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At least 487 records · Page 27Linked to original sources
PubMed1982

[Endoscopic sphincterotomy as a treatment in residual lithiasis of the choledochus].

In this report, the clinical aspects of the residual lithiasis of the choledoch duct, as well as the complications, the diagnosis and the treatment, are developed. The used of endoscopic sphincterotomy is underlined, along with a description of the technique, its indications and contraindications considering this one as the method of choice in the treatment. The experience obtained in ten cases is described in which this method is utilized with success and without complications.

Aged↗
PubMed1982

[Hydrochlorothiazide in the metaphylaxis of recurrent calcium oxalate lithiasis].

The main indication for the application of Disalunil in the convalescent care of recidive calcium-lithiasis patients is renal hypercalciuria. Treatment with 50 mg Disalunil/d reduced the rate of recidivation by two thirds. Even during long-term application of this therapy over 3-7 years, side effects were slight and did not require any cessation of therapy.

Adult↗
PubMed1981

[Surgery of biliary lithiasis. II. Choice of operation and results].

A pre-and intraoperative diagnostic protocol offering morphological and functional evaluation of the bile ducts, Oddi's sphincter, duodenum, and pancreas was employed to classify 633 patients with biliary lithiasis into 6 groups and hence the therapeutic application of 6 surgical techniques, namely: 1) cholecystectomy alone; 2) choledocholithotomy plus closure of the choledoch; 3) choledocholithotomy plus Kehr drainage; 4) papillosphincterotomy alone; 5) papillosphincterotomy plus anterior seclective duodenal vagotomy; 6) hepaticojejunostomy, so as to ensure a rational choice of the best operation fro each situation. Comparison with the literature and prior personal results substantiated the soundness of this approach, as shown by a marked reduction of complications, mortality and residual disease on both short and medium-term follow-up.

Ampulla of Vater↗
PubMedDate not supplied

[Intrahepatic biliary lithiasis : role of Ascaris infection in 150 cases. Experimental study on bile stone formation (author's transl)].

Biliary infection was the cause of intrahepatic biliary lithiasis in 150 patients operated upon over the last twenty years. Diagnosis was established during operation in the majority of cases, but cholangiography, or ultrasound and/or scintiscan examinations were required in a few patients. To determine the mechanism of formation of these biliary stones, a study was conducted in 30 rabbits divided into three groups, each forming a model of lithogenesis. Pathological examination of the liver demonstrated the presence of multiple abscesses, fibrosis, bile duct stenosis, and perihepatitis. The results of the different types of operative techniques employed in these patients are described.

Adult↗
PubMed1980

[Gangrenous cholecystitis without lithiasis. A report on a case diagnosed by simple radiography of the abdomen (author's transl)].

The authors report a case of gangrenous cholecystitis without lithiasis but with secondary infection of the gallbladder by anaerobic germs. Pre-operative diagnosis was possible from simple x-rays of the abdomen which demonstrated an obvious fluid level in the gallbladder, and by parietography. An immediate cholecystectomy was performed. Bacteriological examination of the bile confirmed the presence of Clostridium perfringens. The main bile duct appeared normal and the bile in the common bile duct was sterile. Convalescence was uneventful with antibiotic cover, in spite of the age and condition of the patient. Gangrenous cholecystitis occurs more frequently without gallbladder stones in humans. Clinical signs are not specific but simple x-rays of the abdomen are pathognomonic and enable pre-operative diagnosis to be made. Urgent cholecystectomy appears to be the ideal treatment. This affection has a high mortality and early operation is therefore justified.

Aged↗
PubMedDate not supplied

[Papillo-sphincterotomy in the treatment of lithiasis of the principal bile duct and of non-neoplastic stenosis of the papilla].

Personal experience acquired in a series of 130 papillo-sphincterotomies carried out over a five-year period for the treatment of lithiasis of the VBP and benign stenosis of the papilla is reported. An account is given of the literature data showing that his method, which is comparable with biliodigestive anastomosis techniques, is safe and reliable. Attention is also drawn to its undoubted advantages in the prevention of some serious late complications.

Ampulla of Vater↗
PubMed1980

[Isotopic kidney investigations in staghorn lithiasis in the adult (author's transl)].

The authors report a study of 37 kidneys in 30 patients with staghorn calculi undergoing isotopic investigation of renal function by sequential scintigraphy and isotopic nephrogram by gamma-camera. 7 of the patients had bilateral staghorn calculi. Tracers used: Hippuran labelled with I131 and DPTA labelled with Technetium 99 m. 62% of kidneys poorly tolerated their staghorn calculus as shown by severe impairment of the isotopic nephrogram involving the uptake phase. Amongst the 20 cases of unilateral lithiasis, a nephrectomy was performed whenever the functional value was less than 20% normal (7 kidneys). Twelve stones were removed with conservation of the kidney. It should be noted that with renal function greater than 70% normal, the thickness of the renal parenchyma as assessed by IVU is never less by more than 1/2 cm that of the contralateral kidney. In the group, 11 patients underwent postoperative urography and scintigraphy with a mean follow up of 4 years. All extractions of calculi by pyelotomy with or without a small nephrotomy benefited initially impaired kidneys. By contrast, in 5 kidneys where a large nephrotomy was made, there was a gain in function in only one. 1 remained stationary and the others lost respectively 20, 30 and 100% of their function. Correlation was good with other methods of split renal function studies (IVU and renal arteriography). Of essential importance is the fact that the irradiation associated with these isotopic investigations is 20 to 50 times less than that of IVU. Isotopic investigation is thus a good method for the assessment of changes in renal function after surgery for staghorn calculus.

Adult↗
PubMed1980

[Uric acid and oxalate lithiasis. Physico-chemical and crystallo-chemical explanation of the relationship].

It is tried to explain physico-chemically or crystallo-chemically the so-called "salting out effect", i.e. the influence of the Ca-oxalate precipitation by uric often discussed in urolith research which, indeed, is regarded as real by several researchers and by other investigators refused with emphasis, in order to understand better the connections between hyperuricosuria and oxalate lithiasis which obtrude themselves from the observation material. However, this phenomenon of the facilitated oxalate precipitation at increased uric acid level in the urine further needs directed research.

Calcium Oxalate↗
PubMed1980

[Current status of prevention and therapy of urinary calculi and peroral chemo-litholysis with special attention to the relationship of increased excretion of uric acid in oxalate lithiasis].

A survey shall be given of the present state of prevention and therapy of urolithiasis as well as of the up to now much restricted possibilities of the chemolitholysis. Particular attention is paid to calcium on account of its participation in the development of oxalate and phosphate calculi which together might be 70--80% of all calculi as well as to the rather limited possibilities of the reduction of the oxalate secretion in the urine. The encouragement of the oxalate lithiasis by increased uric acid in the urine as well as the reduction of the frequency of relapses not only of the concrements of the uric acid but also of the oxalate concrements by the uricostatic Allopurinol (e.g. zyloric) is dealt with.

Calcium Oxalate↗
PubMed1980

[Reinterventions in evolutive oddipathies after cholecystectomy for lithiasis. 31 cases (author's transl)].

Angiocholitis induced by an oddipathy occured a long time after a cholecystectomy (average 8 years), for lithiasis in 0.5% of the patients. Indeed, the disorder was so serious that a new operation had to be performed in 31 cases. Although, this complication is rare, it is worth reducing its occurence by a preventive treatment: the best means consists in a circumstantial clinical examination in a precise "radio-mano-débitmétique" test during the cholecystectomy. Precisions are given in these fields. The re-intervention is imperative when the sclero-dystrophy of the area of the Oddi is settle. From the failures or the bad results of the operations of external or internal (sphincterotomy) drainage, we conclude that a bilio-digestive anastomosis must be performed, the most efficient is the cholangio-jejunostomy by implantation which involves a by pass of the whole bile flow.

Adult↗
PubMed1995

Ureteral lithiasis: in situ piezoelectric versus in situ spark gap lithotripsy. A randomized study.

OBJECTIVES: In situ extracorporeal lithotripsy (EL) is the treatment of choice for ureteral lithiasis at our institution since the introduction of the painless lithotripters in clinical practice. The major objections to such clinical approach are: difficult ultrasound localization of ureteral calculi (if an ultrasound-guided lithotripter is used); lower energy of the painless piezoelectric compared to the spark gap system. To evaluate the efficacy of in situ EL of ureteral stones and to compare two different lithotripters (the spark gap fluoroscopically-guided Dornier HM3 versus the piezoelectric ultrasound-guided Wolf Piezolith 2300), we conducted a prospective randomized study. METHODS: 70 patients were randomly divided into two groups according to the following inclusion criteria: radiopaque stones of lumbar or prevesical tract (iliac and pelvic stones were excluded); stones with largest diameter not more than 2 cm. RESULTS AND CONCLUSION: The evaluation of the treatment was done by plain film (KUB) at 24 and 72 hrs and by ultrasound at 48 hrs to assess stone fragmentation using migration of the fragments more distally into the ureter as criteria for success. The results were comparable: 76.6% for extracorporeal piezoelectric lithotripsy (EPL) and 74% for extracorporeal shock wave lithotripsy (ESWL). Better results were observed in both groups for the prevesical stones. The focussing time required was also comparable.

Electricity↗
PubMed1995

Reversible acute renal failure due to sulfonamide-induced lithiasis in an AIDS patient.

OBJECTIVE: Drug-induced lithiasis was well-known some years ago, when sulfonamides poorly soluble in urine were in use. Now, they are again in use for some opportunistic AIDS-related infections. We report herein the case of an AIDS patient, treated with sulfadiazine because of Nocardia pneumonia, that came to the emergency room in acute renal failure. METHODS/RESULTS: Obstructive uropathy due to radiolucent calculi was suspected and retrograde ureteral catheterization was necessary. The calculi recovered were identified as N-acetyl sulfadiazine by infrared spectrophotometry. CONCLUSION: Rapid improvement can be achieved in these patients when the drug is discontinued or decrease and systemic fluid and urine alkalinization are started.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Four cases of urinary lithiasis associated with chronic inflammatory bowel disease].

We report 4 cases of urinary lithiasis associated with chronic inflammatory bowel disease. All cases were surgically treated and the mode of operation was total colectomy in two cases, ileal resection (1 m) in 1 case and total colectomy and ileal resection (1 m) in 1 case. The composition of the stone was uric acid in 2 cases treated with total colectomy and calcium oxalate in the other 2 cases treated with ileal resection. Low urine volume was observed in 3 cases and acid urine in all cases. Hypocitruria was observed in 3 cases. Two cases with ileal resection showed enteric hyperoxaruia and increased urinary excretion of oxalate was observed on the oxalate loading test.

Adult↗
PubMedDate not supplied

[Multimodal treatment of intrahepatic lithiasis with traditional surgery, endoscopy, and extracorporeal lithotripsy. Report of a clinical case].

A patient with residual intra-/extra-hepatic bile duct stones, previously admitted in emergency for acute necrotic pancreatitis and cholangitis, underwent the following procedures: 1) endoscopic sphincterotomy and naso-biliary tube drainage; 2) surgical operation (choledocholithotomy, operative choledochoscopy and T-tube external biliary drainage); 3) extracorporeal shock-wave lithotripsy; 4) endoscopic sessions of fragmented stones removal. The above mentioned multimodal treatment, which resolved the intrahepatic lithiasis as shown 12 months later by endoscopic retrograde cholangiography, is therefore suitable in order to avoid, at least initially, invasive radiologic or surgical procedures, i.e. transparenchymal approaches, intrahepatic derivations and hepatic resections.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

[Therapeutic development in common bile duct lithiasis. Apropos of a 25-year experience].

Authors' experience in the treatment of common bile duct stones (LVBP), including 592, operated patients, is presented. During the years 1969-1983, the most used technique was transduodenal sphincterotomy, while after 1983 choledocotomy, mostly with associated external temporary biliary drainage, was the preferred one. Since 1985 endoscopic sphincterotomy (SE) has been used, firstly for high-risk patients, and then with increasing indications; at present the first choice in treatment of LVBP consists in sequential SE and laparoscopic cholecystectomy. Postoperative results of these techniques showed a specific mortality rate of 1.1% for ST, of 0% for CT and SE, and a specific morbidity rate of 4.6% for ST, of 6.9% for CT and of 5.6% for SE. At follow-up patients in I and II Visick group were 87% for ST, 91% for CT and 100% for SE. Even if a statistical analysis of such results is not proposable, the only existence of a specific mortality for ST made us to change our choice. At present the treatment of choice for LVBP is in our opinion the sequential SE and laparoscopic cholecystectomy, waiting for a complete evaluation of all laparoscopic procedure. Traditional surgery is now indicated for failures of sequential approach and, as a first choice, for treatment of "empierrement" of common bile duct, for intrahepatic lithiasis and for atonic megacholedocus.

Choledochostomy↗
PubMed1995

[Megacalycosis and lithiasis].

OBJECTIVES: Megacalycosis or Puigvert's disease is a clinical entity characterized by dilatation of all renal calyces without dilatation of the renal pelvis or ureter in the absence of any obstructive factor. To date, its pathogenesis remains unclear. The rarity of this disease and the importance of making a correct differential diagnosis prompted us to report on the present case. METHODS/RESULTS: Two patients with urolithiasis associated with ipsilateral megacalyces who were successfully treated by ESWL are described. The clinical, diagnostic and therapeutic aspects reported in the literature are briefly reviewed. CONCLUSIONS: There is a greater lithogenic predisposition in these patients. Intravenous urography has proved to be very accurate in making the differential diagnosis from other disorders such as obstructive uropathy and intermittent hydronephrosis. The efficacy of ESWL in the treatment of lithiasis associated with megacalycosis is underscored. A yearly control follow up by analyses and intravenous urography is advocated.

Chronic Disease↗
PubMed1994

[Metaphylaxis and treatment of cystine lithiasis--personal experience].

The authors presented their own experience with treatment of cystine lithiasis in 7 patients, which has been performed during the course the past of ten years. Identification of cystine was performed by concrement submitted examination, using a polarizating microscope, and x-ray difractometric structural analysis. After stone extraction the patients were treated by a high fluid intake (diuresis over 2.5 l), alcalizating treatment involving citrates (Alkalit Spofa), and Penicilamin (Spofa), or Thiola (Santen) which are currently proved to be the most optimal approach. Recurrence of stones requiring percutaneous treatment, was observed in one of the patients during five years metaphylaxy. Another patient of the same group had three times stated cystine stone recurrence which passed spontaneously.

Adult↗
PubMed1994

[Lithiasis of the prostatic loge].

Lithiasis may develop in the prostate loge following prostate surgery. Calculus formation in the prostate can be ascribed basically to foreign bodies, residual adenomatous spheroids and clots or fragments of sphacelous mucosa in the presence of a stenotic area after surgery and/or infection. The diagnosis is based on the physical examination and particularly on the radiological findings. Treatment is by open surgery or endoscopic or extracorporeal lithotripsy.

Aged↗