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PubMed1987

[Surgical treatment of acute cholecystitis in patients with diabetes mellitus].

The tactics of early operations for acute cholecystitis in patients with diabetes mellitus gives substantially better results of surgery. In the recent years the incidence of complications in this group of patients has been 20.3%, lethality--6.3%. Control of the carbohydrate metabolism must be made at short terms. It is the operation in combination with the rational insulin therapy which gives the correction of the carbohydrate metabolism.

Acute Disease↗
PubMed1987

[Removal of bile stones using a cast].

Experimental studies and clinical observations show that cholangiolithectomy with the help of moulds of fibrinogen and thrombin is an effective method of sanitation of bile ducts.

Adult↗
PubMedDate not supplied

Bronchobiliary fistula in chronic pancreatitis. Case report.

Bronchobiliary fistulas are rare. One aetiological cause is biliary obstruction with secondary suppuration and subsequent hepatic and subphrenic abscesses. Only a few cases of bronchobiliary fistulas in patients with chronic pancreatitis have been reported and we record another case. A 47-year-old white male, with chronic alcohol-induced pancreatitis who had earlier undergone several laparotomies related to this disease, was admitted with a hepatic abscess. Drainage was not successful. The patient developed bilioptysis and a bronchobiliary fistula was diagnosed. The fistulous tract was demonstrated using PTC as well as bronchography. Laparotomy was performed and the fistulous tract was excised. The hepaticoduodenal ligament was completely obstructed by the inflamed pancreatic gland. An earlier but now obstructed cholecystojejunostomy was revised. This case was complicated by episodes of severe gastrointestinal bleeding probably caused by thrombosis of the portal vein and local varices around the gallbladder and common duct.

Alcoholism↗
PubMed1987

Choledochoduodenostomy for benign biliary tract disease in the elderly.

Endoscopic sphincterotomy is an available nonoperative alternative treatment for recurrent or residual common bile duct stones. Nevertheless, immediate, intraoperative and definitive treatment is needed in patients with common duct stones and other pathologies that are prone to develop into such complications, which is important especially in aged high-risk patients during recurrent operations and nonoperative instrumental interventions. To evaluate the safety of choledochoduodenostomy in elderly patients, we reviewed our experience with 55 patients over the age of 70 years with benign biliary tract diseases. Even though the majority of patients (69%) had obstructive jaundice and were operated on urgently, there was one death (1.8%) due to cardiac failure, and nine (16.3%) early postoperative complications including subphrenic abscess, disruption of wound and pneumonia (one case of each), wound infection (three cases) and urinary tract infections (three cases). There were no complications related to the procedure itself. In a follow-up period of one to 12 years, neither cholangitis nor sump syndrome were documented.

Aged↗