Common Bile Duct
Cholangiopancreatography, Endoscopic Retrograde
Bile Duct Diseases
Biliary Tract Diseases
Hepatic Duct, Common
Ambulatory Surgical Procedures
Common Bile Duct Diseases
Cholangiopancreatography, Magnetic Resonance
Conversion to Open Surgery
Sphincter of Oddi
Natural Orifice Endoscopic Surgery
Surgical Procedures, Elective
Technetium Tc 99m Lidofenin
Bile Ducts, Extrahepatic
Technetium Tc 99m Disofenin
Sphincter of Oddi Dysfunction
Surgical Procedures, Operative
Surgical Procedures, Minimally Invasive
Perforation of the gallbladder: analysis of 19 cases. (1/893)Perforation of the gallbladder occurred in 19 (3.8%) of 496 patients with acute cholecystitis treated at one hospital in an 8-year period. The average age of the 19 patients was 69 years and the female:male ratio was 3:2. Most had a history suggestive of gallbladder disease and most had coexisting cardiac, pulmonary, renal, nutritional or metabolic disease. The duration of the present illness was short, perforation occurring within 72 hours of the onset of symptoms in half the patients; the diagnosis was not suspected preoperatively in any. In the elderly patient with acute cholecystitis who has a long history of gallbladder disease, cholecystectomy should be performed early, before gangrene and perforation of the gallbladder can occur. (+info)
Gallstones, cholecystectomy and risk of cancers of the liver, biliary tract and pancreas. (2/893)To examine the association between gallstones and cholecystectomy, we conducted a nationwide population-based cohort study in Denmark. Patients with a discharge diagnosis of gallstones from 1977 to 1989 were identified from the Danish National Registry of Patients and followed up for cancer occurrence until death or the end of 1993 by record linkage to the Danish Cancer Registry. Included in the cohort were 60 176 patients, with 471 450 person-years of follow-up. Cancer risks were estimated by standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) stratified by years of follow-up and by cholecystectomy status. Among patients without cholecystectomy, the risks at 5 or more years of follow-up were significantly elevated for cancers of liver (SIR = 2.0, CI = 1.2-3.1) and gallbladder (SIR = 2.7, CI = 1.5-4.4) and near unity for cancers of extrahepatic bile duct (SIR = 1.1), ampulla of Vater (SIR = 1.0) and pancreas (SIR = 1.1). The excess risk of liver cancer was seen only among patients with a history of hepatic disease. Among cholecystectomy patients, the risks at 5 or more years of follow-up declined for cancers of liver (SIR = 1.1) and extrahepatic bile duct (SIR = 0.7), but were elevated for cancers of ampulla of Vater (SIR = 2.0, CI = 1.0-3.7) and pancreas (SIR = 1.3, CI = 1.1-1.6). These findings confirm that gallstone disease increases the risk of gallbladder cancer, whereas cholecystectomy appears to increase the risk of cancers of ampulla of Vater and pancreas. Further research is needed to clarify the carcinogenic risks associated with gallstones and cholecystectomy and to define the mechanisms involved. (+info)
How can videolaparoscopy be used in a peritoneal dialysis programme? (3/893)BACKGROUND: Recently videolaparoscopy is considered to have a vaster use in surgery due to the undeniable benefits such as low operatory traumatism, quick recovery of canalization, a short stay in the hospital and minor scarring. METHODS: Forty patients were treated with peritoneal dialysis (PD); 15 videolaparoscopic procedures were performed on 13 patients before starting PD and two during the course of PD. The videolaparoscopy procedure was started by inducing pneumoperitoneum after initiation of general anaesthesia through endotracheal intubation. RESULTS: Peritoneal catheter placement was carried out in 11 ESRD patients showing abdominal scars due to previous laparotomies; their abdominal condition precluded safe PC placement using conventional non-laparoscopic procedures with local anaesthesia. Release of adhesions was performed only in two patients. Videolaparoscopy was also used in three patients for elective cholecystectomy; 2/3 underwent concomitant PC insertion. One patient was submitted to cholecystectomy during the course of CAPD; following the procedure we left the peritoneum dry overnight and then we started temporary IPD, using small volumes, avoiding haemodialysis (HD). Regular CAPD was resumed 6 days later. Finally, videolaparoscopy was also used for diagnostic purpose i.e. in one 59-year-old man patient who had a peritoneal catheter obstruction. Repeated rescue attempts using urokinase solution to irrigate the peritoneal catheter had been used in vain attempts prior to the procedure. CONCLUSIONS: Videolaparoscopy proves to be a useful tool in a PD programme. Firstly, it may be used as a technique for catheter implantation, not as a routine procedure but in patients with extensive abdominal scars due to previous laparotomy, i.e. at risk for accidental viscera perforation due to the possibility of adhesions between intestinal loops and parietal peritoneum. Secondly, videolaparoscopy used for abdominal surgery allows the resumption of PD immediately after surgical procedure and thus avoiding HD. Videolaparoscopy is fundamental for diagnosis and rescue of catheter dysfunction and has an integral role in the successful management of these patients in extending catheter function and permitting safe replacement of peritoneal catheter if it becomes necessary. Along with the undeniable advantages, remains the disadvantages that it must be carried out by an expert surgeon in an operating theatre while the patient is under general anaesthesia. (+info)
Evidence for validity of a health status measure in assessing short term outcomes of cholecystectomy. (4/893)OBJECTIVE: To assess the validity of the Nottingham health profile (NHP) as an indicator of short term outcome of cholecystectomy. DESIGN: Prospective assessment of outcome. SETTING: One teaching hospital. Patients--161 consecutive patients admitted for cholecystectomy between January 1989 and September 1990. MAIN MEASURES: Patients' reported symptoms and self assessed NHP scores before cholecystectomy and at follow up at three and 12 months (76 patients); assessment before admission (19). RESULTS: Complete data were obtained preoperatively and at three months' follow up from 154 patients; seven did not respond to the follow up questionnaire. 76/84(90%) patients in the study 12 months or more answered the 12 month follow up questionnaire; eight did not respond. Significant changes in score before and at three months after the operation were observed for four of the six dimensions: energy (35.34 v 19.53, p < 0.0001), pain (27.38 v 9.8, p < 0.0001), sleep (26.99 v 17.51, p = 0.0002), and emotional reactions (16.12 v 7.56, p = 0.001). The mean scores for 76 patients followed up at three and 12 months showed little subsequent change. Scores in readmitted patients were all significantly higher, suggesting poor health. Patients with five reported symptoms had significantly worse scores for all dimensions. Scores were similar before cholecystectomy whether the questionnaire was completed before or after admission. CONCLUSION: The NHP is an appropriate tool for monitoring changes in health after cholecystectomy. (+info)
Comparison of short term outcomes of open and laparoscopic cholecystectomy. (5/893)OBJECTIVE: To compare the three month outcome of open and laparoscopic cholecystectomy. DESIGN: Prospective assessment of outcome for a series of patients encompassing the introduction of the laparoscopic technique. SETTING: One teaching hospital. PATIENTS: 269 patients admitted for open cholecystectomy between January 1989 and March 1992 and 122 admitted for laparoscopic cholecystectomy between January 1991 and March 1992. MAIN MEASURES: Patients' reported symptoms and self assessed scores with the Nottingham health profile before operation and at three month follow up. Incidence of complications and adverse events after discharge. RESULTS: Similar improvements in symptom rates and health scores were seen regardless of surgical technique. A lower rate of postoperative complications was seen in the patients given laparoscopic surgery (6/95(6%) v 45/235(19%)), and their mean length of stay was lower (4.5 v 9.8 days). Similar results were obtained when the analysis was restricted to a subset of fairly uncomplicated cases (patients aged 60 or less without other illnesses on admission who were not undergoing emergency or urgent surgery), which constituted a larger proportion of the group given laparoscopy (35/95(37%) v 40/235(17%)). Between these two groups no significant difference was seen in the frequency of relevant readmissions to hospital or visits to general practitioners or accident and emergency departments. CONCLUSION: Ideally, a new surgical technique would be evaluated in a randomised trial. In the absence of such a trial, this observational study provides some evidence that the switch from open to laparoscopic cholecystectomy has brought benefits, particularly in terms of reduced length of stay in hospital. A range of clinical and patient derived indicators suggests that these gains have not been associated with a reduction in the quality of the outcome at three months. (+info)
Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. (6/893)BACKGROUND: Previous studies suggest that laparoscopic cholecystectomy (LC) is associated with an increased risk of intraoperative injury involving the bile ducts, bowel, and vascular structures compared with open cholecystectomy (OC). Population-based studies are required to estimate the magnitude of the increased risk, to determine whether this is changing over time, and to identify ways by which this might be reduced. METHODS: Suspected cases of intraoperative injury associated with cholecystectomy in Western Australia in the period 1988 to 1994 were identified from routinely collected hospital statistical records and lists of persons undergoing postoperative endoscopic retrograde cholangiopancreatography. The case records of suspect cases were reviewed to confirm the nature and site of injury. Ordinal logistic regression was used to estimate the risk of injury associated with LC compared with OC after adjusting for confounding factors. RESULTS: After the introduction of LC in 1991, the proportion of all cholecystectomy cases with intraoperative injury increased from 0.67% in 1988-90 to 1.33% in 1993-94. Similar relative increases were observed in bile duct injuries, major bile leaks, and other injuries to bowel or vascular structures. Increases in intraoperative injury were observed in both LC and OC. After adjustment for age, gender, hospital type, severity of disease, intraoperative cholangiography, and calendar period, the odds ratio for intraoperative injury in LC compared with OC was 1.79. Operative cholangiography significantly reduced the risk of injury. CONCLUSION: Operative cholangiography has a protective effect for complications of cholecystectomy. Compared with OC, LC carries a nearly twofold higher risk of major bile, vascular, and bowel complications. Further study is required to determine the extent to which potentially preventable factors contribute to this risk. (+info)
Gastrointestinal surgical workload in the DGH and the upper gastrointestinal surgeon. (7/893)Workload implications of upper gastrointestinal (UGI) subspecialisation within the district general hospital (DGH) have been assessed by prospective data collection over a 12-month period in a DGH with six general surgeons serving a population of 320,000. The single UGI surgeon (UGIS) performed all ten oesophageal resections, ten of 11 gastric resections for malignancy and all eight pancreatic operations. He also performed 91 of the 182 cholecystectomies, 164 of the 250 endoscopic retrograde cholangiopancreatograms (ERCP) and all endoscopic procedures for the palliation of unresected oesophageal tumours. The UGIS was responsible for the management of all patients with severe pancreatitis, yet he also performed 51 colorectal resections over the 12-month period. Successful management of severely ill patients with upper GI disease requires consultant supervision on a day-to-day basis. If such UGI disease is to be managed in the DGH, two surgeons with UGI experience will be required if high quality care and reasonable working conditions are to be achieved. Such UGIS will continue to perform some colorectal surgery. (+info)
Ultrasonographic evaluation of the common bile duct in biliary acute pancreatitis patients: comparison with endoscopic retrograde cholangiopancreatography. (8/893)We compared the morphologic findings of the common bile duct by ultrasonography and endoscopic retrograde cholangiopancreatography in patients with biliary acute pancreatitis. Forty-five patients were studied. The diagnosis of acute pancreatitis was based on the presence of characteristic abdominal pain associated with an elevation of serum amylase and lipase concentrations. All patients underwent ultrasonography and subsequently urgent endoscopic retrograde cholangiopancreatography and eventually endoscopic sphincterotomy. Ultrasonography showed gallstones in 33 patients and sludge of the gallbladder in seven patients. In the common bile duct, lithiasis was found in two patients and sludge in 25. Endoscopic retrograde cholangiopancreatography showed choledocolithiasis in eight patients and sludge of the common bile duct in 32. In 27 cases (60%) concordance occurred between ultrasonographic and endoscopic retrograde cholangiopancreatographic detection of lithiasis or sludge of the common bile duct. The average diameter of the common bile duct determined by sonography was significantly smaller (P < 0.001) than that obtained by endoscopic retrograde cholangiopancreatography. The evaluation of this parameter indicated that a good correlation existed between the values obtained with the two techniques (r(s) = 0.765, P < 0.001). Both ultrasonography and endoscopic retrograde cholangiopancreatography can provide reliable measurements of the common bile duct diameter. Ultrasonography is the technique of choice in the initial investigation of patients with biliary acute pancreatitis. (+info)
Cholelithiasis is a common condition that affects millions of people worldwide. It can occur at any age but is more common in adults over 40 years old. Women are more likely to develop cholelithiasis than men, especially during pregnancy or after childbirth.
The symptoms of cholelithiasis can vary depending on the size and location of the gallstones. Some people may not experience any symptoms at all, while others may have:
* Abdominal pain, especially in the upper right side of the abdomen
* Nausea and vomiting
* Shaking or chills
* Loss of appetite
* Yellowing of the skin and eyes (jaundice)
If left untreated, cholelithiasis can lead to complications such as inflammation of the gallbladder (cholangitis), infection of the bile ducts (biliary sepsis), or blockage of the common bile duct. These complications can be life-threatening and require immediate medical attention.
The diagnosis of cholelithiasis is usually made through a combination of imaging tests such as ultrasound, CT scan, or MRI, and blood tests to check for signs of inflammation and liver function. Treatment options for cholelithiasis include:
* Watchful waiting: If the gallstones are small and not causing any symptoms, doctors may recommend monitoring the condition without immediate treatment.
* Medications: Oral medications such as bile salts or ursodiol can dissolve small gallstones and relieve symptoms.
* Laparoscopic cholecystectomy: A minimally invasive surgical procedure to remove the gallbladder through small incisions.
* Open cholecystectomy: An open surgery to remove the gallbladder, usually performed when the gallstones are large or there are other complications.
It is important to seek medical attention if you experience any symptoms of cholelithiasis, as early diagnosis and treatment can help prevent complications and improve outcomes.
Here are some additional details about each of the gallbladder diseases mentioned in the definition:
* Gallstone disease: This is the most common gallbladder disease and occurs when small stones form in the gallbladder. The stones can be made of cholesterol, bilirubin, or other substances. They can cause pain, inflammation, and infection if left untreated.
* Cholecystitis: This is inflammation of the gallbladder that can occur when gallstones block the ducts and cause bile to build up. Symptoms can include abdominal pain, fever, and chills. If left untreated, cholecystitis can lead to more serious complications such as gangrene or perforation of the gallbladder.
* Choledocholithiasis: This is the presence of stones in the bile ducts that carry bile from the liver and gallbladder to the small intestine. These stones can cause blockages and lead to inflammation, infection, and damage to the liver and pancreas.
* Pancreatitis: This is inflammation of the pancreas that can occur when the pancreatic ducts become blocked by gallstones or other substances. Symptoms can include abdominal pain, nausea, vomiting, and fever. If left untreated, pancreatitis can lead to serious complications such as infection, organ failure, and death.
* Gallbladder cancer: This is a rare but aggressive type of cancer that occurs in the gallbladder. Symptoms can include abdominal pain, jaundice, and weight loss. If left untreated, gallbladder cancer can spread to other parts of the body and lead to death.
Overall, these gallbladder diseases can have a significant impact on quality of life and can be fatal if left untreated. It is important to seek medical attention if symptoms persist or worsen over time.
Cholecystitis can be acute or chronic. Acute cholecystitis occurs when the gallbladder becomes inflamed suddenly, usually due to a blockage in the bile ducts. This can cause symptoms such as abdominal pain, nausea, vomiting, and fever. Chronic cholecystitis is a long-standing inflammation of the gallbladder that can lead to scarring and thickening of the gallbladder wall.
The causes of cholecystitis include:
1. Gallstones: The most common cause of cholecystitis is the presence of gallstones in the gallbladder. These stones can block the bile ducts and cause inflammation.
2. Infection: Bacterial infection can spread to the gallbladder from other parts of the body, causing cholecystitis.
3. Pancreatitis: Inflammation of the pancreas can spread to the gallbladder and cause cholecystitis.
4. Incomplete emptying of the gallbladder: If the gallbladder does not empty properly, bile can become stagnant and cause inflammation.
5. Genetic factors: Some people may be more susceptible to developing cholecystitis due to genetic factors.
Symptoms of cholecystitis may include:
1. Abdominal pain, especially in the upper right side of the abdomen
2. Nausea and vomiting
4. Loss of appetite
5. Jaundice (yellowing of the skin and eyes)
6. Tea-colored urine
7. Pale or clay-colored stools
If you suspect that you or someone else may have cholecystitis, it is important to seek medical attention immediately. A healthcare provider can diagnose cholecystitis based on a physical examination, medical history, and results of diagnostic tests such as an ultrasound or CT scan. Treatment for cholecystitis usually involves antibiotics to clear up any infection, and in severe cases, surgery to remove the gallbladder may be necessary.
Gallstones can be made of cholesterol, bilirubin, or other substances found in bile. They can cause a variety of symptoms, including:
* Abdominal pain (often in the upper right abdomen)
* Nausea and vomiting
* Yellowing of the skin and eyes (jaundice)
* Tea-colored urine
* Pale or clay-colored stools
Gallstones can be classified into several types based on their composition, size, and location. The most common types are:
* Cholesterol gallstones: These are the most common type of gallstone and are usually yellow or green in color. They are made of cholesterol and other substances found in bile.
* Pigment gallstones: These stones are made of bilirubin, a yellow pigment found in bile. They are often smaller than cholesterol gallstones and may be more difficult to detect.
* Mixed gallstones: These stones are a combination of cholesterol and pigment gallstones.
Gallstones can cause a variety of complications, including:
* Gallbladder inflammation (cholecystitis)
* Infection of the bile ducts (choledochalitis)
* Pancreatitis (inflammation of the pancreas)
* Blockage of the common bile duct, which can cause jaundice and infection.
Treatment for gallstones usually involves surgery to remove the gallbladder, although in some cases, medications may be used to dissolve small stones. In severe cases, emergency surgery may be necessary to treat complications such as inflammation or infection.
Inflammation of the gallbladder that develops rapidly and usually as a result of obstruction of the cystic duct by a gallstone or rarely by tumors, parasites, or external pressure. Symptoms include right upper quadrant abdominal pain, fever, nausea, vomiting, and Murphy's sign (tenderness over the gallbladder). Treatment is with antibiotics, analgesics, and supportive care; surgical intervention may be required in severe cases or if there are complications. See: biliary colic; cholelithiasis; cholangitis.
There are several types of cholecystolithiasis:
* Pigmented stones (made from bilirubin)
* Cholesterol stones (made from cholesterol and other substances in the bile)
* Mixed stones (a combination of pigmented and cholesterol stones)
* Abdominal pain (especially after meals)
* Nausea and vomiting
* Yellowing of the skin and whites of the eyes (jaundice)
* Rapid weight loss
* High cholesterol levels
* Low HDL (good) cholesterol levels
* High triglycerides
Diagnosis is made through a combination of physical examination, medical history, and imaging tests such as ultrasound, CT or MRI scans. Treatment options include medication to dissolve small stones, surgery to remove the gallbladder (cholecystectomy) or laparoscopic cholecystectomy (removal of the gallbladder through small incisions).
Prevention includes maintaining a healthy weight, eating a balanced diet, and managing underlying medical conditions such as diabetes and high cholesterol. It is important to seek medical attention if symptoms persist or worsen over time.
Some common examples of intraoperative complications include:
1. Bleeding: Excessive bleeding during surgery can lead to hypovolemia (low blood volume), anemia (low red blood cell count), and even death.
2. Infection: Surgical wounds can become infected, leading to sepsis or bacteremia (bacterial infection of the bloodstream).
3. Nerve damage: Surgery can sometimes result in nerve damage, leading to numbness, weakness, or paralysis.
4. Organ injury: Injury to organs such as the liver, lung, or bowel can occur during surgery, leading to complications such as bleeding, infection, or organ failure.
5. Anesthesia-related complications: Problems with anesthesia can include respiratory or cardiac depression, allergic reactions, or awareness during anesthesia (a rare but potentially devastating complication).
6. Hypotension: Low blood pressure during surgery can lead to inadequate perfusion of vital organs and tissues, resulting in organ damage or death.
7. Thromboembolism: Blood clots can form during surgery and travel to other parts of the body, causing complications such as stroke, pulmonary embolism, or deep vein thrombosis.
8. Postoperative respiratory failure: Respiratory complications can occur after surgery, leading to respiratory failure, pneumonia, or acute respiratory distress syndrome (ARDS).
9. Wound dehiscence: The incision site can separate or come open after surgery, leading to infection, fluid accumulation, or hernia.
10. Seroma: A collection of serous fluid that can develop at the surgical site, which can become infected and cause complications.
11. Nerve damage: Injury to nerves during surgery can result in numbness, weakness, or paralysis, sometimes permanently.
12. Urinary retention or incontinence: Surgery can damage the bladder or urinary sphincter, leading to urinary retention or incontinence.
13. Hematoma: A collection of blood that can develop at the surgical site, which can become infected and cause complications.
14. Pneumonia: Inflammation of the lungs after surgery can be caused by bacteria, viruses, or fungi and can lead to serious complications.
15. Sepsis: A systemic inflammatory response to infection that can occur after surgery, leading to organ dysfunction and death if not treated promptly.
It is important to note that these are potential complications, and not all patients will experience them. Additionally, many of these complications are rare, and the vast majority of surgeries are successful with minimal or no complications. However, it is important for patients to be aware of the potential risks before undergoing surgery so they can make an informed decision about their care.
Types of Gallbladder Neoplasms:
1. Adenoma: A benign tumor that grows in the gallbladder wall and can become malignant over time if left untreated.
2. Cholangiocarcinoma: A rare and aggressive malignant tumor that arises in the gallbladder or bile ducts.
3. Gallbladder cancer: A general term used to describe any type of cancer that develops in the gallbladder, including adenocarcinoma, squamous cell carcinoma, and other rare types.
Causes and Risk Factors:
1. Genetics: A family history of gallbladder disease or certain genetic conditions can increase the risk of developing gallbladder neoplasms.
2. Chronic inflammation: Long-standing inflammation in the gallbladder, such as that caused by gallstones or chronic bile duct obstruction, can increase the risk of developing cancer.
3. Obesity: Being overweight or obese may increase the risk of developing gallbladder neoplasms.
4. Age: The risk of developing gallbladder neoplasms increases with age, with most cases occurring in people over the age of 50.
Symptoms and Diagnosis:
1. Abdominal pain: Pain in the upper right abdomen is a common symptom of gallbladder neoplasms.
2. Jaundice: Yellowing of the skin and eyes can occur if the cancer blocks the bile ducts.
3. Weight loss: Unexplained weight loss can be a symptom of some types of gallbladder neoplasms.
4. Fatigue: Feeling tired or weak can be a symptom of some types of gallbladder neoplasms.
Diagnosis is typically made through a combination of imaging tests such as CT scans, MRI scans, and PET scans, and a biopsy to confirm the presence of cancer cells.
1. Surgery: Surgery is the primary treatment for gallbladder neoplasms. The type of surgery depends on the stage and location of the cancer.
2. Chemotherapy: Chemotherapy may be used in combination with surgery to treat advanced or aggressive cancers.
3. Radiation therapy: Radiation therapy may be used in combination with surgery to treat advanced or aggressive cancers.
4. Watchful waiting: For early-stage cancers, a wait-and-watch approach may be taken, where the patient is monitored regularly with imaging tests to see if the cancer progresses.
The prognosis for gallbladder neoplasms depends on the stage and location of the cancer at the time of diagnosis. In general, the earlier the cancer is detected and treated, the better the prognosis. For early-stage cancers, the 5-year survival rate is high, while for advanced cancers, the prognosis is poor.
1. Bile duct injury: During surgery, there is a risk of damaging the bile ducts, which can lead to complications such as bile leakage or bleeding.
2. Infection: There is a risk of infection after surgery, which can be serious and may require hospitalization.
3. Pancreatitis: Gallbladder cancer can cause inflammation of the pancreas, leading to pancreatitis.
4. Jaundice: Cancer of the gallbladder can block the bile ducts, leading to jaundice and other complications.
5. Spread of cancer: Gallbladder cancer can spread to other parts of the body, such as the liver or lymph nodes, which can reduce the chances of a cure.
The term choledocholithiasis is derived from the Greek words "chole" meaning bile, "dochos" meaning duct, and "-iasis" meaning condition or disease. It is used to describe a specific type of gallstone that forms within the common bile duct, rather than in the gallbladder or liver.
Choledocholithiasis can be caused by a variety of factors, including genetic predisposition, inflammation of the bile ducts (cholangitis), and blockages within the ducts. Treatment options for choledocholithiasis include endoscopic therapy, surgery, and medications to dissolve the gallstones.
In summary, choledocholithiasis is a condition characterized by the presence of gallstones in the common bile duct, which can cause a range of symptoms and may require medical intervention to treat.
1. Infection: Bacterial or viral infections can develop after surgery, potentially leading to sepsis or organ failure.
2. Adhesions: Scar tissue can form during the healing process, which can cause bowel obstruction, chronic pain, or other complications.
3. Wound complications: Incisional hernias, wound dehiscence (separation of the wound edges), and wound infections can occur.
4. Respiratory problems: Pneumonia, respiratory failure, and atelectasis (collapsed lung) can develop after surgery, particularly in older adults or those with pre-existing respiratory conditions.
5. Cardiovascular complications: Myocardial infarction (heart attack), cardiac arrhythmias, and cardiac failure can occur after surgery, especially in high-risk patients.
6. Renal (kidney) problems: Acute kidney injury or chronic kidney disease can develop postoperatively, particularly in patients with pre-existing renal impairment.
7. Neurological complications: Stroke, seizures, and neuropraxia (nerve damage) can occur after surgery, especially in patients with pre-existing neurological conditions.
8. Pulmonary embolism: Blood clots can form in the legs or lungs after surgery, potentially causing pulmonary embolism.
9. Anesthesia-related complications: Respiratory and cardiac complications can occur during anesthesia, including respiratory and cardiac arrest.
10. delayed healing: Wound healing may be delayed or impaired after surgery, particularly in patients with pre-existing medical conditions.
It is important for patients to be aware of these potential complications and to discuss any concerns with their surgeon and healthcare team before undergoing surgery.
Examples of bile duct diseases include:
1. Primary sclerosing cholangitis (PSC): An inflammatory condition that damages the bile ducts, leading to scarring and narrowing of the ducts.
2. Cholangiocarcinoma: A type of cancer that originates in the bile ducts.
3. Gallstones: Small, pebble-like deposits that form in the gallbladder or bile ducts and can cause blockages and inflammation.
4. Bile duct injuries: Damage to the bile ducts during surgery or other medical procedures.
5. Biliary atresia: A congenital condition where the bile ducts are blocked or absent, leading to jaundice and other symptoms in infants.
Treatment for bile duct diseases depends on the underlying cause and can include medications, endoscopic procedures, surgery, and in some cases, liver transplantation.
Treatment for biliary dyskinesia typically involves medications to relieve symptoms and reduce inflammation. In severe cases, surgery may be necessary to remove damaged or diseased bile ducts.
Biliary dyskinesia is also known as biliary contractility disorder or biliary spasm. It is important to note that this condition is relatively rare and typically affects individuals with pre-existing liver disease.
There are several types of biliary tract diseases, including:
1. Gallstones: Small, pebble-like deposits that form in the gallbladder and can cause pain and blockages.
2. Cholangitis: An infection of the bile ducts that can cause fever, chills, and abdominal pain.
3. Biliary cirrhosis: Scarring of the liver and bile ducts that can lead to liver failure.
4. Pancreatitis: Inflammation of the pancreas that can cause abdominal pain and digestive problems.
5. Cancer of the biliary tract: Cancer that affects the liver, gallbladder, or bile ducts.
Biliary tract diseases can be caused by a variety of factors, including genetics, obesity, alcohol consumption, and certain medications. Diagnosis is typically made through a combination of imaging tests, such as CT scans and endoscopic ultrasound, and laboratory tests, such as blood tests and liver function tests.
Treatment for biliary tract diseases depends on the underlying cause and severity of the condition. In some cases, treatment may involve medications to dissolve gallstones or treat infections. In more severe cases, surgery may be necessary to remove the gallbladder or repair damaged bile ducts.
Prevention is key in avoiding biliary tract diseases, and this includes maintaining a healthy diet and lifestyle, managing risk factors such as obesity and alcohol consumption, and getting regular medical check-ups. Early detection and treatment of biliary tract diseases can help to improve outcomes and reduce the risk of complications.
1. Gallstones: Small, pebble-like deposits that form in the gallbladder or bile ducts and can cause blockages and inflammation.
2. Cholangitis: An infection of the bile ducts that can cause fever, chills, and abdominal pain.
3. Bile duct cancer: A type of cancer that affects the cells lining the bile ducts.
4. Stricture: A narrowing of the bile duct that can cause obstruction and block the flow of bile.
5. Cysts: Fluid-filled sacs that can form in the bile ducts and cause symptoms such as abdominal pain and jaundice.
Postoperative pain is typically managed with pain medication, which may include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or other types of medications. The goal of managing postoperative pain is to provide effective pain relief while minimizing the risk of complications such as addiction, constipation, or nausea and vomiting.
In addition to medication, other techniques for managing postoperative pain may include breathing exercises, relaxation techniques, and alternative therapies such as acupuncture or massage. It is important for patients to communicate with their healthcare provider about the severity of their pain and any side effects they experience from medication, in order to provide effective pain management and minimize complications.
Postoperative pain can be categorized into several different types, including:
* Acute pain: This type of pain is intense but short-lived, typically lasting for a few days or weeks after surgery.
* Chronic pain: This type of pain persists for longer than 3 months after surgery and can be more challenging to manage.
* Neuropathic pain: This type of pain is caused by damage to nerves and can be characterized by burning, shooting, or stabbing sensations.
* Visceral pain: This type of pain originates in the internal organs and can be referred to other areas of the body, such as the back or abdomen.
1. Gallstones: Gallstones can block the flow of bile from the liver to the small intestine, causing bile to back up into the bloodstream and leading to hemobilia.
2. Pancreatitis: Inflammation of the pancreas (pancreatitis) can cause bleeding in the bile ducts, leading to hemobilia.
3. Cancer: Bile duct cancer or other types of cancer that have spread to the bile ducts can cause hemobilia.
4. Trauma: Injury to the bile ducts, such as from a car accident or fall, can cause bleeding and lead to hemobilia.
5. Vasculitis: Inflammation of the blood vessels (vasculitis) can cause bleeding in the bile ducts and lead to hemobilia.
Hemobilia is a potentially life-threatening condition that requires prompt medical attention, especially if it is caused by a serious underlying condition such as gallstones or cancer. Treatment options for hemobilia will depend on the underlying cause and may include surgery, medication, or endoscopy.
There are several causes of pancreatitis, including:
1. Gallstones: These can block the pancreatic duct, causing inflammation.
2. Alcohol consumption: Heavy alcohol use can damage the pancreas and lead to inflammation.
3. High triglycerides: Elevated levels of triglycerides in the blood can cause pancreatitis.
4. Infections: Viral or bacterial infections can infect the pancreas and cause inflammation.
5. Genetic factors: Some people may be more susceptible to pancreatitis due to inherited genetic mutations.
6. Pancreatic trauma: Physical injury to the pancreas can cause inflammation.
7. Certain medications: Some medications, such as certain antibiotics and chemotherapy drugs, can cause pancreatitis as a side effect.
Symptoms of pancreatitis may include:
1. Abdominal pain
2. Nausea and vomiting
4. Diarrhea or bloating
5. Weight loss
6. Loss of appetite
Treatment for pancreatitis depends on the underlying cause and the severity of the condition. In some cases, hospitalization may be necessary to manage symptoms and address any complications. Treatment options may include:
1. Pain management: Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids may be used to manage abdominal pain.
2. Fluid replacement: Intravenous fluids may be given to replace lost fluids and electrolytes.
3. Antibiotics: If the pancreatitis is caused by an infection, antibiotics may be prescribed to treat the infection.
4. Nutritional support: Patients with pancreatitis may require nutritional support to ensure they are getting enough calories and nutrients.
5. Pancreatic enzyme replacement therapy: In some cases, pancreatic enzyme replacement therapy may be necessary to help the body digest food.
6. Surgery: In severe cases of pancreatitis, surgery may be necessary to remove damaged tissue or repair damaged blood vessels.
It is important to seek medical attention if you experience persistent abdominal pain or other symptoms of pancreatitis, as early treatment can help prevent complications and improve outcomes.
The most common types of biliary fistulas are:
1. Bile duct-enteric fistula: This type of fistula connects the bile ducts to the small intestine.
2. Bile duct-skin fistula: This type of fistula connects the bile ducts to the skin, which can lead to a bile leak and infection.
3. Bile duct-liver fistula: This type of fistula connects the bile ducts to the liver, which can cause bleeding and infection.
Symptoms of biliary fistula may include:
* Jaundice (yellowing of the skin and whites of the eyes)
* Pale or clay-colored stools
* Dark urine
* Loss of appetite
* Weight loss
Diagnosis of biliary fistula is typically made through a combination of imaging tests such as endoscopy, CT scan, and MRI. Treatment options for biliary fistula include:
1. Endoscopic therapy: This may involve the use of an endoscope to repair or close off the fistula.
2. Surgery: In some cases, surgery may be necessary to repair or remove the damaged bile ducts.
3. Stent placement: A stent may be placed in the bile ducts to help keep them open and allow for proper drainage.
It is important to seek medical attention if you experience any symptoms of biliary fistula, as it can lead to serious complications such as infection or bleeding.
1. Adverse drug reactions (ADRs): These are side effects caused by medications, such as allergic reactions, liver damage, or other systemic problems. ADRs can be a significant cause of iatrogenic disease and can result from taking the wrong medication, taking too much medication, or taking medication for too long.
2. Infections acquired during medical procedures: Patients who undergo invasive medical procedures, such as surgeries or insertion of catheters, are at risk of developing infections. These infections can be caused by bacteria, viruses, or other microorganisms that enter the body through the surgical site or the catheter.
3. Surgical complications: Complications from surgery can range from minor issues, such as bruising and swelling, to more serious problems, such as infection, organ damage, or nerve injury. These complications can be caused by errors during the procedure, poor post-operative care, or other factors.
4. Medication overuse or underuse: Medications that are prescribed inappropriately or in excess can cause iatrogenic disease. For example, taking too much medication can lead to adverse drug reactions, while taking too little medication may not effectively treat the underlying condition.
5. Medical imaging complications: Medical imaging procedures, such as X-rays and CT scans, can sometimes cause iatrogenic disease. For example, excessive radiation exposure from these procedures can increase the risk of cancer.
6. Psychiatric iatrogenesis: This refers to harm caused by psychiatric treatment, such as medication side effects or inappropriate use of electroconvulsive therapy (ECT).
7. Overdiagnosis: Overdiagnosis occurs when a condition is diagnosed that would not have caused symptoms or required treatment during the person's lifetime. This can lead to unnecessary testing, treatment, and other iatrogenic harms.
8. Unnecessary surgery: Surgical procedures that are not necessary can cause harm and increase healthcare costs.
9. Inappropriate referrals: Referring patients for unnecessary tests or procedures can lead to iatrogenic disease and increased healthcare costs.
10. Healthcare provider burnout: Burnout among healthcare providers can lead to errors, adverse events, and other forms of iatrogenic disease.
It is important to note that these are just a few examples of iatrogenic disease, and there may be other factors that contribute to this phenomenon as well. Additionally, while many of the factors listed above are unintentional, some may be due to negligence or other forms of misconduct. In all cases, it is important for healthcare providers to take steps to prevent iatrogenic disease and promote high-quality, patient-centered care.
There are several types of PCS, including:
1. Bouveret's syndrome: This is a severe form of PCS that occurs within the first few days after cholecystectomy, characterized by intense abdominal pain, fever, and distension of the small intestine.
2. Mirizzi's syndrome: This type of PCS develops when the cystic duct remnant is obstructed, causing bile to accumulate in the gallbladder bed and leak into surrounding tissues, leading to inflammation and infection.
3. Acute pancreatitis: This condition occurs when the pancreatic duct becomes blocked or obstructed, causing pancreatic enzymes to build up and cause inflammation in the pancreas and surrounding tissues.
4. Chronic pancreatitis: This is a long-term form of PCS that can develop after cholecystectomy, characterized by persistent inflammation and damage to the pancreas, leading to abdominal pain, diarrhea, and weight loss.
5. Biliary-pancreatic dyskinesia: This is a chronic form of PCS that occurs when the sphincter of Oddi, which regulates the flow of bile and pancreatic juice into the small intestine, becomes dysfunctional, leading to abdominal pain, diarrhea, and malabsorption.
The symptoms of PCS can be severe and debilitating, affecting quality of life and requiring ongoing medical management. Treatment options for PCS include medications to manage symptoms, endoscopic therapy to clear obstructions, and in some cases, further surgical intervention.
It is essential to seek medical attention if you experience persistent or severe abdominal pain, as early diagnosis and treatment can help alleviate symptoms and prevent complications. A healthcare professional will perform a thorough physical examination and order imaging tests such as CT scans or endoscopy to confirm the diagnosis of PCS. Treatment will depend on the underlying cause of the condition, but may include medications to manage pain, inflammation, and infection, as well as lifestyle modifications to ensure proper digestion and nutrition.
The symptoms of situs inversus totalis can vary depending on the severity of the condition and the specific organs involved. Some common symptoms include:
* Chest pain or discomfort
* Shortness of breath or difficulty breathing
* Abdominal pain or discomfort
* Nausea and vomiting
* Fatigue or weakness
* Swelling in the legs or feet
* Pale or blue-tinged skin
The exact cause of situs inversus totalis is not known, but it is believed to be due to a combination of genetic and environmental factors. The condition is usually diagnosed during fetal development, and it can be detected through ultrasound imaging.
Treatment for situs inversus totalis typically involves surgery to correct the inverted organs. In some cases, a heart-lung transplant may be necessary. Medications such as antibiotics and pain relievers may also be prescribed to manage symptoms.
The prognosis for situs inversus totalis varies depending on the severity of the condition and the specific organs involved. In general, early diagnosis and treatment can improve outcomes and reduce the risk of complications. However, the condition can be life-threatening, and some individuals with situs inversus totalis may not survive beyond infancy or childhood.
In summary, situs inversus totalis is a rare congenital condition where all the major organs in the chest and abdomen are inverted or mirrored from their normal positions. Symptoms can include chest pain, shortness of breath, abdominal pain, nausea, and fatigue. Treatment typically involves surgery to correct the inverted organs, and medications may be prescribed to manage symptoms. The prognosis varies depending on the severity of the condition and the specific organs involved.
Causes of Colic:
1. Gas and bloating: Gas and bloating are common causes of colic. This can occur when gas builds up in the digestive tract or when the body has difficulty processing certain types of food.
2. Constipation: Constipation can cause colic, as hard stool can put pressure on the intestines and lead to pain.
3. Diarrhea: Diarrhea can also cause colic, as loose stool can irritate the intestines and lead to pain.
4. Eating certain foods: Some foods, such as dairy or gluten, can be difficult for the body to digest and may cause colic.
5. Medical conditions: Certain medical conditions, such as IBS, GERD, or IBD, can cause colic.
Symptoms of Colic:
1. Abdominal pain or discomfort: This is the most common symptom of colic and can be described as crampy, gnawing, or sharp.
2. Gas and bloating: Patients with colic may experience gas and bloating, which can lead to discomfort and abdominal distension.
3. Diarrhea or constipation: Depending on the underlying cause of colic, patients may experience diarrhea or constipation.
4. Nausea and vomiting: Some patients with colic may experience nausea and vomiting.
5. Abdominal tenderness: The abdomen may be tender to the touch, especially in the lower right quadrant of the abdomen.
Treatment for Colic:
1. Dietary changes: Patients with colic may benefit from making dietary changes such as avoiding trigger foods, eating smaller meals, and increasing fiber intake.
2. Probiotics: Probiotics can help to regulate the gut microbiome and reduce symptoms of colic.
3. Antispasmodics: Antispasmodics, such as dicyclomine, can help to reduce abdominal pain and cramping associated with colic.
4. Simethicone: Simethicone is an antigas medication that can help to reduce bloating and discomfort associated with colic.
5. Antidepressants: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have been shown to be effective in reducing symptoms of colic in some patients.
6. Psychological support: Colic can be stressful and emotionally challenging for both patients and their caregivers. Psychological support and counseling may be beneficial in managing the emotional impact of colic.
It is important to note that while these treatments may help to reduce symptoms of colic, there is no cure for this condition. In most cases, colic will resolve on its own within a few months. However, if you suspect that your baby has colic, it is important to consult with your healthcare provider to rule out any other underlying medical conditions and develop an appropriate treatment plan.
Types of Cholangitis:
There are two types of cholangitis:
1. Acute cholangitis: This type of cholangitis occurs suddenly and is usually caused by a blockage in the bile ducts, such as a gallstone or a tumor.
2. Chronic cholangitis: This type of cholangitis develops gradually over time and can be caused by recurring inflammation or scarring of the bile ducts.
Causes and Risk Factors:
The most common cause of cholangitis is a blockage in the bile ducts, which allows bacteria to grow and multiply, leading to infection. Other causes include:
* Pancreatitis (inflammation of the pancreas)
* Trauma to the abdomen
* Inflammatory bowel disease
The symptoms of cholangitis can vary depending on the severity of the infection, but may include:
* Abdominal pain
* Yellowing of the skin and eyes (jaundice)
* Dark urine
* Pale stools
* Nausea and vomiting
Cholangitis is diagnosed through a combination of imaging tests, such as CT scans or endoscopic ultrasound, and laboratory tests to determine the presence of infection. A liver biopsy may also be performed to confirm the diagnosis.
The treatment of cholangitis depends on the cause and severity of the infection, but may include:
* Antibiotics to treat bacterial or fungal infections
* Supportive care, such as fluids and nutrition, to manage symptoms
* Surgical drainage of the bile ducts to relieve blockages
* Endoscopic therapy, such as stent placement or laser lithotripsy, to remove gallstones or other obstructions
* Liver transplantation in severe cases
The prognosis for cholangitis depends on the severity of the infection and the underlying cause. If treated promptly and effectively, the prognosis is generally good. However, if left untreated or if there are complications, the prognosis can be poor.
Preventing cholangitis involves managing any underlying conditions that may increase the risk of infection, such as gallstones or liver disease. Other preventive measures include:
* Practicing good hygiene, such as washing hands regularly
* Avoiding sharing of needles or other drug paraphernalia
* Avoiding close contact with people who are sick
* Getting vaccinated against infections that can cause cholangitis
* Managing any underlying medical conditions, such as diabetes or liver disease
Cholangitis can lead to several complications, including:
* Bile duct damage, which can lead to bile leaking into the abdomen and causing an infection called peritonitis
* Spread of the infection to other parts of the body, such as the bloodstream or lungs
* Sepsis, a severe and life-threatening reaction to the infection
* Organ failure, particularly liver and kidney failure
It is important to seek medical attention promptly if you experience any symptoms of cholangitis, as early treatment can help prevent complications and improve outcomes.
PONV can be caused by various factors, including:
1. Anesthesia-related factors: The type and dose of anesthesia used, as well as the duration of anesthesia exposure, can contribute to PONV.
2. Surgical factors: The type and duration of surgery, as well as any complications during the procedure, can increase the risk of PONV.
3. Patient-related factors: Factors such as age, gender, body mass index (BMI), smoking status, and medical history can influence the likelihood of PONV.
4. Medication-related factors: Certain medications used during or after surgery, such as opioids and benzodiazepines, can increase the risk of PONV.
PONV can lead to a range of complications, including dehydration, electrolyte imbalances, and aspiration pneumonia. It can also cause significant discomfort, pain, and distress for patients, leading to delayed recovery and increased healthcare costs.
There are several strategies to prevent or manage PONV, including:
1. Anti-nausea medications: Prophylactic medications such as ondansetron, dolasetron, and granisetron can be given before or after surgery to reduce the risk of PONV.
2. Anesthesia techniques: Techniques such as avoiding general anesthesia, using regional anesthesia, and maintaining a stable body temperature can help reduce the risk of PONV.
3. Patient positioning: Positioning patients in a way that minimizes pressure on the stomach and diaphragm can help reduce the risk of PONV.
4. Fluid management: Encouraging patients to drink fluids before and after surgery can help prevent dehydration and electrolyte imbalances.
5. Deep breathing exercises: Encouraging patients to perform deep breathing exercises during the recovery period can help reduce nausea and vomiting.
6. Aromatherapy: Using aromatherapy with essential oils such as lavender and peppermint can help reduce nausea and vomiting.
7. Ginger: Ginger has anti-inflammatory properties and has been shown to reduce nausea and vomiting in some studies.
8. Vitamin B6: Some studies have suggested that taking vitamin B6 before surgery may reduce the risk of PONV.
9. Acupuncture: Acupuncture has been shown to reduce PONV in some studies.
10. Herbal remedies: Some herbal remedies such as peppermint, ginger, and chamomile have anti-nausea properties and may help reduce PONV.
It is important for patients to discuss their individual risk factors with their anesthesiologist before undergoing surgery and to follow any instructions provided by their healthcare provider regarding prevention and management of PONV.
Subphrenic abscesses are relatively rare but can be serious complications of conditions such as perforated peptic ulcers, appendicitis, or diverticulitis. They can also occur due to hollow organ perforation or direct inoculation of bacteria into the abdominal cavity during surgical procedures.
Symptoms of subphrenic abscesses include fever, chills, abdominal pain, and difficulty breathing. Diagnosis is made through a combination of physical examination, laboratory tests, and imaging studies such as CT scans or ultrasound. Treatment involves drainage of the abscess, antibiotics, and supportive care to manage symptoms. In severe cases, surgical intervention may be necessary to remove infected tissue or repair any underlying injuries.
Early recognition and treatment of subphrenic abscesses are critical to prevent complications such as sepsis, organ failure, and death. Prompt management can improve outcomes and reduce the risk of long-term sequelae.
The exact cause of acalculous cholecystitis is not known, but it is believed to be due to a combination of factors such as infection, injury, or abnormalities in the gallbladder's functioning. It can occur at any age but is more common in older adults and in women.
The symptoms of acalculous cholecystitis are similar to those of calculous cholecystitis and may include abdominal pain, fever, nausea, vomiting, and fatigue. However, the pain may be less severe and more widespread than in calculous cholecystitis.
The diagnosis of acalculous cholecystitis is based on a combination of clinical symptoms, laboratory tests, and imaging studies such as ultrasound or computed tomography (CT) scans. Laboratory tests may show elevated levels of liver enzymes and leukocyte counts, which are indicative of inflammation.
Treatment of acalculous cholecystitis usually involves antibiotics to treat any underlying infections, as well as supportive care such as fluids, pain management, and rest. In severe cases, surgical removal of the gallbladder may be necessary. Prognosis for patients with acalculous cholecystitis is generally good if the condition is diagnosed and treated promptly. However, delays in diagnosis and treatment can lead to complications such as gangrene or perforation of the gallbladder, which can be life-threatening.
Examples of acute diseases include:
1. Common cold and flu
2. Pneumonia and bronchitis
3. Appendicitis and other abdominal emergencies
4. Heart attacks and strokes
5. Asthma attacks and allergic reactions
6. Skin infections and cellulitis
7. Urinary tract infections
8. Sinusitis and meningitis
9. Gastroenteritis and food poisoning
10. Sprains, strains, and fractures.
Acute diseases can be treated effectively with antibiotics, medications, or other therapies. However, if left untreated, they can lead to chronic conditions or complications that may require long-term care. Therefore, it is important to seek medical attention promptly if symptoms persist or worsen over time.
If left untreated, an abdominal abscess can lead to serious complications such as perforation of the organ, sepsis, and death. In some cases, the infection may spread to other parts of the body, such as the bloodstream or brain. It is important to seek medical attention if symptoms persist or worsen over time.
The sphincter of Oddi is a ring-like muscle that controls the opening and closing of the common bile duct into the small intestine. Sphincter of Oddi dysfunction refers to problems with the functioning of this muscle, which can lead to a range of symptoms including abdominal pain, nausea, vomiting, and jaundice (yellowing of the skin and eyes).
There are several possible causes of sphincter of Oddi dysfunction, including:
1. Gallstones: Gallstones can block the common bile duct and cause inflammation and scarring of the sphincter, leading to dysfunction.
2. Inflammatory conditions: Conditions such as pancreatitis and cholangitis can cause inflammation and damage to the sphincter muscle.
3. Cancer: Bile duct cancer or pancreatic cancer can infiltrate and damage the sphincter muscle, leading to dysfunction.
4. Injury: Trauma to the abdomen or surgical damage to the bile ducts can cause dysfunction of the sphincter.
5. Neurological disorders: Certain neurological conditions such as Parkinson's disease, multiple sclerosis, and peripheral neuropathy can affect the nerves that control the sphincter muscle, leading to dysfunction.
The symptoms of sphincter of Oddi dysfunction can vary depending on the underlying cause and the severity of the dysfunction. They may include:
* Abdominal pain, often in the right upper quadrant or middle of the abdomen
* Nausea and vomiting
* Jaundice (yellowing of the skin and eyes)
* Loss of appetite
* Weight loss
* Pale or clay-colored stools
* Dark urine
If you are experiencing any of these symptoms, it is important to seek medical attention as soon as possible. A healthcare professional can perform a series of tests to diagnose the underlying cause of the dysfunction and develop an appropriate treatment plan. These tests may include:
1. Endoscopy: A thin, flexible tube with a camera and light on the end is inserted through the mouth and into the bile ducts to visualize the sphincter and surrounding tissues.
2. Imaging tests: Such as X-rays, CT scans, or MRI scans to evaluate the structure of the bile ducts and liver.
3. Blood tests: To check for signs of liver damage or pancreas inflammation.
4. ERCP (endoscopic retrograde cholangiopancreatography): A procedure in which a flexible tube with a camera and a special tool is inserted through the mouth and into the bile ducts to diagnose and treat problems.
5. Sphincterotomy: A procedure in which the surgeon makes a small incision in the sphincter muscle to relieve pressure and allow normal flow of bile.
6. Stent placement: A small tube is placed inside the bile duct to keep it open and improve flow.
7. Biliary bypass surgery: A procedure in which the surgeon reroutes the bile flow around the blocked bile duct.
8. Liver transplantation: In severe cases of bile duct injuries, a liver transplant may be necessary.
It is important to note that the treatment plan will depend on the underlying cause of the dysfunction and the severity of the condition. A healthcare professional will be able to determine the best course of treatment based on individual circumstances.
The term "extrahepatic" refers to the fact that the obstruction occurs outside of the liver, as opposed to intrahepatic cholestasis, which occurs within the liver. Extrahepatic cholestasis can be caused by a variety of factors, including gallstones, pancreatitis, and cancer.
Treatment for extrahepatic cholestasis typically involves addressing the underlying cause of the obstruction. In some cases, this may involve surgery to remove the blockage or other procedures such as stent placement or biliary bypass surgery. Medications such as bile salts and ursodeoxycholic acid may also be used to help improve liver function and reduce symptoms.
In summary, extrahepatic cholestasis is a type of bile duct obstruction that occurs outside of the liver, leading to bile buildup in the bloodstream and potentially causing a range of symptoms. Treatment typically involves addressing the underlying cause of the obstruction.
In the medical field, emergencies are situations that require immediate medical attention to prevent serious harm or death. These situations may include:
1. Life-threatening injuries, such as gunshot wounds, stab wounds, or severe head trauma.
2. Severe illnesses, such as heart attacks, strokes, or respiratory distress.
3. Acute and severe pain, such as from a broken bone or severe burns.
4. Mental health emergencies, such as suicidal thoughts or behaviors, or psychosis.
5. Obstetric emergencies, such as preterm labor or placental abruption.
6. Pediatric emergencies, such as respiratory distress or dehydration in infants and children.
7. Trauma, such as from a car accident or fall.
8. Natural disasters, such as earthquakes, hurricanes, or floods.
9. Environmental emergencies, such as carbon monoxide poisoning or exposure to toxic substances.
10. Mass casualty incidents, such as a terrorist attack or plane crash.
In all of these situations, prompt and appropriate medical care is essential to prevent further harm and save lives. Emergency responders, including paramedics, emergency medical technicians (EMTs), and other healthcare providers, are trained to quickly assess the situation, provide immediate care, and transport patients to a hospital if necessary.
Surgical wound infections can be caused by a variety of factors, including:
1. Poor surgical technique: If the surgeon does not follow proper surgical techniques, such as properly cleaning and closing the incision, the risk of infection increases.
2. Contamination of the wound site: If the wound site is contaminated with bacteria or other microorganisms during the surgery, this can lead to an infection.
3. Use of contaminated instruments: If the instruments used during the surgery are contaminated with bacteria or other microorganisms, this can also lead to an infection.
4. Poor post-operative care: If the patient does not receive proper post-operative care, such as timely changing of dressings and adequate pain management, the risk of infection increases.
There are several types of surgical wound infections, including:
1. Superficial wound infections: These infections occur only in the skin and subcutaneous tissues and can be treated with antibiotics.
2. Deep wound infections: These infections occur in the deeper tissues, such as muscle or bone, and can be more difficult to treat.
3. Wound hernias: These occur when the intestine bulges through the incision site, creating a hernia.
4. Abscesses: These occur when pus collects in the wound site, creating a pocket of infection.
Surgical wound infections can be diagnosed using a variety of tests, including:
1. Cultures: These are used to identify the type of bacteria or other microorganisms causing the infection.
2. Imaging studies: These can help to determine the extent of the infection and whether it has spread to other areas of the body.
3. Physical examination: The surgeon will typically perform a physical examination of the wound site to look for signs of infection, such as redness, swelling, or drainage.
Treatment of surgical wound infections typically involves a combination of antibiotics and wound care. In some cases, additional surgery may be necessary to remove infected tissue or repair damaged structures.
Prevention is key when it comes to surgical wound infections. To reduce the risk of infection, surgeons and healthcare providers can take several steps, including:
1. Proper sterilization and disinfection of equipment and the surgical site.
2. Use of antibiotic prophylaxis, which is the use of antibiotics to prevent infections in high-risk patients.
3. Closure of the incision site with sutures or staples to reduce the risk of bacterial entry.
4. Monitoring for signs of infection and prompt treatment if an infection develops.
5. Proper wound care, including keeping the wound clean and dry, and changing dressings as needed.
6. Avoiding unnecessary delays in surgical procedure, which can increase the risk of infection.
7. Proper patient education on wound care and signs of infection.
8. Use of biological dressings such as antimicrobial impregnated dressings, which can help reduce the risk of infection.
9. Use of negative pressure wound therapy (NPWT) which can help to promote wound healing and reduce the risk of infection.
10. Proper handling and disposal of sharps and other medical waste to reduce the risk of infection.
It is important for patients to follow their healthcare provider's instructions for wound care and to seek medical attention if they notice any signs of infection, such as redness, swelling, or increased pain. By taking these precautions, the risk of surgical wound infections can be significantly reduced, leading to better outcomes for patients.
There are many different types of polyps that can occur in various parts of the body, including:
1. Colon polyps: These are the most common type of polyp and typically occur in the colon or rectum. They are usually small and can be removed during a colonoscopy.
2. Thyroid polyps: These occur in the thyroid gland and are often benign. However, some can become cancerous if left untreated.
3. Nasal polyps: These occur in the nasal passages and are often associated with chronic sinusitis.
4. Ovarian polyps: These occur on the ovaries and are typically benign.
5. Uterine polyps: These occur in the uterus and are usually benign, but can occasionally become cancerous.
Polyps are often asymptomatic, meaning they do not cause any noticeable symptoms. However, some people may experience symptoms such as bleeding, abdominal pain, or difficulty swallowing if the polyp is large enough to interfere with normal bodily functions.
If you suspect you have a polyp, it is important to seek medical attention. Your healthcare provider will perform a physical examination and may order imaging tests such as an endoscopy or a CT scan to confirm the presence of the polyp. Treatment options for polyps depend on the type, size, and location of the polyp, as well as your overall health. Some polyps can be removed during an endoscopy or surgery, while others may require no treatment at all.
In summary, polyps are abnormal growths that can occur in various parts of the body. They are typically benign but can occasionally become cancerous if left untreated. If you suspect you have a polyp, it is important to seek medical attention for proper diagnosis and treatment.
The term "intestinal fistula" encompasses several different types of fistulas that can occur in the gastrointestinal tract, including:
1. Enterocutaneous fistula: This type of fistula occurs between the intestine and the skin, typically on the abdominal wall.
2. Enteroenteric fistula: This type of fistula occurs between two segments of the intestine.
3. Enterofistulous intestinal tract: This type of fistula occurs when a segment of the intestine is replaced by a fistula.
4. Fecal fistula: This type of fistula occurs between the rectum and the skin, typically on the perineum.
The causes of intestinal fistulas are varied and can include:
1. Inflammatory bowel disease (IBD): Both Crohn's disease and ulcerative colitis can lead to the development of intestinal fistulas.
2. Diverticulitis: This condition can cause a fistula to form between the diverticula and the surrounding tissues.
3. Infection: Bacterial or parasitic infections can cause the formation of fistulas in the intestine.
4. Radiation therapy: This can damage the intestinal tissue and lead to the formation of a fistula.
5. Trauma: Blunt or penetrating trauma to the abdomen can cause a fistula to form between the intestine and surrounding tissues.
6. Cancer: Malignancies in the intestine or surrounding tissues can erode through the bowel wall and form a fistula.
7. Rare genetic conditions: Certain inherited conditions, such as familial polyposis syndrome, can increase the risk of developing intestinal fistulas.
8. Other medical conditions: Certain medical conditions, such as tuberculosis or syphilis, can also cause intestinal fistulas.
The symptoms of intestinal fistulas can vary depending on the location and severity of the fistula. Common symptoms include:
1. Abdominal pain
3. Rectal bleeding
4. Infection (fever, chills, etc.)
5. Weakness and fatigue
6. Abdominal distension
7. Loss of appetite
8. Nausea and vomiting
The diagnosis of an intestinal fistula is typically made through a combination of physical examination, medical history, and diagnostic tests such as:
1. Imaging studies (X-rays, CT scans, MRI scans) to visualize the fistula and surrounding tissues.
2. Endoscopy to examine the inside of the intestine and identify any damage or abnormalities.
3. Biopsy to obtain a tissue sample for further examination.
4. Blood tests to check for signs of infection or inflammation.
Treatment of an intestinal fistula depends on the underlying cause and the severity of the condition. Treatment options may include:
1. Antibiotics to treat any underlying infections.
2. Surgery to repair the fistula and remove any damaged tissue.
3. Nutritional support to help the body heal and recover.
4. Management of any underlying medical conditions, such as diabetes or Crohn's disease.
5. Supportive care to manage symptoms such as pain, nausea, and vomiting.
The prognosis for intestinal fistulas varies depending on the underlying cause and the severity of the condition. In general, with prompt and appropriate treatment, many people with intestinal fistulas can experience a good outcome and recover fully. However, in some cases, complications such as infection or bleeding may occur, and the condition may be challenging to treat.
Foreign-body migration refers to the movement or migration of a foreign object or material within the body over time. This can occur after a surgical procedure, injury, or other medical intervention where a foreign object is introduced into the body. The term "foreign body" includes any object or material that is not naturally present within the body, such as implants, sutures, staples, and other medical devices.
The migration of a foreign body can occur due to various factors, including:
1. Mechanical forces: Movement of the body, such as during exercise or daily activities, can cause the foreign object to shift position or migrate to another part of the body.
2. Biological forces: The body's natural healing processes and inflammatory responses can cause the foreign object to move or change shape over time.
3. Chemical forces: Corrosion or degradation of the foreign material can lead to its migration within the body.
4. Cellular forces: Cells in the body can surround and interact with the foreign object, leading to its movement or displacement.
The migration of a foreign body can have significant clinical implications, including:
1. Pain and discomfort: The movement of a foreign object within the body can cause pain, discomfort, and inflammation.
2. Infection: The migration of a foreign object can increase the risk of infection, particularly if the object is made of a material that is susceptible to bacterial growth.
3. Organ damage: If the migrated foreign object damages surrounding tissues or organs, it can lead to serious complications and long-term health problems.
4. Revision surgery: In some cases, the migration of a foreign body may require revision surgery to remove or reposition the object.
To prevent foreign-body migration, medical professionals use various techniques, such as:
1. Implant fixation: Implants can be fixed in place using bone screws, sutures, or other fixation devices to minimize their movement.
2. Biocompatible materials: Using biocompatible materials for implants and other medical devices can reduce the risk of foreign-body reaction and migration.
3. Proper surgical technique: Surgeons must use proper surgical techniques when inserting foreign objects into the body, such as using a sterile environment and appropriate insertion angles.
4. Postoperative care: Proper postoperative care, including antibiotics and pain management, can help prevent complications and promote healing.
Overall, preventing the migration of foreign bodies is essential to ensure successful medical outcomes and minimize the risk of complications.
Some common examples of duodenal diseases include:
1. Peptic ulcers: These are open sores that develop in the lining of the duodenum and can be caused by infection with Helicobacter pylori bacteria or the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
2. Duodenal cancer: This is a rare type of cancer that develops in the lining of the duodenum. It can be treated with surgery, chemotherapy, and radiation therapy.
3. Inflammatory bowel disease (IBD): This is a chronic condition that causes inflammation in the digestive tract, including the duodenum. Symptoms of IBD include abdominal pain, diarrhea, and weight loss.
4. Duodenal webs or rings: These are congenital abnormalities that can cause blockages or narrowing in the duodenum.
5. Pancreatitis: This is inflammation of the pancreas, which can spread to the duodenum and cause damage to the lining of the duodenum.
6. Gastrointestinal hormone deficiency: This is a condition where the body does not produce enough gastrointestinal hormones, which can lead to symptoms such as diarrhea, abdominal pain, and weight loss.
7. Duodenal polyps: These are growths that develop in the lining of the duodenum and can be benign or cancerous.
8. Duodenal obstruction: This is a blockage that develops in the duodenum and can be caused by a variety of factors, including tumors, adhesions, and inflammation.
Duodenal diseases can be diagnosed through a range of tests, including:
1. Endoscopy: This is a procedure where a flexible tube with a camera and light on the end is inserted into the duodenum to visualize the inside of the duodenum and collect tissue samples.
2. Biopsy: This is a procedure where a small sample of tissue is removed from the duodenum and examined under a microscope for signs of disease.
3. CT scan or MRI: These are imaging tests that use X-rays or magnetic fields to produce detailed images of the duodenum and surrounding tissues.
4. Blood tests: These can be used to check for signs of infection, inflammation, or other conditions affecting the duodenum.
5. Stool tests: These can be used to check for signs of infection or inflammation in the duodenum.
Treatment for duodenal diseases will depend on the specific condition and its cause, but may include:
1. Medications: Such as antibiotics, anti-inflammatory drugs, and acid-suppressing medications to manage symptoms and reduce inflammation.
2. Lifestyle changes: Such as avoiding trigger foods, eating smaller meals, and managing stress.
3. Endoscopy: To remove any blockages or abnormal growths in the duodenum.
4. Surgery: In some cases, surgery may be necessary to repair damaged tissue or remove affected tissue.
5. Nutritional support: To ensure that the patient is getting enough nutrients and electrolytes.
It's important to note that a proper diagnosis from a medical professional is essential for effective treatment of duodenal diseases.
The word 'ileus' comes from the Greek word 'íleos', which means 'intestine'.
In general, surgical blood loss is considered excessive if it exceeds 10-20% of the patient's total blood volume. This can be determined by measuring the patient's hemoglobin levels before and after the procedure. A significant decrease in hemoglobin levels post-procedure may indicate excessive blood loss.
There are several factors that can contribute to surgical blood loss, including:
1. Injury to blood vessels or organs during the surgical procedure
2. Poor surgical technique
3. Use of scalpels or other sharp instruments that can cause bleeding
4. Failure to control bleeding with proper hemostatic techniques
5. Pre-existing medical conditions that increase the risk of bleeding, such as hemophilia or von Willebrand disease.
Excessive surgical blood loss can lead to a number of complications, including:
1. Anemia and low blood counts
2. Hypovolemic shock (a life-threatening condition caused by excessive fluid and blood loss)
3. Infection or sepsis
4. Poor wound healing
5. Reoperation or surgical intervention to control bleeding.
To prevent or minimize surgical blood loss, surgeons may use a variety of techniques, such as:
1. Applying topical hemostatic agents to the surgical site before starting the procedure
2. Using energy-based devices (such as lasers or ultrasonic devices) to seal blood vessels and control bleeding
3. Employing advanced surgical techniques that minimize tissue trauma and reduce the risk of bleeding
4. Monitoring the patient's hemoglobin levels throughout the procedure and taking appropriate action if bleeding becomes excessive.
Bile Reflux | Symptoms, Causes, Treatments | American ...
* Inguinal hernia: Occurs when part of the intestine bulges through a weakened area in the inguinal canal, which is located in the groin area.
* Umbilical hernia: Occurs when an organ or tissue protrudes through a weakened area near the belly button.
* Hiatal hernia: Occurs when the stomach bulges up into the chest through a weakened area in the diaphragm.
* Ventral hernia: Occurs when an organ or tissue protrudes through a weakened area in the abdominal wall, usually in the upper abdomen.
Symptoms of Abdominal Hernia may include pain or discomfort in the affected area, bulging or swelling, and difficulty passing stool or gas. Treatment options range from lifestyle changes to surgery, depending on the severity of the condition.
Tehemton Erach Udwadia
Tom McNair (surgeon)
Accessory bile duct
Saint Thomas - West Hospital
David B. Adams
Da Vinci Surgical System
Peter V. Delaney
Marion Mahony Griffin
Biliary endoscopic sphincterotomy
Hyperbilirubinemia in adults
Common bile duct stone
List of -ectomies
Common bile duct
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- A multicenter, prospective, randomized non-blinded study to compare treatment outcome, complications and 75-day morbidity in patients with acute cholecystitis randomized to laparoscopic cholecystectomy within 24 hours of symptom onset or antibiotic treatment with moxifloxacin and subsequent elective cholecystectomy. (biomedcentral.com)
- This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. (who.int)
- METHODS: We performed a retrospective analysis of patients with gallbladder cancer who underwent cholecystectomy from 1981 to 2007 at Kitasato university east hospital in Japan. (sages.org)
- During laparoscopic gallbladder surgery, which is also known as cholecystectomy, the surgeon removes the gallstones or the entire gallbladder, depending on the severity of the disease and the number of stones. (gallstonesurgeries.com)
- In 1984, approximately 776,000 patients were discharged from short- stay hospitals with a diagnosis of gallstones, 485,000 of those patients received a cholecystectomy. (cdc.gov)
- There was a statistically significant decrease in the adjusted odds ratio (aOR) for the development of gallstones (aOR 0.81, 95% CI: 0.74, 0.89), development of cholecystitis (aOR 0.59, 95% CI: 0.36, 0.91), and undergoing cholecystectomy (aOR 0.75, 95% CI: 0.69, 0.81). (bvsalud.org)
- CONCLUSION: Ursodiol significantly decreases the odds of development of gallstones, cholecystitis, or cholecystectomy within 1 year following bariatric surgery. (bvsalud.org)
- Early Versus Delayed Cholecystectomy for Acute Cholecystitis. (lww.com)
- Laparoscopic cholecystectomy is the standard of care for the surgical treatment of acute cholecystitis. (medscape.com)
- OBJECTIVE: The present study is designed to compare early and interval laparoscopic/open cholecystectomy in patients of acute cholecystitis. (who.int)
- postoperative haemorrhage (in cholecystectomy patient) and acute chest syndrome (in one appendicectomy patient). (bvsalud.org)
- [ 7 , 8 , 9 ] The most recent developments in laparoscopic surgery have been the combined advances in natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS), as exemplified here by single-port cholecystectomy. (medscape.com)
- To seek the best evidence in order to indicate prophylactic cholecystectomy or conservative treatment (clinical follow-up) in patients with asymptomatic cholelithiasis . (bvsalud.org)
- Studies have indicated that early laparoscopic cholecystectomy resulted in shorter total hospital stays with no significant difference in the conversion rates or complications. (medscape.com)
- The objective of this study is to analyze the main complications arising from laparoscopic cholecystectomy (LC) and, as a secondary objective, to identify risk factors that lead to poor outcomes. (rsdjournal.org)
- These patients should not be considered for single-port cholecystectomy, and a standard four-port laparoscopic cholecystectomy should be performed instead. (medscape.com)
- [ 14 ] Rosales-Velderrain et al al found single-port robotic laparoscopic cholecystectomy to be feasible and safe in pediatric patients. (medscape.com)
- Gallbladder removal surgery (cholecystectomy) is the only surgical procedure so common that my patients consistently forget to list it in their medical records. (ndnr.com)
- However, in post-cardiac transplant patients and those with biliary microlithiasis with low preoperative surgical risk , a prophylactic cholecystectomy is recommended. (bvsalud.org)
- In this randomized prospective study, we investigated the effects of lornoxicam vs. ropivacaine for the management of postoperative pain in patients undergoing elective laparoscopic cholecystectomy. (balkanmedicaljournal.org)
- This study aimed to evaluate the effects of CO2 pneumoperitoneum on serum total PSA (tPSA) and free PSA (fPSA) levels in patients undergoing laparoscopic cholecystectomy. (bozok.edu.tr)
- 56 patients were enrolled in the study from which 26 patients were randomly assigned to early lap/open cholecystectomy and 30 were assigned to interval lap/open cholecystectomy group. (who.int)
- Methods: This study involved 30 men who underwent elective laparoscopic cholecystectomy. (bozok.edu.tr)
- CONCLUSION: Both the methods, early and interval have no significant benefit over each other but through review of all literature, early lap/open cholecystectomy is found to be beneficial overall with less hospital stay. (who.int)
- METHODS: The Mariner database (PearlDiver, Inc.) was queried using Current Procedural Terminology codes for Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between 2011 and 2020. (bvsalud.org)
- Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). (rsdjournal.org)
- Open gallstone removal surgery (open cholecystectomy) - Open cholecystectomy is the conventional complex procedure for gallbladder removal. (gallstonesurgeries.com)
- Laparoscopic gallstone removal surgery (laparoscopic cholecystectomy) - This is the modern and advanced procedure for gallbladder removal. (gallstonesurgeries.com)
- It is nearly always best managed by cholecystectomy, but the timing of surgery has been controversial. (medscape.com)
- Most cases of severe or recurrent cholecystitis eventually require surgery, usually laparoscopic cholecystectomy in the Western World. (biomedcentral.com)
- 1 procedure: gastrectomy and cholecystectomy (n = 1), sleeve gastrectomy and bowel resection (1), sleeve gastrectomy and lap band removal (1), and sleeve gastrectomy, breast augmentation, and abdominoplasty (1). (cdc.gov)
- Laparoscopic cholecystectomy is a widely performed procedure that has been shown to result in less postoperative pain and a shorter hospital stay than the corresponding open procedure. (medscape.com)
- After a thorough evaluation, the doctor advised her to undergo an open cholecystectomy, a surgical procedure involving removing the gallbladder through a large incision in the abdomen. (transparenthands.org)
- Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. (rsdjournal.org)
- Since 1985, many competitive approaches have been developed to minimize the invasiveness of laparoscopic cholecystectomies, with surgeons developing new instruments and techniques to reduce postoperative pain and improve cosmesis by decreasing the number and size of necessary ports. (medscape.com)
- In any single-port cholecystectomy, it is important to maintain a low threshold for conversion to a standard laparoscopic cholecystectomy or open cholecystectomy . (medscape.com)
- She needs an open cholecystectomy to alleviate her symptoms, but she is struggling with finances. (transparenthands.org)
- We urge you to support Rabia's open cholecystectomy. (transparenthands.org)
- I have been told that an open cholecystectomy would help my symptoms, but unfortunately, I do not have the money to pay for one. (transparenthands.org)
- We appeal to donors to support Rabia's open cholecystectomy to regain her health and lead a pain-free life. (transparenthands.org)
- However, the duration of hospital stay was less in early laparoscopic/open cholecystectomy. (who.int)
- one of whom had open cholecystectomy. (bvsalud.org)
- Cholecystectomy is the most common method of treatment of cholecystitis, other diseases and injuries of the gallbladder. (doclandmed.com)
- The study concluded that single-port laparoscopic cholecystectomy is safe and effective and leads to better cosmetic results. (medscape.com)
- Single-port cholecystectomy with the TransEnterix SPIDER: simple and safe. (medscape.com)
- 4 Researchers in Italy stated: "This continuing pain, termed [p]ost- (PCS) is defined as a complex of heterogeneous symptoms, consisting of upper abdominal pain and dyspepsia, which recur and/or persist after cholecystectomy. (ndnr.com)
- Multi-regional, intraperitoneal instillation and port site infiltration of ropivacaine and lornoxicam during laparoscopic cholecystectomy reduces the postoperative pain. (balkanmedicaljournal.org)
- Single Nucleotide Polymorphisms Associated with Pain Sensitivity After Laparoscopic Cholecystectomy. (cdc.gov)
- In a randomized controlled trial by Aktimur et al, single-port cholecystectomy using a facilitating maneuver for better exposure was found to be comparable to four-port cholecystectomy with regard to ease of performance, operating time, reproducibility, and patient safety. (medscape.com)
- Summarises and compares data from Canada and Australia on the use and cost implications of laparoscopic cholecystectomy. (aihw.gov.au)
- Dr. Roe, a general surgeon, performed a laparoscopic cholecystectomy , during which the doctor encountered an unusual amount of bleeding. (robertkreisman.com)
- The first laparoscopic cholecystectomy was performed in 1985 by Erich Mühe in the County Hospital of Böblingen, Germany. (medscape.com)
- From Philippe Rola and the Critical Care & Ultrasound Institute , the first in a series of educational ultrasound cases on PulmCCM: A 64 year-old male is admitted to the ICU from the surgical ward with hypotension, 3 days post-cholecystectomy. (pulmccm.org)
- Vemulapalli P, Agaba EA, Camacho D. Single incision laparoscopic cholecystectomy: a single center experience. (medscape.com)