Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
Surgery of the smooth muscle sphincter of the hepatopancreatic ampulla to relieve blocked biliary or pancreatic ducts.
The sphincter of the hepatopancreatic ampulla within the duodenal papilla. The COMMON BILE DUCT and main pancreatic duct pass through this sphincter.
A painful linear ulcer at the margin of the anus. It appears as a crack or slit in the mucous membrane of the anus and is very painful and difficult to heal. (Dorland, 27th ed & Stedman, 25th ed)
Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
A dilation of the duodenal papilla that is the opening of the juncture of the COMMON BILE DUCT and the MAIN PANCREATIC DUCT, also known as the hepatopancreatic ampulla.
Presence or formation of GALLSTONES in the COMMON BILE DUCT.
Surgical removal of the GALLBLADDER.
Endoscopic examination, therapy or surgery of the luminal surface of the duodenum.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).
Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.
Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both.
Organic or functional motility disorder involving the SPHINCTER OF ODDI and associated with biliary COLIC. Pathological changes are most often seen in the COMMON BILE DUCT sphincter, and less commonly the PANCREATIC DUCT sphincter.
The act of dilating.
Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.
INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.
The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus.
Swollen veins in the lower part of the RECTUM or ANUS. Hemorrhoids can be inside the anus (internal), under the skin around the anus (external), or protruding from inside to outside of the anus. People with hemorrhoids may or may not exhibit symptoms which include bleeding, itching, and pain.
Presence or formation of GALLSTONES in the GALLBLADDER.
Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.
Measurement of the pressure or tension of liquids or gases with a manometer.
A nontoxic radiopharmaceutical that is used in RADIONUCLIDE IMAGING for the clinical evaluation of hepatobiliary disorders in humans.
A condition with abnormally elevated level of AMYLASES in the serum. Hyperamylasemia due to PANCREATITIS or other causes may be differentiated by identifying the amylase isoenzymes.
Excision of the gallbladder through an abdominal incision using a laparoscope.
Abnormal passage in any organ of the biliary tract or between biliary organs and other organs.
A process whereby bile is delivered from the gallbladder into the duodenum. The emptying is caused by both contraction of the gallbladder and relaxation of the sphincter mechanism at the choledochal terminus.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Hand-held tools or implements used by health professionals for the performance of surgical tasks.
Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes.
Pathological processes of the PANCREAS.
The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is LITHOTRIPSY, LASER.
An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken.
Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).
A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.
The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.
Surgery performed on the digestive system or its parts.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
Establishment of an opening into the gallbladder either for drainage or surgical communication with another part of the digestive tract, usually the duodenum or jejunum.
A tube that transports URINE from the URINARY BLADDER to the outside of the body in both the sexes. It also has a reproductive function in the male by providing a passage for SPERM.
Tumor or cancer of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
A storage reservoir for BILE secretion. Gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the CYSTIC DUCT to the DUODENUM, for degradation of dietary lipid.
Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).
Proposed spasmolytic with possible local anesthetic action used in gastrointestinal disorders.
Endoscopic examination, therapy or surgery of the digestive tract.
Conditions which affect the structure or function of the pupil of the eye, including disorders of innervation to the pupillary constrictor or dilator muscles, and disorders of pupillary reflexes.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
A series of steps taken in order to conduct research.
Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.
Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases.
Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.
The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
A congenital anatomic malformation of a bile duct, including cystic dilatation of the extrahepatic bile duct or the large intrahepatic bile duct. Classification is based on the site and type of dilatation. Type I is most common.
Liver disease caused by infections with parasitic tapeworms of the genus ECHINOCOCCUS, such as Echinococcus granulosus or Echinococcus multilocularis. Ingested Echinococcus ova burrow into the intestinal mucosa. The larval migration to the liver via the PORTAL VEIN leads to watery vesicles (HYDATID CYST).
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Toxic proteins produced from the species CLOSTRIDIUM BOTULINUM. The toxins are synthesized as a single peptide chain which is processed into a mature protein consisting of a heavy chain and light chain joined via a disulfide bond. The botulinum toxin light chain is a zinc-dependent protease which is released from the heavy chain upon ENDOCYTOSIS into PRESYNAPTIC NERVE ENDINGS. Once inside the cell the botulinum toxin light chain cleaves specific SNARE proteins which are essential for secretion of ACETYLCHOLINE by SYNAPTIC VESICLES. This inhibition of acetylcholine release results in muscular PARALYSIS.
Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.
The return of a sign, symptom, or disease after a remission.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
Bleeding or escape of blood from a vessel.
A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.
The condition of an anatomical structure's being constricted beyond normal dimensions.
Endoscopic examination, therapy or surgery of the gastrointestinal tract.
An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum.
A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
Elements of limited time intervals, contributing to particular results or situations.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
Disease having a short and relatively severe course.
A group of amylolytic enzymes that cleave starch, glycogen, and related alpha-1,4-glucans. (Stedman, 25th ed) EC 3.2.1.-.
The period of confinement of a patient to a hospital or other health facility.
Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed)
A specific decapeptide obtained from the skin of Hila caerulea, an Australian amphibian. Caerulein is similar in action and composition to CHOLECYSTOKININ. It stimulates gastric, biliary, and pancreatic secretion; and certain smooth muscle. It is used in paralytic ileus and as diagnostic aid in pancreatic malfunction.
A malignant tumor arising from the epithelium of the BILE DUCTS.
Passages within the liver for the conveyance of bile. Includes right and left hepatic ducts even though these may join outside the liver to form the common hepatic duct.
A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.

Early ERCP is an essential part of the management of all cases of acute pancreatitis. (1/201)

The role of early endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy in acute pancreatitis is controversial. Recent randomised controlled trials mostly support the value of this procedure, but concerns remain as to its safety, efficacy and practicability. This debate critically assesses the evidence for and against the use of early ERCP in acute pancreatitis.  (+info)

Ultrasonographic evaluation of the common bile duct in biliary acute pancreatitis patients: comparison with endoscopic retrograde cholangiopancreatography. (2/201)

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)

Manometry based randomised trial of endoscopic sphincterotomy for sphincter of Oddi dysfunction. (3/201)

BACKGROUND: Endoscopic sphincterotomy for biliary-type pain after cholecystectomy remains controversial despite evidence of efficacy in some patients with a high sphincter of Oddi (SO) basal pressure (SO stenosis). AIM: To evaluate the effects of sphincterotomy in patients randomised on the basis of results from endoscopic biliary manometry. METHODS: Endoscopic biliary manometry was performed in 81 patients with biliary-type pain after cholecystectomy who had a dilated bile duct on retrograde cholangiography, transient increases in liver enzymes after episodes of pain, or positive responses to challenge with morphine/neostigmine. The manometric record was categorised as SO stenosis, SO dyskinesia, or normal, after which the patient was randomised in each category to sphincterotomy or to a sham procedure in a prospective double blind study. Symptoms were assessed at intervals of three months for 24 months by an independent observer, and the effects of sphincterotomy on sphincter function were monitored by repeat manometry after three and 24 months. RESULTS: In the SO stenosis group, symptoms improved in 11 of 13 patients treated by sphincterotomy and in five of 13 subjected to a sham procedure (p = 0.041). When manometric records were categorised as dyskinesia or normal, results from sphincterotomy and sham procedures did not differ. Complications were rare, but included mild pancreatitis in seven patients (14 episodes) and a collection in the right upper quadrant, presumably related to a minor perforation. At three months, the endoscopic incision was extended in 19 patients because of manometric evidence of incomplete division of the sphincter. CONCLUSION: In patients with presumed SO dysfunction, endoscopic sphincterotomy is helpful in those with manometric features of SO stenosis.  (+info)

Clinical features and management of biliary ascariasis in a non-endemic area. (4/201)

Biliary ascariasis is common in certain geographical areas of the world. In India, it is common in the Kashmir valley and only stray cases have been reported from other parts of the country. Between January 1995 and May 1997, 14 patients with biliary ascariasis were seen at our centre, which is more than 1000 km from the Kashmir valley. The mean (+/- SD) age of the patients was 31.7 (+/- 6.1) years and all were females. None of them had been to a place known to be endemic for biliary ascariasis. Four patients presented with acute cholangitis, eight with acute abdominal pain and vomiting, and the remaining two were diagnosed incidentally during surgery for gallstone disease. Barring these two patients, ultrasound examination of the abdomen diagnosed the condition accurately. In 10 patients, a part of the worm was visible outside the papilla of Vater. The roundworm was caught in a Dormia basket and could be extracted in nine patients. In one patient the worm migrated inside the bile duct while it was being caught in a Dormia basket. In this and two other patients, in whom the worm had migrated completely inside the bile duct, worms were removed with the help of a Dormia basket after endoscopic sphincterotomy. There were no complications of endoscopic therapy. In the two patients in whom biliary ascariasis was detected during surgery, the worms were removed after choledocholithotomy. On a mean follow-up of 13.8 months, only one patient had a recurrence of biliary ascariasis. It is concluded that biliary ascariasis is not an uncommon disease and must be considered as a possibility in patients presenting with acute cholangitis and biliary pain even in a non-endemic area. Ultrasonography is an excellent diagnostic tool and endoscopic management is very effective and safe in the treatment of these patients.  (+info)

Preoperative versus postoperative endoscopic retrograde cholangiopancreatography in mild to moderate gallstone pancreatitis: a prospective randomized trial. (5/201)

OBJECTIVE: To determine whether endoscopic retrograde cholangiopancreatography (ERCP) and common bile duct (CBD) stone extraction should be performed routinely before surgery or'selectively after surgery in patients with mild to moderate gallstone pancreatitis. SUMMARY BACKGROUND DATA: The role and timing of ERCP in mild to moderate gallstone pancreatitis remains controversial. Routine preoperative ERCP identifies persisting CBD stones but carries risks of complications and may delay definitive care. Selective postoperative ERCP, performed only if a CBD stone is seen on intraoperative cholangiography (IOC), avoids unnecessary ERCP but risks unsuccessful stone extraction. METHODS: A prospective, randomized study of consecutive patients with gallstone pancreatitis was conducted. Using previously determined criteria, patients with acute cholangitis or necrotizing pancreatitis were excluded. Patients considered at high risk for persisting CBD stones (CBD size > or =8 mm on admission ultrasound, serum total bilirubin > or = 1.7 mg/dL, or serum amylase > or = 150 U/L on hospital day 4) were randomly assigned to routine preoperative ERCP followed by laparoscopic cholecystectomy, or laparoscopic cholecystectomy with selective postoperative ERCP and endoscopic sphincterotomy only if a CBD stone was present on IOC. Primary end points were costs, length of hospital stay, and the combined treatment failure rates (failure of diagnostic ERCP and IOC, complications of ERCP and endoscopic sphincterotomy, and complications of surgery). RESULTS: One hundred fifty-four consecutive patients with gallstone pancreatitis were evaluated prospectively for study eligibility. Sixty patients met the randomization criteria. Thirty patients were randomized to routine preoperative ERCP and 29 patients to selective postoperative ERCP (1 patient refused). Age, admission laboratory values, and APACHE II and Imrie scores were similar in both groups. By protocol, ERCP was performed in all patients in the preoperative ERCP group. In the postoperative ERCP group, ERCP was necessary in only 7 of 29 patients (24%). Mean hospital stay was significantly longer in the routine preoperative ERCP group (11.7 days) than in the selective postoperative ERCP group (9.0 days). Mean total cost was higher in the preoperative ERCP group ($9,426) than in the postoperative ERCP group ($7,798). The combined treatment failure rate was 10% in both groups. CONCLUSIONS: In patients with mild to moderate gallstone pancreatitis without cholangitis, selective postoperative ERCP and CBD stone extraction is associated with a shorter hospital stay, less cost, no increase in combined treatment failure rate, and significant reduction in ERCP use compared with routine preoperative ERCP.  (+info)

Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. (6/201)

OBJECTIVE: To evaluate the authors' experience with periduodenal perforations to define a systematic management approach. SUMMARY BACKGROUND DATA: Traditionally, traumatic and atraumatic duodenal perforations have been managed surgically; however, in the last decade, management has shifted toward a more selective approach. Some authors advocate routine nonsurgical management, but the reported death rate of medical treatment failures is almost 50%. Others advocate mandatory surgical exploration. Those who favor a selective approach have not elaborated distinct management guidelines. METHODS: A retrospective chart review at the authors' medical center from June 1993 to June 1998 identified 14 instances of periduodenal perforation related to endoscopic retrograde cholangiopancreatography (ERCP), a rate of 1.0%. Charts were reviewed for the following parameters: ERCP findings, clinical presentation of perforation, diagnostic methods, time to diagnosis, radiographic extent and location of duodenal leak, methods of management, surgical procedures, complications, length of stay, and outcome. RESULTS: Fourteen patients had a periduodenal perforation. Eight patients were initially managed conservatively. Five of the eight patients recovered without incident. Three patients failed nonsurgical management and required extensive procedures with long hospital stays and one death. Six patients were managed initially by surgery, with one death. Each injury was evaluated for location and radiographic extent of leak and classified into types I through IV. CONCLUSIONS: Clinical and radiographic features of ERCP-related periduodenal perforations can be used to stratify patients into surgical or nonsurgical cohorts. A selective management scheme is proposed based on the features of each type.  (+info)

Extrahepatic biliary obstruction due to post-laparoscopic cholecystectomy biloma. (7/201)

BACKGROUND: Jaundice presenting after cholecystectomy may be the initial manifestation of a serious surgical misadventure and requires rigorous diagnostic pursuit and therapeutic intervention. Biloma is a well recognized postcholecystectomy complication that often accompanies biliary ductal injury. CASE REPORT: A 23-year-old female underwent laparoscopic cholecystectomy for symptomatic gallstones and three weeks postoperatively developed painless jaundice. Radiographic and endoscopic studies revealed a subhepatic biloma causing extrinsic compression and obstruction of the common hepatic duct. RESULTS: Percutaneous catheter drainage of the biloma combined with endoscopic sphincterotomy successfully relieved the extrahepatic biliary obstruction and resolved the intrahepatic ductal leak responsible for the biloma. CONCLUSION: Although heretofore undescribed, postcholecystectomy jaundice due to extrahepatic bile duct obstruction caused by biloma may occur and can be successfully treated by means of standard radiologic and endoscopic interventions.  (+info)

Endoscopic injection of botulinum toxin in patients with recurrent acute pancreatitis due to pancreatic sphincter of Oddi dysfunction. (8/201)

AIM: To evaluate the technical feasibility, safety, and short-term efficacy of botulinum toxin injection for pancreatic sphincter of Oddi dysfunction and to analyse whether the symptomatic response to botulinum toxin might be a predictor of outcome for endoscopic sphincterotomy. METHODS: Fifteen consecutive patients (nine female, aged 38 +/- 12 years) with frequent attacks (median four) of acute pancreatitis within 6 months, and manometrically proven pancreatic sphincter of Oddi dysfunction underwent endoscopic injection of 100 units of botulinum toxin into the major papilla. All patients underwent prospective follow-up thereafter and in cases of recurrent pancreatitis manometry this was repeated and pancreatic sphincterotomy was performed. RESULTS: No side-effects occurred after botulinum toxin injection in any patient. Within 3 months after botulinum toxin treatment, 12 out of 15 patients remained asymptomatic (80% primary response). Only one out of three patients without symptomatic benefit showed continued elevated pancreatic sphincter pressure at manometry and only this patient benefited from pancreatic sphincterotomy later on. Eleven of the 12 patients initially responding to botulinum toxin injection developed a symptomatic relapse 6 +/- 2 months after botulinum toxin treatment. These patients then achieved long-term clinical remission from pancreatic or combined (biliary and pancreatic, n=5) sphincterotomy (median follow-up, 15 months). CONCLUSION: Endoscopic botulinum toxin injection into the papilla of Vater is a safe procedure for treatment of pancreatic sphincter of Oddi dysfunction that may provide short-term relief in about 80% of the patients. Those patients who respond to botulinum toxin may subsequently gain definitive cure from sphincterotomy.  (+info)

Endoscopic sphincterotomy is a medical procedure that involves the use of an endoscope (a flexible tube with a light and camera) to cut the papilla of Vater, which contains the sphincter of Oddi muscle. This procedure is typically performed to treat gallstones or to manage other conditions related to the bile ducts or pancreatic ducts.

The sphincterotomy helps to widen the opening of the papilla, allowing stones or other obstructions to pass through more easily. It may also be used to relieve pressure and pain caused by spasms of the sphincter of Oddi muscle. The procedure is usually done under sedation or anesthesia and carries a risk of complications such as bleeding, infection, perforation, and pancreatitis.

Transhepatic sphincterotomy is a medical procedure that involves the incision or cutting of the papilla of Vater, which is a small muscular structure located at the junction of the common bile duct and the main pancreatic duct, with the ampulla of Vater, within the second part of the duodenum. This procedure is performed using a special type of endoscope that is passed through the liver (transhepatically) to access the bile ducts.

The goal of transhepatic sphincterotomy is to relieve obstructions or blockages in the bile ducts, such as gallstones or tumors, that cannot be removed using other endoscopic techniques. This procedure is typically performed by an interventional radiologist or a gastroenterologist with specialized training in endoscopic retrograde cholangiopancreatography (ERCP).

Transhepatic sphincterotomy is considered a higher-risk procedure than traditional ERCP sphincterotomy due to the need for liver puncture and the potential complications associated with this approach, including bleeding, infection, and injury to surrounding organs. However, it may be necessary in certain situations where traditional ERCP is not feasible or has failed.

The Sphincter of Oddi is a muscular valve that controls the flow of bile and pancreatic juice from the pancreatic and bile ducts into the duodenum, which is the first part of the small intestine. It is named after Ruggero Oddi, an Italian physiologist who discovered it in 1887. The Sphincter of Oddi has two parts: the sphincter papillae, which surrounds the common opening of the pancreatic and bile ducts into the duodenum, and the sphincter choledochus, which is located more proximally in the bile duct. The contraction and relaxation of these muscles help regulate the release of digestive enzymes from the pancreas and the flow of bile from the liver to aid in digestion.

A fissure in ano, also known as anal fissure, is a linear tear or split in the lining of the anus, usually occurring in the posterior midline. It can cause pain and bleeding during bowel movements. Anal fissures are often caused by constipation, passing hard stools, or prolonged diarrhea. They can also be associated with underlying conditions such as inflammatory bowel disease or anal cancer. Treatment typically involves increasing fiber intake, using stool softeners, and topical treatments to promote healing and relieve pain. In some cases, surgery may be required for severe or chronic fissures that do not respond to conservative treatment.

Gallstones are small, hard deposits that form in the gallbladder, a small organ located under the liver. They can range in size from as small as a grain of sand to as large as a golf ball. Gallstones can be made of cholesterol, bile pigments, or calcium salts, or a combination of these substances.

There are two main types of gallstones: cholesterol stones and pigment stones. Cholesterol stones are the most common type and are usually yellow-green in color. They form when there is too much cholesterol in the bile, which causes it to become saturated and form crystals that eventually grow into stones. Pigment stones are smaller and darker in color, ranging from brown to black. They form when there is an excess of bilirubin, a waste product produced by the breakdown of red blood cells, in the bile.

Gallstones can cause symptoms such as abdominal pain, nausea, vomiting, and bloating, especially after eating fatty foods. In some cases, gallstones can lead to serious complications, such as inflammation of the gallbladder (cholecystitis), infection, or blockage of the bile ducts, which can cause jaundice, a yellowing of the skin and eyes.

The exact cause of gallstones is not fully understood, but risk factors include being female, older age, obesity, a family history of gallstones, rapid weight loss, diabetes, and certain medical conditions such as cirrhosis or sickle cell anemia. Treatment for gallstones may involve medication to dissolve the stones, shock wave therapy to break them up, or surgery to remove the gallbladder.

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that combines upper gastrointestinal (GI) endoscopy and fluoroscopy to diagnose and treat certain problems of the bile ducts and pancreas.

During ERCP, a flexible endoscope (a long, thin, lighted tube with a camera on the end) is passed through the patient's mouth and throat, then through the stomach and into the first part of the small intestine (duodenum). A narrow plastic tube (catheter) is then inserted through the endoscope and into the bile ducts and/or pancreatic duct. Contrast dye is injected through the catheter, and X-rays are taken to visualize the ducts.

ERCP can be used to diagnose a variety of conditions affecting the bile ducts and pancreas, including gallstones, tumors, strictures (narrowing of the ducts), and chronic pancreatitis. It can also be used to treat certain conditions, such as removing gallstones from the bile duct or placing stents to keep the ducts open in cases of stricture.

ERCP is an invasive procedure that carries a risk of complications, including pancreatitis, infection, bleeding, and perforation (a tear in the lining of the GI tract). It should only be performed by experienced medical professionals in a hospital setting.

Common bile duct diseases refer to conditions that affect the common bile duct, a tube that carries bile from the liver and gallbladder into the small intestine. Some common examples of common bile duct diseases include:

1. Choledocholithiasis: This is the presence of stones (calculi) in the common bile duct, which can cause blockage, inflammation, and infection.
2. Cholangitis: This is an infection or inflammation of the common bile duct, often caused by obstruction due to stones, tumors, or strictures.
3. Common bile duct cancer (cholangiocarcinoma): This is a rare but aggressive cancer that arises from the cells lining the common bile duct.
4. Biliary strictures: These are narrowing or scarring of the common bile duct, which can be caused by injury, inflammation, or surgery.
5. Benign tumors: Non-cancerous growths in the common bile duct can also cause blockage and other symptoms.

Symptoms of common bile duct diseases may include abdominal pain, jaundice (yellowing of the skin and eyes), fever, chills, nausea, vomiting, and dark urine or light-colored stools. Treatment depends on the specific condition and severity but may include medications, endoscopic procedures, surgery, or a combination of these approaches.

The ampulla of Vater, also known as hepatopancreatic ampulla, is a dilated portion of the common bile duct where it joins the main pancreatic duct and empties into the second part of the duodenum. It serves as a conduit for both bile from the liver and digestive enzymes from the pancreas to reach the small intestine, facilitating the digestion and absorption of nutrients. The ampulla of Vater is surrounded by a muscular sphincter, the sphincter of Oddi, which controls the flow of these secretions into the duodenum.

Choledocholithiasis is a medical condition characterized by the presence of one or more gallstones in the common bile duct, which is the tube that carries bile from the liver and gallbladder to the small intestine. Bile is a digestive fluid produced by the liver that helps break down fats in the small intestine. Gallstones are hardened deposits of digestive fluids that can form in the gallbladder or, less commonly, in the bile ducts.

Choledocholithiasis can cause a variety of symptoms, including abdominal pain, jaundice (yellowing of the skin and eyes), nausea, vomiting, and fever. If left untreated, it can lead to serious complications such as infection or inflammation of the bile ducts or pancreas, which can be life-threatening.

The condition is typically diagnosed through imaging tests such as ultrasound, CT scan, or MRI, and may require endoscopic or surgical intervention to remove the gallstones from the common bile duct.

Cholecystectomy is a medical procedure to remove the gallbladder, a small pear-shaped organ located on the right side of the abdomen, just beneath the liver. The primary function of the gallbladder is to store and concentrate bile, a digestive fluid produced by the liver. During a cholecystectomy, the surgeon removes the gallbladder, usually due to the presence of gallstones or inflammation that can cause pain, infection, or other complications.

There are two primary methods for performing a cholecystectomy:

1. Open Cholecystectomy: In this traditional surgical approach, the surgeon makes an incision in the abdomen to access and remove the gallbladder. This method is typically used when there are complications or unique circumstances that make laparoscopic surgery difficult or risky.
2. Laparoscopic Cholecystectomy: This is a minimally invasive surgical procedure where the surgeon makes several small incisions in the abdomen, through which a thin tube with a camera (laparoscope) and specialized surgical instruments are inserted. The surgeon then guides these tools to remove the gallbladder while viewing the internal structures on a video monitor.

After the gallbladder is removed, bile flows directly from the liver into the small intestine through the common bile duct, and the body continues to function normally without any significant issues.

Duodenoscopy is a medical procedure that involves the insertion of a duodenoscope, which is a flexible, lighted tube with a camera and tiny tools on the end, through the mouth and down the throat to examine the upper part of the small intestine (duodenum) and the opening of the bile and pancreatic ducts.

During the procedure, the doctor can take tissue samples for biopsy, remove polyps or other abnormal growths, or perform other interventions as needed. Duodenoscopy is commonly used to diagnose and treat conditions such as gastrointestinal bleeding, inflammation, infection, and cancer.

It's important to note that duodenoscopes have been associated with the spread of antibiotic-resistant bacteria in some cases, so healthcare providers must follow strict cleaning and disinfection protocols to minimize this risk.

The common bile duct is a duct that results from the union of the cystic duct (which drains bile from the gallbladder) and the common hepatic duct (which drains bile from the liver). The common bile duct transports bile, a digestive enzyme, from the liver and gallbladder to the duodenum, which is the first part of the small intestine.

The common bile duct runs through the head of the pancreas before emptying into the second part of the duodenum, either alone or in conjunction with the pancreatic duct, via a small opening called the ampulla of Vater. The common bile duct plays a crucial role in the digestion of fats by helping to break them down into smaller molecules that can be absorbed by the body.

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).

Bile duct diseases refer to a group of medical conditions that affect the bile ducts, which are tiny tubes that carry bile from the liver to the gallbladder and small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are several types of bile duct diseases, including:

1. Choledocholithiasis: This occurs when stones form in the common bile duct, causing blockage and leading to symptoms such as abdominal pain, jaundice, and fever.
2. Cholangitis: This is an infection of the bile ducts that can cause inflammation, pain, and fever. It can occur due to obstruction of the bile ducts or as a complication of other medical procedures.
3. Primary Biliary Cirrhosis (PBC): This is a chronic autoimmune disease that affects the bile ducts in the liver, causing inflammation and scarring that can lead to cirrhosis and liver failure.
4. Primary Sclerosing Cholangitis (PSC): This is another autoimmune disease that causes inflammation and scarring of the bile ducts, leading to liver damage and potential liver failure.
5. Bile Duct Cancer: Also known as cholangiocarcinoma, this is a rare form of cancer that affects the bile ducts and can cause jaundice, abdominal pain, and weight loss.
6. Benign Strictures: These are narrowing of the bile ducts that can occur due to injury, inflammation, or surgery, leading to blockage and potential infection.

Symptoms of bile duct diseases may include jaundice, abdominal pain, fever, itching, dark urine, and light-colored stools. Treatment depends on the specific condition and may involve medication, surgery, or other medical interventions.

Biliary tract diseases refer to a group of medical conditions that affect the biliary system, which includes the gallbladder, bile ducts, and liver. Bile is a digestive juice produced by the liver, stored in the gallbladder, and released into the small intestine through the bile ducts to help digest fats.

Biliary tract diseases can cause various symptoms such as abdominal pain, jaundice, fever, nausea, vomiting, and changes in stool color. Some of the common biliary tract diseases include:

1. Gallstones: Small, hard deposits that form in the gallbladder or bile ducts made up of cholesterol or bilirubin.
2. Cholecystitis: Inflammation of the gallbladder, often caused by gallstones.
3. Cholangitis: Infection or inflammation of the bile ducts.
4. Biliary dyskinesia: A motility disorder that affects the contraction and relaxation of the muscles in the biliary system.
5. Primary sclerosing cholangitis: A chronic autoimmune disease that causes scarring and narrowing of the bile ducts.
6. Biliary tract cancer: Rare cancers that affect the gallbladder, bile ducts, or liver.

Treatment for biliary tract diseases varies depending on the specific condition and severity but may include medications, surgery, or a combination of both.

Cholangitis is a medical condition characterized by inflammation of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are two types of cholangitis: acute and chronic. Acute cholangitis is a sudden and severe infection that can cause symptoms such as abdominal pain, fever, jaundice (yellowing of the skin and eyes), and dark urine. It is usually caused by a bacterial infection that enters the bile ducts through a blockage or obstruction.

Chronic cholangitis, on the other hand, is a long-term inflammation of the bile ducts that can lead to scarring and narrowing of the ducts. This can cause symptoms such as abdominal pain, itching, and jaundice. Chronic cholangitis can be caused by various factors, including primary sclerosing cholangitis (an autoimmune disease), bile duct stones, or tumors in the bile ducts.

Treatment for cholangitis depends on the underlying cause of the condition. Antibiotics may be used to treat bacterial infections, and surgery may be necessary to remove blockages or obstructions in the bile ducts. In some cases, medications may be prescribed to manage symptoms and prevent further complications.

Sphincter of Oddi dysfunction (SOD) is a condition characterized by abnormalities in the functioning of the Sphincter of Oddi, which is a muscular valve that controls the flow of bile and pancreatic juice from the pancreas and gallbladder into the duodenum (the first part of the small intestine).

In SOD, the sphincter may either fail to relax properly or become overactive, leading to a variety of symptoms such as abdominal pain, nausea, vomiting, bloating, and elevated liver enzymes. The condition can be classified into two types: Type I, which is associated with elevated liver enzymes and/or pancreatic enzymes, and Type II, which is characterized by abdominal pain without biochemical abnormalities.

The diagnosis of SOD typically involves a series of tests such as manometry (measuring the pressure inside the sphincter), endoscopic ultrasound, or magnetic resonance cholangiopancreatography (MRCP) to visualize the anatomy and function of the sphincter. Treatment options may include medications to relax the sphincter, endoscopic therapy to cut or stretch the muscle, or surgery in severe cases.

Dilation, also known as dilatation, refers to the process of expanding or enlarging a body passage or cavity. In medical terms, it typically refers to the widening of a bodily opening or hollow organ, allowing for increased flow or access. This can occur naturally, such as during childbirth when the cervix dilates to allow for the passage of a baby, or it can be induced through medical procedures or interventions.

For example, dilation of the pupils is a natural response to darkness or certain medications, while dilation of blood vessels is a common side effect of some drugs and can also occur in response to changes in temperature or emotional state. Dilation of the stomach or intestines may be necessary for medical procedures such as endoscopies or surgeries.

It's important to note that dilation can also refer to the abnormal enlargement of a body part, such as dilated cardiomyopathy, which refers to an enlarged and weakened heart muscle.

Endoscopy is a medical procedure that involves the use of an endoscope, which is a flexible tube with a light and camera at the end, to examine the interior of a body cavity or organ. The endoscope is inserted through a natural opening in the body, such as the mouth or anus, or through a small incision. The images captured by the camera are transmitted to a monitor, allowing the physician to visualize the internal structures and detect any abnormalities, such as inflammation, ulcers, or tumors. Endoscopy can also be used for diagnostic purposes, such as taking tissue samples for biopsy, or for therapeutic purposes, such as removing polyps or performing minimally invasive surgeries.

Pancreatitis is a medical condition characterized by inflammation of the pancreas, a gland located in the abdomen that plays a crucial role in digestion and regulating blood sugar levels. The inflammation can be acute (sudden and severe) or chronic (persistent and recurring), and it can lead to various complications if left untreated.

Acute pancreatitis often results from gallstones or excessive alcohol consumption, while chronic pancreatitis may be caused by long-term alcohol abuse, genetic factors, autoimmune conditions, or metabolic disorders like high triglyceride levels. Symptoms of acute pancreatitis include severe abdominal pain, nausea, vomiting, fever, and increased heart rate, while chronic pancreatitis may present with ongoing abdominal pain, weight loss, diarrhea, and malabsorption issues due to impaired digestive enzyme production. Treatment typically involves supportive care, such as intravenous fluids, pain management, and addressing the underlying cause. In severe cases, hospitalization and surgery may be necessary.

The anal canal is the terminal portion of the digestive tract, located between the rectum and the anus. It is a short tube-like structure that is about 1 to 1.5 inches long in adults. The main function of the anal canal is to provide a seal for the elimination of feces from the body while also preventing the leakage of intestinal contents.

The inner lining of the anal canal is called the mucosa, which is kept moist by the production of mucus. The walls of the anal canal contain specialized muscles that help control the passage of stool during bowel movements. These muscles include the internal and external sphincters, which work together to maintain continence and allow for the voluntary release of feces.

The anal canal is an important part of the digestive system and plays a critical role in maintaining bowel function and overall health.

Hemorrhoids are swollen veins in the rectum or anus that can cause pain, itching, bleeding, and bulging. They can be internal (inside the rectum) or external (under the skin around the anus). Internal hemorrhoids may protrude through the anus and become irritated, leading to bleeding. External hemorrhoids are more likely to cause pain and swelling, especially if they become thrombosed (formed a blood clot). Hemorrhoids can be caused by straining during bowel movements, pregnancy, obesity, chronic constipation or diarrhea, aging, and sitting for long periods of time. They are often treated with over-the-counter creams, suppositories, or warm sitz baths, but severe cases may require surgical intervention.

Cholecystolithiasis is the medical term for the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located under the liver that stores and concentrates 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, become concentrated and crystallize.

Gallstones can vary in size, from tiny grains of sand to large stones several centimeters in diameter. Some people may have a single gallstone, while others may have many. Gallstones may cause no symptoms at all, but if they block the flow of bile out of the gallbladder, they can cause pain, inflammation, and infection.

Symptoms of cholecystolithiasis may include abdominal pain, often in the upper right or center of the abdomen, that may be sharp or crampy and may occur after eating fatty foods. Other symptoms may include nausea, vomiting, fever, and chills. If gallstones are left untreated, they can lead to serious complications such as cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or cholangitis (infection of the bile ducts). Treatment for cholecystolithiasis may include medication to dissolve the gallstones, shock wave lithotripsy to break up the stones, or surgery to remove the gallbladder.

Neurogenic bladder is a term used to describe bladder dysfunction due to neurological damage or disease. The condition can result in problems with bladder storage and emptying, leading to symptoms such as urinary frequency, urgency, hesitancy, incontinence, and retention.

Neurogenic bladder can occur due to various medical conditions, including spinal cord injury, multiple sclerosis, Parkinson's disease, diabetic neuropathy, and stroke. The damage to the nerves that control bladder function can result in overactivity or underactivity of the bladder muscle, leading to urinary symptoms.

Management of neurogenic bladder typically involves a multidisciplinary approach, including medications, bladder training, catheterization, and surgery in some cases. The specific treatment plan depends on the underlying cause of the condition and the severity of the symptoms.

Manometry is a medical test that measures pressure inside various parts of the gastrointestinal tract. It is often used to help diagnose digestive disorders such as achalasia, gastroparesis, and irritable bowel syndrome. During the test, a thin, flexible tube called a manometer is inserted through the mouth or rectum and into the area being tested. The tube is connected to a machine that measures and records pressure readings. These readings can help doctors identify any abnormalities in muscle function or nerve reflexes within the digestive tract.

Technetium Tc 99m Lidofenin is a radiopharmaceutical used in nuclear medicine imaging procedures, specifically for hepatobiliary scintigraphy. It is a technetium-labeled compound, where the radioisotope technetium-99m (^99m^Tc) is bound to lidofenin, a liver-imaging agent.

The compound is used to assess the function and anatomy of the liver, gallbladder, and biliary system. After intravenous administration, Technetium Tc 99m Lidofenin is taken up by hepatocytes (liver cells) and excreted into the bile ducts and ultimately into the small intestine. The distribution and excretion of this radiopharmaceutical can be monitored using a gamma camera, providing functional information about the liver and biliary system.

It is essential to note that the use of Technetium Tc 99m Lidofenin should be under the guidance and supervision of healthcare professionals trained in nuclear medicine, as its administration and handling require specific expertise and safety measures due to the radioactive nature of the compound.

Hyperamylasemia is a medical condition characterized by an elevated level of amylase in the blood. Amylase is an enzyme that is primarily produced by the pancreas and salivary glands, and it plays a crucial role in digesting carbohydrates.

Normally, the levels of amylase in the blood are relatively low, but when there is damage to the pancreas or salivary glands, such as in cases of pancreatitis, salivary gland inflammation, or blockage, the levels of amylase can rise significantly. This condition is called hyperamylasemia.

Mild elevations in amylase levels may not cause any symptoms and may be discovered only during routine blood tests. However, more significant elevations can indicate a serious underlying medical condition that requires prompt treatment. Symptoms of hyperamylasemia may include abdominal pain, nausea, vomiting, fever, and rapid heartbeat.

It is important to note that hyperamylasemia can also be caused by non-pancreatic conditions such as macroamylasemia, a benign condition where large amylase-containing protein complexes are formed and circulate in the bloodstream, leading to elevated amylase levels. Therefore, it is essential to perform further diagnostic tests to determine the underlying cause of hyperamylasemia.

Laparoscopic cholecystectomy is a surgical procedure to remove the gallbladder using a laparoscope, a thin tube with a camera, which allows the surgeon to view the internal structures on a video monitor. The surgery is performed through several small incisions in the abdomen, rather than a single large incision used in open cholecystectomy. This approach results in less postoperative pain, fewer complications, and shorter recovery time compared to open cholecystectomy.

The procedure is typically indicated for symptomatic gallstones or chronic inflammation of the gallbladder (cholecystitis), which can cause severe abdominal pain, nausea, vomiting, and fever. Laparoscopic cholecystectomy has become the standard of care for gallbladder removal due to its minimally invasive nature and excellent outcomes.

A biliary fistula is an abnormal connection or passage between the biliary system (which includes the gallbladder, bile ducts, and liver) and another organ or structure, usually in the abdominal cavity. This connection allows bile, which is a digestive fluid produced by the liver, to leak out of its normal pathway and into other areas of the body.

Biliary fistulas can occur as a result of trauma, surgery, infection, or inflammation in the biliary system. Symptoms may include abdominal pain, fever, jaundice (yellowing of the skin and eyes), nausea, vomiting, and clay-colored stools. Treatment typically involves addressing the underlying cause of the fistula, such as draining an infection or repairing damaged tissue, and diverting bile flow away from the site of the leak. In some cases, surgery may be necessary to repair the fistula.

Gallbladder emptying refers to the process by which the gallbladder releases bile into the small intestine through the bile duct. The gallbladder is a small pear-shaped organ that stores and concentrates bile, a digestive fluid produced by the liver. After eating, especially when fatty or greasy foods are consumed, the hormone cholecystokinin (CCK) is released into the bloodstream, which stimulates the contraction of the gallbladder and relaxation of the sphincter of Oddi, a muscle that controls the opening and closing of the bile duct. This allows the concentrated bile to flow from the gallbladder into the small intestine, where it helps break down fats for absorption.

Gallbladder emptying can be assessed through various diagnostic tests, such as ultrasound or cholescintigraphy (also known as a HIDA scan), which measures the rate and degree of gallbladder emptying in response to CCK stimulation. Abnormalities in gallbladder emptying can contribute to conditions such as gallstones, biliary dyskinesia, and other functional gallbladder disorders.

Catheterization is a medical procedure in which a catheter (a flexible tube) is inserted into the body to treat various medical conditions or for diagnostic purposes. The specific definition can vary depending on the area of medicine and the particular procedure being discussed. Here are some common types of catheterization:

1. Urinary catheterization: This involves inserting a catheter through the urethra into the bladder to drain urine. It is often performed to manage urinary retention, monitor urine output in critically ill patients, or assist with surgical procedures.
2. Cardiac catheterization: A procedure where a catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the heart. This allows for various diagnostic tests and treatments, such as measuring pressures within the heart chambers, assessing blood flow, or performing angioplasty and stenting of narrowed coronary arteries.
3. Central venous catheterization: A catheter is inserted into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, or nutrition, or to monitor central venous pressure.
4. Peritoneal dialysis catheterization: A catheter is placed into the abdominal cavity for individuals undergoing peritoneal dialysis, a type of kidney replacement therapy.
5. Neurological catheterization: In some cases, a catheter may be inserted into the cerebrospinal fluid space (lumbar puncture) or the brain's ventricular system (ventriculostomy) to diagnose or treat various neurological conditions.

These are just a few examples of catheterization procedures in medicine. The specific definition and purpose will depend on the medical context and the particular organ or body system involved.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Surgical instruments are specialized tools or devices that are used by medical professionals during surgical procedures to assist in various tasks such as cutting, dissecting, grasping, holding, retracting, clamping, and suturing body tissues. These instruments are designed to be safe, precise, and effective, with a variety of shapes, sizes, and materials used depending on the specific surgical application. Some common examples of surgical instruments include scalpels, forceps, scissors, hemostats, retractors, and needle holders. Proper sterilization and maintenance of these instruments are crucial to ensure patient safety and prevent infection.

Extrahepatic cholestasis is a medical condition characterized by the impaired flow of bile outside of the liver. Bile is a digestive fluid produced by the liver that helps in the absorption and digestion of fats. When the flow of bile is obstructed or blocked, it can lead to an accumulation of bile components, such as bilirubin, in the bloodstream, resulting in jaundice, dark urine, light-colored stools, and itching.

Extrahepatic cholestasis can be caused by various factors, including gallstones, tumors, strictures, or inflammation of the bile ducts. It is essential to diagnose and treat extrahepatic cholestasis promptly to prevent further complications, such as liver damage or infection. Treatment options may include medications, endoscopic procedures, or surgery, depending on the underlying cause of the condition.

Pancreatic diseases refer to a group of medical conditions that affect the structure and function of the pancreas, a vital organ located in the abdomen. The pancreas has two main functions: an exocrine function, which involves the production of digestive enzymes that help break down food in the small intestine, and an endocrine function, which involves the production of hormones such as insulin and glucagon that regulate blood sugar levels.

Pancreatic diseases can be broadly classified into two categories: inflammatory and non-inflammatory. Inflammatory pancreatic diseases include conditions such as acute pancreatitis, which is characterized by sudden inflammation of the pancreas, and chronic pancreatitis, which is a long-term inflammation that can lead to scarring and loss of function.

Non-inflammatory pancreatic diseases include conditions such as pancreatic cancer, which is a malignant tumor that can arise from the cells of the pancreas, and benign tumors such as cysts or adenomas. Other non-inflammatory conditions include pancreatic insufficiency, which can occur when the pancreas does not produce enough digestive enzymes, and diabetes mellitus, which can result from impaired insulin production or action.

Overall, pancreatic diseases can have serious consequences on a person's health and quality of life, and early diagnosis and treatment are essential for optimal outcomes.

Lithotripsy is a medical procedure that uses shock waves or other high-energy sound waves to break down and remove calculi (stones) in the body, particularly in the kidneys, ureters, or gallbladder. The procedure is typically performed on an outpatient basis and does not require any incisions.

During lithotripsy, the patient lies on a cushioned table while a lithotripter, a device that generates shock waves, is positioned around the area of the stone. As the shock waves pass through the body, they break the stone into tiny fragments that can then be easily passed out of the body in urine.

Lithotripsy is generally a safe and effective procedure, but it may not be suitable for everyone. Patients with certain medical conditions, such as bleeding disorders or pregnancy, may not be able to undergo lithotripsy. Additionally, some stones may be too large or too dense to be effectively treated with lithotripsy. In these cases, other treatment options, such as surgery, may be necessary.

Cholangiography is a medical procedure that involves taking X-ray images of the bile ducts (the tubes that carry bile from the liver to the small intestine). This is typically done by injecting a contrast dye into the bile ducts through an endoscope or a catheter that has been inserted into the body.

There are several types of cholangiography, including:

* Endoscopic retrograde cholangiopancreatography (ERCP): This procedure involves inserting an endoscope through the mouth and down the throat into the small intestine. A dye is then injected into the bile ducts through a small tube that is passed through the endoscope.
* Percutaneous transhepatic cholangiography (PTC): This procedure involves inserting a needle through the skin and into the liver to inject the contrast dye directly into the bile ducts.
* Operative cholangiography: This procedure is performed during surgery to examine the bile ducts for any abnormalities or blockages.

Cholangiography can help diagnose a variety of conditions that affect the bile ducts, such as gallstones, tumors, or inflammation. It can also be used to guide treatment decisions, such as whether surgery is necessary to remove a blockage.

Duodenal diseases refer to a range of medical conditions that affect the duodenum, which is the first part of the small intestine. Here are some examples of duodenal diseases:

1. Duodenitis: This is inflammation of the duodenum, which can cause symptoms such as abdominal pain, nausea, vomiting, and bloating. Duodenitis can be caused by bacterial or viral infections, excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), or chronic inflammation due to conditions like Crohn's disease.
2. Peptic ulcers: These are sores that develop in the lining of the duodenum, usually as a result of infection with Helicobacter pylori bacteria or long-term use of NSAIDs. Symptoms can include abdominal pain, bloating, and heartburn.
3. Duodenal cancer: This is a rare type of cancer that affects the duodenum. Symptoms can include abdominal pain, weight loss, and blood in the stool.
4. Celiac disease: This is an autoimmune disorder that causes the immune system to attack the lining of the small intestine in response to gluten, a protein found in wheat, barley, and rye. This can lead to inflammation and damage to the duodenum.
5. Duodenal diverticulosis: This is a condition in which small pouches form in the lining of the duodenum. While many people with duodenal diverticulosis do not experience symptoms, some may develop complications such as inflammation or infection.
6. Duodenal atresia: This is a congenital condition in which the duodenum does not form properly, leading to blockage of the intestine. This can cause symptoms such as vomiting and difficulty feeding in newborns.

A diverticulum is a small sac or pouch that forms as a result of a weakness in the wall of a hollow organ, such as the intestine. These sacs can become inflamed or infected, leading to conditions like diverticulitis. Diverticula are common in the large intestine, particularly in the colon, and are more likely to develop with age. They are usually asymptomatic but can cause symptoms such as abdominal pain, bloating, constipation, or diarrhea if they become inflamed or infected.

Bile ducts are tubular structures that carry bile from the liver to the gallbladder for storage or directly to the small intestine to aid in digestion. There are two types of bile ducts: intrahepatic and extrahepatic. Intrahepatic bile ducts are located within the liver and drain bile from liver cells, while extrahepatic bile ducts are outside the liver and include the common hepatic duct, cystic duct, and common bile duct. These ducts can become obstructed or inflamed, leading to various medical conditions such as cholestasis, cholecystitis, and gallstones.

The digestive system is a series of organs that work together to convert food into nutrients and energy. Digestive system surgical procedures involve operations on any part of the digestive system, including the esophagus, stomach, small intestine, large intestine, liver, pancreas, and gallbladder. These procedures can be performed for a variety of reasons, such as to treat diseases, repair damage, or remove cancerous growths.

Some common digestive system surgical procedures include:

1. Gastric bypass surgery: A procedure in which the stomach is divided into two parts and the smaller part is connected directly to the small intestine, bypassing a portion of the stomach and upper small intestine. This procedure is used to treat severe obesity.
2. Colonoscopy: A procedure in which a flexible tube with a camera on the end is inserted into the rectum and colon to examine the lining for polyps, cancer, or other abnormalities.
3. Colectomy: A procedure in which all or part of the colon is removed, often due to cancer, inflammatory bowel disease, or diverticulitis.
4. Gastrostomy: A procedure in which a hole is made through the abdominal wall and into the stomach to create an opening for feeding. This is often done for patients who have difficulty swallowing.
5. Esophagectomy: A procedure in which all or part of the esophagus is removed, often due to cancer. The remaining esophagus is then reconnected to the stomach or small intestine.
6. Liver resection: A procedure in which a portion of the liver is removed, often due to cancer or other diseases.
7. Pancreatectomy: A procedure in which all or part of the pancreas is removed, often due to cancer or chronic pancreatitis.
8. Cholecystectomy: A procedure in which the gallbladder is removed, often due to gallstones or inflammation.

These are just a few examples of digestive system surgical procedures. There are many other types of operations that can be performed on the digestive system depending on the specific needs and condition of each patient.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

An ointment is a semi-solid preparation, typically composed of a mixture of medicinal substance with a base, which is usually greasy or oily. The purpose of the base is to act as a vehicle for the active ingredient and allow it to be applied smoothly and evenly to the skin or mucous membranes.

Ointments are commonly used in dermatology to treat various skin conditions such as eczema, psoriasis, rashes, burns, and wounds. They can also be used to deliver medication for localized pain relief, muscle relaxation, and anti-inflammatory or antibiotic effects.

The base of an ointment may consist of various ingredients, including petrolatum, lanolin, mineral oil, beeswax, or a combination of these. The choice of the base depends on the desired properties such as consistency, spreadability, and stability, as well as the intended route of administration and the specific therapeutic goals.

Drainage, in medical terms, refers to the removal of excess fluid or accumulated collections of fluids from various body parts or spaces. This is typically accomplished through the use of medical devices such as catheters, tubes, or drains. The purpose of drainage can be to prevent the buildup of fluids that may cause discomfort, infection, or other complications, or to treat existing collections of fluid such as abscesses, hematomas, or pleural effusions. Drainage may also be used as a diagnostic tool to analyze the type and composition of the fluid being removed.

Cholecystostomy is a medical procedure that involves the creation of an opening or fistula between the gallbladder and the stomach or the skin surface to drain bile from the gallbladder. This procedure is typically performed when there is an obstruction in the cystic duct or common bile duct, leading to inflammation or infection of the gallbladder (cholecystitis).

There are two types of cholecystostomy: percutaneous and open. Percutaneous cholecystostomy is a minimally invasive procedure that involves inserting a small tube through the skin and into the gallbladder under the guidance of imaging techniques such as ultrasound or CT scan. Open cholecystostomy, on the other hand, requires an open surgical incision to access the gallbladder and create the fistula.

Cholecystostomy is usually a temporary measure to manage acute cholecystitis in high-risk patients who are not suitable candidates for surgery or until they become stable enough to undergo a more definitive treatment, such as cholecystectomy (surgical removal of the gallbladder).

The urethra is the tube that carries urine from the bladder out of the body. In males, it also serves as the conduit for semen during ejaculation. The male urethra is longer than the female urethra and is divided into sections: the prostatic, membranous, and spongy (or penile) urethra. The female urethra extends from the bladder to the external urethral orifice, which is located just above the vaginal opening.

Common bile duct neoplasms refer to abnormal growths that can occur in the common bile duct, which is a tube that carries bile from the liver and gallbladder into the small intestine. These growths can be benign or malignant (cancerous).

Benign neoplasms of the common bile duct include papillomas, adenomas, and leiomyomas. Malignant neoplasms are typically adenocarcinomas, which arise from the glandular cells lining the duct. Other types of malignancies that can affect the common bile duct include cholangiocarcinoma, gallbladder carcinoma, and metastatic cancer from other sites.

Symptoms of common bile duct neoplasms may include jaundice (yellowing of the skin and eyes), abdominal pain, dark urine, and light-colored stools. Diagnosis may involve imaging tests such as CT scans or MRCP (magnetic resonance cholangiopancreatography) and biopsy to confirm the type of neoplasm. Treatment options depend on the type and stage of the neoplasm and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

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.

Cholestasis is a medical condition characterized by the interruption or reduction of bile flow from the liver to the small intestine. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats. When the flow of bile is blocked or reduced, it can lead to an accumulation of bile components, such as bilirubin, in the blood, which can cause jaundice, itching, and other symptoms.

Cholestasis can be caused by various factors, including liver diseases (such as hepatitis, cirrhosis, or cancer), gallstones, alcohol abuse, certain medications, pregnancy, and genetic disorders. Depending on the underlying cause, cholestasis may be acute or chronic, and it can range from mild to severe in its symptoms and consequences. Treatment for cholestasis typically involves addressing the underlying cause and managing the symptoms with supportive care.

Trimebutine is an antispasmodic drug that is primarily used to treat functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). It works by relaxing the smooth muscles in the intestines, which helps to reduce cramping, pain, and spasms.

Trimebutine is a derivative of the opioid alkaloid thebaine, but it does not have any significant analgesic or addictive properties. It is thought to exert its effects by acting on certain receptors in the intestinal muscles, including 5-HT3 and mu-opioid receptors.

Trimebutine is available in various forms, such as tablets, capsules, and syrup, and it is typically taken orally several times a day. The dosage may vary depending on the individual's age, weight, and medical condition.

It is important to note that trimebutine should only be used under the supervision of a healthcare provider, as it can have side effects and interact with other medications. Some common side effects of trimebutine include dizziness, dry mouth, and constipation.

Endoscopy of the digestive system, also known as gastrointestinal (GI) endoscopy, is a medical procedure that allows healthcare professionals to visually examine the inside lining of the digestive tract using a flexible tube with a light and camera attached to it, called an endoscope. This procedure can help diagnose and treat various conditions affecting the digestive system, including gastroesophageal reflux disease (GERD), ulcers, inflammatory bowel disease (IBD), and cancer.

There are several types of endoscopy procedures that focus on different parts of the digestive tract:

1. Esophagogastroduodenoscopy (EGD): This procedure examines the esophagus, stomach, and duodenum (the first part of the small intestine). It is often used to investigate symptoms such as difficulty swallowing, abdominal pain, or bleeding in the upper GI tract.
2. Colonoscopy: This procedure explores the large intestine (colon) and rectum. It is commonly performed to screen for colon cancer, as well as to diagnose and treat conditions like inflammatory bowel disease, diverticulosis, or polyps.
3. Sigmoidoscopy: Similar to a colonoscopy, this procedure examines the lower part of the colon (sigmoid colon) and rectum. It is often used as a screening tool for colon cancer and to investigate symptoms like rectal bleeding or changes in bowel habits.
4. Upper GI endoscopy: This procedure focuses on the esophagus, stomach, and duodenum, using a thin, flexible tube with a light and camera attached to it. It is used to diagnose and treat conditions such as GERD, ulcers, and difficulty swallowing.
5. Capsule endoscopy: This procedure involves swallowing a small capsule containing a camera that captures images of the digestive tract as it passes through. It can help diagnose conditions in the small intestine that may be difficult to reach with traditional endoscopes.

Endoscopy is typically performed under sedation or anesthesia to ensure patient comfort during the procedure. The images captured by the endoscope are displayed on a monitor, allowing the healthcare provider to assess the condition of the digestive tract and make informed treatment decisions.

A pupil disorder refers to any abnormality or condition affecting the size, shape, or reactivity of the pupils, the circular black openings in the center of the eyes through which light enters. The pupil's primary function is to regulate the amount of light that reaches the retina, adjusting its size accordingly.

There are several types of pupil disorders, including:

1. Anisocoria: A condition characterized by unequal pupil sizes in either one or both eyes. This may be caused by various factors, such as nerve damage, trauma, inflammation, or medication side effects.

2. Horner's syndrome: A neurological disorder affecting the autonomic nervous system, resulting in a smaller pupil (miosis), partial eyelid droop (ptosis), and decreased sweating (anhidrosis) on the same side of the face. It is caused by damage to the sympathetic nerve pathway.

3. Adie's tonic pupil: A condition characterized by a dilated, poorly reactive pupil due to damage to the ciliary ganglion or short ciliary nerves. This disorder usually affects one eye and may be associated with decreased deep tendon reflexes in the affected limbs.

4. Argyll Robertson pupil: A condition where the pupils are small, irregularly shaped, and do not react to light but constrict when focusing on nearby objects (accommodation). This disorder is often associated with neurosyphilis or other brainstem disorders.

5. Pupillary dilation: Abnormally dilated pupils can be a sign of various conditions, such as drug use (e.g., atropine, cocaine), brainstem injury, Adie's tonic pupil, or oculomotor nerve palsy.

6. Pupillary constriction: Abnormally constricted pupils can be a sign of various conditions, such as Horner's syndrome, Argyll Robertson pupil, drug use (e.g., opioids, pilocarpine), or oculomotor nerve palsy.

7. Light-near dissociation: A condition where the pupils do not react to light but constrict when focusing on nearby objects. This can be seen in Argyll Robertson pupil and Adie's tonic pupil.

Prompt evaluation by an ophthalmologist or neurologist is necessary for accurate diagnosis and management of these conditions.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

In the context of medical research, "methods" refers to the specific procedures or techniques used in conducting a study or experiment. This includes details on how data was collected, what measurements were taken, and what statistical analyses were performed. The methods section of a medical paper allows other researchers to replicate the study if they choose to do so. It is considered one of the key components of a well-written research article, as it provides transparency and helps establish the validity of the findings.

Obstructive Jaundice is a medical condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes due to the accumulation of bilirubin in the bloodstream. This occurs when there is an obstruction or blockage in the bile ducts that transport bile from the liver to the small intestine.

Bile, which contains bilirubin, aids in digestion and is usually released from the liver into the small intestine. When the flow of bile is obstructed, bilirubin builds up in the blood, causing jaundice. The obstruction can be caused by various factors, such as gallstones, tumors, or strictures in the bile ducts.

Obstructive jaundice may present with additional symptoms like dark urine, light-colored stools, itching, abdominal pain, and weight loss, depending on the cause and severity of the obstruction. It is essential to seek medical attention if jaundice is observed, as timely diagnosis and management can prevent potential complications, such as liver damage or infection.

Cholecystitis is a medical condition characterized by inflammation of the gallbladder, a small pear-shaped organ located under the liver that stores and concentrates bile produced by the liver. Bile is a digestive fluid that helps break down fats in the small intestine during digestion.

Acute cholecystitis is a sudden inflammation of the gallbladder, often caused by the presence of gallstones that block the cystic duct, the tube that carries bile from the gallbladder to the common bile duct. This blockage can cause bile to build up in the gallbladder, leading to inflammation, swelling, and pain.

Chronic cholecystitis is a long-term inflammation of the gallbladder, often caused by repeated attacks of acute cholecystitis or the presence of gallstones that cause ongoing irritation and damage to the gallbladder wall. Over time, chronic cholecystitis can lead to thickening and scarring of the gallbladder wall, which can reduce its ability to function properly.

Symptoms of cholecystitis may include sudden and severe abdominal pain, often in the upper right or center of the abdomen, that may worsen after eating fatty foods; fever; nausea and vomiting; bloating and gas; and clay-colored stools. Treatment for cholecystitis typically involves antibiotics to treat any infection present, pain relief, and surgery to remove the gallbladder (cholecystectomy). In some cases, a nonsurgical procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be used to remove gallstones from the bile duct.

The pancreatic ducts are a set of tubular structures within the pancreas that play a crucial role in the digestive system. The main pancreatic duct, also known as the duct of Wirsung, is responsible for transporting pancreatic enzymes and bicarbonate-rich fluid from the pancreas to the duodenum, which is the first part of the small intestine.

The exocrine portion of the pancreas contains numerous smaller ducts called interlobular ducts and intralobular ducts that merge and ultimately join the main pancreatic duct. This system ensures that the digestive enzymes and fluids produced by the pancreas are effectively delivered to the small intestine, where they aid in the breakdown and absorption of nutrients from food.

In addition to the main pancreatic duct, there is an accessory pancreatic duct, also known as Santorini's duct, which can sometimes join the common bile duct before emptying into the duodenum through a shared opening called the ampulla of Vater. However, in most individuals, the accessory pancreatic duct usually drains into the main pancreatic duct before entering the duodenum.

The duodenum is the first part of the small intestine, immediately following the stomach. It is a C-shaped structure that is about 10-12 inches long and is responsible for continuing the digestion process that begins in the stomach. The duodenum receives partially digested food from the stomach through the pyloric valve and mixes it with digestive enzymes and bile produced by the pancreas and liver, respectively. These enzymes help break down proteins, fats, and carbohydrates into smaller molecules, allowing for efficient absorption in the remaining sections of the small intestine.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

A Choledochal cyst is a congenital dilatation or abnormal enlargement of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps in the digestion of fats.

Choledochal cysts can be classified into several types based on their location and the anatomy of the biliary tree. The most common type, called Type I, involves dilatation of the common bile duct. Other types include dilatation of the intrahepatic bile ducts (Type II), dilatation of both the intrahepatic and extrahepatic bile ducts (Type III), and multiple cystic dilatations of the bile ducts (Type IV).

Choledochal cysts are more common in females than males, and they can present at any age. Symptoms may include abdominal pain, jaundice, vomiting, and fever. Complications of choledochal cysts can include bile duct stones, infection, and cancer. Treatment typically involves surgical removal of the cyst, followed by reconstruction of the biliary tree.

Echinococcosis, hepatic is a type of parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus. The infection typically occurs when a person accidentally ingests microscopic eggs of the tapeworm, which can be present in contaminated food, water, or soil.

Once inside the body, the eggs hatch and release larvae that can migrate to various organs, including the liver. In the liver, the larvae form hydatid cysts, which are fluid-filled sacs that can grow slowly over several years, causing symptoms such as abdominal pain, nausea, vomiting, and jaundice.

Hepatic echinococcosis is a serious condition that can lead to complications such as cyst rupture, infection, or organ damage if left untreated. Treatment options include surgery to remove the cysts, medication to kill the parasites, or a combination of both. Prevention measures include good hygiene practices, avoiding contact with contaminated soil or water, and cooking meat thoroughly before eating it.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Botulinum toxins are neurotoxic proteins produced by the bacterium Clostridium botulinum and related species. They are the most potent naturally occurring toxins, and are responsible for the paralytic illness known as botulism. There are seven distinct botulinum toxin serotypes (A-G), each of which targets specific proteins in the nervous system, leading to inhibition of neurotransmitter release and subsequent muscle paralysis.

In clinical settings, botulinum toxins have been used for therapeutic purposes due to their ability to cause temporary muscle relaxation. Botulinum toxin type A (Botox) is the most commonly used serotype in medical treatments, including management of dystonias, spasticity, migraines, and certain neurological disorders. Additionally, botulinum toxins are widely employed in aesthetic medicine for reducing wrinkles and fine lines by temporarily paralyzing facial muscles.

It is important to note that while botulinum toxins have therapeutic benefits when used appropriately, they can also pose significant health risks if misused or improperly handled. Proper medical training and supervision are essential for safe and effective utilization of these powerful toxins.

Choledochostomy is a surgical procedure that involves creating an opening (stoma) into the common bile duct, which carries bile from the liver and gallbladder to the small intestine. This procedure is typically performed to relieve obstructions or blockages in the bile duct, such as those caused by gallstones, tumors, or scar tissue.

During the choledochostomy procedure, a surgeon makes an incision in the abdomen and exposes the common bile duct. The duct is then cut open, and a small tube (catheter) is inserted into the duct to allow bile to drain out of the body. The catheter may be left in place temporarily or permanently, depending on the underlying condition causing the obstruction.

Choledochostomy is typically performed as an open surgical procedure, but it can also be done using minimally invasive techniques such as laparoscopy or robotic-assisted surgery. As with any surgical procedure, choledochostomy carries risks such as bleeding, infection, and damage to surrounding tissues. However, these risks are generally low in the hands of an experienced surgeon.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries by inflating a tiny balloon inside the blocked artery to widen it.

The stent is then inserted into the widened artery to keep it open. The stent is usually made of metal, but some are coated with medication that is slowly and continuously released to help prevent the formation of scar tissue in the artery. This can reduce the chance of the artery narrowing again.

Stents are also used in other parts of the body, such as the neck (carotid artery) and kidneys (renal artery), to help maintain blood flow and prevent blockages. They can also be used in the urinary system to treat conditions like ureteropelvic junction obstruction or narrowing of the urethra.

Hemorrhage is defined in the medical context as an excessive loss of blood from the circulatory system, which can occur due to various reasons such as injury, surgery, or underlying health conditions that affect blood clotting or the integrity of blood vessels. The bleeding may be internal, external, visible, or concealed, and it can vary in severity from minor to life-threatening, depending on the location and extent of the bleeding. Hemorrhage is a serious medical emergency that requires immediate attention and treatment to prevent further blood loss, organ damage, and potential death.

Nitroglycerin, also known as glyceryl trinitrate, is a medication used primarily for the treatment of angina pectoris (chest pain due to coronary artery disease) and hypertensive emergencies (severe high blood pressure). It belongs to a class of drugs called nitrates or organic nitrites.

Nitroglycerin works by relaxing and dilating the smooth muscle in blood vessels, which leads to decreased workload on the heart and increased oxygen delivery to the myocardium (heart muscle). This results in reduced symptoms of angina and improved cardiac function during hypertensive emergencies.

The drug is available in various forms, including sublingual tablets, sprays, transdermal patches, ointments, and intravenous solutions. The choice of formulation depends on the specific clinical situation and patient needs. Common side effects of nitroglycerin include headache, dizziness, and hypotension (low blood pressure).

Pathological constriction refers to an abnormal narrowing or tightening of a body passage or organ, which can interfere with the normal flow of blood, air, or other substances through the area. This constriction can occur due to various reasons such as inflammation, scarring, or abnormal growths, and can affect different parts of the body, including blood vessels, airways, intestines, and ureters. Pathological constriction can lead to a range of symptoms and complications depending on its location and severity, and may require medical intervention to correct.

Gastrointestinal endoscopy is a medical procedure that allows direct visualization of the inner lining of the digestive tract, which includes the esophagus, stomach, small intestine, large intestine (colon), and sometimes the upper part of the small intestine (duodenum). This procedure is performed using an endoscope, a long, thin, flexible tube with a light and camera at its tip. The endoscope is inserted through the mouth for upper endoscopy or through the rectum for lower endoscopy (colonoscopy), and the images captured by the camera are transmitted to a monitor for the physician to view.

Gastrointestinal endoscopy can help diagnose various conditions, such as inflammation, ulcers, tumors, polyps, or bleeding in the digestive tract. It can also be used for therapeutic purposes, such as removing polyps, taking tissue samples (biopsies), treating bleeding, and performing other interventions to manage certain digestive diseases.

There are different types of gastrointestinal endoscopy procedures, including:

1. Upper Endoscopy (Esophagogastroduodenoscopy or EGD): This procedure examines the esophagus, stomach, and duodenum.
2. Colonoscopy: This procedure examines the colon and rectum.
3. Sigmoidoscopy: A limited examination of the lower part of the colon (sigmoid colon) using a shorter endoscope.
4. Enteroscopy: An examination of the small intestine, which can be performed using various techniques, such as push enteroscopy, single-balloon enteroscopy, or double-balloon enteroscopy.
5. Capsule Endoscopy: A procedure that involves swallowing a small capsule containing a camera, which captures images of the digestive tract as it passes through.

Gastrointestinal endoscopy is generally considered safe when performed by experienced medical professionals. However, like any medical procedure, there are potential risks and complications, such as bleeding, infection, perforation, or adverse reactions to sedatives used during the procedure. Patients should discuss these risks with their healthcare provider before undergoing gastrointestinal endoscopy.

Bile is a digestive fluid that is produced by the liver and stored in the gallbladder. It plays an essential role in the digestion and absorption of fats and fat-soluble vitamins in the small intestine. Bile consists of bile salts, bilirubin, cholesterol, phospholipids, electrolytes, and water.

Bile salts are amphipathic molecules that help to emulsify fats into smaller droplets, increasing their surface area and allowing for more efficient digestion by enzymes such as lipase. Bilirubin is a breakdown product of hemoglobin from red blood cells and gives bile its characteristic greenish-brown color.

Bile is released into the small intestine in response to food, particularly fats, entering the digestive tract. It helps to break down large fat molecules into smaller ones that can be absorbed through the walls of the intestines and transported to other parts of the body for energy or storage.

In medical terms, pressure is defined as the force applied per unit area on an object or body surface. It is often measured in millimeters of mercury (mmHg) in clinical settings. For example, blood pressure is the force exerted by circulating blood on the walls of the arteries and is recorded as two numbers: systolic pressure (when the heart beats and pushes blood out) and diastolic pressure (when the heart rests between beats).

Pressure can also refer to the pressure exerted on a wound or incision to help control bleeding, or the pressure inside the skull or spinal canal. High or low pressure in different body systems can indicate various medical conditions and require appropriate treatment.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

A chronic disease is a long-term medical condition that often progresses slowly over a period of years and requires ongoing management and care. These diseases are typically not fully curable, but symptoms can be managed to improve quality of life. Common chronic diseases include heart disease, stroke, cancer, diabetes, arthritis, and COPD (chronic obstructive pulmonary disease). They are often associated with advanced age, although they can also affect children and younger adults. Chronic diseases can have significant impacts on individuals' physical, emotional, and social well-being, as well as on healthcare systems and society at large.

An acute disease is a medical condition that has a rapid onset, develops quickly, and tends to be short in duration. Acute diseases can range from minor illnesses such as a common cold or flu, to more severe conditions such as pneumonia, meningitis, or a heart attack. These types of diseases often have clear symptoms that are easy to identify, and they may require immediate medical attention or treatment.

Acute diseases are typically caused by an external agent or factor, such as a bacterial or viral infection, a toxin, or an injury. They can also be the result of a sudden worsening of an existing chronic condition. In general, acute diseases are distinct from chronic diseases, which are long-term medical conditions that develop slowly over time and may require ongoing management and treatment.

Examples of acute diseases include:

* Acute bronchitis: a sudden inflammation of the airways in the lungs, often caused by a viral infection.
* Appendicitis: an inflammation of the appendix that can cause severe pain and requires surgical removal.
* Gastroenteritis: an inflammation of the stomach and intestines, often caused by a viral or bacterial infection.
* Migraine headaches: intense headaches that can last for hours or days, and are often accompanied by nausea, vomiting, and sensitivity to light and sound.
* Myocardial infarction (heart attack): a sudden blockage of blood flow to the heart muscle, often caused by a buildup of plaque in the coronary arteries.
* Pneumonia: an infection of the lungs that can cause coughing, chest pain, and difficulty breathing.
* Sinusitis: an inflammation of the sinuses, often caused by a viral or bacterial infection.

It's important to note that while some acute diseases may resolve on their own with rest and supportive care, others may require medical intervention or treatment to prevent complications and promote recovery. If you are experiencing symptoms of an acute disease, it is always best to seek medical attention to ensure proper diagnosis and treatment.

Amylases are enzymes that break down complex carbohydrates, such as starch and glycogen, into simpler sugars like maltose, glucose, and maltotriose. There are several types of amylases found in various organisms, including humans.

In humans, amylases are produced by the pancreas and salivary glands. Pancreatic amylase is released into the small intestine where it helps to digest dietary carbohydrates. Salivary amylase, also known as alpha-amylase, is secreted into the mouth and begins breaking down starches in food during chewing.

Deficiency or absence of amylases can lead to difficulties in digesting carbohydrates and may cause symptoms such as bloating, diarrhea, and abdominal pain. Elevated levels of amylase in the blood may indicate conditions such as pancreatitis, pancreatic cancer, or other disorders affecting the pancreas.

"Length of Stay" (LOS) is a term commonly used in healthcare to refer to the amount of time a patient spends receiving care in a hospital, clinic, or other healthcare facility. It is typically measured in hours, days, or weeks and can be used as a metric for various purposes such as resource planning, quality assessment, and reimbursement. The length of stay can vary depending on the type of illness or injury, the severity of the condition, the patient's response to treatment, and other factors. It is an important consideration in healthcare management and can have significant implications for both patients and providers.

A Gastrectomy is a surgical procedure involving the removal of all or part of the stomach. This procedure can be total (complete resection of the stomach), partial (removal of a portion of the stomach), or sleeve (removal of a portion of the stomach to create a narrow sleeve-shaped pouch).

Gastrectomies are typically performed to treat conditions such as gastric cancer, benign tumors, severe peptic ulcers, and in some cases, for weight loss in individuals with morbid obesity. The type of gastrectomy performed depends on the patient's medical condition and the extent of the disease.

Following a gastrectomy, patients may require adjustments to their diet and lifestyle, as well as potential supplementation of vitamins and minerals that would normally be absorbed in the stomach. In some cases, further reconstructive surgery might be necessary to reestablish gastrointestinal continuity.

Ceruletide is a synthetic analog of the natural hormone cholecystokinin (CCK). It is a decapeptide with the following sequence: cyclo(D-Asp-Tic-Phe-Ser-Leu-Hand-Ala-Lys-Thr-Nle-NH2).

Ceruletide has several pharmacological actions, including stimulation of the release of digestive enzymes from the pancreas, contraction of the gallbladder and sphincter of Oddi, and inhibition of gastric acid secretion. It is used in clinical medicine for diagnostic purposes to test the motor function of the biliary tract and to diagnose gastrointestinal motility disorders.

Ceruletide has also been investigated as a potential treatment for certain conditions such as pancreatitis, gallstones, and intestinal obstruction, but its use is limited due to its side effects, which include nausea, vomiting, abdominal cramps, and diarrhea.

Cholangiocarcinoma is a type of cancer that arises from the cells that line the bile ducts, which are small tubes that carry digestive enzymes from the liver to the small intestine. It can occur in different parts of the bile duct system, including the bile ducts inside the liver (intrahepatic), the bile ducts outside the liver (extrahepatic), and the area where the bile ducts join the pancreas and small intestine (ampulla of Vater).

Cholangiocarcinoma is a relatively rare cancer, but its incidence has been increasing in recent years. It can be difficult to diagnose because its symptoms are often nonspecific and similar to those of other conditions, such as gallstones or pancreatitis. Treatment options depend on the location and stage of the cancer, and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

Intrahepatic bile ducts are the small tubular structures inside the liver that collect bile from the liver cells (hepatocytes). Bile is a digestive fluid produced by the liver that helps in the absorption of fats and fat-soluble vitamins from food. The intrahepatic bile ducts merge to form larger ducts, which eventually exit the liver and join with the cystic duct from the gallbladder to form the common bile duct. The common bile duct then empties into the duodenum, the first part of the small intestine, where bile aids in digestion. Intrahepatic bile ducts can become obstructed or damaged due to various conditions such as gallstones, tumors, or inflammation, leading to complications like jaundice, liver damage, and infection.

A reoperation is a surgical procedure that is performed again on a patient who has already undergone a previous operation for the same or related condition. Reoperations may be required due to various reasons, such as inadequate initial treatment, disease recurrence, infection, or complications from the first surgery. The nature and complexity of a reoperation can vary widely depending on the specific circumstances, but it often carries higher risks and potential complications compared to the original operation.

Pre-cut sphincterotomy: pre-cut biliary endoscopic sphincterotomy refers to the techniques used to cut the papillary mucosa and ... Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it ... Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic ... The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure ...
Intestinal perforation is a risk of any gastroenterologic endoscopic procedure, and is an additional risk if a sphincterotomy ... Kelly, N. M.; Caddy, G. R. (2008). "Successful Endoscopic Management of Fractured Dormia Basket During Endoscopic Retrograde ... "ERCP (Endoscopic Retrograde Cholangiopancreatography) , MNGI". "Endoscopic Retrograde Cholangiopancreatography (ERCP) , NIDDK ... Endoscopic sphincterotomy of the sphincter of Oddi Extraction of gallstones or other biliary debris Insertion of a stent ...
October 2007). "Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct ... "Cholecystectomy deferral in patients with endoscopic sphincterotomy". Cochrane Database Syst Rev. 2010 (4): CD006233. doi: ... A sphincterotomy (making a cut in the sphincter of Oddi) is typically done to ease the flow of bile from the duct and to allow ... On the endoscopic image of the ampulla, one can sometimes see a protuberant ampulla from an impacted gallstone in the common ...
"Cholecystectomy Deferral in Patients with Endoscopic Sphincterotomy". Cochrane Database of Systematic Reviews. 2010 (4): ... Common bile duct stone impacted at ampulla of Vater seen at time of endoscopic retrograde cholangiopancreatography (ERCP) ... Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP). Murphy's sign is commonly ... an endoscopic retrograde cholangiopancreatography (ERCP), or an intraoperative cholangiogram. If the patient must have the ...
"Role of endoscopic sphincterotomy of the minor papilla in pancreas divisum". La Clinica Terapeutica. 165 (4): e312-6. doi: ... A surgeon may attempt a sphincterotomy by cutting the minor papilla to enlarge the opening and allow pancreatic enzymes to flow ... However, if there is recurrent pancreatitis, then a sphincterotomy of the minor papilla may be indicated. The human embryo ... The presence of pancreas divisum is usually identified with cross sectional diagnostic imaging, such as endoscopic retrograde ...
Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy. Gastrointest Endosc. ... ERCP, short for endoscopic retrograde cholangiopancreatography, is an endoscopic procedure that can remove gallstones or ... Peroperative Endoscopic Retrograde Cholangio-Pancreaticography (ERCP)/ Laparo-endoscopic rendezvous (LERV) technique CBDS are ... Natural orifice transluminal endoscopic surgery (NOTES) is an experimental technique where the laparoscope is inserted through ...
For those who are poor surgical candidates, endoscopic sphincterotomy may be performed to reduce the risk of developing ... Endoscopic ultrasonography is another more sensitive option. However, the gold standard is considered to be direct microscopy ...
The EPISOD trial has substantiated the ineffectiveness of endoscopic sphincterotomy in patients with these symptoms and SOD ... "Effect of endoscopic sphincterotomy for suspected sphincter of Oddi dysfunction on pain-related disability following ... Overall, the investigators found that only 23% of the patients who underwent sphincterotomy improved versus 37% of the control ... Medication (to prevent spasms) or sphincterotomy (surgical procedure to cut the muscle) are the standard treatments for ...
Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) ... following endoscopic retrograde cholangiopancreatography (ERCP). The medications ursodeoxycholic acid (UDCA) and ...
August 2018). "Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for ... If bile stones are present in the common bile duct, an endoscopic sphincterotomy can be conducted either with or without ... In cases where a patient is not a suitable candidate for surgery, an endoscopic stent can be placed. If this is not possible or ... Endoscopic retrograde cholangiography may be useful to visualize the extrahepatic biliary ducts. In case of anatomical ...
... sphincterotomy, endoscopic MeSH E04.210.120.860 - sphincterotomy, transhepatic MeSH E04.210.169 - biliopancreatic diversion ... sphincterotomy, endoscopic MeSH E04.800.250.250.260 - esophagoscopy MeSH E04.800.250.280 - fetoscopy MeSH E04.800.250.360 - ... sphincterotomy, endoscopic MeSH E04.210.240.260 - esophagoscopy MeSH E04.210.338 - enterostomy MeSH E04.210.338.175 - cecostomy ... endoscopic retrograde MeSH E04.210.240.250 - endoscopy, gastrointestinal MeSH E04.210.240.250.160 - colonoscopy MeSH E04.210. ...
It also has better endoscopic access to the biliary tree and more physiologic bile drainage. CDD is used in the treatment of ... biliary sphincterotomy). In 1888, a German surgeon named Bernhard Riedel performed the first CDD. He intended to cut across the ... Endoscopic Emergencies. 17 (2): 289-306, vi. doi:10.1016/j.giec.2007.03.006. PMID 17556149. Baert AL, ed. (2008), "Sump ... A CDD allows for the passage of any retained gallstones, such as impacted stones, or stones where endoscopic treatments of ...
He is principal investigator of an NIH-funded multi-center randomised sham-controlled study of sphincterotomy in Sphincter of ... Cotton, P. B. (2012). "Endoscopic Retrograde Cholangiopancreatography". Gastrointestinal Endoscopy Clinics of North America. 22 ... "A lexicon for endoscopic adverse events: Report of an ASGE workshop". Gastrointestinal Endoscopy. 71 (3): 446-454. doi:10.1016/ ... "Long-Term Clinical Outcomes After Endoscopic Minor Papilla Therapy in Symptomatic Patients with Pancreas Divisum". Pancreas. 38 ...
Left lateral anal sphincterotomy (49.52) Posterior anal sphincterotomy (49.59) Other anal sphincterotomy (49.6) Excision of ... Closed endoscopic biopsy of lung (33.28) Open biopsy of lung (33.29) Other diagnostic procedures on lung and bronchus (33.3) ... endoscopic) biopsy of bronchus (33.25) Open biopsy of bronchus (33.26) Closed (percutaneous) (needle) biopsy of lung (33.27) ... endoscopic) gastrostomy (PEG) (43.3) Pyloromyotomy (43.4) Local excision or destruction of lesion or tissue of stomach (43.5) ...
If TC-325 is used for the control of bleeding at the site of a sphincterotomy or ampullary resection, there is a risk of ... Mullady, Daniel K.; Wang, Andrew Y.; Waschke, Kevin A. (June 2020). "AGA Clinical Practice Update on Endoscopic Therapies for ... "DE NOVO CLASSIFICATION REQUEST FOR HEMOSPRAY ENDOSCOPIC HEMOSTAT" (PDF). AccessData. FDA. de Rezende, Daniel Tavares; Brunaldi ...
Pre-cut sphincterotomy: pre-cut biliary endoscopic sphincterotomy refers to the techniques used to cut the papillary mucosa and ... Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it ... Biliary endoscopic sphincterotomy is sometimes used, with or without stenting, to relieve the obstruction, but systematic ... The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure ...
Approximately 150,000 patients undergo endoscopic biliary sphincterotomy in the United States each year. ... Introduction Endoscopic biliary sphincterotomy was first reported in 1974. ... including endoscopic sphincterotomy, endoscopic papillary balloon dilatation (EPBD), and endoscopic sphincterotomy with balloon ... encoded search term (Endoscopic Sphincterotomy) and Endoscopic Sphincterotomy What to Read Next on Medscape ...
Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. ... NS: Not significant; ERCP: Endoscopic retrograde cholangiopancreatography; EST: Endoscopic sphincterotomy; EBS: Endoscopic ... Endoscopic sphincterotomy, Endoscopic balloon sphincteroplasty Core tip: We evaluated the efficacy of prior minimal endoscopic ... Figure 1 Flow chart of patients in this study. EST: Endoscopic sphincterotomy; EBS: Endoscopic balloon sphincteroplasty. ...
Endoscopic retrograde cannulation of the pancreatic duct without sphincterotomy. * Biliary stent insertion without ... The American Society of Gastrointestinal Endoscopy divided endoscopic procedures into low and high risk for bleeding in its ... Low bleeding-risk endoscopic procedures do not require a change in anticoagulation. ... According to the American Society of Gastrointestinal Endoscopy, which endoscopic procedures do not require changes to ...
Transpancreatic precut sphincterotomy using a soft guide wire is a safe and effective procedure in patients with difficult bile ... duct access where classic sphincterotomy or needle-knife procedures fail. ... The common treatment of patients with biliary tract obstruction is the decompression by endoscopic procedures. However, ... Transpancreatic precut sphincterotomy for cannulation of inaccessible common bile duct: a safe and successful technique ...
Endoscopic retrograde cannulation of the pancreatic duct without sphincterotomy. * Biliary stent insertion without ... The American Society of Gastrointestinal Endoscopy divided endoscopic procedures into low and high risk for bleeding in its ... Low bleeding-risk endoscopic procedures do not require a change in anticoagulation. ... According to the American Society of Gastrointestinal Endoscopy, which endoscopic procedures do not require changes to ...
... endoscopic sphincterotomy; CD, Clavien-Dindo classification; ENBD, endoscopic nasobiliary drainage; ERBD, endoscopic retrograde ... endoscopic sphincterotomy; CD, Clavien-Dindo classification; ENBD, endoscopic nasobiliary drainage; ERBD, endoscopic retrograde ... endoscopic sphincterotomy; CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography; NA, nonapplicable. ... endoscopic sphincterotomy; CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography; NA, nonapplicable.. ...
Endoscopic retrograde cholangiopancreatography-related early perforations: A study of effects of procedure duration, complexity ... Sphincterotomy performed. Stent placement. Sphincterotomy device. Peritonitis. Prior biliary surgery. 1. 4. 4. LHD tumor biopsy ... Wojtun S, Gil J, Gietka W, Gil M. Endoscopic sphincterotomy for choledocholithiasis: a prospective single-center study on the ... sphincterotomy, sphincterotomy device used, stent placement, peritonitis. Patients were stratified based on the endoscopists ...
Outcome of a session of extracorporeal shock wave lithotripsy before endoscopic retrograde cholangiopancreatography for ... Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. ... Complications of endoscopic sphincterotomy and their prevention. N Engl J Med. 1996;335:961-963. [PubMed] [DOI] [Cited in This ... Endoscopic sphincterotomy and endoscopic papillary balloon dilatation for bile duct stones: A prospective randomized controlled ...
Endoscopic sphincterotomy • Laparoscopic pancreatectomy • Endoscopic pancreatic necrosectomy and Natural orifice transluminal ... Surgeries include; Percutaneous drainage using a needle, usually under CT scan guidance Endoscopic - assisted drainage using an ... Surgical management • Laparoscopic cholecystectomy or choledochotomy ( incision of common bile duct) • Sphincterotomy • ... Endoscopic ultrasound  CT scan of the pancreas  MRI  ERCP  Chest X ray ...
Endoscopic biliary sphincterotomy. *Endoscopic retrograde cholangiopancreatography (ERCP). *Gallbladder and biliary dyskinesia ...
Twenty-one to 80% of patients had undergone previous cholecystectomy or endoscopic sphincterotomy. ... presumably owing to enhanced patency of the biliary system after surgical or endoscopic sphincterotomy. [42] ...
JGES guidelines for endoscopic sphincterotomy. 16 December 2017. 10.1111/den.13001. Dig Endosc 2018; 30: 149-173. ... Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer. 04 October 2015. ... Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer (second edition). 26 ... Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. 19 February 2020. 10.1111/den. ...
ERCP (endoscopic retrograde cholangiopancreatography). * Sphincterotomy. * Gallbladder removal (cholecystectomy). * Liver ...
... it is sometimes treated with laparoscopic cholecystectomy or endoscopic sphincterotomy... read more occurs in the absence of ...
How necessary is endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy in acute gallstone pancreatitis? ...
Testoni PA, Bagnolo F, Caporuscio S, Lella F. Serum amylase measured four hours after endoscopic sphincterotomy is a reliable ... Endoscopic therapies should not be routinely performed in those with borderline elevation of enzymes. Pancreatitis can occur ...
Comparison of laparoscopic cholecystectomy combined with intraoperative endoscopic sphincterotomy and laparoscopic exploration ... Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev. 2013;CD003327. [PubMed] [DOI] [Cited in ... Laparoscopic exploration can salvage failed endoscopic bile duct stone extraction. Singapore Med J. 2012;53:313-317. [PubMed] [ ... Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones. Cochrane Database Syst ...
ENDOSCOPIC MINOR PAPILLA SPHINCTEROTOMY IN PATIENTS WITH PANCREAS DIVISUM AND ACUTE RECURRENT PANCREATITIS: A METANALYSIS ... ENDOSCOPIC MINOR PAPILLA SPHINCTEROTOMY IN PATIENTS WITH PANCREAS DIVISUM AND ACUTE RECURRENT PANCREATITIS: A METANALYSIS ... ENDOSCOPIC PANCREATIC SPHINCTEROTOMY IN PATIENTS WITH IPMN-RELATED RECURRENT PANCREATITIS: A SINGLE CENTER EXPERIENCE ... ENDOSCOPIC PANCREATIC SPHINCTEROTOMY IN PATIENTS WITH IPMN-RELATED RECURRENT PANCREATITIS: A SINGLE CENTER EXPERIENCE ...
Complete external sphincterotomy: correlation between endoscopic observation and the anatomic sphincter. J Urol. 1975 Mar; 113( ...
Role of Prophylactic Cholecystectomy After Endoscopic Sphincterotomy for Biliary Stone Disease: A Systematic Review and Meta- ... Endoscopic Ultrasound-Guided, Percutaneous, and Transjugular Liver Biopsy: A Comparative Systematic Review and Meta-Analysis. ...
bypass (8) or endoscopic sphincterotomy (2). Five patients had prior. surgical therapy including two with left hepatic ... introduction of endoscopic accessories such as baskets, dilators and laser. fibers. We have adapted these advances in biliary ...
Endoscopic balloon dilatation versus endoscopic sphincterotomy for the removal of bile duct stones: a prospective randomised ...
Endoscopic management via the conventional route with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ... Therapeutic interventions included laparoscopic cholecystectomy, lysis of adhesions, biliary and pancreatic sphincterotomy, ...
The SpHincterotomy for Acute Recurrent Pancreatitis (SHARP) clinical trial will determine the benefits and effects of an ... Endoscopic Retrograde CholangioPancreatography (ERCP) procedure with minor papilla sphincterotomy (cutting of the opening of ...
... endoscopic sphincterotomy, ERCP, gallstone disease, IOC, LC, LCBDE, stricture, T-tube, trancystic approach, transcholedochal ...
In Japan, common bile duct stones (CBDS) were first treated with endoscopic sphincterotomy (EST), and then with laparoscopic ... Postoperative bile drainage was carried out via C-tube, endoscopic nasobiliary drainage (ENBD), or endoscopic retrograde ... Daiichi-Towakai-Hospital endoscopic surgery center. INTRODUCTION ... Fundamentals of Endoscopic Surgery. *Fundamental Use of ...
... instrument is passed through the endoscope and used to cut the sphincter of Oddi-a procedure called endoscopic sphincterotomy. ... During endoscopic retrograde cholangiopancreatography Endoscopic Retrograde Cholangiopancreatography Imaging tests of the liver ... ERCP Endoscopic Retrograde Cholangiopancreatography Imaging tests of the liver, gallbladder, and biliary tract include ... endoscopic retrograde cholangiopancreatography... read more (ERCP), a surgical ...
... it is sometimes treated with laparoscopic cholecystectomy or endoscopic sphincterotomy... read more occurs in the absence of ...
Endoscopic sphincterotomy plus large-balloon dilation versus endoscopic sphincterotomy for removal of bile-duct stones. ... B) Endoscopic view of endoscopic sphincterotomy knife insertion into the bile duct alongside a guidewire placed into the ... Endoscopic balloon dilation of the biliary sphincter compared to endoscopic biliary sphincterotomy for removal of common bile ... endoscopic sphincterotomy; SOD, sphincter of Oddi dysfunction; NR, not reported; ERCP, endoscopic retrograde ...
  • In addition, it is commonly performed during an endoscopic retrograde cholangiopancreatography (ERCP), and it may be used for facilitating diagnostic procedures such as transpapillary bile duct biopsy, papillary tumor biopsy, and insertion of a cholangioscope. (wikipedia.org)
  • How necessary is endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy in acute gallstone pancreatitis? (the-hospitalist.org)
  • Endoscopic management via the conventional route with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) is quite limited due to the altered anatomy. (duke.edu)
  • The SpHincterotomy for Acute Recurrent Pancreatitis (SHARP) clinical trial will determine the benefits and effects of an Endoscopic Retrograde CholangioPancreatography (ERCP) procedure with minor papilla sphincterotomy (cutting of the opening of the pancreatic duct) for patients with PD. (rochester.edu)
  • Endoscopic Retrograde Cholangiopancreatography Imaging tests of the liver, gallbladder, and biliary tract include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography. (merckmanuals.com)
  • Pancreatitis is the most frequent and distressing complication of endoscopic retrograde cholangiopancreatography (ERCP). (e-ce.org)
  • Pancreatitis is the most common complication of post-endoscopic retrograde cholangiopancreatography (post-ER-CP). (e-ce.org)
  • The treatment for gallstones that obstruct the common bile duct is endoscopic retrograde cholangiopancreatography (ERCP) or surgery. (gi.org)
  • NKS was successful in 95.5%, 95.7%, and 89.6% at initial endoscopic retrograde cholangiopancreatography and 100%, 97.8%, and 95.6% after a second endoscopic retrograde cholangiopancreatography. (elsevierpure.com)
  • This meta-analysis aims to compare the clinical outcomes associated with endoscopic retrograde cholangiopancreatography (ERCP)-guided biliary stents placed above and across the SO in patients with MBO. (bvsalud.org)
  • On the initial endoscopic retrograde cholangiopancreatography (ERCP), we failed to approach to the BBF due to severe hilar obstruction. (kjpbt.org)
  • 저자들은 간암 환자에서 여러 차례의 TACE 시행 후 발생한 기관지담관루를 PTBD로는 호전이 없어 내시경적 역행성 담관 조영술(endoscopic retrograde cholangiopancreatography, ERCP)로 담관 스텐트 삽입을 통하여 치료한 1예를 문헌고찰과 함께 보고하는 바이다. (kjpbt.org)
  • Characteristics of Patients Undergoing Endoscopic Retrograde Cholangiopancreatography for Sphincter of Oddi Disorders. (musc.edu)
  • Evaluation of Pharmacologic Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Systematic Review. (musc.edu)
  • Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed for diagnostic or therapeutic indications. (medicalalgorithms.com)
  • Endoscopic retrograde cholangiopancreatography (ERCP, shown below) can be performed in patients with Caroli disease and can aid in diagnosis. (medscape.com)
  • Scholars@Duke publication: Laparoscopic-assisted ERCP and EUS in patients with prior Roux-en-Y gastric bypass surgery: a dual-center case series experience. (duke.edu)
  • ERCP), a surgical instrument is passed through the endoscope and used to cut the sphincter of Oddi-a procedure called endoscopic sphincterotomy. (merckmanuals.com)
  • Because most patients undergo endoscopic retrograde cholangiopancreaticogram (ERCP) during the diagnostic workup for obstructive jaundice endoscopic insertion of biliary endoprostheses is performed more often than percutaneous drainage. (kipdf.com)
  • 5)(6) Indeed, it is recommended that patients without an easily identified cause of acute pancreatitis undergo endoscopic retrograde cholangiopan-creatography (ERCP) with bile aspiration to exclude microcrystals as an etiology. (the-medical-dictionary.com)
  • This study was performed to compare the safety and efficacy of one-stage laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC) with those of endoscopic sphincterotomy (EST) plus LC for concomitant gallbladder (GB) and common bile duct (CBD) stones in elderly patients. (e-jmis.org)
  • Both one-stage laparoscopic common bile duct exploration (LCBDE) plus laparoscopic cholecystectomy (LC) and two-stage endoscopic sphincterotomy (EST) plus LC are standard treatment options for patients with GB and CBD stones. (e-jmis.org)
  • it is sometimes treated with laparoscopic cholecystectomy or endoscopic sphincterotomy. (merckmanuals.com)
  • Therapeutic interventions included laparoscopic cholecystectomy, lysis of adhesions, biliary and pancreatic sphincterotomy, biliary and pancreatic stent placement, stone removal including mechanical lithotripsy and EUS biopsy and diagnosis of pancreatic cancer. (duke.edu)
  • In Japan, common bile duct stones (CBDS) were first treated with endoscopic sphincterotomy (EST), and then with laparoscopic cholecystectomy Recently however, the advent of laparoscopic procedures has led to an increasingly important role for laparoscopic common bile duct exploration in the treatment of CBDS. (sages.org)
  • After endoscopic retrograde sphincterotomy, patients with an intact gallbladder are at risk for developing symptoms or complications of gallbladder stones. (umn.edu)
  • However, sphincterotomy alters emptying dynamics of the gallbladder and markedly reduces bile salt pool size, effects that may alter response to chenodeoxycholic acid or ursodeoxycholic acid treatment. (umn.edu)
  • A long-term trial of bile acid treatment in sphincterotomy patients with stones in an intact gallbladder is needed. (umn.edu)
  • Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it enters the duodenum are cannulated and then cut with a sphincterotome, a device that includes a wire which cuts with an electric current (electrocautery). (wikipedia.org)
  • The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure gradient between the bile duct and the duodenum, encouraging transpapillary bile flow and allowing the leak to heal. (wikipedia.org)
  • Standard sphincterotomy: the sphincterotome is inserted into the bile duct. (wikipedia.org)
  • Pre-cut sphincterotomy: pre-cut biliary endoscopic sphincterotomy refers to the techniques used to cut the papillary mucosa and biliary sphincter in order to expose the underlying bile duct and gain access to it when standard cannulation fails. (wikipedia.org)
  • Transpancreatic biliary sphincterotomy (septotomy): when the guidewire is unintentionally inserted into the main pancreatic duct the sphincterotome is then placed in the pancreatic duct and used to cut the septum between the pancreatic duct and bile duct. (wikipedia.org)
  • Haseeb A, Freeman ML. Endoscopic Papillary Large Balloon Dilation Versus Endoscopic Sphincterotomy for Treatment of Bile Duct Stones. (medscape.com)
  • Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline. (medscape.com)
  • Needle-knife or precut sphincterotomy has been described as technique to facilitate biliary access in patients with difficult bile duct cannulation. (nih.gov)
  • Between January 2003 and June 2006, a total of 108 patients with jaundice but with inaccessible bile ducts using classic techniques (failed primary cannulation or failed needle-knife papillotomy) underwent a wire-guided transpancreatic precut sphincterotomy. (nih.gov)
  • Transpancreatic precut sphincterotomy using a soft guide wire is a safe and effective procedure in patients with difficult bile duct access where classic sphincterotomy or needle-knife procedures fail. (nih.gov)
  • Postoperative bile drainage was carried out via C-tube, endoscopic nasobiliary drainage (ENBD), or endoscopic retrograde biliary drainage (ERBD). (sages.org)
  • The majority of strictures of the mid and lower common bile ducts, which are mainly caused by carcinoma of the head of the pancreas, can be drained effectively by the endoscopic approach.5 Many hilar biliary strictures are difficult to treat endoscopically, however, and are best dealt with interventional radiologic techniques.6 The indications for PTBD are summarized in Table 15.1. (kipdf.com)
  • Recently, a large balloon dilation performed after endoscopic sphincterotomy (ESLBD) was useful for the removal of large bile duct stones. (keyopinionleaders.com)
  • Japan Gastroenterological Endoscopy Society guidelines for endoscopic sphincterotomy. (medscape.com)
  • Biliary endoscopic sphincterotomy allows for opening of the sphincter of Oddi, allowing stones to be removed. (wikipedia.org)
  • Sphincterotomy appears to be safe and effective for the treatment of sphincter of Oddi dysfunction. (wikipedia.org)
  • Endoscopic sphincterotomy has been employed in the treatment of postcholecystectomy abdominal pain potentially attributable to type III (without elevated biochemical markers or CBD dilation) sphincter of Oddi dysfunction. (medscape.com)
  • However, the EPISOD (Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction) study, which assessed 103 such patients with little or no objective evidence of biliary obstruction, found endoscopic sphincterotomy to be no better than sham treatments in this setting. (medscape.com)
  • Evaluating the efficacy of endoscopic sphincterotomy on biliary-type sphincter of Oddi dysfunction: A retrospective clinical trial. (medscape.com)
  • They are most often used for a pre-cut sphincterotomy when standard methods of cannulation fail. (wikipedia.org)
  • Background: Precut biliary needle-knife sphincterotomy (NKS) allows biliary access when standard cannulation techniques fail. (elsevierpure.com)
  • It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. (bvsalud.org)
  • Although pancreatic sphincterotomy is generally known to be a significant risk factor for PEP, the incidence of severe pancreatitis is very low. (e-ce.org)
  • 2023: Extracorporeal shock wave lithotripsy and endoscopic pancreatic stenting without pancreatic sphincterotomy for the treatment of pancreatolithiasis: a case series. (storzmedical.com)
  • Adverse Events and Reinterventions Following Pancreatic Endoscopic Sphincterotomy. (musc.edu)
  • Risk of Pancreatitis Following Biliary Stenting With/Without Endoscopic Sphincterotomy: A Randomized Controlled Trial. (medscape.com)
  • Abstract Endoscopic therapy and extracorporeal shock wave lithotripsy (ESWL) are recommended as the first choice in. (storzmedical.com)
  • Surgical resection or drainage procedures and endoscopic therapy have been demonstrated to be effective for management of pain in the context of "large duct disease" (i.e. (biomedcentral.com)
  • Endoscopic sphincterotomy has been used in conjunction with endoscopic balloon dilatation in the treatment of choledocholithiasis. (medscape.com)
  • Park et al carried out a meta-analysis aimed at assessing the relative efficacy of various endoscopic techniques for removal of CBD stones, including endoscopic sphincterotomy, endoscopic papillary balloon dilatation (EPBD), and endoscopic sphincterotomy with balloon dilatation (ESBD). (medscape.com)
  • Between January 2010 and December 2020, all patients aged >80 years who underwent endoscopic or surgical treatment for concomitant GB and CBD stones were evaluated. (e-jmis.org)
  • Surgical, endoscopic, and interventional radiologic (IR) percutaneous techniques are available for biliary drainage. (kipdf.com)
  • Percutaneous transhepatic cholangiography (PTC) is now rarely employed for purely diagnostic purposes and has been largely replaced by noninvasive imaging techniques, such as ultrasonography (US), computed tomography, magnetic resonance cholangiography (MRC), and endoscopic retrograde cholangiography (ERC). (kipdf.com)
  • A wide variation exists in the endoscopic appearance of normal major duodenal papillae. (medscape.com)
  • In patients with strictures below the hilum of the liver, endoscopic drainage achieves a high rate of success, is associated with fewer complications than percutaneous intervention, and avoids the discomfort of a percutaneous biliary catheter. (kipdf.com)
  • Endoscopic sphincterotomy with sphincteroplasty for the management of choledocholithiasis: a single-centre experience. (medscape.com)
  • BACKGROUND: Patients with Roux-en-Y gastric bypass (RYGB) develop pancreatobiliary issues after surgery. (duke.edu)
  • In addition, they found that 42% of intra-ampullary tumors became apparent only after endoscopic sphincterotomy. (medscape.com)
  • Goals: To assess the outcome differences following different precut biliary sphincterotomy needle-knife techniques. (elsevierpure.com)
  • There were no endoscopic-related complications. (duke.edu)
  • The differential diagnostic value of the above endoscopic diagnostic methods was evaluated by means of sensitivity, specificity, accuracy, positive predictive value, negative predictive value, etc. and safety was evaluated by the incidence rate of adverse events. (bvsalud.org)
  • Approximately 150,000 patients undergo endoscopic biliary sphincterotomy in the United States each year. (medscape.com)
  • The common treatment of patients with biliary tract obstruction is the decompression by endoscopic procedures. (nih.gov)
  • One-stage LCBDE + LC is a safe and effective treatment for concomitant GB and CBD stones, even in elderly patients, and may be considered as the first treatment option in elderly patients with previous gastrectomy, multiple large (≥ 15 mm) CBD stones, or inability to cooperate with endoscopic procedures. (e-jmis.org)
  • In a series of 52 patients with biopsy-proven ampullary adenomas or carcinomas, Ponchon et al noted a normal endoscopic appearance of the papilla in 37% of patients. (medscape.com)
  • Endoscopic treatment of biliary fistulas in patients with hepatic hydatid cysts is effective. (mimimika.com)
  • BACKGROUND/AIMS: Endoscopic biliary stenting is an essential treatment for malignant biliary obstruction (MBO). (bvsalud.org)