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At least 109 records · Page 6Linked to original sources
PubMed1991

Sclerotherapy for ablation of the gallbladder after gallstone lithotripsy with a mechanical lithotriptor. An experimental study in pigs on the effect of absolute ethanol on edematous gallbladder wall.

Chemical ablation of the gallbladder with absolute ethanol following mechanical lithotripsy with the RotoLith lithotriptor was attempted in 10 pigs after open cholecystostomy. Two gallbladders removed immediately after the sclerotherapy demonstrated extensive ulcerations of the mucosa with preserved glands and sinuses under the ulcerations. In 8 gallbladders removed 8 weeks after sclerotherapy a gallbladder remnant with hydrops and/or mucus and more or less intact epithelium was seen in all the pigs. In order to prevent regeneration of epithelium from gallbladder sinuses and glands, more effective sclerosing agents must be found.

Animals↗
PubMed1978

Gallbladder wall thickening: a new sign of gallbladder disease visualized by gray scale cholecystosonography.

The use of gray scale equipment in a prospective study of radiologically non-visualizing gallbladders, permitted detection of a new echographic aspect of gallbladder disease. Along with even, discrete bile thickening and the presence of sand-sized calculi, thickening of the gallbladder wall incholecystitis is another ultrasonographic sign of gallbladder disease that can be visualized successfully by gray scale ultrasound.

Cholecystography↗
PubMed1980

Gallbladder carcinoma first diagnosed at microscopic examination of gallbladders removed for presumed benign disease.

The patients who survive gallbladder carcinomas more than five years are usually those in whom the carcinoma was first diagnosed at microscopic examination of gallbladders removed for presumed benign disease. A group of 32 such patients (from a series of 120 cases) was studied. The prognosis was very bad (longest survival 2.5 years) in 21 of the patients where the cancer involved all the layers of the gallbladder wall. The prognosis was far better in the 11 patients in which the cancer was confined to the mucosa or submucosa. Sixty-four per cent of the patients were alive after 5 years and 44% after 10 years. Five of the 11 patients died because of recurrence. Simple cholecystectomy had been performed in all the patients except one who underwent a right hepatic lobectomy. Radical cholecystectomy including a wedge resection of liver tissue and dissection of the regional lymph nodes is recommended in all patients with inapparent gallbladder carcinomas.

Adenocarcinoma↗
PubMed1991

"Adenomatous polyps of the gallbladder" adenomas of the gallbladder.

The finding of adenomatous polyps of the gallbladder is a rare occurrence and an unusual clinical problem. Among 2,145 patients who underwent cholecystectomy for gallbladder disease only 9 (0.4 per cent) presented with adenomatous polyps. There were 6 women and 3 men, aged 17 to 70 years. Preoperative ultrasonographic diagnosis was made in only 1 of 7 patients with gallstones, in contrast polypoid lesions within a gallbladder without stones were easily confirmed by both ultrasonography and oral cholecystography in the remaining 2 patients. All polyps were 1.0 cm or less in size and without histologic evidence of malignant change. The clinical significance of this rare condition is discussed, with particular reference to a possible role in development of gallbladder carcinoma. Surgical treatment should be advocated regardless of clinical manifestation when the polyp exceeds 1.0 cm in diameter or rapid growth of the lesion is seen on ultrasonographic follow-up examinations.

Adenoma↗
PubMed1984

Gallbladder carcinoma. Another cause of the distended photon-deficient gallbladder in cholescintigraphy.

A case report of an 82-year-old woman with carcinoma of the gallbladder is presented. Technetium-99m DISIDA cholescintigraphy demonstrated nonvisualization of the gallbladder, with a large photon-deficient region corresponding to the gallbladder fossa, with medial displacement of the common bile duct. Carcinoma of the gallbladder has not been previously described as a cause of this scintigraphic pattern.

Adenocarcinoma↗
PubMed1997

Carcinoma of the gallbladder and anomalous arrangement of the pancreaticobiliary ductal system: cell kinetic studies of gallbladder epithelial cells.

Anomalous arrangement of the pancreaticobiliary ductal system (AAPB), a congenital anomaly defined as a union of the pancreatic and biliary ducts located outside the duodenal wall, is a newly designated disease entity, and is frequently found in adult patients with gallbladder carcinoma (GBX). In the present study, the relationship of AAPB and GBX was investigated. We studied 27 patients with GBX and AAPB, 34 patients with AAPB and without GBX, and as a control group, 56 patients without AAPB (10 with GBX, 24 with cholecystolithiasis, and 22 with normal gallbladder). Tissue sections from cancerous and non-cancerous mucosa of the gallbladder of all of these patients were stained for proliferating cell nuclear antigen (PCNA), Ki-67 nuclear antigen, and bromodeoxyuridine (BrdU). The Ki-67 labeling index (Ki-67-LI), PCNA labeling index (PCNA-LI), and BrdU labeling index (BrdU-LI) of the noncancerous mucosa in the patients with AAPB and/or GBX were significantly higher than those in the patients without GBX and AAPB (P < 0.01). These indices of the noncancerous mucosa in the patients with AAPB and GBX were significantly higher than those in the patients with either AAPB or GBX (P < 0.05). Cell proliferation in the gallbladder epithelia was accelerated in patients with AAPB. Consequently, AAPB appears to be an important risk factor for the occurrence of GBX.

Adult↗
PubMed2002

So-called carcinosarcoma of the gallbladder; spindle cell carcinoma of the gallbladder: report of a case.

We report a so-called carcinosarcoma of the gallbladder in a 53-year-old man. The findings of ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography, and angiography revealed a large mass of the gallbladder with a cholesterol stone. He underwent three operations, and died from liver failure with multiple liver metastasis immediately after the third operation. A pathological examination revealed neoplastic tissue composed of sarcomatous and glandular components. Hematoxylin-eosin stain proved the presence of carcinosarcoma in the gallbladder, but an immunohistochemical study proved that the sarcomatous component was stained by antivimentin and also anticytokeratin antibodies, which thus proved it to be so-called carcinosarcoma of the gallbladder. As a result, an immunohistochemical study is considered to provide valuable information regarding the identification of sarcomatous elements in such cases.

Carcinoma↗
PubMed1993

Expression of oncogene products and growth factors in early gallbladder cancer, advanced gallbladder cancer, and chronic cholecystitis.

The expression of oncogene products and growth factors (epidermal growth factor, transforming growth factor-beta, erbB-2, ras p 21, and c-myc) in gallbladder cancer and chronic cholecystitis was measured by immunohistochemical staining on paraffin-embedded serial sections. Expression of these products was graded according to staining intensity in an area of positively stained cells. This study reports the detection of oncogene products and growth factors in cholecystitis as well as in early and late gallbladder cancer. The multiexpression of oncogene products and growth factors was greater for both gallbladder cancer groups as compared with the cholecystitis group. The percentage of epidermal growth factor positivity diminished with increased proportion of interstitial tissue and, conversely, the percentage of transforming growth factor positivity increased with increased proportion of interstitial tissue. The proportion of ras positivity was significantly greater in both early and advanced cholecystic cancer as compared with cholecystitis, but also was considerable even for cholecystitis. These results suggest that various oncogenes may have significant roles in gallbladder cancer and that collagen synthesis is reduced by epidermal growth factor and enhanced by transforming growth factor-beta.

Cholecystitis↗
PubMed1976

Route of infection in extrahepatic biliary tract disease. II: Bacterial recovery from gallbladder bile and gallbladder wall in human biliary tract disease.

Bacterial recovery from gallbladder wall and gallbladder bile was investigated in 73 patients with extrahepatic biliary tract diseases. The technique of anaerobic culture was based on the use of a 'glove-box' and prereduced anaerobically sterilized media. Transport of samples was based on evacuation of atmospheric air with oxygen-free carbon dioxide and a transport time less than 30 minutes. When samples of bile and tissue were obtained simultaneously before operations on the biliary tract were begun and handled by one of the authors to avoid contamination, no significant difference in bacterial recovery between bile and tissue was observed. If samples were handled routinely by the staff or if biopsy from the gallbladder wall was not obtained until after operation on the biliary tract was finished, bacterial recovery from gallbladder tissue was significantly more frequent compared to bile. Under these last mentioned circumstances, the difference in bacterial recovery was due to bacterial species like Staph. aureus, Staph. albus, P. acnes and Difteroids.

Adult↗
PubMed1992

[Benign polypoid lesions of the gallbladder. Their relation to gallbladder adenocarcinoma].

Out of 12,153 cholecystectomies performed over a period of 10 years, 114 polypoid lesions were found in 81 removed gallbladders (0.7%). 225 adenocarcinomas of the gallbladder were found in the same population (1.85%). The mean age of patients with polypoid lesions was 46 years, with a male to female ratio of 1:2.7. 94% of lesions measured less than 10 mm and only 9.6% were adenomas. Among these, dysplastic alterations were found in all and one had evidence of early adenocarcinoma. The mean age of patients with adenocarcinoma was 62 years with a male to female ratio of 1:6. Residual adenomas were found in 2 cases and multiple adenomas coexisted in another case. Thus, polypoid lesions of the gallbladder are less frequent than adenocarcinoma. Only adenomas show a potential to evolve to malignant lesions, but their low incidence makes them an unimportant precursor of gallbladder carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[Ultrasonographic changes in the gallbladder wall in non-gallbladder diseases].

Alterations of the gallbladder wall is a well known sonographic sign of acute cholecystitis. But thickening of the gallbladder wall is also found in patients without intrinsic gallbladder disease. We present our experience on this regard in patients with cirrhosis, acute viral hepatitis, infectious mononucleosis, halothane hepatitis, fulminant hepatic failure, malaria due to plasmodium falciparum, heart failure, severe malnutrition due to gastric obstruction, septicemia, pyogenic hepatic abscess, amoebic hepatic abscess and in a 14 years old patient with fracture of the skull-acute anemia-shock. Most of these diseases affected the liver directly or indirectly. Knowledge of these alterations of the gallbladder wall in these circumstances are important in order to avoid a the erroneous diagnosis of acute cholecystitis.

Acute Disease↗
PubMed1989

Ectopic gastric mucosa of the gallbladder: comparison with metaplastic polyp of the gallbladder.

We report a case of ectopic gastric mucosa of the gallbladder in a 44-yr-old man. A sessile polypoid lesion 1.0 cm in diameter was seen in the body of the gallbladder, without gallstones. The polypoid lesion consisted of gastric pyloric glands and fundic glands. The surrounding mucosa consisted of ordinary gallbladder epithelium without any metaplastic change. To elucidate the characteristics of this lesion, a clinicopathological comparison was made with metaplastic polyp of the gallbladder.

Adult↗
PubMed1989

[Diagnostic imaging of gallbladder carcinomas with special reference to ultrasonographic findings. Retrospective review with emphasis on diagnostic problems in preoperatively undiagnosed gallbladder carcinomas].

The diagnostic images of twenty surgically-resected gallbladder carcinomas were retrospectively reviewed for correlations with macroscopic findings. Among them, nine cases were correctly diagnosed preoperatively; 11 were not. Macroscopically, all correctly diagnosed lesions were elevated type carcinomas. Preoperatively undiagnosed lesions were comprised by 9 superficial and 2 elevated types of carcinomas. None of these 11 undiagnosed carcinomas could be identified on retrospective review of the ultrasonographic findings. Thorough evaluation of the gallbladder wall was prevented by gallstones and/or emphysema in 6 cases, and by contraction of the gallbladder in 4 cases. There was no definite evidence of wall thickening in one case of diffuse superficial carcinoma involving the muscle layer. As for lesion detectability, computed tomography was inferior to ultrasonography, though the former demonstrated localized wall thickening of the gallbladder in the majority of cases of elevated type carcinomas. Intravenous cholangiographic findings were non-specific.

Adenocarcinoma↗
PubMed1986

[Anatomopathological behavior of gallbladder cancer. Frequency and importance of precancerous epithelial lesions of gallbladder cancer].

Surgical and autopsy materials were analyzed in a period of six years at La Paz, Bolivia "Bolivian Japanese Gastroenterological Institute" (Instituto de Gastroenterología Boliviano Japonés de La Paz, Bolivia), searching for macro and microscopic appearance of gallbladder cancer. Adenocarcinoma with infiltrative growth was the most frequent finding. Cholecystitis and Cholelithiasis were present in all the cases of gallbladder cancer. Epithelial lesions such hyperplasia, atypical hyperplasia and carcinoma in situ were frequent findings in the surrounding mucosa of invasive gallbladder carcinoma and not so frequent in benign gallbladder lesions. Group V of Nevin classification was common in our cases.

Adenocarcinoma↗
PubMed1979

[Acute acalculous gallbladder disease in children: acute cholecystitis or acute gallbladder distension (author's transl)].

Acute acalculous gallbladder disease is rarely encountered in children. Two observations permit a review of its clinical, diagnostic, and therapeutic aspects. Acute acalculous cholecystitis and acute gallbladder distension present clinically in a similar fashion, although, in the latter the fever is usually absent and there is a history of episodic pain. The pathogenesis of these affections remains uncertain but generalized infection and anomalies of the cystic duct seem to be favoring circumstances. The diagnosis, rarely initially made, could be confirmed by oral cholecystography showing an non visualized gallbladder. Surgery is necessary in order to confirme or refute the diagnosis. The therapeutic approach can be either the simple drainage of the gallbladder or a cholecystectomy. Due to the risk of allowing a cervicocystic obstacle persist, it seems that a cholecystectomy, which is well tolerated by the child, would be preferable.

Acute Disease↗
PubMedDate not supplied

Diffuse papillomatosis of the gallbladder: case report of a hydropic gallbladder.

We present the case of a 47 year-old man with a gallbladder papillomatosis. His medical history showed typical biliary symptoms with chronic colicky pain and two episodes of jaundice. Unusually, the patient himself discovered a right hypochondrial mass which appeared to be a hydropic gallbladder. Pre-operative diagnosis was done by ultrasonography and percutaneous cholecystography. A cholecystectomy was performed. Gross description and microscopic examination confirmed the diagnosis of benign diffuse papillomatosis involving the entire mucosal surface of the gallbladder. The clinical and anatomical aspects of this lesion are discussed.

Edema↗
PubMed1994

The relation between biliary lipids, nucleation time, and number of gallbladder stones after percutaneous gallbladder puncture.

BACKGROUND: Biliary lipids and nucleation time are increasingly of importance in the understanding of the cholesterol nucleation process in gallstone patients. METHODS: Biliary lipids, total lipid concentration (TLC), cholesterol saturation index (CSI) and nucleation time (NT) were studied in 221 bile samples from patients with solitary (n = 120) and multiple (n = 101) gallbladder stones. RESULTS: Biliary cholesterol concentration and CSI did not differ between patients with solitary or multiple stones; however, it was positively correlated with the CSI (r = 0.93; p < 0.01). We found a negative correlation between CSI and TLC (r = -0.77 for solitary stones and r = -0.79 for multiple stones; p < 0.01). Furthermore, levels of total bile acids and phospholipids were similar in cases with solitary and multiple gallbladder stones. TLC did not correlate with single or multiple stones, whereas NT was determined to be negatively correlated with the number of gallstones (r = -0.39; p < 0.01). Patients with solitary stones had a significantly (p < 0.01) longer NT than those with multiple gallbladder stones (7.5 +/- 4.2 days versus 2.3 +/- 1.5 days). CONCLUSIONS: Our findings suggest that there exists a nucleation-promoting activity, which seems to be more pronounced in patients with multiple gallbladder stones than in those with solitary stones, indicating a major risk factor for the higher recurrence rate seen in these patients.

Adult↗