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At least 19 recordsLinked to original sources
PubMed1978

Gallbladder disease and gallbladder cancer among American Indians in tricultural New Mexico.

Previous studies have reported high rates of gallbladder disease and gallbladder cancer among all American Indians. Data from the New Mexico Tumor Registry confirm these findings, specifically showing high rates for New Mexico's American Indians, as well as for the state's Spanish population. This review explores several risk factors, including parity, obesity, age, cholesterol level, and genetic factors. From the available evidence, genetic factors appear to be the most important, with parity a contributing factor.

Epidemiologic Methods↗
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↗
PubMed1979

Prevalence of gallbladder disease in hyperlipoproteinemia.

An analysis of the occurrence of gallbladder disease (ie, cholelithiasis, cholecystitis, cholecystectomy) in 210 consecutive patients with primary hyperlipoproteinemia showed that the prevalence of gallbladder disease was 8%, 18%, and 42% in males with type IIa, IIb, and IV hyperlipoproteinemia, and 22%, 48%, and 72% in the corresponding groups of females. The 40-59-year-old patients were compared to three necropsy series from Malmö, Sweden. The occurrence of gallbladder disease was within normal limits in type IIa and abnormally high in type IV hyperlipoproteinemia. There were no differences with regard to age, body weight, glucose intolerance, or ischemic heart disease between type IV patients with and without GBD. It is suggested that certain forms of disturbances of lipoprotein metabolism are associated with an increased risk for development of gallbladder disease.

Adult↗
PubMed1977

Prevalence of gallstones and gallbladder disease in Canadian Micmac Indian women.

The prevalence of gallstones and gallbladder disease was studied between October 1973 and June 1976 in Canadian Micmac Indian women aged 15 to 50 years in an inland rural community near Shubenacadie, NS. Of 132 women at risk 98 underwent cholecystography, 6 had a history of cholecystectomy (verified from hospital records) and 3 had cholecystectomy because of cholecystitis during the 3 years of the study. Of the 17 abnormal cholecystograms 10 showed radiolucent gallstones, and repeated studies documented gallstones in 6 of the 7 radiographs on which the gallbladder was not visualized. The prevalence of gallstones was found to be 211/1000, and that of gallbladder disease, 240/1000. The peak prevalence was at 30 to 39 years of age. The women with gallbladder disease were significantly more obese and of greater parity than those without gallbladder disease even when age was controlled. The Micmac Indian women of Nova Scotia appear to be at a much higher risk for the development of cholesterol gallstones and gallbladder disease than Caucasian women in Framingham, Massachusetts.

Adolescent↗
PubMed1979

[Laparoscopy in chronic gallbladder diseases].

The laparoscopy is the only riskless possibility of directly inspecting the gall-bladder, to ascertain the diagnosis of a chronic cholecystitis, further to consider the indications to internal or surgical measures. For the judgment the form of the gall-bladder, the behaviour of its wall with different colouring, oedema and furthermore its behaviour to neighbouring organs are of decisive evidence. In a disease of the bile-ducts the laparoscopy allows to prove or to exclude a participation of the liver. For the judgment of the activity of a disease of the gall-bladder should, however, always be used clinical and radiological findings, the microbiological investigation of the A-, B-, and C-bile and the testing of the reflex of the gall-bladder. This is necessary with regard to the therapy.

Cholecystitis↗
PubMed1992

A case-control study of smoking and gallbladder disease: importance of examining time relations.

We report a case-control study of gallbladder disease and cigarette smoking. Subjects were 252 incident cases and 233 age-sex-residence-matched community controls. Three quarters of the subjects were women. The age-matched risk of gallbladder disease was increased in current smokers vs never-smokers [odds ratio (OR) = 1.6 and 1.3 in women and men, respectively] and in past smokers (OR = 1.5 for each sex). In light of earlier research, showing that, in women, certain risk factors for gallbladder disease may act maximally soon after first exposure, we examined time relations. In women, multivariable analysis showed that the risk increase was especially high in current-smoking women less than 35 years of age [OR = 3.5, 95% confidence interval (CI) = 1.2-9.8] and in women who had been smoking for 1-8 years (OR = 2.8, 95% CI = 1.1-7.1). These results indicate that, in women, the smoking-related risk of gallbladder disease is greatest soon after first exposure--as has also been reported for oral contraceptive use. The findings highlight the potential for mis-estimating risk in case-control studies when late-occurring cases have a different relation to the exposure factor than do the early-occurring cases within the original, albeit undocumented, exposure cohort.

Adult↗
PubMed1977

Detection of occult gallbladder disease by duodenal drainage.

Examination of gallbladder bile in the sediment of duodenal drainage obtained after magnesium sulfate stimulation was used to evaluate the presence or absence of gallbladder disease in thirty-four patients with symptoms suggestive of cholecystitis and normal or equivocal oral cholecystography. Ten patients had positive tests and nine of these had cholecystectomy. All nine had pathologically confirmed cholecystitis and seven of nine had cholelithiasis. Three patients with negative test results had laparotomy and normal gallbladders. The remaining twenty-one patients with negative tests have been followed up to three years, and none have returned with evidence of biliary tract disease. The results of this study suggest that duodenal drainage (Meltzer-Lyon test) is a valuable adjunctive diagnostic study in patients with gallbladder disease symptoms in whom normal or equivocal oral cholecystograms are obtained.

Adult↗
PubMed1977

Gallbladder disease as a side effect of drugs influencing lipid metabolism. Experience in the Coronary Drug Project.

We analyzed data obtained during the Coronary Drug Project to discover the influence of the drugs used on the frequency of gallbladder disease. Of 2680 placebo-treated men who had had myocardial infarction, gallbladder disease developed in 69. Corresponding figures for those given 2.5 mg of estrogen, 5.0 mg of estrogen and 1.8 g of clofibrate per day were 46 of 1061, 47 of 1081 and 42 of 1051, respectively. Each treatment group differed from placebo by over twice the standard error of the difference, life-table analysis yielding P less than 0.05 for each drug-placebo comparison. Forty-five variables, including age, body weight, blood pressure, serum lipids and blood sugar, were evaluated as risk factors. Age significantly correlated with prevalence of known gallbladder disease at entry (r = 0.066, P less than 0.001). No variable yielded a strong and consistent correlation with the incidence of subsequent new gallbladder disease. Gallstone formation is a risk whenever clofibrate or estrogen is prescribed.

Adult↗
PubMed1975

The negative cholecystogram in gallbladder disease.

Seventeen cases of radiologically negative gallbladder disease are presented. In all it was possible to explain the symptoms on the basis of the 'disappearing stone' hypothesis. It is suggested that cholecystectomy should be advised in such patients provided that the symptoms are sufficiently characteristic and sufficiently severe.

Adult↗
PubMed1975

Gallbladder disease in hyperlipoproteinaemia.

The occurrence of gallbladder disease (G.B.D.) (cholelithiasis, cholecystitis, cholecystectomy) was examined in patients consecutively admitted beccause of hyperlipoproteinaemia types IIa and IV. Altogether 37 of the 52 patients with the type IIa pattern were women, whereas 56 of the 75 subjects with hyperlipoproteinaemia type IV were men. The overall incidence of G.B.D. in the group with the type IIa was 13 per cent in the males and 22 per cent in the females; the corresponding figures in type IV were 41 per cent and 68 per cent, respectively. The findings in the major age-group (40-59 years) were compared with those from three necropsy series covering subjects of the same age. The incidence of G.B.D. was then found to be normal in type IIa but abnormally high in type IV. Patients with and without G.B.D. did not differ with regard to body-weight or glucose tolerance.

Age Factors↗
PubMed1979

The use of ultrasonography in the diagnosis of calculous gallbladder disease.

During a 12-month period from September 1976 to September 1977, 114 patients in a community hospital had ultrasonography as part of their diagnostic work-up for suspected gallbladder disease. While 65 per cent had an additional study, such as an oral cholecystogram or intravenous cholangiogram, 35 per cent had ultrasonography as the only study to make the diagnosis. All patients in this group had laparotomy and cholecystectomy to confirm or disprove the diagnosis of calculous gallbladder disease. The overall accuracy rate of ultrasonography for calculous gallbladder disease was 90 per cent, which compares favorably with the standard oral cholecystogram. Ultrasonography has some distinct advantages in certain clinical situations such as acute cholecystitis, jaundice, pancreatitis and pregnancy. A review of our clinical experience in the everyday use of ultrasonography for calculous biliary disease has been discussed, and guidelines for the use of ultrasonography as part of the diagnostic armamentarium for gallbladder disease are presented.

Cholangiography↗
PubMed1975

Development and evaluation of use of cholecystokinin in the diagnosis of acalculous gallbladder disease.

The need to differentiate patients with acalculous gallbladder disease who would benefit from cholecystectomy and those who would not led to the search for a procedure that would be of value in this respect. For this purpose, cholecystokinin (CCK) has been used, and many reports have indicated that CCK does identify patients in whom the gallbladder is the source of pain. A review of papers dealing with CCK as a diagnostic aid suggests, however, that some radiographic evaluations have not been subjected to adequate, unbiased interpretation and that some follow-up studies have been incomplete and of short duration. Despite these objections there is evidence that CCK can be useful as a diagnostic aid, and further, continued, well-designed studies are indicated.

Cholecystography↗
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↗
PubMed1976

Acalculous gallbladder disease: a prospective study.

A prospective study of 62 cases of acalculous gallbladder disease is reported. The clinical, radiological and pathological features are described as well as the results of cholecystectomy with a minimum follow-up of 3 years. The results compare favourably with those for calculous disease, and it is concluded that there is no clear-cut distinction between acalculous and calculous biliary disease.

Cholecystectomy↗
PubMed1992

Gallbladder disease in cystic fibrosis.

Among the various gastrointestinal manifestations observed in patients with cystic fibrosis (CF), gallbladder abnormalities occur frequently. These include a high prevalence of nonfunctioning gallbladders (30%), micro-gallbladders (8-30%), and gallstones (4-30%). The underlying pathophysiology for this increased prevalence in patients with CF is not completely understood, due to contradictory findings. These findings concern: (1) abnormalities in bile acid metabolism resulting in bile that is supersaturated with cholesterol, (2) an impaired nucleation time, and (3) biliary stasis, due to bile duct abnormalities and/or impaired gallbladder motility. The diagnosis of gallbladder disease in CF may be obscured by other common gastrointestinal complications, resulting in a long delay between onset of symptoms and the diagnosis. Cholecystectomy in CF is the treatment of choice, provided they are carefully managed in the pre- and perioperative period. The operative morbidity and mortality, even with intensive management of pulmonary disease, amounted to 10% and 5%, respectively. Therefore, alternative options, like laparoscopic cholecystectomy are of interest and require further investigation, especially for CF patients with severe pulmonary disease.

Cholecystectomy↗
PubMed1992

Significance of wall thickness in symptomatic gallbladder disease.

One hundred cases of patients who underwent urgent cholecystectomy after presenting with symptoms of acute or subacute gallbladder disease were retrospectively reviewed. Sixty patients had pathologically proved acute cholecystitis, and 40 had chronic cholecystitis alone. One patient had an incidental gallbladder carcinoma, and four had global gangrene of the gallbladder. Focal ischemia, transmural hemorrhage, or focal necrosis (indicating more severe disease) was present in 19 patients. Fifty-four percent of patients had thin-walled gallbladders. Among patients with more severe acute disease, 56% had thin walls. Conversely, 24% of thin-walled gallbladders and 22% of thick-walled gallbladders had evidence of focal necrosis or gangrene. We conclude that gallbladder wall thickness, although demonstrable on preoperative ultrasound examination in all patients, does not correlate directly with severity of disease or pathologic findings.

Acute Disease↗