Double gallbladder originating from left hepatic duct: a case report and review of literature. (1/63)BACKGROUND: Double gallbladder is a rare anomaly of the biliary tract. Double gallbladder arising from the left hepatic duct was previously reported only once in the literature. CASE REPORT: A case of symptomatic cholelithiasis in a double gallbladder, diagnosed on preoperative ultrasound, computed tomography (CT) and endoscopic retrograde cholangiopancreatogram (ERCP) is reported. At laparoscopic cholangiography via the accessory gallbladder no accessory cystic duct was visualized. After conversion to open cholecystectomy, the duplicated gallbladder was found to arise directly from the left hepatic duct; it was resected and the duct repaired. CONCLUSIONS: We emphasize that a careful intraoperative cholangiographic evaluation of the accessory gallbladder is mandatory in order to prevent inadvertent injury to bile ducts, since a large variety of ductal abnormality may exist. (+info)
Abnormalities in gallbladder morphology and function in patients with cholelithiasis. (2/63)Thirty-seven symptomatic cholelithiasis patients who had cholecystectomy were studied to determine the relationships between clinical manifestations, histologic findings and gallbladder absorptive capability. A clinical score was calculated from clinical data which we thought might be predictive of abnormal gallbladder histology. Histologic parameters indicative of gallbladder disease were used to calculate a histologic score. Shortcircuit current measurements, which reflect gallbladder sodium absorption,were used to assess absorptive function. Patients with very high clinical scores, indicative of pronounced clinical score was not predictive of histologic findings or absorptive function of the gallbladder is directly related to the degree of histologic abnormality, and that absorptive capability is not an all-or-none phenomenon. The data also show that visualization on oral cholecystography is an unreliable measure of gallbladder absorptive capability. (+info)
Assessment and treatment of recurrent peptic ulceration. (3/63)From the experience of treating 91 patients with a proven recurrent ulcer we consider that if a proven ulcer is shown to be present and a gastrin-secreting tumour is excluded an appropriate reoperation will almost always produce a successful result (94 per cent). Before subjecting patients to reoperation all attempts must be made to secure a precise diagnosis. The following investigations should be performed: barium meal, panendoscopy of the upper gastrointestinal tract, determination of maximum acid output (with insulin test and gastrin analysis if appropriate), and cholecystography. Before accepting a diagnosis of recurrent ulcer at least 2 of the first 3 tests should be postive. If the primary operation was a resection we advocate vagotomy alone as the second operation, provided there are no local complications such as stenosis, bleeding, or fistula. If the primary operation was a vagotomy and the recurrence is associated with a positive response to the insulin test we advocate revagotomy and antrectomy. If the insulin test is negative we normally repeat the test; if it is still negative then we use antrectomy alone. (+info)
Biliary lipid output during three meals and an overnight fast. II. Effect of chenodeoxycholic acid treatment in gallstone subjects. (4/63)Oral treatment with chenodeoxycholic acid causes dissolution of cholesterol gallstones in man. In order to determine the mechanism of this effect, we have measured 24-hour biliary lipid output, lipid composition of fasting gallbladder bile, and bile acid pool sizes before and during such treatment in six patients with radiolucent gallstones in functioning gallbladders. In all six patients, the degree of cholesterol saturation of fasting-state gallbladder bile was decreased during treatment to a level below the thermodynamic solubility line. This effect was due to a decrease in biliary cholesterol output, associated with conversion of more than 90% of the total bile acid pool to chenodeoxycholic acid. It could not be attributed to an increase in total bile acid pool size nor to an increase in biliary bile acid or phospholipid output. (+info)
The value of radiology in predicting gallstone type when selecting patients for medical treatment. (5/63)Since medical treatment of gallstones is confined to cholesterol-rich stones, the ability of clinical radiographs to predict gallstone type was tested prospectively by comparing the preoperative radiological appearance of gallstones from 57 unselected patients with cholelithiasis coming to cholecystectomy with the subsequent analysis of the stones both by X-ray diffraction and by chemical techniques. Fifty-two per cent of the patients had 'non-functioning' gallbladders which failed to opacify after at least two contrast examinations and 25 out of 50 had radioopaque stones. Of the 25 patients with radiolucent stones, the stones in 20 ((80%) were predominantly cholesterol in type but radiology was misleading in five; three contained 40-55% calcium salts but were still radiolucent while two were amorphous and contained less than 10% cholesterol by weight on chemical analysis. While radiology was sometimes misleading when the stones were small and irregular, large radiolucent stones with a smooth profile were invariably cholesterol-rich stones. The results also show that in men calcified stones were commoner than in women and that in older women the gallstones contained more calcium salts and less cholesterol than in younger women less than 50 yr). This paper analyses critically the value and limitations of clinical radiology in predicting gallstone type. (+info)
Gallstones after ileostomy and ileal resection. (6/63)One hundred and eight patients with ileostomies were investigated for cholelithiasis at routine annual review in a large Ileostomy Clinic. Gallstones were demonstrated in 24-5%, which is three times the incidence that might have been expected in a population of this age and sex distribution. The frequency of cholelithiasis was significantly increased in those patients who had lost more than 10 cm of ileum at operation, regardless of whether the primary condition had been ulcerative colitis or Crohn's disease. It was significantly increased in those patients who had had a resection of less than 10 cm of ileum if the original condition had been Crohn's disease, but not if it had been colitis. (+info)
The study between the dynamics and the X-ray anatomy and regularizing effect of gallbladder on bile duct sphincter of the dog. (7/63)AIM: To study the relationship between the radiological anatomy and the dynamics on bile duct sphincter in bile draining and regularizing effect of gallbladder. METHODS: Sixteen healthy dogs weighing 18 kg to 25 kg were divided randomly into control group and experimental group (cholecystectomy group). Cineradiography, manometry with perfusion, to effect of endogenous cholecystokinin and change of ultrastructure were employed. RESULTS: According to finding of the choledochography and manometry, in control group the intraluminal basal pressure of cephalic cyclic smooth muscle of choledochal sphincter cCS was 9.0+/-2.0 mmHg and that of middle oblique smooth muscle of choledochal sphincter (mOS) was 16.8+/-0.5 mmHg, the intraluminal basal pressure of cCS segment was obviously lower than that of mOS (P<0.01) in the interval period of bile draining, but significative difference of intraluminal basal pressure of the mOS segment was not found between the interval period of bile draining (16.8+/-0.5 mmHg) and the bile flowing period (15.9+/-0.9 mmHg) (P>0.05). The motility of cCS was mainly characterized by rhythmically concentric contraction, just as motility of cCS bile juice was pumped into the mOS segment in control group. And motility of mOS segment showed mainly diastolic and systolic activity of autonomically longitudinal peristalsis. There was spasmodic state in cCS and mOS segment and reaction to endogenous cholecystokinin was debased after cholecystectomy. The change of ultrastructure of cCS portion showed mainly that the myofilaments of cell line in derangement and mitochondria is swelling. CONCLUSION: During fasting, the cCS portion has a function as similar cardiac "pump" and it is main primary power source in bile draining, and mOS segment serves mainly as secondary power in bile draining. The existence of the intact gallbladder is one of the important factors in guaranteeing the functional coordination between the cCS and mOS of bile duct sphincter. There is dysfunction in the cCS and mOS with cholecystectomy. (+info)
Stomach-interposed cholecystogastrojejunostomy: a palliative approach for periampullary carcinoma. (8/63)AIM: For patients of periampullary carcinoma found to be unresectable at the time of laparotomy, surgical palliation is the primary choice of treatment. Satisfactory palliation to maximize the quality of life with low morbidity and mortality is the gold standard for a good procedure. Our aim is to explore such a procedure as an alternative to the traditional ones. METHODS: A modified double-bypass procedure is performed by, in addition to the usual gastrojejunostomy, implanting a mushroom catheter from the gall bladder into the jejunum through the interposed stomach as an internal drainage. A retrospective review was performed including 22 patients with incurable periampullary carcinomas who underwent this surgery. RESULTS: Both jaundice and impaired liver function improved significantly after surgery. No postoperative deaths, cholangitis, gastrojejunal, biliary anastomotic leaks, recurrent jaundice or late gastric outlet obstruction occurred. Delayed gastric emptying occurred in two patients. The total surgical time was 150+/-26 min. The estimated blood loss was 160+/-25 mL. The mean length of hospital stay after surgery was 22+/-6 d. The mean survival was 8 mo (range 1.5-18 mo). CONCLUSION: In patients of unresectable periampullary malignancies, stomach-interposed cholecystogastrojejunostomy is a safe, simple and efficient technique for palliation. (+info)
Cholecystography is a medical procedure that involves the use of X-rays to examine the gallbladder and bile ducts. It is also known as an oral cholecystogram (OCG).
The procedure involves administering a contrast agent, typically a iodine-based dye, which is absorbed by the liver and excreted into the bile ducts and gallbladder. The dye makes the bile ducts and gallbladder visible on X-ray images, allowing doctors to diagnose conditions such as gallstones, tumors, or inflammation of the gallbladder.
Cholecystography is not commonly used today due to the development of more advanced imaging techniques, such as ultrasound and computed tomography (CT) scans, which are non-invasive and do not require the use of contrast agents. However, it may still be used in certain cases where other imaging tests are inconclusive or unavailable.
The gallbladder is a small, pear-shaped organ located just under the liver in the right upper quadrant of the abdomen. Its primary function is to store and concentrate bile, a digestive enzyme produced by the liver, which helps in the breakdown of fats during the digestion process. When food, particularly fatty foods, enter the stomach and small intestine, the gallbladder contracts and releases bile through the common bile duct into the duodenum, the first part of the small intestine, to aid in fat digestion.
The gallbladder is made up of three main parts: the fundus, body, and neck. It has a muscular wall that allows it to contract and release bile. Gallstones, an inflammation of the gallbladder (cholecystitis), or other gallbladder diseases can cause pain, discomfort, and potentially serious health complications if left untreated.
Gallbladder diseases refer to a range of conditions that affect the function and structure of the gallbladder, a small pear-shaped organ located beneath the liver. The primary role of the gallbladder is to store, concentrate, and release bile into the small intestine to aid in digesting fats. Gallbladder diseases can be chronic or acute and may cause various symptoms, discomfort, or complications if left untreated. Here are some common gallbladder diseases with brief definitions:
1. Cholelithiasis: The presence of gallstones within the gallbladder. Gallstones are small, hard deposits made of cholesterol, bilirubin, or a combination of both, which can vary in size from tiny grains to several centimeters.
2. Cholecystitis: Inflammation of the gallbladder, often caused by obstruction of the cystic duct (the tube connecting the gallbladder and the common bile duct) due to a gallstone. This condition can be acute or chronic and may cause abdominal pain, fever, and tenderness in the right upper quadrant of the abdomen.
3. Choledocholithiasis: The presence of gallstones within the common bile duct, which can lead to obstruction, jaundice, and potential infection of the biliary system (cholangitis).
4. Acalculous gallbladder disease: Gallbladder dysfunction or inflammation without the presence of gallstones. This condition is often seen in critically ill patients and can lead to similar symptoms as cholecystitis.
5. Gallbladder polyps: Small growths attached to the inner wall of the gallbladder. While most polyps are benign, some may have malignant potential, especially if they are larger than 1 cm in size or associated with certain risk factors.
6. Gallbladder cancer: A rare form of cancer that originates in the gallbladder tissue. It is often asymptomatic in its early stages and can be challenging to diagnose. Symptoms may include abdominal pain, jaundice, or a palpable mass in the right upper quadrant of the abdomen.
It is essential to consult with a healthcare professional if experiencing symptoms related to gallbladder disease for proper diagnosis and treatment.
Cholelithiasis is a medical term that refers to the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located beneath the liver that stores bile, a digestive fluid produced by the liver. Gallstones are hardened deposits that can form in the gallbladder when substances in the bile, such as cholesterol or bilirubin, crystallize.
Gallstones can vary in size and may be as small as a grain of sand or as large as a golf ball. Some people with gallstones may not experience any symptoms, while others may have severe abdominal pain, nausea, vomiting, fever, and jaundice (yellowing of the skin and eyes) if the gallstones block the bile ducts.
Cholelithiasis is a common condition that affects millions of people worldwide, particularly women over the age of 40 and those with certain medical conditions such as obesity, diabetes, and rapid weight loss. If left untreated, gallstones can lead to serious complications such as inflammation of the gallbladder (cholecystitis), infection, or pancreatitis (inflammation of the pancreas). Treatment options for cholelithiasis include medication, shock wave lithotripsy (breaking up the gallstones with sound waves), and surgery to remove the gallbladder (cholecystectomy).
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- Oral cholecystography is a radiological procedure used to visualize the gallbladder and biliary channels, developed in 1924 by American surgeons Evarts Ambrose Graham and Warren Henry Cole. (wikipedia.org)
- Failure of gallbladder visualisation during oral cholecystography when abnormal liver function returns to normal, or there is mild to moderate liver disease, maybe due to extrahepatic (outside the liver) causes. (wikipedia.org)
- Oral cholecystography can have better sensitivity and specificity in diagnosing acute and chronic gallbladder disease than ultrasound. (wikipedia.org)
- For all contrast formulas, CT cholecystography showed the gallbladder and the intra- and extrahepatic bile ducts. (bvsalud.org)
- A radiographic contrast medium formerly used for oral cholecystography. (theodora.com)
- An improved oral method for cholecystography. (nih.gov)
- Working to heal leaky gut severity of the condition and and oral cholecystography, equal to molecular Zetia By Mail through which the. (meloathens.com)
- The gall stone dissolution rates at six and 12 months were determined by standardised oral cholecystography and expressed as the percentage reduction in the gall stone volume after treatment. (lifewithnogallbladder.org)
- Diagnostic value of cholecystography [Marquette Univ. (nih.gov)
- Radiodiagnostic procedures such as cholecystography practiced between the 4th and 6th week of gestation. (eyewiki.org)
- With an increasingly obese population, particular attention may well be warranted to this subgroup and CT cholecystography has shown promising results in small trials but would require further exploration. (plainmath.org)
- In addition, minimally invasive techniques also come to use: fiber fibrogastroduodenoscopy, cholecystography, high-precision analyses of the liver, etc. (medigerman.com)
- Therefore, they are used in the process of cholecystography, which uses x-rays to show the cavity of the liver as well as its ability to contract and concentrate. (changingyourbusiness.com)