is diminished with age, but this appears, teleologically, to be matched by the increased release of CCK, so the kinetics of gallbladder emptying are little different in the aged.

Adult↗

PubMed1994

Gallbladder sludge: spontaneous course and incidence of complications in patients without stones.

Although the ultrasonic detection of gallbladder sludge is relatively frequent, its clinical importance remains unclear, partly because of the paucity of reliable investigations regarding its natural course in patients without stones. In a retrospective study we investigated the course and clinical significance of gallbladder sludge in patients without stones or other identified gallbladder abnormalities. The diagnosis of gallbladder sludge was made by ultrasound scan in 286 (1.7%) of 17,021 patients. The mean follow-up period for these patients was 20.3 +/- 11.5 mo. Of this group 56 patients were without both stones and sludge at the initial examination, and gallbladder sludge developed after a mean observation period of 11.2 +/- 10.6 mo. Within 2.0 +/- 3.5 mo after sludge detection, 40 (71.4%) patients were free of sludge and showed normal gallbladder findings. Gallbladder stones without sludge persistence developed in five patients (8.9%) within 2.5 +/- 0.6 mo after diagnosis of sludge, and gallstones with persistence of sludge developed in two other patients (3.6%) after 6.1 and 30.7 mo, respectively. In no cases did the stones become clinically symptomatic in the course of the follow-up period. Acute acalculous cholecystitis developed in four patients (7.1%) from 6.5 to 37.5 mo after the first examination. In five patients, sludge persisted after a mean 22.3 +/- 13.5 mo of follow-up. Although our data show that gallbladder sludge disappeared spontaneously within a relatively short time in 71.4% of patients, gallbladder sludge must be considered an important pathologic entity because gallbladder stones or complications such as acute cholecystitis occurred in 19.6% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMedDate not supplied

Gallbladder injury secondary to blunt trauma: CT findings.

OBJECTIVE: Our objective was to determine CT findings of gallbladder injury secondary to blunt trauma. MATERIALS AND METHODS: Computed tomography scans and medical records of seven patients diagnosed with gallbladder injury secondary to blunt trauma, including six surgically confirmed cases and one presumptive diagnosis based on CT findings, were reviewed retrospectively to delineate CT findings associated with gallbladder injury. Evaluation of CT scans included assessment of gallbladder distention, wall thickness and contour, intraluminal contents, presence of pericholecystic fluid, and associated injuries. Data obtained included age, gender, mechanism of injury, surgical and pathologic findings when available, treatment, morbidity, and mortality. RESULTS: Four patients had gallbladder contusions and three had either gallbladder laceration, partial avulsion, or intraluminal hemorrhage. The spectrum of CT findings included pericholecystic fluid (seven), ill defined contour of the gallbladder wall (four), high density intraluminal hemorrhage (four), mass effect on the duodenum (three), and gallbladder collapse (one). No combination of findings was specific for the type of injury. The most common associated injuries were pericholecystic liver lacerations and duodenal hematoma or perforation. CONCLUSION: The CT finding of an ill defined contour of the gallbladder wall, a collapsed lumen, or high density intraluminal hemorrhage, especially in the presence of pericholecystic fluid, strongly suggests primary gallbladder injury.

Adult↗

PubMed1993

[Ultrasound study of gallbladder motility in healthy subjects. Reproducibility of the method and effect of alcohol].

The protective effect of alcohol against cholesterol cholelithiasis has been established in several epidemiologic studies. An impairment of gallbladder motility in gallstone disease has been demonstrated in animals and in man. At a daily dose of 39 g, alcohol reduces the lithogenic index of bile, but its effect on gallbladder motility is still debated. To test this potential mechanism, the effect of 20 g of alcohol on gallbladder motility was studied, using an ultrasonographic ellipsoid method in 16 healthy male subjects. The stimulus for gallbladder contraction was a Lundh test meal. Using a cross over method, this meal was ingested by each subject once with water and once with alcohol. A third set of measurements was taken in each subject after ingestion of a Lundh meal and water to test the reproducibility of the sonographic method. The gallbladder kinetics were studied for 90 minutes following ingestion of the test meal and beverage. Alcohol stimulated rapid post prandial gallbladder emptying, and accelerated gallbladder filling. This second action could result from sphincter of Oddi pressure enhancement and, perhaps, decrease of gallbladder absorption by Na+ K+ ATPase inhibition. The reproducibility of the method was good. With a decrease of lithogenic bile index, the protective effect of alcohol against biliary cholesterol cholelithiasis could be due either to stimulation of gallbladder emptying and/or acceleration of gallbladder filling.

Adolescent↗

PubMed1993

Ultrasonographic determination, in vitro and in vivo, of canine gallbladder volume, using four volumetric formulas and stepwise-regression models.

Twelve resected canine gallbladders (in vitro) and the gallbladder in each of 14 dogs (in vivo) were ultrasonographically examined. Gallbladder volume was calculated from ultrasonographically measured geometric dimensions, using 4 volumetric model formulas: cone, ellipse, biplanar ellipse, and prolate ellipse. Calculated volume was compared with true gallbladder volume, as measured by water displacement. All examined models for calculation of gallbladder volume were closely associated with true gallbladder volume (P < 0.005), and all models provided accurate predictions of true gallbladder volume (r2 > 0.80). Calculated volumes can be corrected mathematically by use of the regression coefficient and constant for each model. Body weight was not significantly associated with gallbladder volume in any of the models considered. Use of ultrasonography to accurately measure gallbladder volume could be combined with synthetic cholecystokinin-stimulated gallbladder emptying to provide information about biliary function and patency in icteric animals. Such information could aid the clinical decision between surgical or medical treatment. Correction of calculated volumes would not be necessary in association with induced emptying studies, because volume change is more important than absolute volume.

Animals↗

PubMed1993

Agenesis of the gallbladder revisited laparoscopically.

Gallbladder agenesis is an extremely rare disease. Necropsy incidence has been reported to be 0.016%. Failure to locate the gallbladder at the time of a planned cholecystectomy can be very challenging. We report such a case during a laparoscopic cholecystectomy. The indication for surgery in these patients are complaints of gallbladder symptoms along with a false-positive ultrasound study. During exploration, an abnormal location of the gallbladder has to be excluded. Ectopic gallbladder locations include intrahepatic, lesser omentum, retroperitoneal, retrohepatic, within the falciform ligament, retroduodenal, and retrohepatic areas. Thorough exploration and cholangiography are essential. Embryologically, the gallbladder and cystic duct arise from the caudal portion of the hepatic bud. All of the previously reported cases of gallbladder agenesis have shown an absence of both the gallbladder and cystic duct. We report an embryological oddity wherein a patent cystic duct was found along with an agenetic gallbladder. This is the first case report of this finding, along with this being the first absent gallbladder discovered laparoscopically.

Cholecystectomy, Laparoscopic↗

PubMed1996

Double gallbladder of swine.

In research on the reduplication of the pig gallbladder, a total of 297,531 swine from 130 breeders were surveyed at a slaughter house (Ozu Health Center, Ehime Prefecture, Japan) between October 1993 and December 1995. The swine were 6-7 months old and their body weights ranged from 95 to 120 kg. Twenty-nine swine were found to have reduplication of the gallbladder. Of these 19 were females, nine were males and the sex of one was not identified. The second sac was smaller than main one. Eleven cases were diverticulum of a cystic duct (Type I). Diverticulum of the neck of the main gallbladder of six cases also gave rise to the second gallbladder (Type II). A sac attached to the neck of the main gallbladder via a small cystic duct in seven cases was another type of reduplication (Type III). Connection of the second sac to the middle of the hepatic duct via a small cystic duct was seen in three cases (Type IV). The positions of these small sacs to the main gallbladder were right (13 cases), left (II cases) and ventral (three cases). The fundus of one gallbladder were divided and resulted in double sacs (Type V). One second sac was set apart from the main gallbladder and attached to a hepatic duct of lateral left lobe of the liver (Type VI). One specimen of the Type III gallbladder had two additional small sacs as diverticulum of the cystic duct. Compared to occurrences in humans and the Japanese monkey, the ratio of gallbladder reduplication to normal system anatomy in swine was extremely low. It was similar to the ratio of spleen reduplication in swine (1/10,000).

Animals↗