936 results on '"Cholelithiasis physiopathology"'
Search Results
2. Pathophysiological connections between gallstone disease, insulin resistance, and obesity.
- Author
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Cortés VA, Barrera F, and Nervi F
- Subjects
- Adipose Tissue physiopathology, Animals, Bile Acids and Salts metabolism, Cholecystectomy statistics & numerical data, Energy Metabolism physiology, Fatty Liver complications, Fatty Liver physiopathology, Female, Gallbladder physiopathology, Humans, Intestines physiopathology, Lipid Metabolism physiology, Liver physiopathology, Risk Factors, Cholelithiasis complications, Cholelithiasis physiopathology, Insulin Resistance physiology, Obesity complications, Obesity physiopathology
- Abstract
Obesity and cholesterol gallstone disease (GSD) are frequently coexisting diseases; therefore and considering the current worldwide obesity epidemics, a precise understanding of the pathophysiological relationships between GSD and insulin resistance (IR) is important. Classically, obesity has been understood as a risk factor for GSD and the gallbladder (GB) viewed as a simple bile reservoir, with no metabolic roles whatsoever. However, consistent evidence has showed that both GSD and cholecystectomy associates with fatty liver and IR, raising the possibility that the GB is indeed an organ with metabolic regulatory roles. Herein, we review the pathophysiological mechanisms by which GSD, IR, and obesity are interconnected, with emphasis in the actions of the GB as a regulator of bile acids kinetics and a hormone secreting organ, with metabolic actions at the systemic level. We also examine the relationships between increased hepatic lipogenic in IR states and GSD pathogenesis. We propose a model in which GSD and hepatic IR mutually interact to determine a state of dysregulated lipid and energy metabolism that potentiate the metabolic dysregulation of obesity., (© 2019 World Obesity Federation.) more...
- Published
- 2020
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3. New Avenues in the Regulation of Gallbladder Motility-Implications for the Use of Glucagon-Like Peptide-Derived Drugs.
- Author
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Gether IM, Nexøe-Larsen C, and Knop FK
- Subjects
- Bile Acids and Salts metabolism, Cholecystitis chemically induced, Cholecystitis physiopathology, Cholecystokinin metabolism, Cholelithiasis chemically induced, Cholelithiasis physiopathology, Diabetes Mellitus, Type 2 drug therapy, Gallbladder physiopathology, Gallbladder Emptying physiology, Glucagon-Like Peptide 1 metabolism, Glucagon-Like Peptide 2 metabolism, Glucagon-Like Peptide-1 Receptor agonists, Glucagon-Like Peptide-1 Receptor metabolism, Glucagon-Like Peptide-2 Receptor agonists, Glucagon-Like Peptide-2 Receptor metabolism, Humans, Muscle Contraction physiology, Muscle, Smooth drug effects, Muscle, Smooth physiopathology, Obesity drug therapy, Postprandial Period physiology, Gallbladder drug effects, Gallbladder Emptying drug effects, Glucagon-Like Peptides adverse effects, Muscle Contraction drug effects
- Abstract
Context: Several cases of cholelithiasis and cholecystitis have been reported in patients treated with glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RAs) and GLP-2 receptor agonists (GLP-2RAs), respectively. Thus, the effects of GLP-1 and GLP-2 on gallbladder motility have been investigated. We have provided an overview of the mechanisms regulating gallbladder motility and highlight novel findings on the effects of bile acids and glucagon-like peptides on gallbladder motility., Evidence Acquisition: The articles included in the present review were identified using electronic literature searches. The search results were narrowed to data reporting the effects of bile acids and GLPs on gallbladder motility., Evidence Synthesis: Bile acids negate the effect of postprandial cholecystokinin-mediated gallbladder contraction. Two bile acid receptors seem to be involved in this feedback mechanism, the transmembrane Takeda G protein-coupled receptor 5 (TGR5) and the nuclear farnesoid X receptor. Furthermore, activation of TGR5 in enteroendocrine L cells leads to release of GLP-1 and, possibly, GLP-2. Recent findings have pointed to the existence of a bile acid-TGR5-L cell-GLP-2 axis that serves to terminate meal-induced gallbladder contraction and thereby initiate gallbladder refilling. GLP-2 might play a dominant role in this axis by directly relaxing the gallbladder. Moreover, recent findings have suggested GLP-1RA treatment prolongs the refilling phase of the gallbladder., Conclusions: GLP-2 receptor activation in rodents acutely increases the volume of the gallbladder, which might explain the risk of gallbladder diseases associated with GLP-2RA treatment observed in humans. GLP-1RA-induced prolongation of human gallbladder refilling may explain the gallbladder events observed in GLP-1RA clinical trials., (Copyright © 2019 Endocrine Society.) more...
- Published
- 2019
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4. Association between cholelithiasis and sialolithiasis: Two longitudinal follow-up studies.
- Author
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Kim SY, Kim HJ, Lim H, Lim MS, Kim M, Park IS, and Choi HG
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Cholelithiasis epidemiology, Cohort Studies, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Proportional Hazards Models, Republic of Korea epidemiology, Salivary Gland Calculi epidemiology, Cholelithiasis physiopathology, Salivary Gland Calculi physiopathology
- Abstract
This study aimed to evaluate the association between cholelithiasis and sialolithiasis using a national sample cohort in Korea.The Korean National Health Insurance Service-National Sample Cohort (patients ≥20 years old) was collected from 2002 to 2013. In study I, we extracted cholelithiasis patients (n = 21,170) and 1:4 matched control I subjects (n = 84,680) and analyzed the occurrence of sialolithiasis. In study II, we extracted sialolithiasis patients (n = 761) and 1:4 matched control II subjects (n = 3044) and analyzed the occurrence of cholelithiasis. Hazard ratios (HRs) were determined using the stratified Cox proportional hazard model.The HR for sialolithiasis was 1.49 (95% CI = 0.88-2.52) in the cholelithiasis group (P = .14), and the HR for cholelithiasis was 1.18 (95% CI = 0.53-2.59) in the sialolithiasis group (P = .69).We did not find an association between cholelithiasis and sialolithiasis. more...
- Published
- 2019
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5. Cholelithiasis: Presentation and Management.
- Author
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Littlefield A and Lenahan C
- Subjects
- Cholangiopancreatography, Endoscopic Retrograde, Cholecystectomy, Laparoscopic, Cholelithiasis physiopathology, Female, Humans, Male, Pregnancy, Pregnancy Complications physiopathology, Pregnant Women, Risk Factors, Ultrasonography, Cholelithiasis diagnosis, Cholelithiasis therapy, Pregnancy Complications diagnosis, Pregnancy Complications therapy
- Abstract
Cholelithiasis affects approximately 15% of the US population. Rising trends in obesity and metabolic syndrome have contributed to an increase in diagnosis of cholelithiasis. There are several risk factors for cholelithiasis, both modifiable and nonmodifiable. Women are more likely to experience cholelithiasis than are men. Pregnancy, increasing parity, and obesity during pregnancy further increase the risk that a woman will develop cholelithiasis. The classic presentation of persons experiencing cholelithiasis, specifically when gallstones obstruct the common bile duct, is right upper quadrant pain of the abdomen that is often elicited upon palpation during physical examination and documented as a positive Murphy's sign. Referred pain to the right supraclavicular region and/or shoulder, nausea, and vomiting are also frequently reported by persons with cholelithiasis. Cholelithiasis can result in complications, including cholecystitis (inflammation of the gallbladder) and cholangitis (inflammation of the bile duct). Lack of physical examination findings does not rule out a diagnosis of cholelithiasis. Laboratory tests such as white blood cell count, liver enzymes, amylase, and lipase may assist the clinician in diagnosing cholelithiasis; however, ultrasonography is the gold standard for diagnosis. Management is dependent on severity and frequency of symptoms. Lifestyle and dietary modifications combined with medication management, such as use of gallstone dissolution agents, may be recommended for persons who have a single symptomatic episode. If symptoms become severe and/or are recurrent, laparoscopic cholecystectomy is recommended. It is recommended that individuals with an established diagnosis of cholelithiasis be referred to a surgeon and/or gastroenterologist within 2 weeks of initial presentation regardless of severity or frequency of symptoms., (© 2019 by the American College of Nurse-Midwives.) more...
- Published
- 2019
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6. Frequency of Hepatobiliary Manifestations and Concomitant Liver Disease in Inflammatory Bowel Disease Patients.
- Author
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Silva J, Brito BS, Silva INN, Nóbrega VG, da Silva MCSM, Gomes HDN, Fortes FM, Pimentel AM, Mota J, Almeida N, Surlo VC, Lyra A, Rocha R, and Santana GO
- Subjects
- Adult, Azathioprine adverse effects, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Colitis, Ulcerative diagnosis, Colitis, Ulcerative physiopathology, Crohn Disease diagnosis, Crohn Disease physiopathology, Cross-Sectional Studies, Female, Hepatitis B diagnosis, Hepatitis B physiopathology, Hepatitis C diagnosis, Hepatitis C physiopathology, Hepatitis, Autoimmune diagnosis, Hepatitis, Autoimmune physiopathology, Humans, Inflammatory Bowel Diseases classification, Inflammatory Bowel Diseases physiopathology, Liver Diseases classification, Liver Diseases pathology, Liver Diseases, Alcoholic diagnosis, Liver Diseases, Alcoholic physiopathology, Male, Middle Aged, Non-alcoholic Fatty Liver Disease diagnosis, Non-alcoholic Fatty Liver Disease physiopathology, Young Adult, Hepatobiliary Elimination, Inflammatory Bowel Diseases diagnosis, Liver physiopathology
- Abstract
Background: In inflammatory bowel disease (IBD) patients there are reports of the occurrence of hepatobiliary manifestations, so the aim of this study was to evaluate the hepatobiliary manifestations in patients with Crohn's disease (CD) and ulcerative colitis (UC) from an IBD reference center., Methods: Cross-sectional study in an IBD reference center, with interviews and review of medical charts, between July 2015 and August 2016. A questionnaire addressing epidemiological and clinical characteristics was used., Results: We interviewed 306 patients, and the majority had UC (53.9%) and were female (61.8%). Hepatobiliary manifestations were observed in 60 (19.6%) patients with IBD. In the greater part of the patients (56.7%) hepatobiliary disorders were detected after the diagnosis of IBD. In UC (18.2%) patients, the hepatobiliary disorders identified were 11 (6.7%) non-alcoholic fatty liver disease, 9 (5.5%) cholelithiasis, 6 (3.6%) primary sclerosing cholangitis (PSC), 3 (1.8%) hepatotoxicity associated with azathioprine, 1 (0.6%) hepatitis B, and 1 (0.6%) hepatic fibrosis. In CD (21.3%) patients, 11 (7.8%) had cholelithiasis, 11 (7.8%) non-alcoholic fatty liver disease, 4 (2.8%) PSC, 3 (2.1%) hepatotoxicity, 1 (0.7%) hepatitis B, (0.7%) hepatitis C, 1 (0.7%) alcoholic liver disease, and 1 (0.7%) autoimmune hepatitis (AIH). There was one case of PSC/AIH overlap syndrome., Conclusion: The frequency of hepatobiliary disorders was similar in both forms of IBD in patients evaluated. The most common nonspecific hepatobiliary manifestations in IBD patients were non-alcoholic liver disease and cholelithiasis. The most common specific hepatobiliary disorder was PSC in patients with extensive UC or ileocolonic CD involvement; this was seen more frequently in male patients. more...
- Published
- 2019
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7. Gallbladder interstitial Cajal-like cells and gallbladder contractility in patients with cholelithiasis: a prospective study.
- Author
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Ding R, Wei J, and Xu J
- Subjects
- Adult, Aged, Animals, Antibodies immunology, Cell Count, Cholelithiasis pathology, Female, Gallbladder pathology, Goats, Humans, Male, Mice, Middle Aged, Prospective Studies, Proto-Oncogene Proteins c-kit immunology, Rabbits, Telocytes pathology, Tryptases immunology, Cholelithiasis physiopathology, Gallbladder cytology, Gallbladder physiology, Gallbladder Emptying physiology, Telocytes cytology
- Abstract
Introduction: A reduced number of interstitial Cajal-like cells (ICLCs) in the gallbladder have been proposed to play a role in the pathogenesis of cholelithiasis. Therefore, this prospective study was conducted to investigate the relationship between gallbladder contractility and the number of gallbladder ICLCs in patients with cholelithiasis., Material and Methods: Patients admitted to the Department of Hepatobiliary Surgery for cholecystectomy were divided into the cholelithiasis (n = 18) and non-cholelithiasis (n = 8) groups based on their clinical data. Patients' clinical data were collected on admission, and B-mode ultrasonography was performed to assess their gallbladder contractility. The resected gallbladder specimens were fixed, paraffin sections mounted on slides, and the immunofluorescence staining with the anti-human CD-117 and anti-human tryptase antibodies was performed to identify ICLSs and mast cells, respectively. The number of ICLCs was counted in 10 high-power fields (HPFs) randomly., Results: Independent sample t-tests revealed differences between the cholelithiasis and non-cholelithiasis groups in the number of ICLCs (mean ± standard deviation: 88.61 ± 28.22 vs. 115.89 ± 27.87 per HPFs, P = 0.032) and gallbladder contractility (43.94% ± 18.50% vs. 61.00% ± 20.50%, P = 0.046). Pearson and Spearman cor-relation analyses revealed no significant correlation between the number of ICLCs and gallbladder contractility., Conclusion: The results suggest that the number of gallbladder ICLCs in the wall of the gallbladder of patients with or without cholelithiasis is not a decisive factor affecting gallbladder contractility. more...
- Published
- 2019
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8. Exercising the hepatobiliary-gut axis. The impact of physical activity performance.
- Author
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Molina-Molina E, Lunardi Baccetto R, Wang DQ, de Bari O, Krawczyk M, and Portincasa P
- Subjects
- Adult, Aged, Bile Acids and Salts metabolism, Cholecystitis physiopathology, Cholecystitis prevention & control, Cholelithiasis physiopathology, Cholelithiasis prevention & control, Female, Healthy Lifestyle, Humans, Male, Microbiota physiology, Middle Aged, Non-alcoholic Fatty Liver Disease physiopathology, Non-alcoholic Fatty Liver Disease prevention & control, Biliary Tract physiology, Exercise physiology
- Abstract
Background: Physical inactivity puts the populations at risk of several health problems, while regular physical activity brings beneficial effects on cardiovascular disease, mortality and other health outcomes, including obesity, glycaemic control and insulin resistance. The hepatobiliary tract is greatly involved in several metabolic aspects which include digestion and absorption of nutrients in concert with intestinal motility, bile acid secretion and flow across the enterohepatic circulation and intestinal microbiota. Several metabolic abnormalities, including nonalcoholic fatty liver as well as cholesterol cholelithiasis, represent two conditions explained by changes of the aforementioned pathways., Materials and Methods: This review defines different training modalities and discusses the effects of physical activity in two metabolic disorders, that is nonalcoholic fatty liver disease (NAFLD) and cholelithiasis. Emphasis is given to pathogenic mechanisms involving intestinal bile acids, microbiota and inflammatory status., Results: A full definition of physical activity includes the knowledge of aerobic and endurance exercise, metabolic equivalent tasks, duration, frequency and intensity, beneficial and harmful effects. Physical activity influences the hepatobiliary-gut axis at different levels and brings benefits to fat distribution, liver fat and gallbladder disease while interacting with bile acids as signalling molecules, intestinal microbiota and inflammatory changes in the body., Conclusions: Several beneficial effects of physical activity are anticipated on metabolic disorders linking liver steatosis, gallstone disease, gut motility, enterohepatic circulation of signalling bile acids in relation to intestinal microbiota and inflammatory changes., (© 2018 Stichting European Society for Clinical Investigation Journal Foundation.) more...
- Published
- 2018
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9. Incidence of cholecystectomy after bariatric surgery.
- Author
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Altieri MS, Yang J, Nie L, Docimo S, Talamini M, and Pryor AD
- Subjects
- Adult, Body Mass Index, Cholecystectomy methods, Cholelithiasis etiology, Cholelithiasis physiopathology, Cholelithiasis surgery, Cohort Studies, Confidence Intervals, Databases, Factual, Female, Gastrectomy adverse effects, Gastrectomy methods, Gastric Bypass methods, Gastroplasty adverse effects, Gastroplasty methods, Hospitals, University, Humans, Incidence, Male, Middle Aged, New York, Obesity, Morbid diagnosis, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Treatment Outcome, Bariatric Surgery adverse effects, Bariatric Surgery methods, Cholecystectomy statistics & numerical data, Obesity, Morbid surgery
- Abstract
Background: Bariatric surgery predisposes patients to development of cholelithiasis, and therefore the need of a subsequent cholecystectomy; however, the incidence of cholecystectomy after bariatric surgery is debated., Objective: The purpose of our study is to assess the incidence of cholecystectomy after 3 of the most common bariatric procedures., Setting: University Hospital, involving a large database in New York State., Methods: The Statewide Planning and Research Cooperative System administrative longitudinal database was used to identify all patients undergoing Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB) between 2004 and 2010. Through the use of a unique identifier patients were followed to evaluate for the need of a subsequent cholecystectomy over at least 5 years. Cox proportional hazard regression analysis was used to identify risk factors for subsequent cholecystectomy., Results: During this time period, there were 15,301 LAGB procedures, 19,996 RYGB, and 1650 SG. There were 989 (6.5%) patients who underwent cholecystectomy after LAGB, 1931 (9.7%) patients after RYGB, and 167 (10.1%) after SG. Approximately one quarter of follow-up cholecystectomies were performed at the same institutions. LAGB and RYGB were less likely to have a subsequent cholecystectomy compared with SG (hazard ratio .5, 95% confidence interval .4-.6 for LAGB; and hazard ratio .7, 95% confidence interval .6-.9 for RYGB). Risk factors for a subsequent cholecystectomy included age, sex, race, and some co-morbidities and complications (P<.05) based on a multivariable Cox proportional hazard model., Conclusion: The rate of cholecystectomy after LAGB, RYGB, and SG was 6.5%, 9.7% and 10.1%, respectively. Patients should be counseled preoperatively about this risk and biliary prophylaxis should be contemplated., (Published by Elsevier Inc.) more...
- Published
- 2018
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10. An update on the pathogenesis of cholesterol gallstone disease.
- Author
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Di Ciaula A, Wang DQ, and Portincasa P
- Subjects
- Animals, Bile chemistry, Biliary Dyskinesia etiology, Biliary Dyskinesia physiopathology, Cholelithiasis etiology, Disease Models, Animal, Epigenesis, Genetic, Gallstones etiology, Gastrointestinal Microbiome physiology, Gene-Environment Interaction, Genetic Predisposition to Disease, Humans, Intestines physiopathology, Mice, Cholelithiasis physiopathology, Cholesterol metabolism, Gallstones physiopathology
- Abstract
Purpose of Review: Gallstone disease is a major epidemiologic and economic burden worldwide, and the most frequent form is cholesterol gallstone disease., Recent Findings: Major pathogenetic factors for cholesterol gallstones include a genetic background, hepatic hypersecretion of cholesterol, and supersaturated bile which give life to precipitating cholesterol crystals that accumulate and grow in a sluggish gallbladder. Additional factors include mucin and inflammatory changes in the gallbladder, slow intestinal motility, increased intestinal absorption of cholesterol, and altered gut microbiota. Mechanisms of disease are linked with insulin resistance, obesity, the metabolic syndrome, and type 2 diabetes. The role of nuclear receptors, signaling pathways, gut microbiota, and epigenome are being actively investigated., Summary: Ongoing research on cholesterol gallstone disease is intensively investigating several pathogenic mechanisms, associated metabolic disorders, new therapeutic approaches, and novel strategies for primary prevention, including lifestyles. more...
- Published
- 2018
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11. Mouse models of gallstone disease.
- Author
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Wang TY, Portincasa P, Liu M, Tso P, and Wang DQ
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- Animals, Cholelithiasis physiopathology, Gallstones physiopathology, Genetic Predisposition to Disease genetics, Humans, Mice, ATP Binding Cassette Transporter, Subfamily G genetics, Cholelithiasis genetics, Disease Models, Animal, Gallstones genetics
- Abstract
Purpose of Review: The establishment of mouse models of gallstones, and the contribution of mouse models to genetic studies of gallstone disease, as well as the latest advances in the pathophysiology of gallstones from mouse experiments are summarized., Recent Findings: The combined uses of genomic strategies and phenotypic studies in mice have successfully led to the identification of many Lith genes, which pave the way for the discovery of human LITH genes. The physical-chemical, genetic, and molecular biological studies of gallstone disease in mice with knockout or transgene of specific target genes have provided many novel insights into the complex pathophysiological mechanisms of this very common hepatobiliary disease worldwide, showing that interactions of five primary defects play a critical role in the pathogenesis of cholesterol gallstones. Based on mouse studies, a new concept has been proposed that hepatic hypersecretion of biliary cholesterol is induced by multiple Lith genes, with insulin resistance as part of the metabolic syndrome interacting with cholelithogenic environmental factors to cause the phenotype., Summary: The mouse model of gallstones is crucial for elucidating the physical-chemical and genetic mechanisms of cholesterol crystallization and gallstone formation, which greatly increase our understanding of the pathogenesis of this disease in humans. more...
- Published
- 2018
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12. Cholecystectomy as a risk factor of metabolic syndrome: from epidemiologic clues to biochemical mechanisms.
- Author
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Chen Y, Wu S, and Tian Y
- Subjects
- Animals, Bile Acids and Salts metabolism, Cholelithiasis epidemiology, Cholelithiasis etiology, Cholelithiasis metabolism, Cholelithiasis physiopathology, Comorbidity, Dyslipidemias epidemiology, Dyslipidemias etiology, Dyslipidemias metabolism, Dyslipidemias physiopathology, Energy Metabolism, Gallbladder metabolism, Gallbladder physiopathology, Glucose Intolerance epidemiology, Glucose Intolerance etiology, Glucose Intolerance metabolism, Glucose Intolerance physiopathology, Humans, Insulin Resistance, Liver metabolism, Liver physiopathology, Metabolic Syndrome epidemiology, Metabolic Syndrome metabolism, Metabolic Syndrome physiopathology, Non-alcoholic Fatty Liver Disease epidemiology, Non-alcoholic Fatty Liver Disease etiology, Non-alcoholic Fatty Liver Disease metabolism, Non-alcoholic Fatty Liver Disease physiopathology, Obesity, Abdominal epidemiology, Obesity, Abdominal etiology, Obesity, Abdominal metabolism, Obesity, Abdominal physiopathology, Postoperative Complications epidemiology, Postoperative Complications metabolism, Postoperative Complications physiopathology, Risk Factors, Cholecystectomy adverse effects, Metabolic Syndrome etiology, Models, Biological, Postoperative Complications etiology
- Abstract
Cholecystectomy has long been regarded as a safe procedure with no deleterious influence on the body. However, recent studies provide clues that link cholecystectomy to a high risk for metabolic syndrome (MetS). In the present review, we describe the epidemiologic evidence that links cholecystectomy to MetS. Various components of MetS are investigated, including visceral obesity, dyslipidemia, elevated blood pressure, impaired fasting glucose, and insulin resistance. The possible mechanisms that associate cholecystectomy with MetS are discussed on the basis of experimental studies. more...
- Published
- 2018
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13. Neonatal cholelithiasis in Down syndrome: Is hypothyroidism involved? A case-report.
- Author
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Ricci F, Stagi S, Messa F, and de Martino M
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- Bile Ducts abnormalities, Cholelithiasis diagnostic imaging, Cholelithiasis etiology, Cholelithiasis physiopathology, Down Syndrome complications, Humans, Hypothyroidism drug therapy, Hypothyroidism etiology, Infant, Male, Treatment Outcome, Ultrasonography, Bile Ducts diagnostic imaging, Cholagogues and Choleretics therapeutic use, Cholelithiasis drug therapy, Down Syndrome physiopathology, Gallbladder diagnostic imaging, Hypothyroidism physiopathology, Ursodeoxycholic Acid therapeutic use
- Abstract
We report a 3-month-old male with Down syndrome (DS), prolonged jaundice and poor weight gain, that showed biliary lithiasis and undiagnosed congenital hypothyroidism (CH).CH should be considered in DS, especially in presence of gastrointestinal symptoms or malformations. Clinicians should be aware of the increased risk of gallstones in hypothyroid children with DS, even in neonatal age. more...
- Published
- 2018
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14. SpyGlass percutaneous transhepatic cholangioscopy-guided lithotripsy of a large intrahepatic stone.
- Author
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Franzini T, Cardarelli-Leite L, Figueira ERR, Morita F, Domingos FUG, Carnevale FC, and de Moura EGH
- Subjects
- Adult, Anti-Bacterial Agents administration & dosage, Cholangiopancreatography, Magnetic Resonance methods, Drainage methods, Female, Humans, Surgery, Computer-Assisted methods, Treatment Outcome, Bile Ducts, Intrahepatic diagnostic imaging, Bile Ducts, Intrahepatic surgery, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Cholangiopancreatography, Endoscopic Retrograde methods, Cholangitis drug therapy, Cholangitis etiology, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Cholelithiasis surgery, Lithotripsy adverse effects, Lithotripsy methods, Postoperative Complications drug therapy, Reoperation methods
- Abstract
Competing Interests: Competing interests: None
- Published
- 2017
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15. Endoscopic management of chronic pancreatitis with a fully covered self-expanding metal stent and laser lithotripsy.
- Author
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Novikov A, Xu MM, Tyberg A, and Kahaleh M
- Subjects
- Cholelithiasis diagnosis, Cholelithiasis physiopathology, Constriction, Pathologic, Humans, Lithotripsy adverse effects, Lithotripsy methods, Lithotripsy, Laser methods, Male, Middle Aged, Retreatment methods, Surgery, Computer-Assisted methods, Treatment Outcome, Cholangiopancreatography, Endoscopic Retrograde instrumentation, Cholangiopancreatography, Endoscopic Retrograde methods, Cholelithiasis surgery, Endosonography methods, Pancreatic Ducts diagnostic imaging, Pancreatic Ducts pathology, Pancreatitis, Chronic etiology, Pancreatitis, Chronic physiopathology, Pancreatitis, Chronic surgery, Self Expandable Metallic Stents, Surgical Stomas
- Abstract
Competing Interests: Competing interests: Michel Kahaleh MD has received grant support from Boston Scientific, Fujinon, EMcison, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, NinePoint Medical, Merit Medical, Olympus and MI Tech. He is a consultant for Boston Scientific, Xlumena Inc., Concordia Laboratories Inc, ABBvie, and MaunaKea Tech. All other authors have no conflicts of interest to report. more...
- Published
- 2017
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16. The Troponin Cascade: A Teachable Moment.
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Judson TJ, Beach LY, and Soni K
- Subjects
- Diagnosis, Differential, Echocardiography methods, Exercise Test methods, Humans, Male, Middle Aged, Preoperative Care methods, Tomography, X-Ray Computed methods, Treatment Outcome, Abdominal Pain diagnosis, Abdominal Pain etiology, Cholecystectomy, Laparoscopic methods, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Cholelithiasis surgery, Coronary Artery Disease diagnosis, Troponin analysis
- Published
- 2017
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17. Effect of Inhibition of Intestinal Cholesterol Absorption on the Prevention of Cholesterol Gallstone Formation.
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Portincasa P and Wang DQ
- Subjects
- Animals, Cholelithiasis physiopathology, Humans, Membrane Proteins antagonists & inhibitors, Membrane Transport Proteins, Anticholesteremic Agents pharmacology, Cholelithiasis prevention & control, Cholesterol metabolism, Ezetimibe pharmacology, Intestinal Absorption drug effects
- Abstract
Background: Cholesterol cholelithiasis is a multifactorial hepatobiliary disease., Methods: Interactions between genetic and environmental factors play a critical role in biliary cholesterol homeostasis and its imbalance enhances cholelithogenesis., Results: In patients developing symptoms or complications of gallstone disease, laparoscopic cholecystectomy is recommended for treatment of gallstones. In a subgroup of patients with small, radiolucent pure cholesterol gallstones, the hydrophilic bile acid, ursodeoxycholic acid (UDCA) is still considered the only pharmacological therapy able to induce oral litholysis. Identifying novel and effective pharmacological therapies is being investigated., Conclusions: We propose that the specific intestinal Niemann-Pick C1-like 1 protein inhibitor ezetimibe is a potential agent for preventing gallstone formation by reducing bioavailability of intestine- derived cholesterol to the liver for biliary secretion and desaturating bile through the inhibition of intestinal absorption of cholesterol., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.) more...
- Published
- 2017
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18. [THE REMOTE RESULTS OF SIMULTANEOUS LAPAROSCOPIC CORRECTION OF CHRONIC DUODENAL OBSTRICTION AND CHOLECYSTECTOMY IN CHOLELITHIASIS].
- Author
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Isayev H and Hachverdiyev B
- Subjects
- Adult, Aged, Cholecystectomy, Laparoscopic, Cholelithiasis complications, Cholelithiasis physiopathology, Cholelithiasis psychology, Chronic Disease, Duodenal Diseases complications, Duodenal Diseases physiopathology, Duodenal Diseases psychology, Female, Follow-Up Studies, Humans, Intestinal Obstruction complications, Intestinal Obstruction physiopathology, Intestinal Obstruction psychology, Male, Middle Aged, Quality of Life, Time Factors, Young Adult, Cholelithiasis surgery, Duodenal Diseases surgery, Intestinal Obstruction surgery
- Abstract
The aim of the research was to investigate the remote results of surgical treatment of 75 patients with cholelithiasis combined with chronic duodenal obstruction. Control group was composed of 40 patients who underwent laparoscopic cholecystectomy. Compensated stage of cholelithiasis with chronic duodenal obstruction was detected in 16 (21.3%) patients, subcompensated in 37 (49.3%) and decompensated stage in 17 (22.7%) patients. In 14 patients (18.7%) with cholelithiasis combined with chronic duodenal obstruction laparoscopic cholecystectomy was conducted due to the positive results of preoperative conservative treatment. In the long-term quality of life after surgery in the main group of patients were average 35.4% higher than in the control group; in the main group postcholecystectomical syndrome was diagnosed in one case (2,1%) and in 13 (32,2%) cases in the control group. more...
- Published
- 2016
19. Gallbladder Volume in Sikkimese Population.
- Author
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Dey R, Sharma BK, Singh VK, and Jha DK
- Subjects
- Adult, Body Mass Index, Cholelithiasis physiopathology, Cross-Over Studies, Female, Gallbladder Emptying, Humans, Male, Middle Aged, Obesity epidemiology, Prospective Studies, Gallbladder diagnostic imaging, Gallbladder physiopathology
- Abstract
Background Gall bladder volume can have clinical and therapeutic implications and possibly affect certain pathophysiological mechanisms of many diseases affecting the gallbladder including gall stones. Objective The objective of the study was to establish baseline indices of gallbladder volume for the Sikkimese population and determine its correlation with age, sex and Body Mass Index. Method A prospective epidemiologic study on selected 100 patients (equal male to female ratio) over the age of 36 years, undergoing ultrasound scan of abdomen, was undertaken. Age, Sex, Body Mass Index and gall bladder volume for each subject were collected and analysed statistically. Spearman's correlation test was performed to look for significant variables. Result The overall mean gallbladder volume in the present study was 15.47±7.9 ml with 17.2±8.9 ml and 13.74±6.4 ml being average volumes in males and females respectively, which gives the baseline indices for the Sikkimese population. Gall bladder volume was strikingly increased in obese subjects. There was a positive correlation between gall bladder volume and age (r=0.114), gender (r=0.182) and BMI (r= 0.175) but the strength of correlation was weak and not statistically significant (p <0.001). Conclusion Ultrasonography is an easy and effective method for evaluation of gall bladder volume. Sikkimese males have a larger fasting gall bladder volume which is directly correlated with higher body mass index. Fasting gall bladder volume has a weak correlation with advancing age. more...
- Published
- 2016
20. Roles of Sphincter of Oddi Laxity in Bile Duct Microenvironment in Patients with Cholangiolithiasis: From the Perspective of the Microbiome and Metabolome.
- Author
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Liang T, Su W, Zhang Q, Li G, Gao S, Lou J, Zhang Y, Ma T, and Bai X
- Subjects
- Adult, Aged, Bile metabolism, Bile microbiology, Biomarkers metabolism, Case-Control Studies, Cholelithiasis metabolism, Cholelithiasis microbiology, Cholelithiasis physiopathology, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Bile Ducts metabolism, Bile Ducts microbiology, Cholelithiasis etiology, Metabolome, Microbiota, Sphincter of Oddi physiopathology
- Abstract
Background: Bile duct microenvironment plays several key roles in cholangiolithiasis occurrence. Sphincter of Oddi laxity (SOL) is associated with cholangiolithiasis, probably due to enhanced reflux of intestinal contents that changes the microenvironment. However, the microenvironment has not been investigated comprehensively., Study Design: Patients with cholangiolithiasis were consecutively recruited and their bile was collected intraoperatively for high-throughput experiments. Pyrosequencing of 16S ribosomal RNA gene was performed to characterize the microbiota in the bile. A liquid chromatography mass spectrometry-based method was used to profile bile composition. Clinical manifestation, microbiome, and bile composition were compared between patients with and without SOL., Results: Eighteen patients with SOL and 27 patients without SOL were finally included. Patients with SOL showed more severe inflammation. Bacteria in the bile duct were overwhelmingly aerobes and facultative anaerobes. Proteobacteria and Firmicutes were the most widespread phylotypes, especially Enterobacteriaceae. Compared with those without SOL, patients with SOL possessed more varied microbiota. In the SOL group, pathobionts, such as Bilophila and Shewanella algae had richer communities, and harmless bacteria were reduced. Metabolomics analysis showed the differences in bile composition between groups were mainly distributed in lipids and bile acids. Particularly, the increased abundance of Bilophila involved in taurine metabolism was associated with reduced contents of taurine derivatives in the bile of patients with SOL., Conclusions: A bile duct microenvironment with more severe bacterial infection and stronger lithogenicity was found in patients with SOL. The findings suggest a possible mechanism of cholangiolithiasis and provide the basis for future strategies for prevention of cholangiolithiasis recurrence., (Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2016
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- View/download PDF
21. 77-Year-Old Man With Hypothyroidism, Right Upper Quadrant Pain, and Diarrhea.
- Author
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Krajicek EJ, Wan SH, and Collins NM
- Subjects
- Aged, Anticholesteremic Agents administration & dosage, Anticholesteremic Agents adverse effects, Drug Administration Schedule, Hormone Replacement Therapy methods, Humans, Male, Obesity complications, Pain Measurement, Severity of Illness Index, Treatment Outcome, Ultrasonography, Abdominal Pain diagnosis, Abdominal Pain etiology, Abdominal Pain physiopathology, Cholecystectomy, Laparoscopic adverse effects, Cholecystectomy, Laparoscopic methods, Cholelithiasis complications, Cholelithiasis diagnostic imaging, Cholelithiasis physiopathology, Cholestyramine Resin administration & dosage, Cholestyramine Resin adverse effects, Diarrhea drug therapy, Diarrhea etiology, Hypothyroidism chemically induced, Hypothyroidism diagnosis, Hypothyroidism therapy, Postoperative Complications drug therapy, Thyroxine administration & dosage
- Published
- 2016
- Full Text
- View/download PDF
22. Liraglutide-related cholelithiasis.
- Author
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Korkmaz H, Araz M, Alkan S, and Akarsu E
- Subjects
- Aged, Cholagogues and Choleretics administration & dosage, Female, Glucagon-Like Peptide 1 analogs & derivatives, Humans, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents adverse effects, Treatment Outcome, Ursodeoxycholic Acid administration & dosage, Withholding Treatment, Cholelithiasis chemically induced, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Cholelithiasis therapy, Diabetes Mellitus, Type 2 drug therapy, Liraglutide administration & dosage, Liraglutide adverse effects
- Abstract
Liraglutide is a glucagon-like peptide-1 analog and recently started to be using as an incretin-based treatment for diabetes mellitus. Liraglutide causes some adverse affects including nausea, vomiting, acute nasopharyngitis and acute pancreatitis. However, development of liraglutide-dependent cholelithiasis has not been reported in the literature. A 75-year-old female patient had been diagnosed with type 2 diabetes mellitus for 10 years and she has been treated by liraglutide for 6 months. The patient was admitted to the emergency service due to sudden onset of abdominal pain. After laboratory and imaging studies, she was diagnosed with acute cholecystitis and cholelithiasis. And then patient's oral intake was stopped, intravenous fluid and ceftriaxone 2 g/day were started. Furthermore, liraglutide treatment discontinued and ursodeoxycholic acid (UDCA) was started to treat cholelithiasis. During follow-up, abdominal pain completely relieved. Hepatobiliary ultrasonography in sixth month follow-up showed entirely regression of cholelithiasis. Any liraglutide-related cholelithiasis case has not been reported in the literature previously. Therefore, our case is the first case. Especially, elderly diabetic patients who are started to liraglutide treatment should be monitored closely for the formation of cholelithiasis. UDCA treatment would be an alternative prior to surgical treatment for liraglutide-related cholelithiasis. more...
- Published
- 2015
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23. [COURSE OF BILIARY SLUDGE ON THE BACKGROUND NON-ALCOHOLIC FATTY LIVER DISEASE].
- Author
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Radchenko VG and Seliverstov PV
- Subjects
- Adult, Cholelithiasis physiopathology, Female, Humans, Liver physiopathology, Male, Middle Aged, Non-alcoholic Fatty Liver Disease physiopathology, Bile metabolism, Cholelithiasis metabolism, Liver metabolism, Non-alcoholic Fatty Liver Disease metabolism
- Abstract
To date, the factors significantly reduces the tolerance of the liver against the development of NAFLD and GSD. At the stage of biliary sludge cholelithiasis is found in more than half of the patients suffering from NAFLD. BS violates jelchnokamennouu and releaxation activity of hepatocytes, thereby slowing the passage of bile through the intrahepatic and extrahepatic bile ducts that aggravate the course of NAFLD. The reasons for the formation of sludge is not completely understood. To date there are no accepted tactics of conducting and treatment of patients with HB in the background of NAFLD. In our work we demonstrate one possible way to tackle this important problem. more...
- Published
- 2015
24. [The relationship between the effectiveness and specific features of the early postoperative rehabilitation of the patients presenting with cholelithiasis].
- Author
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Poddubnaya OA and Marsheva SI
- Subjects
- Cholelithiasis physiopathology, Cholelithiasis psychology, Cholelithiasis surgery, Female, Humans, Male, Middle Aged, Postoperative Period, Cholelithiasis rehabilitation, Physical Therapy Modalities
- Abstract
The objective of the early postoperative rehabilitation of the patients presenting with cholelithiasis is to prevent the further progression of the disease and reduce the risk of development of post-cholecystectomy disorders. The combined treatment including the use of low-mineralized mineral waters, magnetic, laser, and EHF-therapy makes it possible to significantly improve the parameters of interest due to the marked improve mentor normalization of the clinical and laboratory characteristics, the increase of adaptive capabilities, and the correction of the psycho-emotional and vegetative status of the patients. Taken together, the peculiarities of the combined rehabilitative treatment of the patients with cholelithiasis during the early postoperative period account for its high clinical effectiveness amounting to 94.7%. The results of the study give reason to recommend the application of the proposed technology for the rehabilitative treatment of the patients presenting with cholelithiasis. more...
- Published
- 2015
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- View/download PDF
25. [Clinical and paraclinical features of the hepatobiliary system in children with cholelitiasis].
- Author
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Shutova EV
- Subjects
- Adolescent, Bile Ducts diagnostic imaging, Bile Ducts pathology, Child, Child, Preschool, Cholelithiasis diagnostic imaging, Cholelithiasis pathology, Female, Gallbladder diagnostic imaging, Gallbladder pathology, Humans, Liver diagnostic imaging, Liver pathology, Liver physiopathology, Male, Ultrasonography, Bile Ducts physiopathology, Cholelithiasis physiopathology, Gallbladder physiopathology
- Abstract
The article is devoted to actual issues of diagnostics of the initial stage of cholelithiasis in children. Special attention is paid to the role of functional disorders of the biliary tract as factors in the pathogenesis of metabolic pathology of the hepatobiliary system. According to the results of the study highlighted the predominant types of functional disorders of the gallbladder and biliary tract stone disease in children. Highlighted the role of diagnostics of the initial manifestations ECB in the prevention of progression and formation of calculous stage of the disease. more...
- Published
- 2014
26. Evaluation of daily energy expenditure and health-related physical fitness parameters in patients with cholelithiasis.
- Author
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Celikagi C, Genc A, Bal A, Ucok K, Turamanlar O, Ozkececi ZT, Yalcinkaya H, Coban NF, and Yorulmaz S
- Subjects
- Actigraphy, Adiposity, Adult, Biomechanical Phenomena, Case-Control Studies, Cholelithiasis diagnosis, Electric Impedance, Exercise Test, Exercise Tolerance, Female, Humans, Middle Aged, Motor Activity, Muscle Strength, Oxygen Consumption, Predictive Value of Tests, Skinfold Thickness, Sleep, Cholelithiasis metabolism, Cholelithiasis physiopathology, Energy Metabolism, Health Status, Physical Fitness
- Abstract
Objective: The aim of this study was to investigate the daily energy expenditure; resting metabolic rate (RMR); health-related physical fitness parameters such as maximal aerobic capacity, muscle strength, and flexibility; pulmonary function tests (PFTs); and body composition and body fat distribution changes in patients with cholelithiasis, and to compare them with healthy controls., Materials and Methods: Thirty female patients with cholelithiasis and 30 controls were included in this study. Daily physical activity was monitored using a metabolic Holter and the maximal aerobic capacity was estimated using the Astrand submaximal exercise protocol. The body composition was established with a bioelectrical impedance analyzer. RMR, PFTs, strength, flexibility, circumference, and skinfold measurements were also carried out., Results: Maximal aerobic capacity, trunk flexibility, daily moderate activity duration, daily vigorous activity duration, total energy expenditure, RMR, PFT, lean body mass, adiposity, and body fat distribution values were not significantly different between the patients and the controls. The cholelithiasis patients had lower daily step numbers, handgrip strength, and back-leg strength values, whereas their higher daily sleep duration values were comparable with those of the controls., Conclusion: Our results suggest that daily physical activity and muscle strength were impaired in female cholelithiasis patients when compared with the healthy controls. We suggest that using daily exercises, including not only aerobic but also strength training as lifestyle modifications in cholelithiasis patients, might be helpful for the development of more beneficial illness management strategies. more...
- Published
- 2014
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27. Management of symptomatic cholelithiasis while on ketogenic diet: a case report.
- Author
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Desai AA, Thompson LM, Abdelmoity AT, Kayyali H, and St Peter SD
- Subjects
- Child, Preschool, Cholelithiasis physiopathology, Humans, Male, Postoperative Period, Seizures diet therapy, Seizures physiopathology, Cholecystectomy, Laparoscopic, Cholelithiasis diet therapy, Cholelithiasis surgery, Diet, Ketogenic
- Abstract
Introduction: The ketogenic diet is a treatment modality used for patients with refractory epilepsy. Development of cholelithiasis while on the ketogenic diet is a potential side effect that has been described in the literature. There however have not been any reports on the outcomes of continuing the diet after cholecystectomy., Patient: We present a 5-year-old boy with history of pharmacologically intractable epilepsy that was well controlled on the ketogenic diet. He underwent laparoscopic cholecystectomy for the development of symptomatic cholelithiasis 12 months after the initiation of ketogenic diet for seizure control., Results: Patient tolerated the surgery well and was able to continue the ketogenic diet postoperatively., Discussion: There have been no reports describing the continuation of ketogenic diet after cholecystectomy. This child demonstrates the safety of the procedure and the ability to continue the ketogenic diet without further biliary or surgical complications., (Copyright © 2014 Elsevier Inc. All rights reserved.) more...
- Published
- 2014
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28. [Optimization of cholecystectomy method in patients with professional diseases of respiratory organs].
- Author
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Lupal'tsov VI and Mel'nikov VV
- Subjects
- Blood Pressure physiology, Cholecystectomy, Laparoscopic methods, Cholecystitis complications, Cholecystitis diagnosis, Cholecystitis physiopathology, Cholelithiasis complications, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Endothelin-1 blood, Endothelium, Vascular physiopathology, Fibronectins blood, Hemodynamics physiology, Humans, Respiratory Function Tests, Respiratory Insufficiency complications, Respiratory Insufficiency diagnosis, Respiratory Insufficiency physiopathology, Severity of Illness Index, Silicosis complications, Silicosis diagnosis, Silicosis physiopathology, Treatment Outcome, Cholecystectomy methods, Cholecystitis surgery, Cholelithiasis surgery, Respiratory Insufficiency surgery, Silicosis surgery
- Abstract
Results of cholecystectomy performance were analyzed in 99 patients with a biliary calculous disease, the course of which have become complicated by cholecystitis occurrence, in 49 of them professional diseases of respiratory organs, including silicosis, antracosis, were registered. Estimating results of laparoscopic and open cholecystectomy, we have established, that carboperitoneum in laparoscopic cholecystectomy impacts negatively the course of early postoperative period, what manifests with hemodynamic and respiratory disorders. The level of fibronectin and endotelin--1 in the blood plasm directly depends on the respiratory disorders severity and may be applied as a test for respiratory dysfunction. The method of cholecystectomy in patients, suffering professional diseases of respiratory organs, must be selected, depending on severity of functional disorders of respiratory organs. more...
- Published
- 2014
29. Effect of statin use on outcome of symptomatic cholelithiasis: a case-control study.
- Author
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Pulkkinen J, Eskelinen M, Kiviniemi V, Kotilainen T, Pöyhönen M, Kilpeläinen L, Käkelä P, Kastarinen H, and Paajanen H
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Cholecystectomy statistics & numerical data, Cholelithiasis complications, Cholelithiasis physiopathology, Female, Humans, Hypercholesterolemia complications, Male, Middle Aged, Operative Time, Severity of Illness Index, Cholecystectomy, Laparoscopic statistics & numerical data, Cholelithiasis surgery, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypercholesterolemia drug therapy, Postoperative Complications
- Abstract
Background: Statins can modify bile cholesterol and, thus, the formation of gallstones. We examined whether statin use also modifies the severity of symptomatic gallstone disease and its treatment., Methods: A total of 1,140 consecutive patients with symptomatic gallstone disease were recruited during 2008-2010 at Kuopio university hospital, Finland. Case-control analysis matched the patients using (n = 272) or not using (n = 272) statins by age and sex. The baseline characteristics of the patients, need and type of surgical treatment, duration of operation, perioperative bleeding, postoperative complications and overall mortality rate were compared statistically between the study groups., Results: Morbidity and subsequent polypharmacy occurred more frequently among the patients with statins compared to the patients without statins. There were no significant differences between the statin users and non-users regarding surgical treatment (open vs. laparoscopic cholecystectomy). The mean operation time for laparoscopic cholecystectomy was 10% shorter for the patients with statin use than for the patients without. In addition, there was a non-significant tendency for statin users to bleed less during laparoscopic operations than the non-users. There were no differences in other procedure-related parameters (e.g., operation urgency, conversions, choledochotomies, complications and mortality) in patients with or without statins., Conclusions: Compared to no treatment, statin treatment was associated with a shorter operation time for laparoscopy cholecystectomy. Other surgical outcome parameters were similar in patients with or without statins, although statin users had more polypharmacy and circulatory illnesses than non-users. more...
- Published
- 2014
- Full Text
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30. [Gastroesophageal reflux disease associated with duodenogastroesophageal reflux in patients with biliary pathology: the specific features of the course and esophagogastroduodenal microbial biocenosis].
- Author
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Dzhulai GS, Sekareva EV, Chervinets VM, Mikhailova ES, and Dzhulai TE
- Subjects
- Acalculous Cholecystitis microbiology, Adult, Cholelithiasis microbiology, Chronic Disease, Duodenogastric Reflux microbiology, Duodenum microbiology, Duodenum physiopathology, Esophagus microbiology, Esophagus physiopathology, Female, Gastroesophageal Reflux microbiology, Humans, Hydrogen-Ion Concentration, Middle Aged, Acalculous Cholecystitis physiopathology, Cholelithiasis physiopathology, Duodenogastric Reflux physiopathology, Gastroesophageal Reflux physiopathology
- Abstract
Aim: To study the specific features of the clinical course of gastroesophageal reflux disease (GERD) associated with duodenogastroesophageal reflux (DGER) in patients with chronic acalculous cholecystitis (CAC) and cholelithiasis (CL), as well as qualitative and quantitative characteristics., Subjects and Methods: The clinical, morphological, motor tonic characteristics of the esophagogastroduodenal area, mucosal microbial biocenosis in the esophagus, stomach, and duodenum were studied in detail in 83 patients with GERD that was associated with DGER and ran concurrently with CAC or CL., Results: Impaired duodenal propulsive activity as a concomitance of the signs of gastrostasis and duodenal dyskinesia with dyscoordination of both anthroduodenal and duodenojejunal propulsion and with the development of duodenogastric reflux and DGER, which in turn determine esophageal and gastric pH values is shown to be of importance in CAC and CL, which match GERD. Abnormal microbiocenosis in the upper digestive tract is characterized by the higher quantitative and qualitative content of the mucous microflora. Opportunistic microorganisms exhibit cytotoxic, hemolytic, lecithinase, caseinolytic, urease, and RNAase activities., Conclusion: The found specific features of the course of GERD associated with DGER in patients with biliary tract abnormalities lead us to search for novel therapeutic approaches based on the correction of digestive motor tonic disorders and abnormal microbiocenoses of the mucous flora in the esophagus, stomach, and duodenum. more...
- Published
- 2014
31. [Hepatolithiasis].
- Author
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Brazhnikova NA, Tskhaĭ VF, Merzlikin NV, Mar'ina ME, and Lyzko IA
- Subjects
- Adult, Aged, Bile Ducts, Intrahepatic pathology, Cholangiopancreatography, Endoscopic Retrograde methods, Drainage methods, Female, Follow-Up Studies, Humans, Intraoperative Care methods, Male, Middle Aged, Opisthorchiasis therapy, Recurrence, Retrospective Studies, Survival Analysis, Treatment Outcome, Anthelmintics therapeutic use, Bile Ducts, Intrahepatic surgery, Biliary Tract Surgical Procedures adverse effects, Biliary Tract Surgical Procedures methods, Cholelithiasis diagnosis, Cholelithiasis etiology, Cholelithiasis mortality, Cholelithiasis physiopathology, Cholelithiasis surgery, Hepatectomy adverse effects, Hepatectomy methods, Liver Diseases diagnosis, Liver Diseases etiology, Liver Diseases mortality, Liver Diseases physiopathology, Liver Diseases surgery, Opisthorchiasis complications, Postoperative Complications prevention & control
- Abstract
The authors present an analysis of treatment results in 14 patients with hepatolithiasis. An influence of chronic opisthorchosis invasion on the frequency was determined. Hepatolithiasis was detected in 8 (0.14%) out of 5757 patients, who underwent the operation for cholelithiasis and its complications. The disease was found out in 6 (0.31%) patients out of 1965, who had cholelithiasis and accompanying chronic opisthorchosis. It was 2,2 times more frequent due to proliferative sclerotic changes of biliary system. The trasdermal teanshepatic cholangiography was contraindicated for opisthorchiasis injuries, because of the danger of subcapsular cholangioectates damage. The endoscopic retrograde cholangiopancreatography and the endopapillosphincterotomy were complicated due to extensive structures of the large duodenal papilla and distal section of the general bile duct. The patients were treated by using the cholecystectomy, extraction of stones from ducts, reconstruction of liver passage. Choledochoduodenostomy was performed with compulsory external drainage for ducts sanation from infections and helminthes in the case of the opisthorchiasis. Interportal infusions were carried out. The surgical, conservative and endoscopic treatment was required for multiple colangiolithiasis. The lethality consisted of 7.1%. more...
- Published
- 2014
32. [Features of vegetative dysfunction development in patients with cholelithiasis before and after cholecystectomy].
- Author
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Taiutina TV, Bagmet AD, Ruban AP, Nedoruba EA, and Kobzar' ON
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Postoperative Period, Preoperative Period, Autonomic Nervous System Diseases complications, Autonomic Nervous System Diseases physiopathology, Autonomic Nervous System Diseases surgery, Cholecystectomy, Cholelithiasis complications, Cholelithiasis physiopathology, Cholelithiasis surgery, Sympathetic Nervous System physiopathology
- Abstract
Unlabelled: The aim of the present study was a comprehensive study of the features autonomic nervous system in cholelithiasis before and after cholecystectomy., Materials and Methods: 88 patients aged 40 to 60 years. 55 patients with cholelithiasis before and after laparoscopic cholecystectomy (CE). Control group consisted of 33 patients of similar age and gender. To investigate the function of the autonomic nervous system were evaluated themes complaint history, physical examination data, and used less Tod mathematical analysis of cardiac rhythm by Baevsky RM using the author's computer-related programs "Korveg" with the definition of heart rate variability and table--Solovevoj Wayne., Results and Conclusions: The study of autonomic provision in rest and during exercise were increased sympathetic activity, exceeding those in the control group. Studies indicate a tendency to sympathicotonia patients with gall stones before and after cholecystectomy, which is enhanced adaptive compensatory mechanisms to maintain homeostasis in the body. Identify logical connections between clinical and autonomic indicators will predict flow pattern cholelithiasis before and after cholecystectomy, as well as pick individual therapy for each patient taking into account the autonomic features that can be widely used in practical medicine--not. more...
- Published
- 2014
33. Gallstone ileus after biliointestinal bypass: report of two cases.
- Author
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Micheletto G, Danelli P, Morandi A, Panizzo V, and Montorsi M
- Subjects
- Adult, Cholelithiasis physiopathology, Female, Humans, Ileus physiopathology, Male, Obesity, Morbid surgery, Tomography, X-Ray Computed, Cholelithiasis complications, Ileus etiology, Jejunoileal Bypass adverse effects
- Abstract
Introduction: Gallstone ileus is an uncommon disease and accounts for 1-4 % of all cases of mechanical intestinal obstruction. The physiopathology is related to the presence of a bilioenteric fistula., Method: We report two cases of gallstone ileus in patients operated on biliointestinal bypass for morbid obesity. The anastomosis of the gallbladder to the proximal end of the bypassed jejunum allowed the transit of gallstones in the excluded ileum and its impaction in anti-reflux valvular system., Results: Preoperative exams were unable to solve the diagnostic query, and the diagnosis was achieved only at laparotomy. One-stage combined enterolithotomy and cholecystectomy were performed., Conclusion: The two patients had an uneventful recovery. To our knowledge, this is the first report of gallstone ileus after biliointestinal bypass. more...
- Published
- 2013
- Full Text
- View/download PDF
34. [Obesity and diseases of digestive organs].
- Author
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Luzina EV, Tomina EA, and Zhilina AA
- Subjects
- Body Mass Index, Cholagogues and Choleretics therapeutic use, Cholelithiasis etiology, Cholelithiasis metabolism, Cholelithiasis physiopathology, Diet Therapy methods, Endoscopy, Gastrointestinal, Fatty Liver etiology, Fatty Liver metabolism, Fatty Liver physiopathology, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux etiology, Gastroesophageal Reflux physiopathology, Health Behavior, Humans, Life Style, Non-alcoholic Fatty Liver Disease, Risk Factors, Ursodeoxycholic Acid therapeutic use, Cholelithiasis prevention & control, Fatty Liver prevention & control, Gastroesophageal Reflux prevention & control, Obesity complications, Obesity diagnosis, Obesity metabolism, Obesity physiopathology, Obesity psychology
- Abstract
Obesity is non-infectious pandemic. Its association with cardiovascular pathology is especially widely discussed, but an overweight patient is actually polymorbid. An increase of body mass provides a pathogenetic basis for many diseases including those of digestive system This review deals with pathogenesis, clinical features, and treatment of gastroesophageal reflux disease, cholelithiasis and non-alcoholic fatty liver disease in obese patients. This pathology and its aggravation result from such pathophysiological processes as a rise in intra-abdominal pressure, excess adipokine, cholesterol and free fatty acid synthesis, activation of lipid peroxidation. Gastroesophageal reflux disease in obese patients has an atypical clinical course characterized by discrepancy between clinical, endoscopic and morphological features in oesophagus and frequent formation of Barrett's oesophagus. Cholelethiasis in obesity is fraught with further progress of the disease after prescription of low-fat diet. The risk of calculi formation can be reduced by prescription of ursodeoxycholic acid that produces both litholytic and hypolipidemic effects. Treatment of non-alcoholic fatty liver disease requires combined therapy with statins, insulin sensitizers, hepatoprotectors and adequate physical activity. Sustained remission of diseases of digestive organs is impossible without correction of body mass and their pharmacotherapy requires increasing doses of medicines and duration of their administration. more...
- Published
- 2013
35. [An effect of endoscopic cholecystectomy on neurological status, cognitive functions and anxiety feelings in women with chronic calculous cholecystitis].
- Author
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Laskov VB and Masaleva IO
- Subjects
- Adult, Anxiety psychology, Cholelithiasis physiopathology, Cholelithiasis psychology, Chronic Disease, Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Period, Young Adult, Anxiety etiology, Cholecystectomy, Laparoscopic psychology, Cholelithiasis surgery, Cognition physiology
- Abstract
A comparative clinical study of 136 female patients with uncomplicated chronic calculous cholecystitis, including 106 patients examined in the pre- and postoperative periods of endoscopic cholecystectomy, revealed the effect of chronic illness and surgery on the neurological status and cognition which was more pronounced in adulthood. We investigated anxiety feelings before and after surgery. Our findings should be taken into consideration in the preoperative preparation of patients and their care in the postoperative period. more...
- Published
- 2013
36. [Residual cholelithiasis. Multidetector computed tomography in the diagnosis of its complication].
- Author
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Belen'kaia OI, Iudin AL, and Afukova OA
- Subjects
- Aged, Female, Humans, Liver Abscess etiology, Liver Abscess physiopathology, Male, Middle Aged, Postoperative Complications physiopathology, Treatment Outcome, Cholecystectomy adverse effects, Cholelithiasis diagnostic imaging, Cholelithiasis etiology, Cholelithiasis physiopathology, Liver Abscess diagnostic imaging, Multidetector Computed Tomography methods, Postoperative Complications diagnosis, Reoperation methods
- Published
- 2013
37. Disruption of gallbladder smooth muscle function is an early feature in the development of cholesterol gallstone disease.
- Author
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Lavoie B, Nausch B, Zane EA, Leonard MR, Balemba OB, Bartoo AC, Wilcox R, Nelson MT, Carey MC, and Mawe GM
- Subjects
- Animals, Cholecystitis etiology, Cholecystitis pathology, Cholecystitis physiopathology, Cholelithiasis etiology, Cholelithiasis pathology, Cholesterol, Dietary adverse effects, Chromatography, High Pressure Liquid, Disease Models, Animal, Gallbladder pathology, Gallbladder physiopathology, Gallstones complications, Gallstones pathology, Immunohistochemistry, Lipids, Male, Mice, Mice, Inbred BALB C, Muscle Contraction physiology, Muscle, Smooth pathology, Bile chemistry, Cholelithiasis physiopathology, Cholesterol adverse effects, Gallstones physiopathology, Muscle, Smooth physiopathology
- Abstract
Unlabelled: BACKGROUND; Decreased gallbladder smooth muscle (GBSM) contractility is a hallmark of cholesterol gallstone disease, but the interrelationship between lithogenicity, biliary stasis, and inflammation are poorly understood. We studied a mouse model of gallstone disease to evaluate the development of GBSM dysfunction relative to changes in bile composition and the onset of sterile cholecystitis., Methods: BALB/cJ mice were fed a lithogenic diet for up to 8 weeks, and tension generated by gallbladder muscle strips was measured. Smooth muscle Ca(2+) transients were imaged in intact gallbladder., Key Results: Lipid composition of bile was altered lithogenically as early as 1 week, with increased hydrophobicity and cholesterol saturation indexes; however, inflammation was not detectable until the fourth week. Agonist-induced contractility was reduced from weeks 2 through 8. GBSM normally exhibits rhythmic synchronized Ca(2+) flashes, and their frequency is increased by carbachol (3 μm). After 1 week, lithogenic diet-fed mice exhibited disrupted Ca(2+) flash activity, manifesting as clustered flashes, asynchronous flashes, or prolonged quiescent periods. These changes could lead to a depletion of intracellular Ca(2+) stores, which are required for agonist-induced contraction, and diminished basal tone of the organ. Responsiveness of Ca(2+) transients to carbachol was reduced in mice on the lithogenic diet, particularly after 4-8 weeks, concomitant with appearance of mucosal inflammatory changes., Conclusions & Inferences: These observations demonstrate that GBSM dysfunction is an early event in the progression of cholesterol gallstone disease and that it precedes mucosal inflammation., (© 2012 Blackwell Publishing Ltd.) more...
- Published
- 2012
- Full Text
- View/download PDF
38. Prevalences of and risk factors for biliary stones and gallbladder polyps in a large Chinese population.
- Author
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Xu Q, Tao LY, Wu Q, Gao F, Zhang FL, Yuan L, and He XD
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Blood Glucose analysis, Blood Pressure, China epidemiology, Cholecystitis epidemiology, Cholelithiasis blood, Cholelithiasis physiopathology, Comorbidity, Female, Gallbladder Diseases blood, Gallbladder Diseases physiopathology, Glucose Metabolism Disorders epidemiology, Hepatitis B epidemiology, Humans, Hypertension epidemiology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Obesity epidemiology, Odds Ratio, Polyps blood, Polyps physiopathology, Prevalence, Retrospective Studies, Risk Assessment, Risk Factors, Sex Factors, Young Adult, Cholelithiasis epidemiology, Gallbladder Diseases epidemiology, Polyps epidemiology
- Abstract
Objectives: This study aimed to identify the prevalences of and risk factors associated with the development of gallbladder stones and polyps in a large Chinese population., Methods: Prevalences of and risk factors for biliary stones and gallbladder polyps were retrospectively investigated among subjects who underwent a general check-up at the Health Screening Centres of Peking Union Medical College Hospital and Beijing Charity Hospital between January 2007 and June 2010., Results: A total of 60,064 people were enrolled in the study. Overall prevalences of biliary stones and gallbladder polyps were 4.2% (n= 2527) and 6.9% (n= 4119), respectively. Risk factors associated with increased odds ratios (ORs) for the development of biliary stones were female gender (OR = 1.51), age ≥ 50 years (OR = 2.09), history of hypertension (OR = 1.37), thickened gallbladder wall (cholecystitis) (OR = 1.98), fasting blood glucose ≥ 6.10 mmol/l (OR = 1.27), body mass index ≥ 25 kg/m(2) (OR = 1.25), systolic blood pressure ≥ 140 mmHg (OR = 1.31) and diastolic blood pressure ≥ 90 mmHg (OR = 1.44). Factors associated with gallbladder polyps were female gender (OR = 0.66), thickened gallbladder wall (OR = 2.09), negativity for hepatitis B surface antigen (HBsAg) and positivity for hepatitis B core antibody (anti-HBc) (OR = 2.61), and positivity for both HBsAg and anti-HBc (OR = 3.21)., Conclusions: Prevalences of biliary stones and gallbladder polyps among Chinese people are similar to those reported for other populations. Biliary stones appear to be associated with female gender, age, obesity, blood glucose, blood pressure and cholecystitis. Male gender, hepatitis B virus infection and cholecystitis were strong risk factors for the formation of gallbladder polyps., (© 2012 International Hepato-Pancreato-Biliary Association.) more...
- Published
- 2012
- Full Text
- View/download PDF
39. [Current principles of cholelithiasis prophylaxis in the practice of district physician].
- Author
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Galkin VA
- Subjects
- Combined Modality Therapy, Disease Management, Humans, Monitoring, Physiologic methods, Ultrasonography methods, Anti-Bacterial Agents therapeutic use, Bile metabolism, Cholagogues and Choleretics therapeutic use, Cholelithiasis metabolism, Cholelithiasis physiopathology, Cholelithiasis therapy, Diet Therapy methods, Digestion
- Abstract
The key task of the district physician is staged diagnostic search and clinical detection of functional disorders--conduction of laboratory tests and device investigations (in cholelithiasis patients--ultramicroscopic investigation of bile, x-ray methods, ultrasonography) to initiate prophylactic-therapeutic measures (medico-social, pharmacological and therapeutic-dietary). more...
- Published
- 2012
40. [Factors affecting contractile function of the gall blader in patients with cholelithiasis].
- Author
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Trifonova ÉV and Saĭfutdinov RG
- Subjects
- Case-Control Studies, Cholelithiasis blood, Cholelithiasis diagnostic imaging, Cholelithiasis therapy, Female, Gallbladder diagnostic imaging, Humans, Male, Methyl Ethers administration & dosage, Middle Aged, Sex Factors, Solvents administration & dosage, Treatment Outcome, Ultrasonography, Cholelithiasis physiopathology, Gallbladder physiopathology, Muscle Contraction physiology, Thyroid Hormones blood
- Abstract
In article the data on interrelation between gallbladder contractility and a level of hormones of a thyroid gland (threeiodethyronine, thyroxine, thyrotropin hormone (TTH) and antibodies to thyreoperoxidase (AT to TPO)) in plasma of blood at 470 healthy persons and 540 patients with gallstone disease are submitted. The contractility function of a gallbladder on ultrasonic at persons with gallstone disease is authentic less, than at healthy persons. Dysfunction of a thyroid gland is found out in women with gallstone disease: increase TTH and AT to TPO. Among men hormonal shifts are not revealed. Contact chemical litholysis with methyl tert butyl ether of cholesterol stones in gallbladder except for their dissolution, improves its contractility activity. more...
- Published
- 2012
41. [Therapeutic tactics in cholelithiasis in children].
- Author
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Kharitonova LA
- Subjects
- Adolescent, Child, Child, Preschool, Cholelithiasis pathology, Cholelithiasis physiopathology, Female, Humans, Male, Pediatrics methods, Quality of Life, Recurrence, Cholelithiasis diagnosis, Cholelithiasis therapy
- Abstract
Biliary tract diseases in children in recent years increasingly attracted the attention of not only physicians and surgeons, but this problem is becoming increasingly important in pediatric practice. Thus, gallstone disease in childhood is becoming a serious medical and social problem because of its chronic relapsing course, the development of severe complications, reduced quality of life and social adaptation of children. A particular difficulty is to select treatment tactics at cholelithiasis in childhood. The aim of this study was to demonstrate on the basis of own experience observing children with cholelithiasis, advantages and disadvantages of both surgical and conservative treatment of cholelithiasis in children, suggest alternative approaches for different periods of childhood. more...
- Published
- 2011
42. [The results of different types of cholecystectomy in elderly patients].
- Author
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Dobrovol'skiĭ SR, Ramazanova AR, Kurbanov FS, and Sadovyĭ PG
- Subjects
- Aged, Aged, 80 and over, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Female, Gallbladder physiopathology, Humans, Intraoperative Complications etiology, Intraoperative Complications physiopathology, Intraoperative Complications prevention & control, Male, Minimally Invasive Surgical Procedures adverse effects, Minimally Invasive Surgical Procedures methods, Postcholecystectomy Syndrome etiology, Postcholecystectomy Syndrome physiopathology, Postcholecystectomy Syndrome prevention & control, Treatment Outcome, Cholecystectomy adverse effects, Cholecystectomy methods, Cholelithiasis surgery, Gallbladder surgery, Laparoscopy adverse effects, Laparoscopy methods, Perioperative Care methods
- Abstract
Treatment results of 1048 elderly patients, operated on the cholelithiasis, were analyzed. The group of minilaparotomic access cholecystectomy numbered 488 (46,6%) patients; the second group consisted of 560 (53,4%) patients, who had the traditional operation. All patients were operated on in a single hospital during 1998-2008 yy. The cholecystectomy from minilaparotomic access proved to be less traumatic and preferable for elderly patients. The rate of postoperative morbidity was 5,7%, mortality - 0,2%. The procedure, though, is subjected to the experienced surgeons. more...
- Published
- 2011
43. Hereditary liver disease: gallstones.
- Author
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Wittenburg H
- Subjects
- Bile chemistry, Bilirubin metabolism, Cholecystectomy, Laparoscopic, Cholecystolithiasis genetics, Cholecystolithiasis physiopathology, Cholesterol metabolism, Gallbladder physiopathology, Gallstones diagnostic imaging, Gallstones surgery, Genetic Predisposition to Disease, Humans, Liver metabolism, Pancreatitis etiology, Pancreatitis physiopathology, Polymorphism, Single Nucleotide, Risk Factors, Ultrasonography, Weight Loss, Cholelithiasis complications, Cholelithiasis diagnostic imaging, Cholelithiasis epidemiology, Cholelithiasis genetics, Cholelithiasis physiopathology, Cholelithiasis surgery
- Abstract
Gallstones are common in Western countries and due to pain and complications pose a substantial burden on health care systems. In general, cholesterol gallstones are distinguished from bilirubin gallstones. Bilirubin gallstones form if the ion product of unconjugated bilirubin and calcium in gallbladder bile exceeds the solubilisation capacities of mixed micelles and vesicles. Cholesterol gallstones develop if the amount of cholesterol in gallbladder bile exceeds the maximum concentration that is soluble at the given concentration of bile salts and phospholipids. In addition, cholesterol gallstone formation requires hypomotility of the gallbladder and a mucin gel as nucleation matrix for monohydrate crystals. The individual risk of gallstone formation is determined by interactions of lithogenic alleles of gallstone susceptibility genes and multiple environmental factors. For asymptomatic gallstones, expectant management is recommended, whereas an episode of gallstone-associated pain substantially increases the risk of complications such as cholecystitis, cholangitis and pancreatitis and therefore necessitates cholecystectomy., (Copyright © 2010 Elsevier Ltd. All rights reserved.) more...
- Published
- 2010
- Full Text
- View/download PDF
44. Quality-of-life measures in Taiwanese adults with symptomatic gallstone disease.
- Author
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Lien HH, Huang CC, Wang PC, Huang CS, Chen YH, Lin TL, and Tsai MC
- Subjects
- Adult, Asian People, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Cholelithiasis psychology, Female, Humans, Male, Prospective Studies, Surveys and Questionnaires, Taiwan, Treatment Outcome, Alkaline Phosphatase blood, Bilirubin blood, Cholelithiasis surgery, Health Status Indicators, Quality of Life
- Abstract
Purpose: The objective of this study was to investigate the association of quality-of-life status with baseline laboratory findings among Taiwanese adults having symptomatic gallstone disease., Methods: A prospective quality-of-life survey was administered at a tertiary referral medical center among 102 consecutive adults with symptomatic gallstone disease. Patients underwent regular laboratory testing at admission and were evaluated using the 36-Item Short-Form Health Survey (SF-36) and the Gastrointestinal Quality of Life Index (GIQLI). Correlation and regression models were used to investigate quality-of-life predictors., Results: Compared with the general Taiwanese adult population, patients having symptomatic gallstone disease had significantly poorer performance on all eight SF-36 subscales (P < 0.001). Total GIQLI showed moderate to strong correlation with all eight SF-36 subscale scores (gamma = 0.29 ~ 0.62, P < 0.05). In multivariate analysis, serum levels of direct bilirubin (beta = -32.6, P = 0.001) and alkaline phosphatase (beta = -13.6, P = 0.032) were predictive of worse total GIQLI (adjusted R (2) = 0.183)., Conclusions: Symptomatic gallstone disease may considerably affect patient quality of life in terms of general health status and gastrointestinal-specific measures. Before gallstone surgery, serum levels of direct bilirubin and alkaline phosphatase significantly correlated with quality-of-life measures and can be used to evaluate patient well-being at admission. more...
- Published
- 2010
- Full Text
- View/download PDF
45. Pathophysiological preconditions promoting mixed "black" pigment plus cholesterol gallstones in a DeltaF508 mouse model of cystic fibrosis.
- Author
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Freudenberg F, Leonard MR, Liu SA, Glickman JN, and Carey MC
- Subjects
- Animals, Cholelithiasis genetics, Cholelithiasis metabolism, Cholelithiasis pathology, Cholelithiasis physiopathology, Cystic Fibrosis genetics, Cystic Fibrosis metabolism, Cystic Fibrosis pathology, Cystic Fibrosis physiopathology, Disease Models, Animal, Enterohepatic Circulation, Feces chemistry, Female, Gallbladder metabolism, Gallbladder pathology, Gallstones genetics, Gallstones metabolism, Gallstones pathology, Gallstones physiopathology, Hydrogen-Ion Concentration, Hydrophobic and Hydrophilic Interactions, Male, Mice, Mice, Inbred CFTR, Mucins metabolism, Risk Factors, Bile metabolism, Bilirubin metabolism, Cholelithiasis etiology, Cholesterol metabolism, Cystic Fibrosis complications, Gallbladder physiopathology, Gallstones etiology
- Abstract
Gallstones are frequent in patients with cystic fibrosis (CF). These stones are generally "black" pigment (i.e., Ca bilirubinate) with an appreciable cholesterol admixture. The pathophysiology and molecular mechanisms for this "mixed" gallstone in CF are unknown. Here we investigate in a CF mouse model with no overt liver or gallbladder disease whether pathophysiological changes in the physical chemistry of gallbladder bile might predict the occurrence of "mixed" cholelithiasis. Employing a DeltaF508 mouse model with documented increased fecal bile acid loss and induced enterohepatic cycling of bilirubin (Am J Physiol Gastrointest Liver Physiol 294: G1411-G1420, 2008), we assessed gallbladder bile chemistry, morphology, and microscopy in CF and wild-type mice, with focus on the concentrations and compositions of the common biliary lipids, bilirubins, Ca(2+), and pH. Our results demonstrate that gallbladder bile of CF mice contains significantly higher levels of all bilirubin conjugates and unconjugated bilirubin with lower gallbladder bile pH values. Significant elevations in Ca bilirubinate ion products in bile of CF mice increase the likelihood of supersaturating bile and forming black pigment gallstones. The risk of potential pigment cholelithogenesis is coupled with higher cholesterol saturations and bile salt hydrophobicity indexes, consistent with a proclivity to cholesterol phase separation during pigment gallstone formation. This is an initial step toward unraveling the molecular basis of CF gallstone disease and constitutes a framework for investigating animal models of CF with more severe biliary disease, as well as the human disease. more...
- Published
- 2010
- Full Text
- View/download PDF
46. Juxtapapillary duodenal diverticula and pancreatobiliary disease.
- Author
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Egawa N, Anjiki H, Takuma K, and Kamisawa T
- Subjects
- Age Factors, Ampulla of Vater surgery, Cholangiopancreatography, Endoscopic Retrograde, Choledocholithiasis epidemiology, Choledocholithiasis etiology, Choledocholithiasis physiopathology, Choledocholithiasis surgery, Cholelithiasis epidemiology, Cholelithiasis etiology, Cholelithiasis physiopathology, Cholelithiasis surgery, Diverticulum complications, Diverticulum epidemiology, Diverticulum surgery, Duodenal Diseases complications, Duodenal Diseases epidemiology, Duodenal Diseases surgery, Humans, Incidence, Pancreatitis epidemiology, Pancreatitis etiology, Pancreatitis physiopathology, Pancreatitis surgery, Risk Factors, Sphincterotomy, Endoscopic, Ampulla of Vater physiopathology, Diverticulum physiopathology, Duodenal Diseases physiopathology
- Abstract
Juxtapapillary duodenal diverticula (JPD) are observed in around 10-20% of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). They are acquired extraluminal outpouchings of the duodenal wall through 'locus minoris resistance' and their incidence increases with age. They have been studied mainly with regard to their association with pancreatobiliary disease. Choledocholithiasis is considered to be strongly associated with JPD, but the role of JPD in the development of cholecystolithiasis and pancreatitis is still disputable. Since JPD are located in the vicinity of the papilla of Vater, they not only cause mechanical compression of the bile duct but also induce dysfunction of the sphincter of Oddi. They are considered to lead to bile stasis and to allow reflux from the duodenum into the bile duct, which results in an ascending infection of beta-glucuronidase-producing bacteria. The ERCP procedure can be hampered by JPD, although recent papers have reported no difference in the successful cannulation rate or complications between patients with JPD and those without JPD. Disorders caused by JPD are amenable to appropriate therapy, e.g. endoscopic sphincterotomy and surgical intervention., ((c) 2010 S. Karger AG, Basel.) more...
- Published
- 2010
- Full Text
- View/download PDF
47. [Current aspects of diseases biliary tract in childhood].
- Author
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Zaprudnov AM and Kharitonova LA
- Subjects
- Age Factors, Bile chemistry, Bile Ducts abnormalities, Child, Cholelithiasis classification, Cholelithiasis diagnosis, Cholelithiasis physiopathology, Diagnosis, Differential, Gallbladder physiopathology, Humans, Sphincter of Oddi physiopathology, Biliary Tract Diseases classification, Biliary Tract Diseases diagnosis, Biliary Tract Diseases physiopathology
- Abstract
This article describes the current status of the issue of biliary tract disease in children. There were shown current differences according to age-appropriate. Was presented a new structure of the bile-excreting system diseases, among them dysfunction of the gallbladder and Oddi's sphincter, bile duct abnormalities, biliary sludge, cholelithiasis; cholesterosis of the gall bladder isn't casuistry. Was established necessity of modern intrascope research methods for the differential diagnosis of these diseases. Were identified promising areas of study of biliary tract diseases in childhood. more...
- Published
- 2010
48. [Cholelitiasis and age: tactic of surgical treatment].
- Author
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Kostiuchenko MV, Shvidko VS, Abdurakhmanov AM, Gabibov RM, Iuanov AA, Bekerov BM, Gazimagomedov MP, Rodionov IE, and Dibirov MD
- Subjects
- Age Factors, Aged, Biliary Tract Surgical Procedures methods, Cholelithiasis metabolism, Cholelithiasis pathology, Cholelithiasis physiopathology, Female, Humans, Male, Middle Aged, Cholelithiasis surgery, Geriatrics methods
- Abstract
Material and Methods: We examined the resultants of treatment of 268 old patients. RESULTATES: The global demographic transition to an older population effects developing as well as developed coutries. Cganges in mitochondria with age, in body composition, in biliary tract gives to start for many diseases such as cholelitiasis. It has recommended the special surgic tactict of treatment such situations. more...
- Published
- 2010
49. [Effectiveness of early rehabilitative treatment of patients after cholecystectomy].
- Author
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Kulikov AG, Ardatskaia MD, and Sarapulova NIu
- Subjects
- Acid-Base Equilibrium drug effects, Adult, Aged, Bile chemistry, Cholelithiasis blood, Cholelithiasis physiopathology, Combined Modality Therapy, Fatty Acids, Volatile analysis, Feces chemistry, Female, Glycosaminoglycans administration & dosage, Humans, Intestines drug effects, Intestines physiopathology, Liver blood supply, Liver drug effects, Liver physiopathology, Liver Function Tests, Male, Middle Aged, Time Factors, Treatment Outcome, Young Adult, Cholecystectomy, Cholelithiasis rehabilitation, Cholelithiasis surgery, Glycosaminoglycans therapeutic use, Magnetic Field Therapy
- Published
- 2010
50. [Changes in liver function and immune function following laparoscopic and traditional open cholecystectomy: a comparative study].
- Author
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Wu CD and Zuo D
- Subjects
- Adult, Antibody Formation immunology, Cholelithiasis immunology, Cholelithiasis physiopathology, Female, Gallbladder Neoplasms immunology, Gallbladder Neoplasms physiopathology, Gallbladder Neoplasms surgery, Humans, Killer Cells, Natural immunology, Liver Function Tests, Male, Middle Aged, Polyps immunology, Polyps physiopathology, Polyps surgery, Cholecystectomy, Cholecystectomy, Laparoscopic, Cholelithiasis surgery, Immunity, Liver physiopathology
- Abstract
Objective: To compare the effect of laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) on liver function and immune function., Methods: Forty-two patients with normal liver function underwent LC (n=21) or OC (n=21) according to the patients' preference. One day before and 7 days after the operations, the liver functions (ALT, AST, TBIL, ALB) and immune functions (CD3, CD4, CD8, NK cell percentage, IgA, IgM, IgG and C3, C4) of the patients were measured., Results: No statistical differences were found in the liver functions or immune functions between the two groups after the operation., Conclusion: LC and OC show no significant difference in the effects on the liver function and immune function. more...
- Published
- 2009
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