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Cholecystectomy

Cholecystectomies


Presentation

  • Following evaluation, she underwent excision of the cystic duct remnant with no malignancy being present on final pathology. We present this case to discuss the management of cystic duct dysplasia in the absence of gallbladder malignancy.[ncbi.nlm.nih.gov]
  • At presentation, she had moderately deranged liver function tests and significantly elevated inflammatory markers and was found on cross-sectional imaging to have developed a liver abscess.[ncbi.nlm.nih.gov]
  • : Abdominal pain is the most common chief complaint of patients presenting to the emergency department in the United States, and emergency physicians routinely encounter patients with postcholecystectomy syndrome.[ncbi.nlm.nih.gov]
  • It is of note that all patients who presented residual stones by IOC had undergone pre-operative sphincterotomy.[ncbi.nlm.nih.gov]
  • To our best knowledge this video presents the first RASS-RN with concomitant cholecystectomy performed in Latin America.[ncbi.nlm.nih.gov]
Platypnea
  • As these episodes were mainly induced by postural changes, a platypnea-orthodeoxia syndrome was suspected. A transthoracic echocardiogram was performed and revealed a patent foramen ovale.[actamedicaportuguesa.com]
Tenderness in the Right Upper Quadrant
  • To assess for the latter risks, the patient is observed for severe pain and tenderness in the right upper quadrant, an increase in abdominal girth, leakage of bile-colored drainage from the puncture site, a fall in blood pressure, and increased heart[medical-dictionary.thefreedictionary.com]
Fat Intolerance
  • intolerance 1.3 0.83 43 68 Tenderness of upper abdomen 1.3 0.73 62 53 Food intolerance 1.2 0.86 51 57 Upper abdominal pain 1.2 0.74 68 43 Acute cholecystitis Murphy sign* (general population) 5.0 0.4 65 87 Chills 2.6 0.9 13 95 Right upper quadrant pain[aafp.org]
Dyspareunia
  • Moreover, several studies reported no dyspareunia or difference in return to sexual activity between TVC and CLC groups after short-term follow-up[ 47 - 49 ].[doi.org]
Agitation
  • A Patent Foramen Ovale (PFO) with a right to left shunt was evident on echocardiogram employing colour doppler and agitated normal saline studies.[ncbi.nlm.nih.gov]

Workup

  • On workup, she was found to have gall stones, and her condition was at last attributed to biliary colic after months of follow-up in the Department of Pediatrics.[ncbi.nlm.nih.gov]
  • A cholecystokinin-HIDA scan is helpful in patients with suspected gallstones, but who have normal findings on ultrasonography and workup for their symptoms (e.g., upper endoscopy, upper gastrointestinal series, negative Helicobacter pylori serology).[aafp.org]
Nonvisualization of the Gallbladder
  • No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor.[ncbi.nlm.nih.gov]
Nonvisualization of the Gallbladder
  • No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor.[ncbi.nlm.nih.gov]
Colitis
  • Postoperative pain and rising liver function tests; requiring further investigations to exclude CBD stone 1 Postoperative readmission with gallbladder fossa abscess requiring percutaneous drainage 1 Postoperative chest infection and Clostridium difficile colitis[dx.doi.org]

Treatment

  • Abstract Eluxadoline has emerged as an effective treatment option for patients with diarrhea- predominant irritable bowel syndrome (IBS-D). It was approved by the Food and Drug Administration (FDA) in May 2015 for treatment of IBS-D.[ncbi.nlm.nih.gov]
  • Treatment involves splenectomy and antibiotic therapy. In the case the abscess is limited, and particularly in young patients, percutaneous abscess drainage may be performed.[ncbi.nlm.nih.gov]
  • What Are the Alternative Medical and Surgical Treatments of Gallstone Disease? In the past 20 years, a variety of treatment options for gallstone disease have been developed.[consensus.nih.gov]
  • This study aimed to investigate potential risk factors for the recurrence of primary CBD stones after endoscopic treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis A small number of people are affected with post cholecystectomy syndrome, which has symptoms like gastrointestinal distress and/or constant pain in the right upper quadrant of the abdomen.[healthpages.org]
  • Prognosis Patients who show early signs of multiple organ failure (renal failure, disseminated intravascular coagulation [DIC], alterations in the level of consciousness, and shock) as well as evidence of acute cholangitis (fever accompanied by chills[doi.org]
  • Lowenfels AB, Maisonneuve P, Sullivan T (2009) The changing character of acute pancreatitis: epidemiology, etiology, and prognosis. Curr Gastroenterol Rep 11:97–103 PubMed CrossRef Google Scholar 125.[doi.org]

Etiology

  • Thus, surgeons should keep in mind the increased possibility for the tuberculous etiology of wound infection in chronic, non-healing wounds.[ncbi.nlm.nih.gov]
  • Pathology of a retained gallbladder remnant is an exceedingly rare etiology of this pain.[ncbi.nlm.nih.gov]
  • The primary etiology of acute cholangitis/cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract.[doi.org]
  • There are two other etiologies of acute cholangitis; Mirizzi syndrome and lemmel syndrome.[doi.org]
  • On CT, depending on the time course and etiology, various imaging findings such as vascular thrombosis, pneumatosis intestinalis, gas in the portal or mesenteric vein, pneumoperitoneum, submucosal haemorrhage, or free fluid is seen [Figure 19].[dx.doi.org]

Epidemiology

  • […] evidence, further discussion took place on terminology, etiology, and epidemiological data.[doi.org]
  • Davies is affiliated with the MRC Integrative Epidemiology Unit [MC_UU_12013/9], which receives funding from the Medical Research Council (MRC) and the University of Bristol. Dr.[doi.org]
  • Department of Epidemiology Lazio Regional Health Service Rome Italy[doi.org]
  • Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO). Am J Epidemiol. 1984; 119:796-805. Patino JF, Quintero GA. – Asyptomatic Cholelitiasis Revited. World J Surg. 1998; 22:1119-24.[revistas.unifoa.edu.br]
Sex distribution
Age distribution

Pathophysiology

  • Gadacz Article First Online: 30 January 2007 Abstract This article discusses the definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis.[doi.org]
  • Pulmonary pathophysiology. The essentials, pp. 1 [24.] M.D. Altose, R.O. Crapo, A. Wanner The determination of static lung volumes Chest, 86 (1984), pp. 471-489 [25.] P.H. Quanjer, G.J. Tammeling, J.E. Cotes, O.F. Pedersen, R. Peslin, J.C.[archbronconeumol.org]
  • Monjur Ahmed, Acute cholangitis - an update, World Journal of Gastrointestinal Pathophysiology, 9, 1, (1), (2018). C.S. Loozen, B. van Ramshorst, H.C. van Santvoort and D.[doi.org]
  • Rastogi A, Slivka A, Moser AJ, Wald A (2005) Controversies concerning pathophysiology and management of acalculous biliary-type abdominal pain. Dig Dis Sci 50(8):1391–1401 PubMed Google Scholar 93.[doi.org]

Prevention

  • -- Indications to Laparoscopic Cholecystectomy -- Biliary Tree Stones -- Laparoscopy and Acute Cholecystitis: The Evidence -- Number of Trocars, Types of Dissection, Exploration of Bile Duct, Drainage and Analgesia -- Complications: How to Prevent and[worldcat.org]
  • Once a child is diagnosed with symptomatic cholilithiasis, cholecystectomy is required to relieve the symptoms and prevent complication.[ncbi.nlm.nih.gov]

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