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PubMed1990

[Cholelithiasis and acute pancreatitis].

The authors evaluate the results of treatment of acute pancreatitis at the surgical clinic in 1972-1988. In 64% biliary pancreatitis was involved. The group with a more severe, complicated course is formed by 22.1% patients. In that group the mortality rate was 21.6%. In 57% it was accounted for by patients with biliary pancreatitis. In the group with a mild course of pancreatitis (77.9% of patients) the mortality was 0.9%. The approach to treatment of cholelithiasis in the acute stage of pancreatitis must be considered on an individual basis. In the majority of patients disease of the biliary pathways can be treated after control of acute pancreatitis during the primary hospitalization. In some patients surgery of the biliary pathways during acute pancreatitis is indicated. The risk of operation is high. Therefore in some patients endoscopic papillosphincterotomy is indicated.

Acute Disease↗
PubMed1990

The incidence of cholelithiasis and cholecystitis in Rochester, Minn, 1950 through 1969.

During the period 1950 through 1969, 2344 persons (755 men and 1589 women) in Rochester, Minn, met diagnostic and residency criteria for cholelithiasis. The age-adjusted average annual incidence rates per 100,000 population were 217 for men and 370 for women (adjusted rates were 255 and 276, respectively). Incidence rates increased with age in both sexes, but more rapidly so for men, so that by 70 years of age the rate for men was higher than that for women. For the decades covered in this study, no secular trend in incidence was detected for the two sexes combined or separately.

Age Factors↗
PubMed1989

[Cholelithiasis in advanced age].

Fifty seven patients over 65 affected with cholelithiasis underwent surgical procedures at II Patologia Chirurgica-University of Bari-Italy, from July 1987 to December 1988. Different risk factors were considered. The results, which reported a low incidence of morbidity and mortality, suggest the importance to adopt early surgery. Though 73.2% of patients had associated pathologies and 28.6% had two or more risk factors, only 5.3% of them had complications not strictly related to surgery.

Age Factors↗
PubMed1989

Prevalence of cholelithiasis in Nigerians with sickle cell disease.

Gall bladder ultrasonography was performed on 157 fasting patients (mainly adults) with sickle cell disease (133 SS and 24 SC) with a view to establishing the prevalence of cholelithiasis in Nigerian 'sicklers'. There were 82 females and 75 males whose ages ranged from 9 to 60 years (mean 34.5). Gallstones were demonstrated in 38 patients, giving an overall prevalence of 24.2% (22.6% in SS and 33.3% in SC). Their ages ranged from 18 to 56 years (mean 37.0) in HbS + C patients and 10-34 (mean 22.0) in SS patients. All the patients except one were asymptomatic. Autopsy confirmed gallstones in two SS patients who died of unrelated problems. The higher prevalence obtained in this study (24.2%) compared with the prevalence (less than 10%) in earlier studies from Africa could be due to the predominantly adult age group screened and the greater sensitivity of cholecystosonography.

Adolescent↗
PubMed1989

[Correction of disorders of bile lipid-mineral composition as a method of preventing cholelithiasis].

A study of 60 patients with biliary tract diseases revealed different disorders of the lipid and mineral composition of bile of monotypical character but different by severity in patients with dyskinesias, cholecystitis and cholelithiasis. Silibor favours normalization of the lipid composition of bile, a dry protein mixture--the mineral composition quadevit--the mineral and lipid composition of bile.

Amino Acids↗
PubMed1989

[Gas-chromatographic analysis of hypercholestanol in the bile and its role in the pathogenesis of cholelithiasis].

The cholestanol/cholesterol ratio in the bladder and liver bile was estimated by capillary gas-liquid chromatography in patients with dyskinesia of the gallbladder, chronic acalculous cholecystitis, and chronic calculous cholecystitis. Cholesterol biliary calculi and their surface and intermediate layers and the core were examined either. The authors came to a conclusion that cholestanol/cholesterol ratio in the bladder and liver bile reflected the progress of liver cholesterol metabolism starting from the early stages of cholelithiasis to the formation of cholesterol biliary calculi. Therefore hypercholestanolcholia should be considered as an indicator of the risk of cholesterol biliary calculi development.

Bile↗
PubMedDate not supplied

Normal neuronal features of the human gallbladder and structural changes in cholelithiasis patients.

Report on a histological study of ten gallbladders, of which five were from normal subjects and five from patients with cholelithiasis. In normal controls a higher number of nerve cells was found in the neck (23.45 +/- 10.14 per mm2) and a lesser one in the body (7.70 +/- 8.45 per mm2) and fundus (5.60 +/- 3.66 per mm2). In the lithiasic gallbladder wall the higher number of the nerve cells was present in the neck (5.83 +/- 4.92 per mm2), and a lowest one in the body (2.63 +/- 1.56 per mm2) and fundus (1.03 +/- 0.71 per mm2).

Adult↗
PubMed1989

Cholelithiasis in horses: ten cases (1982-1986).

Ten horses with clinical signs consistent with cholelithiasis were evaluated. Fever, icterus, mild intermittent colic, and weight loss were reported. Clinical laboratory abnormalities included leukocytosis, hyper-proteinemia, and hyperfibrinogenemia. Gamma glutamyltransferase and liver isoenzyme of lactate dehydrogenase activities also were high. Choleliths were observed via ultrasonography of the liver in 5 of the 8 horses evaluated, and increased echogenicity of the hepatic parenchyma and dilated bile ducts were observed in all horses. Seven horses were treated medically, 5 of which died or were euthanatized. Three horses were treated surgically, of which only 1 survived. Cholelith composition varied, but cholesterol, calcium bilirubinate, and mixed bile pigments were most commonly observed.

Animals↗
PubMed1977

Intraperitoneal drain in cholelithiasis operations.

571 patients were operated on for cholelithiasis, 70 acute cases and 501 chronic ones. On 142 cases of the latter type choledochus exploration was performed, while on the others only simple cholecystectomy was carried out. Intraperitoneal drain in the form of a latex tube was used on all the acute cases except 4, on all who underwent choledochus exploration except 3, and on 254 of the 359 chronic cases on whom simple cholecystectomy was performed. The analysi of the material shows that the indications for intraperitoneal drainage are not very convincing after cholecystectomy at a chronic stage, considering the amount of fluid drawn via the intraperitoneal drain and the complications that arose. After choledochus exploration, however, intraperitoneal drain serves its purpose in connection with the removal of the choledochus drain. Intraperitoneal drain should therefore be used when choledochus has been explored. In routine cases it should not be removed until the choledochus drain has been withdrawn.

Aged↗
PubMed1989

[Prevalence of cholelithiasis. Results of an epidemiologic study using sonography in East Germany].

In two middle-sized towns in the northern part of the German Democratic Republic, a random sample of the population and unselected subjects, respectively, were examined for gallbladder stones (GS) by ultrasound. The prevalence of cholelithiasis (sum of GS detected by ultrasound and history of cholecystectomy for GS) ist higher than in other European populations screened by similar methods. It is suggested that dietary habits are responsible for this finding. About one third of subjects with GS had complications of GS and about one third gave a history of cholecystectomy for GS. The frequency of nonspecific dyspeptic complaints was the same in persons with GS as in persons without GS.

Adolescent↗
PubMed1989

[The interrelationship of cholelithiasis and ischemic heart disease].

Ultrasonic scanning of the gallbladder was realized in 234 patients with ischemic heart disease and results of 924 autopsy findings in those who died of myocardial infarction. A high incidence of concomitant cholelithiasis was found in patients with ischemic heart disease as compared with the general population. The data obtained by ultrasound examination were close to the results of autopsy findings.

Adult↗
PubMedDate not supplied

Treatment of biliary fistulas and cholelithiasis: is endoscopic sphincterotomy acceptable in the paediatric age group?

Two children, both girls, aged 11 and 16 with a postoperative biliary fistula and cholelithiasis, choledochal cyst and common bile duct stones have undergone endoscopic sphincterotomy (EST), leading to a rapid recovery from their pathologies, thanks to cooperative work. In reviewing the literature we have not come across any cases of EST in our patients' age group. There were no complications during or immediately after endoscopic sphincterotomies. We believe that it has become an important and valuable rival to conventional surgical means with correct indications and in experienced hands.

Adolescent↗
PubMed1989

[The importance of early cholecystectomy in cholelithiasis for the prevention of carcinoma of the gallbladder].

The authors report on a series of 324 patients operated on for cholelithiasis. They summarize the histological findings obtained by detailed examination of the surgical specimens carried out by one pathologist. The relatively high rate (43%) of severe pathological changes in the gallbladder wall in emphasized as these may be sites of predilection for the development of carcinoma. Three cases of only histologically established carcinoma are briefly described. In two of them carcinoma developed on the basis of chronic fibroproductive cholecystitis. In the third case the gall bladder was not removed and thus histologically not examined. In the light of their findings, the authors strongly advocate early cholecystectomy, particularly in patients of advanced age groups.

Adult↗
PubMed1989

[Diagnosis and treatment of cholelithiasis in children].

At the period of from 1965 to 1988, the authors observed 20 children with cholelithiasis. Among the patients, the number of girls was predominant. Operated on were 13 patients. The indications for operative intervention, immediate and long-term results of the treatment are presented.

Adolescent↗
PubMed1989

[Secretory immunoglobulin A levels of the bile in cholelithiasis].

Secretory immunoglobulin A (SIgA) in the bile was measured in 71 patients with cholelithiasis and in a control group of 10 patients without hepatobiliary disease, by using enzyme immunoassay specific to SIgA. Bile SIgA levels of patients with pigment stone, positive culture of bile for bacteria in a all of them, were significantly lower than that in control group (P less than 0.005); constituent ratios of SIgA in total immunoglobulins were markedly lower than that in the control (P less than 0.001); relative coefficient of excretion of SIgA was also significantly lower than that in the control (P less than 0.001). In patients with infectious cholecystolithiasis, bile SIgA concentrations were lower than that without infection (P less than 0.01), and that in the control (P less than 0.01). These results suggest that there is certain relation between biliary tract infection and low concentrations of bile SIgA.

Bile↗
PubMed1989

[Clinical and experimental observations of jinqiancao gao on preventive and therapeutic effects in cholelithiasis].

This paper reports the clinical treatment of 120 patients with cholelithiasis for 2 months with Jinquiancao Gao. The Results showed that the clinical effective rate was 92.5%, among which 29 cases were cured, 42 cases markedly improved and 40 cases ineffective. Animal experiments showed that this medicine can prevent gallstone growth. The gallstone growth rate was 78.5% in the control group and 42.8% in the experimental group (P less than 0.05). The mechanism of the decrease of gallstone growth rate suggests that the said medicine could inhibit the activity of beta-Glucuronidase in the bile, diminish the non-combined bilirubin and prevent the bile from forming bilirubin stones. The result of cultured liver cells in vitro showed that the cholesterol synthesis was markedly inhibited by Jinqiancao Gao. Thus the cholesterol concentration of bile was decreased. These effects in turn prevented the bile from forming cholesterol stones.

Adult↗