Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Calculi”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed1984

Monooctanoin perfusion treatment of intrahepatic calculi.

Seventeen patients who had intrahepatic calculi underwent perfusion with monooctanoin. While five patients responded with a decrease in size or number of calculi, only one had a complete response; 12 showed no response; and one died during the perfusion (however, the perfusion was not believed to have contributed to the death). Fifteen of the 17 patients required further treatment by a combination of basket extraction, oral administration of chenodeoxycholic acid, or surgery. The lack of response to monooctanoin perfusion was in part due to calculus composition. Because of the poor response to this treatment and the prolonged hospitalization generally required, monooctanoin is not recommended for dissolution of intrahepatic calculi.

Adult↗
PubMed1988

Common bile duct calculi: updated experience with dissolution with methyl tertiary butyl ether.

The authors describe their experience with methyl tertiary butyl ether (MTBE) in a larger series of patients than previously reported in order to acquaint physicians with both its effectiveness for dissolution of common bile duct calculi and the limitations of its use. Ten patients with 13 biliary calculi underwent percutaneous stone dissolution treatment with the experimental cholesterol solvent, MTBE. Three stones completely dissolved within 30 minutes, seven were reduced in size, and three were visibly unaffected. All stones not completely dissolved were easily extracted by means of a stone basket except for one in a patient taken to surgery. Although MTBE perfusion is an effective technique for management of biliary calculi, practitioners should be aware that its use is quite time consuming and its odor difficult to control.

Aged↗
PubMed1989

Role of percutaneous intracorporeal electrohydraulic lithotripsy in the treatment of biliary tract calculi. Work in progress.

Although surgery is the treatment of choice for symptomatic gallstones, most bile duct calculi can be successfully treated with the use of routine percutaneous or endoscopic methods. Failure of these methods is most often associated with stones larger than 1.5 cm. The authors used percutaneous intracorporeal electrohydraulic lithotripsy (EHL) to treat 11 patients with calculi in the bile ducts (n = 10) or gallbladder (n = 1) in whom the use of other percutaneous or endoscopic methods failed. The stones in all 11 patients were successfully fragmented and removed. There were no complications. Intracorporeal EHL is an effective alternative therapy for the treatment of biliary tract calculi when standard methods fail.

Aged↗
PubMed1998

Spontaneous passage of gallbladder calculi--facilitation by endoscopic sphincterotomy.

After endoscopic sphincterotopy (ES) gallbladder motility increases leading to expulsion of crystals and stones. But this is not a universal phenomenon. We evaluated cholangiographic findings in patients emptying their gallbladder after ES for common bile duct (CBD) stones. Cholangiographic features of twenty patients expelling gallbladder calculi after ES were studied. Controls included 20 age and sex matched patients with gallstones and CBD stones, who did not expel gallstones after ES. Of 20 cases in study group, 9 recovered more than 20 stones each in the stool within 7 days of ES. Repeat ERCP showed empty gallbladder in all, whereas CBD was full of stones in 11 of the 20 cases. In the study group, low insertion of the cystic duct was more common (10 vs 0, p < 0.04), the cystic duct made a narrow angle (20 +/- 5 degrees vs 50 +/- 10 degrees, p < 0.04) with CBD before insertion and cystic duct diameter was higher (5 mm vs 2.5 mm, p < 0.04) as compared to controls. We conclude that in patients undergoing ES with intact gallbladder and small gallbladder calculi, spontaneous emptying of gallbladder calculi occurs, if cystic duct is wider, has low insertion and makes narrow angle with CBD before insertion.

Adult↗
PubMedDate not supplied

Chronic tympanomastoiditis with formation of calculi.

Numerous calculi of varying sizes and shapes were discovered in the mastoid, antrum, and attic during mastoid surgery for persistent chronic suppurative inflammation of the middle ear cleft with retroauricular and external meatal fistulas in an 8-year-old boy. Light microscopic and scanning electron microscopic examinations and x-ray microanalysis revealed the calculi to consist of masses of crystals containing calcium-oxalate and calcium- and magnesium-phosphate. No signs of tuberculosis were found. Since the patient had multiple dysplasias, including ipsilateral macrotia, in addition to chronic otitis media and mastoiditis, it is suggested that the formation of the calculi may have been due to congenital predisposition.

Calcinosis↗
PubMed1977

Treatment of retained bile duct calculi with T-tube infusion of sodium cholate and heparin.

A series of 26 patients with retained radiolucent bile duct calculi diagnosed at postoperative cholangiagrophy through the T-tube is presented. All patients were treated with infusion of 15-20 g sodium cholate in 1000 ml saline and 20,000 units of heparin in 1000 ml saline per 24 hours. In 19 of 26 patients (73 per cent) the calculi disappeared. No complications were encountered. This treatment is recommended prior to reoperation in all patients with retained radiolucent bile duct calculi diagnosed by postoperative cholangiography through the T-tube.

Adult↗
PubMedDate not supplied

Cholangiocellular carcinoma depending on the kind of intrahepatic calculi in patients with hepatolithiasis.

BACKGROUND/AIMS: Association of cholangiocellular carcinoma in patients with hepatolithiasis has been reported. However, its incidence depending on the kind of stones is obscure. The aim was to examine the association rate of cholangiocellular carcinoma in patients with hepatolithiasis with a special reference to the kind of intrahepatic stones. METHODOLOGY: One hundred and thirty-nine patients with hepatolithiasis who have been treated from 1973 to 1997 were retrospectively reviewed to examine the characteristics of cholangiocellular carcinoma. The type and location of intrahepatic calculi were analyzed. RESULTS: Cholangiocellular carcinoma was found in 8 of 139 patients, the incidence being 5.8%. The incidence of carcinoma was more than twice in patients whose stones were located in intrahepatic bile duct only (9.3%; 5/54) than in those located in both intrahepatic and extrahepatic bile duct (3.5%; 3/85). Of 121 patients excluding 18 whose calculi were not available for classification, the kind of intrahepatic calculi was brown pigment in 106 patients (87.6%), cholesterol in 10 (8.3%), black pigment in 4, and fatty acid calcium in one. Cholangiocellular carcinoma was associated in 3 (2.8%) of 106 patients with brown pigment stones, 3 (30%) of 10 with cholesterol stones, in one with fatty acid calcium stones, and one patient whose stone was not available for analysis. The association rate of cancer was significantly (P < 0.01) higher in patients with cholesterol stones than those with brown pigment stones. One patient survived for 24 months after left lobectomy but the others died within six months. CONCLUSIONS: An early and attentive evaluation for the possible presence of cholangiocellular carcinoma is mandatory not only in patients with brown pigment stones but also in those with intrahepatic cholesterol stones.

Adult↗
PubMedDate not supplied

[Minimally invasive treatment of common bile duct calculi].

UNLABELLED: Miniinvasive treatment of lithiasis of the common bile duct hasn't reached yet a standard end point. There are multiple techniques used for it. In this study we evaluate its indications, possibilities and limits. MATERIAL AND METHOD: In a series of 14,024 biliary patients operated over 9 years 719 patients underwent open choledocolithotomy. In 173 (1.2%) of patients we used miniinvasive procedures as follows: 71 cases underwent sequential treatment, 91 laparoscopic treatment and in 11 cases the remnant calculi were extracted 1-6 days postoperative. RESULTS: Sequential treatment was the preferred treatment when the lithiasis of the common bile duct was detected preoperative. Transcistic extraction was more often performed for the lithiasis diagnosed intraoperative. The conversion to open surgery was performed in 13 cases, remnant calculi were early diagnosed in 11 patients and late diagnosed in 14 cases (the calculi were extracted by endoscopic sphyncterotomy). All patients were healed. DISCUSSIONS: The miniinvasive procedures have to be practiced as frequently as possible because of rapid healing and early recovery of the patients, despite some disadvantage of them. The choledocotomy and choledocoduodenostomy are exceptional techniques to be used in specific cases.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

Shock wave lithotripsy monotherapy for renal calculi.

Shock wave lithotripsy (ESWL) remains the most common treatment for renal calculi. In this article, recent literature pertaining to ESWL monotherapy of renal calculi was reviewed, with the goal of improving ESWL results through better case selection. When selecting the optimal surgical approach for a patient, multiple factors must be considered. Factors to consider include stone-related factors (size, number, composition and location), renal anatomical factors, and patient-related factors. Each of these factors is presented in detail, with the discussion limit to non-staghorn renal calculi. Children, the elderly, patients with hypertension, and patients with impaired renal function, may be at increased risk of ESWL complications and adverse effects and care should be taken to limit the number and energy of shock waves applied in these special cases. Absolute contraindications to ESWL remain pregnancy, distal obstruction, untreated infection, and uncorrected coagulopathy.

Journal Article↗
PubMed1979

[Fissures in biliary calculi. Personal contribution (author's transl)].

In a series of 70 patients suffering from biliary lithiasis, the roentgenologic findings of fissures in the calculi was observed in 5 cases examined by means of cholecystography and in 7 cases who underwent cholangiocholecystography. Fissures were demonstrated 11 times in calculi after surgery. The "Mercedes-Benz" sign was never observed at the abdominal examination without contrast medium. The presence of fissures may be an additional sign in the radiologic diagnosis of biliary calculi, but its value is not determinant.

Adult↗
PubMed1977

Dissolution of retained choledochal calculi.

The history of the technique of promoting dissolution of retained gallstones in the biliary tree is briefly reviewed. Present methods are described in detail and our own experience recorded. We have treated six patients with retained calculi by means of heparinized saline and sodium cholate infusions of the common bile duct. Successful dissolution of calculi was achieved in five cases, but one patient developed severe pancreatitis and renal failure which responded to peritoneal dialysis. We believe that the method is a valuable alternative to re-exploration of the common bile duct, particularly when calculi are situated in the distal part of the duct.

Aged↗
PubMedDate not supplied

Endoscopic sphincterotomy for bile duct calculi-factors influencing the success rate.

BACKGROUND/AIMS: Endoscopic sphincterotomy is an established treatment of retained or recurrent common bile duct calculi after cholecystectomy and in the majority of patients with an intact gallbladder. In order to identify patients ultimately requiring additional endoscopic procedures or surgery, factors predictive of decreased endoscopic bile duct clearance were sought. MATERIAL AND METHODS: Between 1981 and 1992 endoscopic sphincterotomy was performed in 393 consecutive patients with either intact gallbladders (n = 246), recurrent (n = 92) or retained (n = 55) calculi. RESULTS: There was a 9.4% overall early complication rate for the procedure and a 30-day mortality rate of 0.5% (two patients, non-procedure related). Complete removal of all bile duct calculi failed in 35/393 patients (8.9%). In patients with intact gallbladder the clearance rate at first attempt was higher (p = 0.002; Chi-square test) in the presence of solitary as compared to multiple stones. The same was found in patients with recurrent stones as well (p < 0.001). In non-cholecystectomized patients with single or multiple stones smaller than 10 mm, the clearance rate was higher at first (p = 0.02) as well as at final (p < 0.002) attempt as compared to patients with larger stones. Single small ( < 10 mm) compared to single large stones in patients with intact gallbladder had a higher clearance rate at final (p = 0.002) but not at first (p = 0.18) attempt. Patients with intact gallbladder and pancreatitis had higher clearance rate at first attempt compared to patients with jaundice (p = 0.001) or patients without concomitant pancreatobiliary disease (p = 0.002). Clearance rate was the same in patients with and without endoscopic sphincterotomy complications, except for patients with basket impaction, in whom the clearance rate was decreased (p = 0.02). CONCLUSIONS: Thus, in patients with intact gallbladder surgery should be considered after failed complete bile duct clearance at first attempt.

Cholecystectomy↗
PubMedDate not supplied

Factors predictive of early complications of endoscopic treatment of bile duct calculi.

BACKGROUND/AIMS: Factors associated with an increased early complication rate of the endoscopic sphincterotomy procedure have been identified. Precut or needle knife papillotomy has been shown to improve the success rate of endoscopic retrograde cholangiography and endoscopic sphincterotomy, but has often been reported to be hazardous. In order to identify patients with bile duct stones at risk for a complicated course in connection with endoscopic clearance of the calculi, factors predictive of early complications were sought. METHODOLOGY: 417 consecutive patients with bile duct calculi at endoscopic retrograde cholangiography were considered for endoscopic treatment in our department from 1981 to 1992. Endoscopic sphincterotomy was performed in 246 patients with intact gallbladders and in 147 with prior cholecystectomy, 55 of whom had retained calculi. RESULTS: There was a 9.4% overall and 7.1% major early complication rate of the EST procedure and a 30-day mortality of 0.5% (2 patients, non-procedure related). In 22% (6/27) of the patients with major complications, surgery was required or preferred to additional endoscopic measures. Complete stone removal failed in 35/393 patients (8.9%). The immediate and early complication rate of standard sphincterotomy was not found to be increased in patients with prior or present biliopancreatic complications, failed bile duct clearance at first attempt, or juxtapapillary diverticula. It was the same after standard sphincterotomy as after precut papillotomy followed by immediate or delayed sphincterotomy. No increased morbidity was found after failed therapy as compared to failed diagnostic precut papillotomy. There was neither a greater need for, nor an increased complication rate following, precut papillotomy in patients with, as compared to those without, juxtapapillary diverticula. Endoscopic experience did not influence the complication rate. There were no significant differences regarding outcome or risk factors associated morbidity between patients with and without intact gallbladder. CONCLUSIONS: These findings confirm that endoscopic treatment is safe and that precut papillotomy can be performed without increased morbidity. Furthermore, none of the commonly identified factors associated with increased morbidity were found to be risk factors in this study.

Aged↗
PubMed1998

[Nonabsorbable suture material as a source of biliary calculi formation].

Chemical and structural-morphological analysis of the ligature calculi in 23 patients was done. The calculi revealed were localized on silk ligatures on the 40-48th day after the operation, on the ligatures made of polyether compounds (lavsan, dagrofil)--on the 70-80th day, on polyamide ligatures (nylon, capron)--on 90-96th day. On the silk ligatures bilirubin have prevailed in the calculi structure, on the rest ligatures--cholesterol. Tactics of the patients treatment is similar to such in ordinary choledocholithiasis.

Adolescent↗
PubMed1983

Siliceous deposits in human urinary calculi--an E. M. study.

Silica calculi in man are extremely rare; only 12 cases have been reported. In an electron microscopic study of human urinary stones, siliceous deposits were encountered in three out of 180 stones as a discrete component of stones. There were no histories of magnesium trisilicate administration in these cases. Morphology of the deposits was distinctive from any other components of the stones and bore some resemblance to animal silica calculi. Siliceous deposits in human urinary stones appear to be more common than generally recognized.

Electron Probe Microanalysis↗
PubMed1994

Experience with extracorporeal shock-wave lithotripsy (ESWL) for urinary calculi.

Over a 36-month period 2800 patients were subjected to extracorporeal shock-wave lithotripsy (ESWL). A total of 5154 procedures were done. Best results were seen with renal pelvic calculi (not larger than 2.5 cm in diameter). Fragments of crushed lower calyceal calculi proved the most difficult to eliminate. As ureteral stone localization approached the bladder, the ESWL results were poorer. Post-ESWL complications were proportional to the stone mass; the higher the mass the more numerous the complications tended to be. Besides erythrocyturia and gross haematuria renal colic was the most frequent complication in almost 60% of the patients. Less prevalent were impacted ureteral stones, subcapsular haematoma and fever. At our institution, thanks to the ESWL method about 80% of the patients were spared surgery.

Adolescent↗
PubMed1986

Impact of shockwave lithotripsy on upper urinary tract calculi.

Extracorporeal shock wave lithotripsy (ESWL) currently is performed in selected urologic centers to treat over 80 per cent of patients with symptomatic upper urinary tract calculi. This noninvasive technique utilizing shockwaves to disintegrate stones into sand-sized particles allows the patient to pass the particles with spontaneous urination and replaces most surgery or percutaneous endoscopy for stone removal. However, stone-free success rates must be individualized depending on stone position, stone size, and composition. Lithotripsy of renal stones prior to migration and proximal ureteral stones early in their symptomatic course may alter significantly the incidence of distal ureteral calculi requiring hospitalization, cystoscopy, or ureteroscopy.

Adolescent↗
PubMed2005

Extracorporeal shock wave lithotripsy of upper urinary tract calculi in patients with cystectomy and urinary diversion.

OBJECTIVES: To present our experience with extracorporeal shock wave lithotripsy (ESWL) in the management of upper urinary tract calculi in patients with urinary diversion. METHODS: Between March 1989 and June 2004, 27 patients with radical cystectomy and urinary diversion were treated using ESWL for upper urinary tract calculi using the Dornier MFL 5000 lithotripter. The mean length of the stones was 11 +/- 3.1 mm and the mean width was 8.8 +/- 3.5 mm. The follow-up protocol included plain abdominal x-ray and renal ultrasonography every 2 weeks until complete stone clearance. All follow-up data were collected and analyzed after 3 months. Success was defined as the absence of residual stones or the presence of insignificant gravel less than 4 mm. RESULTS: Retreatment was required in 12 patients (44.4%). Failure to disintegrate the stones was recorded in 2 cases (7.4%) and significant residual stones were recorded in 1 (3.7%). Post-ESWL renal obstruction was observed in 2 cases (7.4%). Secondary procedures were needed in 5 cases (18.5%). Two percutaneous nephrolithotomy and one antegrade ureteroscopy were performed for treatment of ESWL failure. One open ureterolithotomy and one antegrade ureteroscopy were performed for treatment of post-ESWL renal obstruction. Thus, the overall success rate of ESWL monotherapy in the treatment of upper urinary tract stones was 81.5% (22 of 27). CONCLUSIONS: ESWL monotherapy proved to be a valuable option in the treatment of upper tract lithiasis in patients with urinary diversion. However, it may cause renal obstruction, and antegrade endoscopic maneuvers should be available.

Adult↗