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PubMed1983

[Colorectal carcinoma--relation to cholecystectomy or to cholelithiasis?].

On 2200 autopsy cases was investigated if patients after cholecystectomy or with cholelithiasis show a higher rate of colorectal cancer than those with normal gall bladder. Thereby was found that 7,6% of the cases with previously cholecystectomy and 7,0% of these with cholelithiasis had large bowel cancer, but only 2,9% of the dead without these findings. These differences were highly significant. In cases with state after gall bladder removing the significance was only given during the first four years post operation. Furthermore the connections were modified by age and sex. The results suggest that not a previously cholecystectomy seems to increase the danger of cancer in the colorectal area, but that the high risk factor could be connected with cholelithiasis.

Adolescent↗
PubMed1982

Effects of synthesized hard water and of cadmium in the drinking water upon lipid metabolism and cholelithiasis in rabbits.

Rabbits were fed a purified ration known to result in cholelithiasis and alterations in lipid metabolism. During a 12-week experimental period, either synthesized hard water (500 mg of Ca/L and 100 mg of Mg/L) or deionized distilled water were available as drinking water, and half of each of these groups of rabbits were also given 5 mg of Cd/L of water. Hair samples taken at the beginning and end of the experiment revealed an increase in the Ca concentration in rabbits given hard water, but no increase in Cd in rabbits given this element in the water. Cadmium in the drinking water resulted in accumulations of this element in liver and kidneys, and water hardness did not influence the amount of accumulation. Liver cholesterol concentrations and the severity of cholelithiasis were less in rabbits given Cd. The hard water administration resulted in lower liver cholesterol concentrations and less cholelithiasis. These results indicate that hard water does not reduce cardiovascular disease frequency by lessening Cd accumulation, but may affect cholesterol metabolism.

Animals↗
PubMed1995

Frequency of cholelithiasis in alcoholics.

In order to determine the frequency of biliary lithiasis in alcoholic patients without signs of hepatic cirrhosis, we submitted 106 male alcoholics (mean age, 42.2 +/- 11.2 years) to ultrasound examination of the biliary system. Cholelithiasis was present in 6 (5.6%). We did not observe any association between the quantity of ethanol consumed and/or the time of consumption and the presence of cholelithiasis. There was no significant difference between the frequency of cholelithiasis in these patients and that found in autopsies carried out on 716 male patients (6%) at the Hospital de Clínicas, Universidade Federal de Uberlândia, during the period 1982 to 1993. Thus, we conclude that in the cases we examined, alcoholism did not represent a risk factor for biliary lithogenesis.

Adult↗
PubMed1995

[Prevalence of digestive symptoms in normal adult women and its association with cholelithiasis].

The aim of this work was to study the prevalence of biliary diseases and digestive symptoms in normal adult women. Four hundred nineteen women were chosen; of these 145 were discarded due to previous gastrointestinal diseases (20), previous gastrointestinal complaints (38) and previous cholecystectomy (85). Two hundred seventy six women were subjected to abdominal ultrasound examination; of these 53 had cholelithiasis and in three a gallbladder cancer was suspected (and confirmed by surgery). Considering women with previous cholecystectomy, cholelithiasis and gallbladder cancer, a 33.6% prevalence of biliary diseases can be inferred. An interrogation about gastrointestinal symptoms was performed to women subjected to ultrasound examinations, by 2 professionals unaware of ultrasound results. A high frequency of pyrosis, food intolerance and constipation was found, not observing differences between women with or without cholelithiasis. However, these last women had a higher frequency of upper abdominal pain. Both groups had also a high rate of previous surgical procedures.

Adult↗
PubMed1994

Effects of cholelithiasis and cholecystectomy on gastric emptying.

In this prospective, clinical study, four groups, each consisting of 12 patients were established to determine how gastric emptying is influenced in cholelithiasis with accompanied flatulent dyspepsia and the relationship of symptoms and gastric emptying after cholecystectomy: group 1--healthy people; group 2--patients with dyspeptic cholelithiasis; group 3--patients with no dyspepsia after cholecystectomy; group 4--patients with dyspepsia after cholecystectomy. Groups are compared according to solid phase gastric emptying scintigraphies performed with Tc 99m sulphur colloid bound with scrambled eggs. Gastric emptying delayed in groups 2 (P < 0.001) and 4 (P < 0.005) postprandially and did not differ in the group 3 (P > 0.005). These results demonstrate that dyspepsia, in cholelithiasis and persisting after cholecystectomy, has a close relation with delay in gastric emptying.

Adult↗
PubMed1994

[Acute cholecystitis and laparoscopic cholecystectomy. Comparison with non-complicated cholelithiasis].

Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cholelithiasis. However, the indication of the laparoscopic approach for acute inflammation of the gallbladder in unclear and further analysis of the results is required. The aim of our study was to compare the results of laparoscopic cholecystectomy after uncomplicated cholelithiasis and after acute cholecystitis. Data from 201 patients who underwent laparoscopic cholecystectomy were collected prospectively. Uncomplicated cholelithiasis was present in 149 patients and 52 individuals had acute cholecystitis. No differences in age, sex distribution or associated diseases were observed between groups. The mean operative time was significantly higher in patients with acute cholecystitis. However, no difference was observed regarding conversion rate (7.3%-7.6%) and morbidity rate (8.7%-9.6%). No mortality has occurred in any group. The average hospital stay after laparoscopic cholecystectomy was greater when acute cholecystitis was present (2.6 days-4.9 days; p < 0.01). But in this case hospitalization was shorter than after elective conversion (8 days; p < 0.001 and p < 0.05). We conclude that patients with acute cholecystitis can undergo laparoscopic cholecystectomy safely, with low morbidity and mortality rates and reduced hospital stay.

Acute Disease↗
PubMedDate not supplied

Scoliosis surgery: a risk factor for cholelithiasis?

Scoliosis surgery has been associated with pancreatitis and acalculous cholecystitis, and also has been implicated as a risk factor for cholelithiasis. A prospective study of 36 children and adolescents undergoing scoliosis surgery was performed using ultrasound to determine the incidence of cholelithiasis following spine surgery. The patients underwent abdominal ultrasound exams preoperatively, immediately postoperatively, and then at intervals following surgery with 2-5-year follow-up. Four of 36 patients (11.1%) (one male, three female) developed gallstones, although all had been free of gallstones after surgery. The gallstones appeared between 2 + 5 and 5 years after surgery. Those with gallstones were not different from those without with respect to 14 factors. It is concluded that scoliosis surgery is not a risk factor for gallstones, because of the delay in onset of cholelithiasis after surgery. Furthermore, the prevalence of gallstones in this study sample is not greater than that reported in historical control studies of European young adults.

Adolescent↗
PubMed1993

[Cholelithiasis in young people].

The results of the treatment for cholelithiasis from 1979 to 1989 were considered. The percentage correlation between young and older patients was established. The time--course of the disease incidence was demonstrated. In the age group studied (16-35 years) clinical signs of the disease were characterized, anthropometric values presented, sex-related incidence and general duration of the diseases considered. Diagnostic techniques for the main disease and some concurrent conditions of the alimentary tract were discussed. The frequency of complicated cholelithiasis in young persons and the specificity of complications were established. Problems of cholelithiasis treatment in young persons were discussed.

Adolescent↗
PubMed1994

[Cholelithiasis after total gastrectomy for gastric cancer].

AIM: To examine the incidence of cholelithiasis in patients after total gastrectomy for gastric cancer. PATIENTS AND METHODS: Patients operated for gastric cancer at our hospital were retrospectively studied. Criteria to be included in the study were: 1) Follow-up of more than 3 years, 2) Cholelithiasis excluded preoperatively by ultrasonography, 3) Ultrasonographic postoperative control once a year. RESULTS: Ten patients met the established criteria. Six of them developed biliary lithiasis, and four of them needed surgical treatment for biliary symptomatology. CONCLUSIONS: The incidence of cholelithiasis after total gastrectomy for gastric cancer is high, and surgical treatment is often necessary. However our data does not support prophylactic cholecystectomy in the course of total gastrectomy.

Adult↗
PubMed1993

[Effect of cholelithiasis and cholecystectomy on duodenogastric biliary reflux].

The aim of this work was to study the influence of cholelithiasis and cholecystectomy on duodenogastric biliary reflux. Total bile acid concentration (TBAC) in fasting gastric juice was measured in 23 consecutive patients with cholelithiasis and functioning gallbladder before and at least 3 months after cholecystectomy (group 1) and in 14 healthy volunteers (group II). In group two, TBAC was 8.5 +/- 2.8 uMol/l (mean +/- sem), the preoperative value in group I was 32.8 +/- 8.9 uMol/l and the postoperative value 69.9 +/- 14 uMol/l (p < 0.002 compared with group II and < 0.035 compared with preoperative values). These results suggest that cholelithiasis, even with a functioning gallbladder is associated with a significant increase in bile reflux to the stomach, with raises further after cholecystectomy.

Adult↗
PubMedDate not supplied

Incidental diagnosis of asymptomatic neonatal cholelithiasis: case report and literature review.

A case of asymptomatic cholelithiasis detected incidentally at the age of 3 days in an otherwise healthy newborn infant is presented. The hospitalization was uneventful. At follow-up the biliary stones had completely resolved at the age of 3 months with no symptoms. Fourteen similar cases of incidentally diagnosed neonatal cholelithiasis were found in the literature. Clinical course was benign; 12 cases (86%) were asymptomatic and eight (57%) had spontaneous resolution by the age of 6 months. We conclude that incidentally diagnosed neonatal cholelithiasis usually has a benign course with about a 50% chance of spontaneous resolution during the first 6 months of life. In cases of persistent gallstones by age 6 months, no treatment is needed except for long-term follow-up.

Cholelithiasis↗
PubMed1996

Role of endoscopic sphincterotomy alone in patients with choledocholithiasis and cholelithiasis.

OBJECTIVE: To study the long-term effects of endoscopic sphincterotomy alone in elderly patients with choledocholithiasis and cholelithiasis. DESIGN: A chart review. SETTING: A university-affiliated hospital. PATIENTS: Twenty-one patients over 60 years of age, who presented with cholecystitis, jaundice or cholangitis. The follow-up ranged from 1 to 5 years (mean 3.51 years). INTERVENTION: Endoscopic sphincterotomy. MAIN OUTCOME MEASURES: The occurrence of postsphincterotomy pancreatitis, cholangitis and cholecystitis. RESULTS: In the early postsphincterotomy period, 3 of the 21 patients had pancreatitis, which was treated conservatively. One patient had cholangitis. In this patient the initial sphincterotomy did not clear the common bile duct of all stones, but a repeat procedure was successful and the cholangitis resolved. One patient had mild cholecystitis that responded to conservative therapy. In the long term, 9 of the 21 patients had cholecystitis. This was treated conservatively in six patients, but three required cholecystectomy. One patient had choledocholithiasis requiring exploration of the common bile duct. CONCLUSIONS: In elderly debilitated patients with cholelithiasis and choledocholithiasis, endoscopic sphincterotomy alone may be adequate therapy. However, patients presenting with cholangitis and cholelithiasis may eventually require cholecystectomy.

Age Factors↗
PubMedDate not supplied

Cholelithiasis and cholecystitis after gastrectomy for gastric carcinoma: a comparison of lymphadenectomy of varying extent.

BACKGROUND/AIMS: The complications of cholelithiasis and cholecystitis after gastrectomy for gastric carcinoma were reviewed. PATIENTS AND METHODS: Between 1983 and 1988, 474 patients with a normal gallbladder received gastrectomy for gastric cancer. RESULTS: Among the 288 patients who underwent radical gastrectomy with systematic lymphadenectomy (RG), 9 (3.1%) were suffering from acute postoperative acalculous cholecystitis, and 2 of them died. None of the 186 patients treated with simple gastrectomy (SG) developed this complication (RG vs. SG, p <0.05). The long-term prognosis of RG is better than that of SG. However, as of July 1993, of among the 463 patients with a normal gallbladder who survived the operation, 85 of the 281 patients who underwent RG and 9 of the 182 patients who underwent SG had gallstones (RG vs. SG, P<0.001). Of the cases complicated by postgastrectomy cholelithiasis, the mean interval between gastrectomy and gallstone formation was shorter in the RG patients (31.4 +/- 20.9 months) than in the SG patients (48.0 +/- 12.8 months) (P<0.05). Following gallstone formation, there was a higher rate of acute biliary symptoms in patients who underwent RG. CONCLUSIONS: Early cholecystectomy should be performed in patients who received an RG with gallstone formation. Moreover, it would be better to include a policy of prophylactic cholecystectomy in the procedures of RG, even if the gallbladder is normal, in order to prevent the complications of acute cholecystitis and cholelithiasis.

Acute Disease↗
PubMed1996

[Development of intrahepatic cholelithiasis long after primary excision of choledochal cysts].

Biliary sricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proven. Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up time of 14 years and 6 months. The incidence of complications such as intrahepatic cholelithiasis was analyzed according to the morphologic types of the intrahepatic bile ducts as observed at the initial operation. Group I patients (29 cases) did not show any dilatation of the intrahepatic bile ducts. Only one (3%) developed intrahepatic cholelithiasis. In Group II (24 cases), the intrahepatic bile ducts were dilated but not associated with any down-stream stenosis, one patient (4%) suffered from intrahepatic chalelithasis. Group III patients (3 cases) had dilatation of the intrahepatic bile ducts associated with a down-stream stenosis, and none of them was free from the development of intrahepatic biliary stones (3 cases). Group III patients are most likely to develop intrahepatic cholelithiasis afterwards, and their stenosis should be relieved by whatever means are feasible at initial operation.

Adolescent↗
PubMed1996

[Cholelithiasis in children].

The article contains the data about the examination and surgical treatment of 21 children with cholelithiasis, most of them girls (6:1). There were 7 children at the age between 4 and 10 and 14 children at the age between 11 and 14 years. 15 patients had accompanying diseases of the gastrointestinal tract. Cholelithiasis in children generally may be caused by abnormalities of biliary tract formation. The ultrasonography is the most informative method of the diagnosis of the biliary tract diseases. This method enables early surgery and preventing involvement of other organs into pathological process to aroid complications. 18 patients had cholecystectomy and 3 patients had the additional lithotomy with papillosphincteroplasty. The remote results within 1 to 4 years were very good in 19 patients. Two patients were reoperated because of major duodenal papilla stenosis and cholelithiasis relapse.

Adolescent↗
PubMed1997

Study of the secretion of substance P, neurotensin and somatostatin in patients with cholelithiasis.

A comparative, case-control study on the pre- and postprandial release of three gastrointestinal peptides implicated in gallbladder motility has been carried out in humans in the attempt to determine their possible role in the pathogenesis of cholelithiasis. Fifty-seven adult patients (40 females and 17 males) with an ultrasound diagnosis of gallstones and 20 healthy subjects (9 females and 11 males) without cholelithiasis or other digestive pathology were studied. Plasma substance P, neurotensin and somatostatin were measured by means of RIA-I125 in basal fasting conditions and 30, 60 and 90 minutes after the oral intake of a semiliquid mixed meal. The levels of secretion of each hormone were compared in patients and healthy controls on an overall basis and in terms of sex, age and body weight. We found a basal and postprandial hypersecretion of substance P in patients with gallstones when compared with controls. Individuals with cholelithiasis showed a moderate decrease in neurotensin secretion after the oral meal. Somatostatin release was unchanged. In conclusion, patients with gallstones may present a functional disorder in the secretion of gastrointestinal hormones involved in gallbladder motility.

Adult↗
PubMed1997

[Prevalence of cholelithiasis in El Real-Gandia].

The aim of this study was to know the prevalence of cholelithiasis (C) in the El Real-Gandia (Spain) as well as the degree of the response of the population. Health examinations were performed in 1,803 adults from El Real (2,000 inhabitants) and Gandia (54,000 inhabitants) using abdominal echography as the screening technique. Cholelithiasis was defined as the presence of biliary lithiasis (BL) or previous cholecystectomy (PC). Of 1,268 (70.3%) participants in the study, C was found in 126 cases (BL in 102 and P in 24) representing a standardized prevalence of around 15% in women and 5% in men. Cholelithiasis was more frequent in females (13.8%) than in males (5.7%) (p < 0.001) increasing linearly with age (p < 0.005). The proportion of PC was significantly higher in women (23.9%) than in men (5.9%) (p < 0.05) and in Gandia (34.4%) than in El Real (13.8%) (p < 0.02). The prevalence of biliary mud and polyps was of 0.3% and 1.1%, respectively. Working obligations (35.4%) and fear of hospitals (22.4%) were the most frequent causes for no response (NR). Males with more than primary a school education originating from outside the Valencian community (VC) were significantly associated with NR in multivariant analysis.

Abdomen↗
PubMed1976

Cholecystitis and cholelithiasis masking as abdominal crises in sickle cell disease.

A case of sickle cell (HbSS) disease is presented in a patient with a history of recurrent admissions for abdominal pain, jaundice, and abnormal liver function tests. Although he was believed to have a sickle cell abdominal crisis, his abdominal X-ray films revealed three calcified stones. Each of these stones progressively passed through the common duct and into the duodenum while awaiting surgery. He has been followed for two years since his cholecystectomy without further hospitalizations. This case led to the investigation of cholelithiasis in sickle cell disease to dispel the following misconceptions. Some physicians and pediatricians believe that (1) cholelithiasis and cholecystitis are uncommon in sickle cell disease; (2) the complications of gallstones are not significant; (3) the operative risk in patients with sickle cell disease is high; (4) these patients with HbSS disease do not live long enough to get into trouble with gallstones. A review of the literature on cholelithiasis and HbSS disease presents adequate evidence to cause us to urge investigation of the gallbladder in all patients with HbSS disease and abdominal crises, and cholecystectomy as an elective procedure should stones be present.

Adolescent↗