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Análise dos lipídios biliares no cálculo e na bile em portadores brasileiros de litíase biliar; Analysis of gallstones and biliar lipids in gallbladder disease of Brazilians patients

Souza, Miriam Karine de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 24/02/2010 PT
Relevância na Pesquisa
46.8%
INTRODUÇÃO: A litíase biliar é uma doença do trato digestivo que apresenta prevalência variada em diferentes grupos étnicos e que gera altos gastos aos sistemas de saúde. A possibilidade de aplicação de tratamento não invasivo medicamentoso está direcionada a presença de cálculo de colesterol o que leva a necessidade de identificar corretamente os pacientes que podem beneficiar-se com o tratamento. No Brasil estima-se uma prevalência da doença em 9,3% da população em geral. Porém, ainda não há estudos que demonstrem a composição de cálculo de colesterol e pigmentos nos pacientes, bem como não há estudos de análise dos lipídios biliares e sua relação com os mecanismos fisiopatológicos da doença. Nossos objetivos foram analisar a composição do cálculo e da bile e compará-la com fatores pré-dispositivos da doença como tempo de nucleação e hiper saturação de colesterol em pacientes brasileiros. MÉTODOS: Foram analisadas 72 amostras de bile vesicular e cálculo biliar de pacientes com litíase biliar submetidos a procedimento cirúrgico laparoscópico em diferentes hospitais da grande São Paulo. Quatorze amostras de bile vesicular de pacientes que foram submetidos à laparoscopia por problemas gastrointestinais...

Colecistectomia por mini-laparotomia em sistema ambulatorial : analise da metodologia e resultados

Elinton Adami Chaim
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 23/08/1993 PT
Relevância na Pesquisa
26.52%
Quarenta doentes foram submetidos à colecistectomia por minilaparotomia em sistema ambulatorial, no período de junho de 1991 a junho de 1992, na Disciplina de Moléstias do Aparelho Digestivo do Departamento de Cirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. A idade variou entre 23 e 55 anos (média: 39 anos), predominando o sexo feminino (80%) e a raça branca (90%). Os critérios de inclusão no programa foram: idade máxima de 55 anos; estado físico classe 1 e 2 (ASA); índice de massa corpórea menor que 30; ter acesso a um telefone; residir ou estar hospedado próximo ao Hospital; ter condições familiares para cuidados pós-operatórios; e possuir aceitação do doente. No pós-operatório a introdução da dieta foi feita na quarta hora, a deambulação na quinta hora e a alta hospitalar na oitava hora após o término da cirurgia. O controle clínico foi realizdo através de contato telefônico, pela equipe cirúrgica, e de visita domiciliar, pela equipe de enfermagem. Os critérios de seleção analisados (fatores fisiológicos, idade, peso corporal, psicológicos e condições sociais) foram adequados considerando-se os bons resultados verificados. A colangiografia peroperatória foi realizada com sucesso em 92...

Cholelithiasis and biliary sludge in Down’s syndrome patients

Boëchat,Márcia Cristina Bastos; Silva,Kátia Silveira da; Llerena Jr,Juan Clinton; Boëchat,Paulo Roberto Mafra
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2007 EN
Relevância na Pesquisa
37.2%
CONTEXT AND OBJECTIVE: Although studies have demonstrated increased frequency of gallbladder abnormalities among Down’s syndrome (DS) patients in some countries, there is only one paper on this subject in the Brazilian literature. The aim of this study was to demonstrate the prevalence, clinical characteristics and evolution of lithiasis and biliary sludge among DS patients in a maternity and children’s hospital in Rio de Janeiro. DESIGN AND SETTING: This was a cross-sectional study followed by a retrospective cohort study on all individuals with an ultrasound diagnosis of gallbladder abnormalities. METHODS: 547 DS patients (53.2% male, 46.8% female) attending the Instituto Fernandes Figueira in 2001 underwent abdominal ultrasound examination at ages of between one day and three years (mean: five months). Clinical and ultrasound data were analyzed. RESULTS: In 50 patients (9.1%), the ultrasound demonstrated gallbladder abnormalities (6.9% lithiasis and 2.1% biliary sludge). Spontaneous resolution was observed in 66.7% of the patients with biliary sludge and 28.9% with lithiasis. Cholecystectomy was carried out on 26.3% of the patients with gallstones. CONCLUSION: The results from this study and comparison with the literature suggest that DS patients are at risk of developing lithiasis and biliary sludge and should be monitored throughout the neonatal period...

Reliability of pre- and intraoperative tests for biliary lithiasis.

Escallon, A; Rosales, W; Aldrete, J S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1985 EN
Relevância na Pesquisa
46.8%
The records of 242 patients, operated consecutively for biliary lithiasis, were analyzed to determine the reliability of oral cholecystography (OCG), ultrasonography (US), and HIDA in detecting biliary calculi. Preoperative interpretations were correlated to operative findings. OCG obtained in 138 patients was accurate in 92%. US obtained in 150 was correct in 89%. The accuracy of HIDA was 92% in acute and 78% in chronic cholecystitis. Intraoperative cholangiography (IOC) done in 173 patients indicated the need for exploratory choledochotomy in 24; 21 had choledocholithiasis. These observations suggest that OCG and US are very accurate, but not infallible, in detecting cholelithiasis. US should be done first; when doubt persists, the addition of OCG allows the preoperative diagnosis of gallstones in 97% of the cases. HIDA is highly accurate but not infallible in detecting acute calculous cholecystitis. IOC is very reliable in detecting choledocholithiasis; thus, its routine is justifiable.

Evaluation and Treatment of Acute and Chronic Pancreatitis: A Review of 380 Cases

Aldrete, Joaquin S.; Jimenez, Hernan; Halpern, Norman B.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1980 EN
Relevância na Pesquisa
26.94%
The cases of 380 patients with pancreatitis were analyzed retrospectively. There were 237 men (62%) and 143 women (38%). Etiologic factors included: alcoholism, 62%; biliary lithiasis, 16.6%; idiopathic, 12%; miscellaneous, 7%; and trauma, 2.4%. Acute pancreatitis occurred in 279 patients (73%); 189 (67%) were treated nonoperatively, 90 (33%) underwent operation; electively in 43 and urgently in 47. Postoperatively, one patient (2.3%) died in the elective group and 14 (30%) in the emergency group. Chronic pancreatitis occurred in 101 patients. Their pertinent findings were: alcoholism in 78%, biliary lithiasis in 8%, absence of abdominal pain in 15%, diabetes in 40%, and jaundice in 20%. Fifty patients were treated without operation; 43 were alcoholics, 17 of them died in the follow-up period. Fifty-one patients, 36 of them alcoholics, underwent a variety of operations, with three deaths (6%); 21 were improved after operation. It was concluded that 30% of patients with acute pancreatitis require operation, mainly to correct biliary lithiasis. Emergency operations dictated by relentless deterioration or uncertain diagnosis had a high operative mortality (30%), particularly in patients with necrotizing or hemorrhagic pancreatitis. Operative treatment for chronic pancreatitis was most effective when directed toward specific goals...

Is biliary lithiasis associated with pancreatographic changes?

Barthet, M; Affriat, C; Bernard, J P; Berthezene, P; Dagorn, J C; Sahel, J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1995 EN
Relevância na Pesquisa
47.27%
The aetiological role of biliary lithiasis for chronic pancreatitis remains controversial. Previous studies based on pancreatographic studies reported changes in the pancreatic duct system caused by biliary lithiasis. This study analysed retrospectively the endoscopic retrograde cholangiopancreatography of 165 patients presenting with biliary lithiasis and of 53 controls. Among the 165 patients, 113 had choledochal stones (53 with gall bladder stones, 50 had had a cholecystectomy, 10 with a normal gall bladder), 35 had gall bladder stones without choledochal stones, 17 had cholecystectomy for gall bladder stones. Pancreatograms were analysed by measuring the diameter of the pancreatic duct in the head, the body, and the tail of the pancreas, and evaluating the regularity of the main pancreatic duct and the presence of stenosis, the regularity or the dilatation of secondary ducts, and the presence of cysts. In addition, we established a score, based on the above parameters, by which pancreatograms were classified as normal or with mild, intermediate, moderate or severe abnormalities. A multivariate analysis (stepwise multiple discriminant analysis) was performed for age, sex, presence of gall stones, presence of choledochal stones. Patients were comparable with controls for sex...

Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

Pandey, Manoj
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 20/08/2007 EN
Relevância na Pesquisa
26.42%

Biliary Surgery Via Minilaparotomy — A Limited Procedure for Biliary Lithiasis

Nagakawa, Takukazu
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em //1993 EN
Relevância na Pesquisa
36.58%
Cholelithiasis until now has been treated using solvents, lithotripsy via a biliary endoscope, laser or shock wave lithotripsy, and laparoscopic cholecystectomy. have developed a new surgical treatment for cholelithiasis in which a cholecystectomy is performed through a minilaparotomy. This paper presents this new technique and discusses the principles of surgery for cholelithiasis using this technique. This procedure is performed by a 2 to 3 cm subcostal skin incision in the right hypochondrium. More than 400 patients were treated by this technique. This procedure is not different in terms of blood loss .or operation time from conventional methods, and no significant complications have occurred. Intraoperative X-ray examination is performed routinely because of easy insertion of a tube from the cystic duct into the bile duct. Reduction of the length of the incision greatly facilitates postoperative recovery, shortening the hospital length-of-stay to within 3 days. The surgical manipulation of only a limited area of the upper abdomen is unlikely to induce postoperative syndromes, such as adhesions or ileus. Following this experience, a biliary drainage procedure based on cholangionmanomery and primary closure of the choledochotomy was introduced. This approach allowed even patients with choledocholithiasis to undergo a minilaparotomy and be discharged within one week.

Laparoscopic T-Tube Choledochotomy for Biliary Lithiasis

Martínez, Denzil Garteiz; Sánchez, Alejandro Weber; López Acosta, María Elena
Fonte: Society of Laparoendoscopic Surgeons Publicador: Society of Laparoendoscopic Surgeons
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
36.52%
T-tube choledochotomy has been an established practice in common bile duct exploration for many years. Although bile leaks, biliary peritonitis, and long-term postoperative strictures have been reported and are directly associated with the placement or removal of the T-tube, the severity of these complications may often be underestimated by surgeons. We present the case of a 31-year-old male patient who developed biliary peritonitis and septic shock after removal of a T-tube and illustrate one of the catastrophic events that may follow such procedures. Literature shows that these complications may occur more frequently and have higher morbidity and mortality than other less invasive procedures. This article reviews the advances in laparoscopic and endoscopic techniques, which provide alternative therapeutic approaches to choledocholithiasis and allow the surgeon to avoid having to perform a choledochotomy with T-tube drainage.

Minimally invasive treatment of cholecysto-choledocal lithiasis: The point of view of the surgical endoscopist

Palma, Giovanni D De
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.51%
The rate of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be approximately 10%-33%, depending on the patient’s age. Development of Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Surgery and improvement of diagnostic procedures have influenced new approaches to the management of common bile duct stones in association with gallstones. At present available minimally-invasive treatments of cholecysto-choledocal lithiasis include: single-stage laparoscopic treatment, perioperative endoscopic treatment and endoscopic treatment alone. Published data evidence that, associated endoscopic-laparoscopic approach necessitates increased number of procedures per patient while single-stage laparoscopic treatment is associated with a shorter hospital stay. However, current data does not suggest clear superiority of any one approach with regard to success, mortality, morbidity and cost-effectiveness. Considering the variety of therapeutic options available for management, a critical appraisal and decision-making is required. Endoscopic retrograde cholangiopancreatography/EST should be adopted on a selective basis, i.e., in patients with acute obstructive suppurative cholangitis, severe biliary pancreatitis...

Postoperative biliary adverse events following orthotopic liver transplantation: Assessment with magnetic resonance cholangiography

Boraschi, Piero; Donati, Francescamaria
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.69%
Biliary adverse events following orthotopic liver transplantation (OLT) are relatively common and continue to be serious causes of morbidity, mortality, and transplant dysfunction or failure. The development of these adverse events is heavily influenced by the type of anastomosis during surgery. The low specificity of clinical and biologic findings makes the diagnosis challenging. Moreover, direct cholangiographic procedures such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography present an inadmissible rate of adverse events to be utilized in clinically low suspected patients. Magnetic resonance (MR) maging with MR cholangiopancreatography is crucial in assessing abnormalities in the biliary system after liver surgery, including liver transplant. MR cholangiopancreatography is a safe, rapid, non-invasive, and effective diagnostic procedure for the evaluation of biliary adverse events after liver transplantation, since it plays an increasingly important role in the diagnosis and management of these events. On the basis of a recent systematic review of the literature the summary estimates of sensitivity and specificity of MR cholangiopancreatography for diagnosis of biliary adverse events following OLT were 0.95 and 0.92...

Imaging tests for accurate diagnosis of acute biliary pancreatitis

Surlin, Valeriu; Săftoiu, Adrian; Dumitrescu, Daniela
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.86%
Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis (ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct (CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography (US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography (TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography (EUS) seems to be a more effective tool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography (ERCP), which should be performed only for therapeutic purposes. As the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography (MRCP) or EUS, especially for small stones and small diameter of CBD, the later techniques are nowadays preferred for the evaluation of ABP patients. ERCP has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies...

Double common bile duct: A case report

Djuranovic, Srdjan P; Ugljesic, Milenko B; Mijalkovic, Nenad S; Korneti, Viktorija A; Kovacevic, Nada V; Alempijevic, Tamara M; Radulovic, Slaven V; Tomic, Dragan V; Spuran, Milan M
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
26.51%
Double common bile duct (DCBD) is a rare congenital anomaly in which two common bile ducts exist. One usually has normal drainage into the papilla duodeni major and the other usually named accessory common bile duct (ACBD) opens in different parts of upper gastrointestinal tract (stomach, duodenum, ductus pancreaticus or septum). This anomaly is of great importance since it is often associated with biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction (APBJ) and upper gastrointestinal tract malignancies. We recently recognized a rare case of DCBD associated with APBJ with lithiasis in better developed common bile duct. The opening site of ACBD was in the pancreatic duct. The anomaly was suspected by transabdominal ultrasonography and finally confirmed by endoscopic retrograde cholangiopancreatography (ERCP) followed by endoscopic sphincterotomy and stone extraction. According to the literature, the existence of DCBD with the opening of ACBD in the pancreatic duct is most frequently associated with APBJ and gallbladder carcinoma. In case of DCBD, the opening site of ACBD is of greatest clinical importance because of its close implications with concomitant pathology. The adequate diagnosis of this rare anomaly is significant since the operative complications may occur in cases with DCBD which is not recognized prior to surgical treatment.

Apolipoprotein A1 and biliary lithiasis in hepatic cirrhosis.; Apolipoproteína A1 e litíase biliar na cirrose hepática.

Baranda, J; Serviço de Gastrenterologia, Hospitais da Universidade de Coimbra (HUC).; Ministro, P; Amaro, P; Rosa, A; Pimenta, I; Donato, A; De Freitas, D
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 30/09/1996 POR
Relevância na Pesquisa
47.22%
A prospective study was performed in 67 male patients with cirrhosis, admitted in our Department during one year. Biliary lithiasis was found in 37% of patients. The occurrence of lithiasis was not related to age, weight or severity of liver disease. Seric total bilirubin was higher in lithiasic patients (p < 0.05). Apolipoprotein A1 levels were lower in those ones with lithiasis (p < 0.005). Apolipoprotein A1 was the only factor associated independently with the finding of lithiasis.; A prospective study was performed in 67 male patients with cirrhosis, admitted in our Department during one year. Biliary lithiasis was found in 37% of patients. The occurrence of lithiasis was not related to age, weight or severity of liver disease. Seric total bilirubin was higher in lithiasic patients (p < 0.05). Apolipoprotein A1 levels were lower in those ones with lithiasis (p < 0.005). Apolipoprotein A1 was the only factor associated independently with the finding of lithiasis.

Intraoperative echography in biliary tract surgery. A comparative study of intraoperative echography/cholangiography in the detection of calculi in the common bile duct.; Ecografia per-operatória em cirurgia das vias biliares. Estudo comparativo ecografia/colangiografia per-operatória na detecção de cálculos na via biliar principal.

Garcia, J P; Serviço de Cirurgia do Hospital de Santa Marta, Lisboa.; Sousa, J T; Silva, E; Soares, E; Pedroso, C; Cid, M O
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 30/04/1993 POR
Relevância na Pesquisa
36.9%
We report 3 years of experience with operative ultrasonography on 200 patients who underwent cholecystectomy for biliary lithiasis. Intraoperative ultrasonography and intraoperative cholangiography were performed on all of these patients and compared with the operative findings. The diagnostic accuracy of sonography was 98% and that of cholangiography 96% in the whole patient group. The predictive value of a positive ultrasonography was 92.5% while that of a positive cholangiogram was lower at 81.5%. In 32 patients who underwent surgical exploration of the common duct the use of these two intraoperative screening tests together led to a positive common duct exploration in 75% of the patients. Overall morbidity in this series was 4.8% against 12.8% (common duct exploration) and retained stones following duct exploration were present in 1 patient in intra-hepatic situation. The overall mortality rate of the entire patient group was 0%. Operative ultrasonography of the biliary tract as a screening procedure is a reliable method, a possible substitute for operative cholangiography, but perhaps in reality both methods are complementary.; We report 3 years of experience with operative ultrasonography on 200 patients who underwent cholecystectomy for biliary lithiasis. Intraoperative ultrasonography and intraoperative cholangiography were performed on all of these patients and compared with the operative findings. The diagnostic accuracy of sonography was 98% and that of cholangiography 96% in the whole patient group. The predictive value of a positive ultrasonography was 92.5% while that of a positive cholangiogram was lower at 81.5%. In 32 patients who underwent surgical exploration of the common duct the use of these two intraoperative screening tests together led to a positive common duct exploration in 75% of the patients. Overall morbidity in this series was 4.8% against 12.8% (common duct exploration) and retained stones following duct exploration were present in 1 patient in intra-hepatic situation. The overall mortality rate of the entire patient group was 0%. Operative ultrasonography of the biliary tract as a screening procedure is a reliable method...

Does bilioenteric anastomosis impair results of liver resection in primary intrahepatic lithiasis?

HERMAN, Paulo; PERINI, Marcos V.; PUGLIESE, Vincenzo; PEREIRA, Julio Cesar; MACHADO, Marcel Autran C.; SAAD, William A.; D'ALBUQUERQUE, Luiz A. C.; CECCONELLO, Ivan
Fonte: W J G PRESS Publicador: W J G PRESS
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
47.03%
AIM: To evaluate the long-term results of liver resection for the treatment of primary intrahepatic lithiasis. Prognostic factors, especially the impact of bilioenteric anastomosis on recurrence of symptoms were assessed. METHODS: Forty one patients with intrahepatic stones and parenchyma fibrosis/atrophy and/or biliary stenosis were submitted to liver resection. Resection was associated with a Roux-en-Y hepaticojejunostomy in all patients with bilateral stones and in those with unilateral disease and dilation of the extrahepatic biliary duct (> 2 cm). Late results and risk factors for recurrence of symptoms or stones were evaluated. RESULTS: There was no operative mortality. After a mean follow-up of 50.3 mo, good late results were observed in 82.9% of patients; all patients submitted to liver resection alone and 58.8% of those submitted to liver resection and hepaticojejunostomy were free of symptoms (P = 0.0006). Patients with unilateral and bilateral disease showed good late results in 94.1% and 28.6%, respectively (P < 0.001). CONCLUSION: Recurrence of symptoms in patients with hepaticojejunostomy showed that this may not be the ideal solution. Further studies are needed to establish the best treatment for patients with bilateral stones or unilateral disease and a dilated extrahepatic duct. (C) 2010 Baishideng. All rights reserved.

Cholelithiasis Presented as Chronic Right Back Pain

Bobé-Armant, Francesc; Buil-Arasanz, Maria Eugenia; Trubat-Muñoz, Griselda; Llor-Vilà, Carles; Vicente-Guillen, Vicente
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
27%
Chronic right back pain is a symptom in both biliary lithiasis and chronic cholecystitis. Ten percent of the population in the world suffers from biliary lithiasis. Only 20% are symptomatic. The first diagnostic test of choice is an abdominal ultrasound. When a suggestive clinical sign of biliary colic with negative abdominal ultrasound is identified, we should consider the option of carrying out an endoscopic ultrasound in order to rule out microlithiasis. The case discussed in the report presented with chronic right back pain, which is an atypical manifestation of biliary lithiasis and chronic cholecystitis. It is important to know about the atypical manifestations of the prevalent illnesses as well as the limits of the diagnostic tests, in order to avoid diagnostic delays which may cause complications that could worsen a patient's prognosis. This case should contribute to the medical knowledge and must have educational value or highlight the need for a change in clinical practice, especially in primary care.

Early and late complications after endoscopic sphincterotomy for biliary lithiasis with and without the gall bladder 'in situ'.

Escourrou, J; Cordova, J A; Lazorthes, F; Frexinos, J; Ribet, A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1984 EN
Relevância na Pesquisa
46.8%
Endoscopic sphincterotomy has gained wide acceptance in the treatment of biliary lithiasis. We attempted endoscopic sphincterotomy in 443 patients and were successful in 407 (92%). Sphincterotomy was carried out with the gall bladder in situ in 234 cases (57%) of advanced age or high surgical risk. Immediate complications occurred in 7%, of which haemorrhage was the most frequent. The mortality rate was 1.5%. Three hundred and sixteen endoscopic sphincterotomies were performed more than six months before writing and follow up was available for 226 (72%) from six to 78 months. Late complications were observed in 16 patients with gall bladder 'in situ' (12%); the most frequent was cholecystitis in 6%. In five patients of the group without gall bladder, four had cholangitis related to retained or recurrent stones, and one restenosed . No episodes of cholangitis were observed in patients without stones despite reflux of barium up the biliary tree as observed during a barium meal examination.

COLECISTECTOMIA: ASPECTOS TÉCNICOS E INDICAÇÕES PARA O TRATAMENTO DA LITÍASE BILIAR E DAS NEOPLASIAS; CHOLECYSTECTOMY: TECHNICAL ASPECTS AND INDICATIONS FOR THE TREATMENT OF BILIARY CALCULI AND NEOPLASMS

Santos, José Sebastião; Sankarankutty, Ajith Kumar; Salgado Júnior, Wilson; kemp, Rafael; Módena, José Luís Pimenta; Elias Júnior, Jorge; Silva Júnior, Orlando Castro e
Fonte: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto Publicador: Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Formato: application/pdf
Publicado em 30/12/2008 POR
Relevância na Pesquisa
36.62%
A remoção cirúrgica da vesícula biliar é uma operação realizada há mais de um século e nos últimos 25 anos foi objeto de inovação nos seus fundamentos técnicos, especialmente, em relação ao acesso e a exploração da via biliar principal. As indicações mais freqüentes de colecistectomia são a litíase biliar e suas complicações (colecistite aguda, coledocolitíase, colangite , pancreatite aguda biliar) e o câncer da vesícula biliar. Inicialmente, as colecistectomias para tratamento da litíase biliar eram realizadas por meio de laparotomia. No fim do século vinte, a colecistectomia passou a ser feita por meio de acessos menores como a minilaparotomia e em seguida pela videolaparoscopia, que é o acesso considerado como padrão na atualidade. Mais recentemente, a colecistectomia tem sido realizada, em caráter experimental ou excepcional, por meio do acesso transgástrico e transvaginal. Os benefícios do acesso videolaparoscópico são incontestáveis, mas o emprego desse acesso requer cautela e capacitação para minimizar a incidência de lesões traumáticas da via biliar e de outras estruturas.; The surgical removal of the gallbladder has been practiced for more than a century and in the last 25 years has undergone fundamental changes in its technique...

Resección hepática en enfermedad de Caroli localizada

Espinoza G,Ricardo; San Martín R,Sergio; Court A,Felipe; Vera P,Emilio; Ferreira S,Rodrigo; Croxatto A,Héctor
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2003 ES
Relevância na Pesquisa
26.51%
Caroli disease is a cystic congenital malformation of the intrahepatic biliary tract, frequently associated with lithiasis. Commonly, cystic dilatations are bilateral and infrequently they affect only one hepatic lobule or segment. We report six patients with localized Caroli disease, three in the right and three in the left hepatic lobule, that were subjected to a hepatic resection. There were no postoperative complications or mortality. After 28 months of follow up, patients are asymptomatic and with normal hepatic function and ultrasonography. The importance of diagnosing localized Caroli disease, in which hepatic resection can be curative, is emphasized (Rev Méd Chile 2003; 131: 183-9)