Include cholangitis patients with gallstone ileus. Medical search. Frequent questions

Biliary colic, also known as symptomatic cholelithiasis, a gallbladder attack or gallstone attack, is when a colic (sudden pain) occurs due to a gallstone temporarily blocking the cystic duct. (wikipedia.org)
Up to one half of elderly patients have underlying cholelithiasis , one half have diverticula, and 5-10% have AAA. (medscape.com)
Cholecystitis is inflammation of the gallbladder that occurs most commonly because of the presence of stones in the gallbladder or an obstruction of the cystic duct by gallstones arising from the gallbladder (cholelithiasis). (medscape.com)
Cholecystitis is one of the most common complications of cholelithiasis (calculous cholecystitis) but inflammation without gallstones (acalculous cholecystitis) can occur in a minority of patients. (lecturio.com)
Inclusion criteria: the consenting patients of all ages and both sexes with symptomatic cholelithiasis planned for LC. (hvt-journal.com)

However, patients with primary sclerosing cholangitis (PSC) and those with choledochal cysts present nearly two decades earlier. (gastrotraining.com)

Other conditions that produce similar symptoms include appendicitis, stomach ulcers, pancreatitis, and gastroesophageal reflux disease. (wikipedia.org)
gallstone disease is the major cause of pancreatitis. (wikipedia.org)
citation needed] The presence of gallstones can lead to inflammation of the gallbladder (cholecystitis) or the biliary tree (cholangitis) or acute inflammation of the pancreas (pancreatitis). (wikipedia.org)
Gallstones and alcohol consumption account for ≥ 70% of acute pancreatitis cases. (msdmanuals.com)
Gallstones are the most common etiology of acute pancreatitis. (msdmanuals.com)
The precise mechanism of gallstone pancreatitis is unknown but likely involves increased pressure in the pancreatic duct caused by obstruction at the ampulla secondary to a stone or edema caused by the passage of a stone. (msdmanuals.com)
Gallstone pancreatitis is rare in pregnancy and occurs most commonly in the 3rd trimester. (msdmanuals.com)
risk was once thought to increase proportionally to duration of alcohol consumption, but acute pancreatitis attacks may occur in susceptible patients after short periods of high alcohol intake. (msdmanuals.com)
10% of patients with chronic alcohol consumption develop acute pancreatitis, suggesting additional triggers or cofactors are needed to precipitate pancreatitis. (msdmanuals.com)
Surgical treatment choices are based on the patient's clinical condition: less radical surgical procedures such as endoscopic retrograde cholangiopancreatography (ERCP) are done emergently in sick patients with ascending cholangitis or gall stone pancreatitis. (learnsurgeryonline.com)
The incidence of acute pancreatitis ranges from 54 to 238 episodes per 1 million per year,(1) with up to 80 percent of the cases secondary to alcohol use or gallstones. (the-medical-dictionary.com)
2) The older terms, "relapsing acute pancreatitis" and "chronic relapsing pancreatitis," were discarded, since patients with chronic pancreatitis may have acute exacerbations and patients with acute pancreatitis may have repeated attacks of acute pancreatitis. (the-medical-dictionary.com)
Eighty percent of patients have mild edematous pancreatitis. (the-medical-dictionary.com)
3) Patients with mild pancreatitis respond well to conservative therapy, but those with severe pancreatitis may have a progressively downhill course to respiratory failure, sepsis and death. (the-medical-dictionary.com)
Rarely, patients will present with a case of acute pancreatitis after an initial exposure to ethanol, but this is the exception rather than the rule. (the-medical-dictionary.com)
Most patients with alcoholic pancreatitis already have chronic pancreatitis and present with an acute exacerbation. (the-medical-dictionary.com)
Following alcoholic and gallstone-related pancreatitis, the next largest category is idiopathic pancreatitis. (the-medical-dictionary.com)
4) Even this approximation may be high in light of recent reports implicating biliary microlithiasis and biliary sludge as etiologic in patients believed to have idiopathic pancreatitis. (the-medical-dictionary.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)
Acute pancreatitis caused by the passage of biliary tract stones is referred to as "gallstone pancreatitis. (the-medical-dictionary.com)
Gallstones may be recovered in the feces in up to 88 percent of patients with gallstone pancreatitis. (the-medical-dictionary.com)
Marked elevation of serum triglycerides has been causally linked with acute pancreatitis in 12 percent to 38 percent of patients. (the-medical-dictionary.com)
9) A Type V lipid profile is the most common pattern seen in patients with lipid-associated pancreatitis. (the-medical-dictionary.com)
[1] Complications of acute cholecystitis include gallstone pancreatitis , common bile duct stones , or inflammation of the common bile duct . (wikizero.com)
Acute, chronic, or acalculous cholecystitis (biliary inflammation that is not caused by gallstones), repeated episodes of biliary colic, biliary dyskinesia, gallstone pancreatitis, and occasionally cholangitis are indications for the procedure. (unboundmedicine.com)
Most patients with mild Acute pancreatitis recover completely, but severe Acute pancreatitis is associated with local complications such as acute fluid collection, pancreatic necrosis, abscess, and pseudocyst. (pocketdrugguide.com)
A cause cannot be identified in some patients (idiopathic pancreatitis). (pocketdrugguide.com)
Acute pancreatitis is usually caused by drinking too much alcohol or by gallstones. (drmichaelsoo.com.au)
A gallstone can block the pancreatic duct, trapping digestive enzymes in the pancreas and causing pancreatitis. (drmichaelsoo.com.au)
Biliary microlithiasis/sludge is detected in approximately 30% of patients with idiopathic acute pancreatitis (IAP). (qxmd.com)
To develop a machine learning (ML) based decision tool for the use of endosonography (EUS) in pancreatitis patients to detect sludge and microlithiasis. (qxmd.com)
The management of patients with necrotizing pancreatitis has shifted from early surgical débridement (necrosectomy) to aggressive intensive medical care. (clinicalgate.com)
The precise role of these techniques in the management of patients with necrotizing pancreatitis still needs to be precisely defined, although they seem to be increasingly used as an alternative to surgery. (clinicalgate.com)

Choledocholithiasis occurs when the stone becomes lodged in the common bile duct, with the potential sequelae of cholangitis and ascending infections. (medscape.com)
patients having choledocholithiasis, cholangitis, biliary fistula and surgical jaundice. (hvt-journal.com)

Risk factors for acalculous cholecystitis include diabetes, human immunodeficiency virus (HIV) infection, vascular disease, total parenteral nutrition, prolonged fasting, or being an intensive care unit (ICU) patient. (medscape.com)
Patients with acalculous cholecystitis may present with fever and sepsis alone, without the history of pain. (medscape.com)

Elderly patients tend to wait much longer to seek medical attention than younger patients, and they are much more likely to present with vague symptoms and have nonspecific findings on examination. (medscape.com)
Most people don't get any symptoms from gallstones and so don't need treatment. (bupa.co.uk)
Most people with gallstones don't have any symptoms. (bupa.co.uk)
If this happens, gallstone symptoms may then include the following. (bupa.co.uk)
Some other conditions of the bowel such as gastritis, duodenitis, ulcer disease and functional bowel disorde r can give symptoms like those of gallstones. (exeteruppergi.co.uk)
Similarly, endoscopy (camera looking at the oesophagus, stomach and duodenum) may be required to rule out other conditions with similar symptoms to gallstones. (exeteruppergi.co.uk)
However, almost all patients develop symptoms before complications, such as steady pain in the right hypochondrium or epigastrium, nausea, vomiting, and fever. (medscape.com)
In this article we will tackle down all about gallstones - what they are, how they form and why, what symptoms they cause, what are the treatment options, what health complications they can cause and what diet is best suited for them. (icloudhospital.com)
The patient typically has consumed large quantities of alcohol before the onset of symptoms. (the-medical-dictionary.com)
[8] Symptoms include right upper abdominal pain , pain in the right shoulder, nausea, vomiting, and occasionally fever. (wikizero.com)
Most people with gallstones do not have symptoms. (wikizero.com)
[14] People who are old, have diabetes , chronic illness, or who are immunocompromised may have vague symptoms that may not include fever or localized tenderness. (wikizero.com)
The patient has not had similar symptoms in the past. (osmosis.org)
His magnum opus, De Sedibus et Causis Morborum per Anatomem Indagatis , published in 1761, describes the findings of over 600 partial and complete autopsies, organised anatomically and methodically correlated with the symptoms exhibited by the patients prior to their demise. (bionity.com)
Then when you add the contested issue of the patient telling the Nurse that he had "chills" and wanted to be seen, even Dr. Gabriel agreed "that had I known he was experiencing systemic symptoms (chills), or that he requested to be reexamined before his trip, I certainly would have arranged to re-examine him. (malpracticeexperts.com)
Symptoms include chronic constipation. (iiab.me)

Furthermore, biliary pain may be associated with functional disorders of the biliary tract, so-called acalculous biliary pain (pain without stones), and can even be found in patients post-cholecystectomy (removal of the gallbladder), possibly as a consequence of dysfunction of the biliary tree and the sphincter of Oddi. (wikipedia.org)
Complications from gallstone disease is 0.3% per year and therefore prophylactic cholecystectomy are rarely indicated unless part of a special population that includes porcelain gallbladder, individuals eligible for organ transplant, diabetics and those with sickle cell anemia. (wikipedia.org)
The effect of gallstones and cholecystectomy on the development of pancreatic cancer has recently prompted many population-based studies. (bvsalud.org)
We conducted an updated systematic review and meta-analysis to explore the causality among gallstones, cholecystectomy and pancreatic cancer. (bvsalud.org)
1] However, the incidence of acute cholecystitis is falling, likely due to increased acceptance by patients of laparoscopic cholecystectomy as a treatment of symptomatic gallstones. (medscape.com)
Analysis was done retrospectively with the emphasis on the outcome including all complications, conversion rate, hospital stay and operation time after elective cholecystectomy. (hvt-journal.com)
ERCP/cholecystectomy), or previous cholangitis . (teachmesurgery.com)

Tumour markers- The value of CA 19-9 in patients with suspected cholangiocarcinoma is unclear. (gastrotraining.com)
Another role for PET is in screening patients with PSC for the presence of cholangiocarcinoma. (gastrotraining.com)
Surgery is the only curative treatment for patients with cholangiocarcinoma. (gastrotraining.com)
Neoadjuvant or adjuvant chemotherapy or radiotherapy therapy is not shown to be beneficial in patients with cholangiocarcinoma. (gastrotraining.com)
Photodynamic therapy is emerging as an important palliative option for patients with unresectable cholangiocarcinoma. (gastrotraining.com)
The most common causes are gallstones , ERCP (iatrogenic), and cholangiocarcinoma . (teachmesurgery.com)

However, the presence of gallstones is a frequent incidental finding and does not always necessitate treatment, in the absence of identifiable disease. (wikipedia.org)
The gold standard imaging modality for the presence of gallstones is ultrasound of the right upper quadrant. (wikipedia.org)

Typical gallbladder colic generally includes 1-5 hours of constant pain, most commonly in the epigastrium or right upper quadrant. (medscape.com)
Patients are commonly asymptomatic but may present with biliary colic (intermittent pain in the right upper quadrant). (lecturio.com)

patients with esophageal varices have a strong tendency to develop bleeding . (en-academic.com)

Other less common causes include liver cirrhosis , and peritoneal dialysis associated peritonitis. (wikidoc.org)

Biliary pain is most frequently caused by obstruction of the common bile duct or the cystic duct by a gallstone. (wikipedia.org)
Stones may temporarily obstruct the cystic duct or pass through into the common bile duct, leading to symptomatic biliary colic, which develops in 1-4% of patients with gallstones annually. (medscape.com)
More than 90% of the time acute cholecystitis is caused from blockage of the cystic duct by a gallstone . (wikizero.com)
[1] However, when a gallstone temporarily lodges in the cystic duct, they experience biliary colic . (wikizero.com)

Sometimes, gallstones are found if you have a scan to investigate something else. (bupa.co.uk)
CT scans demonstrate the gallbladder and sometimes gallstones, but are not as good as ultrasound or MRI. (exeteruppergi.co.uk)

Gallstone formation occurs from the precipitation of crystals that aggregate to form stones. (wikipedia.org)
Gallstones are stones that develop in your gallbladder. (bupa.co.uk)
Mixed gallstones are a combination of cholesterol and pigmented stones. (bupa.co.uk)
Gall stone disease presents a spectrum of pathology, ranging from asymptomatic gall stones, to acute cholecystitis and ascending cholangitis. (learnsurgeryonline.com)
7 in 10 patients with gall stones are likely to be asymptomatic. (learnsurgeryonline.com)
Age increases rates of gallstones, cholecystitis, and common bile duct stones. (medscape.com)
Most gallstones are cholesterol stones, while the rest are composed of bilirubin (pigment stones) and other mixed components. (lecturio.com)

Elderly patients also have a high incidence of asymptomatic underlying pathology. (medscape.com)
Surgery is not indicated in asymptomatic patients, except in some select groups (e.g. sickle cell disease). (learnsurgeryonline.com)
Most patients with gallstones are asymptomatic. (medscape.com)
Elderly patients are more likely to go from asymptomatic gallstones to serious complications of gallstones without gallbladder colic. (medscape.com)
Most gallstones (60-80%) are asymptomatic at a given time. (medscape.com)
The gallbladder does not usually need to be removed for asymptomatic gallstone disease, except in patients with diabetes mellitus. (unboundmedicine.com)

The evaluation of elderly patients presenting with abdominal pain poses a difficult challenge for the emergency physician. (medscape.com)
Studies published in the 1980s and 1990s demonstrated that, among elderly patients presenting to the ED with abdominal pain, at least 50% were hospitalized and 30-40% eventually had surgery for the underlying condition. (medscape.com)
Today, it is relatively rare for a patient with significant abdominal pain to leave the ED without some type of advanced imaging. (medscape.com)
Elderly patients often have underlying cardiovascular and pulmonary disease, which decreases physiologic reserve and predisposes them to conditions such as abdominal aortic aneurysm (AAA) and mesenteric ischemia . (medscape.com)
For patient education resources, see Digestive Disorders Center , as well as Abdominal Pain (Adults) , Appendicitis , Diverticulitis (Diverticulosis) , Gastroenteritis (Stomach Flu) , Constipation (Adults) , and Blood in the Urine . (medscape.com)
CT scanning with intravenous (IV) contrast medium is useful in diagnosing acute cholecystitis in patients with nonspecific abdominal pain. (medscape.com)
a nasogastric (NG) tube is frequently required to prevent abdominal distention and ileus, and is attached to low intermittent suction. (unboundmedicine.com)
Most patients have periods of intractable abdominal pain. (pocketdrugguide.com)
Patients present with severe abdominal pain associated with fever , chills , nausea and vomiting . (wikidoc.org)

Signs of complications include high fever, shock and jaundice . (wikizero.com)
On the other hand, there is often uncertainty as to resectability as well as the timetable of surgical evaluation and operative management in patients presenting with jaundice. (gastrotraining.com)
50 μmol/L). The patient may also complain of pruritus (itching), as a result of bile accumulation, and pale stool with dark urine, from the obstructive jaundice. (teachmesurgery.com)

Other complications include inflammation of the pancreas. (wikipedia.org)
Patients that have gallstones and biliary colic are at increased risk for complications, including cholecystitis. (wikipedia.org)
Multiple factors contribute to the diagnostic difficulty and high incidence of complications seen in elderly patients. (medscape.com)
If this patient goes untreated, which of the following complications is he most likely to develop? (osmosis.org)
Complications may include necrosis and ulcers of the rectal tissue. (iiab.me)

These effects include increased enzyme content, destabilization of lysosomal and zymogen granules, sustained increase in calcium overload, and activation of pancreatic stellate cells. (msdmanuals.com)
Control of sepsis with delayed elective surgery for repair of external pancreatic fistulas related to catheter placement was achieved in nine patients. (clinicalgate.com)
Complete nonsurgical resolution has been achieved in 84% of patients with this form of late, or "organized" pancreatic necrosis. (clinicalgate.com)

Biliary pain in the absence of gallstones, known as postcholecystectomy syndrome, may severely affect the patient's quality of life, even in the absence of disease progression. (wikipedia.org)
The patient may be flushed, jaundiced, dehydrated, tachycardic and hypotensive, all depending on the stage of gall stone disease continuum. (learnsurgeryonline.com)
[1] Risk factors for gallstones include birth control pills , pregnancy , a family history of gallstones, obesity , diabetes , liver disease , or rapid weight loss . (wikizero.com)
Gallstone-associated biliary tract disease and ethanol use account for most cases in the United States. (pocketdrugguide.com)
Disease processes may be incited or exacerbated by a variety of external and internal influences, including trauma , infection , poisoning , loss of blood flow , autoimmunity , inherited or acquired genetic damage, or errors of development . (bionity.com)
Modern surgical treatment of the liver includes the use of minimally invasive resection techniques for benign and malignant disease [1]. (fortunejournals.com)

It may develop an abnormal connection with other parts of the bowel (fistula) and this can cause other problems including bowel blockage (gallstone ileus) which may require emergency surgery. (exeteruppergi.co.uk)
CASE REPORT Laparoscopic hepatobiliary intervention, rather than open surgery, is associated with increased risk of biliary tree injury, including biliary leaks, which typically arise in the immediate postoperative period. (bvsalud.org)
Our main goal is to increase the interest in this neglected branch of surgery, thus optimizing the management of critical surgical patients. (surgicalpizza.org)
If a laparoscopic approach is used, the patient will typically be discharged on the day of or the day after surgery. (unboundmedicine.com)
The initial experience with laparoscopic liver surgery demonstrated that even major resections could be performed with acceptable morbidity and mortality, in a selected group of patients and in specialized centers. (fortunejournals.com)
Risks of surgery include bleeding, infection and recurrence of the wound. (apsapedsurg.org)
Nine patients required immediate surgery for failure of percutaneous therapy. (clinicalgate.com)

In fact, two newer studies showed that CT scanning significantly improved the certainty of diagnosis and altered therapy in elderly patients. (medscape.com)
The simplest and most common way to confirm the diagnosis of gallstones is with an ultrasound scan. (exeteruppergi.co.uk)
If you are suffering, or think you are have gallstones and are looking for a definitive diagnosis or wish to consider possible treatment options contact Mr Wajed today. (exeteruppergi.co.uk)
Patients with sepsis are at high risk for acute gastrointestinal injury (AGI), but the diagnosis and treatment of AGI due to sepsis are unsatisfactory. (qxmd.com)
Cholangitis is not a complete diagnosis, as there is nearly always an underlying cause that should be identified and treated. (teachmesurgery.com)
SPECIFIC INFECTIONS Necrotizing soft tissue infections Diagnosis and management of primary, secondary, and tertiary peritonitis High-risk patients: Who are they and how should they be managed? (docksci.com)

Although gallstones and cholecystitis are more common in women, men with gallstones are more likely to develop cholecystitis (and more severe cholecystitis) than women with gallstones. (medscape.com)

You may only discover you have gallstones when you have a test, such as an ultrasound of your abdomen (tummy) for some other reason. (bupa.co.uk)
Ultrasound imaging may also demonstrate the presence an underlying cause (e.g. gallstones). (teachmesurgery.com)

Risk factors for biliary colic and cholecystitis include pregnancy, elderly population, obesity, certain ethnic groups (Northern European and Hispanic), weight loss, and liver transplant patients. (medscape.com)
Drugs that have been associated with cholecystitis include octreotide and ceftriaxone. (medscape.com)

The gold standard investigation for cholangitis is ERCP , as it is both diagnostic and therapeutic. (teachmesurgery.com)
Figure 3 - ERCP showing an obstruction in the biliary tree, resulting in cholangitis. (teachmesurgery.com)

Pigmented gallstones form from calcium salts and bilirubin in your bile. (bupa.co.uk)
If the bile duct does become completely or partially obstructed, the patient will also develop pale stools and dark urine (since bilirubin can no longer pass into the gut in the normal way). (learnsurgeryonline.com)
Routine bloods should be taken, especially FBC ( leucocytosis is found in the vast majority of patients) and LFTs (showing a raised ALP ± GGT with a raised bilirubin ). (teachmesurgery.com)

Lab studies that should be ordered include a complete blood count, liver function tests and lipase. (wikipedia.org)
A prospectively maintained medical database of patients who required a liver resection was used for analysis. (fortunejournals.com)
A total of n=156 patients were divided into a group of n=47 patients (30.1%) receiving laparoscopic (LLR) and n=109 patients (69.9%) undergoing open liver resections (OLR). (fortunejournals.com)

The most common form is cholesterol gallstones. (wikipedia.org)
Cholesterol gallstones form if you have too much cholesterol in your bile. (bupa.co.uk)

In the setting of acute pain and anxiety, patients with intestinal obstruction may swallow excessive amounts of air. (basicmedicalkey.com)

There may be a reduction in bowel sounds and distension due to a secondary ileus. (learnsurgeryonline.com)

Patients with cholangitis may present with sepsis , so should be managed promptly, appropriately and often in a higher level of care. (teachmesurgery.com)

Drainage of the abscess may be all that is necessary for some children who present with a perianal abscess and no obvious fistula If the abscess returns, alternatives include repeat drainage of abscess or a fistulotomy (unroofing of the sinus tract) may be performed. (apsapedsurg.org)

Murphy's sign is demonstrated by asking the patient to inspire while the examiner palpates deeply in the right subcostal region. (learnsurgeryonline.com)

An infection of the bile ducts in this situation (cholangitis) can rapidly become life-threatening. (exeteruppergi.co.uk)

Empiric azoles are not beneficial in surgical patients: A propensity-matched cohort study. (docksci.com)

Mechanical irritation by gallstones can also produce chronic GB inflammation. (lecturio.com)

Gallstones may block the flow of bile for a long time, or leave your gallbladder and cause problems in your bile duct and pancreas. (bupa.co.uk)
If a gallstone does pass into the common bile duct, it can irritate or get stuck at the point where it enters the duodenum. (exeteruppergi.co.uk)

dehydration is a serious consequence of cholera, and may trigger serious sequelae -including, in rare instances, death-as rapidly as 24 hours after onset if not addressed promptly. (wikipedia.org)

Many elderly patients have underlying conditions such as diabetes or malignancy, further suppressing immunity. (medscape.com)

The definitive management of cholangitis is via endoscopic biliary decompression , removing the cause of the blocked biliary tree. (teachmesurgery.com)

Gallstones cause irritation to the lining of the gallbladder wall which can lead to inflammation (cholecystitis). (exeteruppergi.co.uk)

The patient's workup including core temperature, head imaging and laboratory tests (including AST/ALT, albumin, INR) were unremarkable with the exception of an ammonia level of 142 umol/L (normal range 16-53), slightly elevated CK, and urine toxicology screen with multiple positive agents. (ddxof.com)
The patient's past medical history may include gallstones , recent biliary tract instrumentation (i.e. (teachmesurgery.com)

Morbidity and mortality was observed in n= 29 (18.6 %) and n= 7 (4.5 %) patients, respectively. (fortunejournals.com)
The mortality was 12% in these ill patients, many of whom had multisystem organ failure. (clinicalgate.com)

CLASSIFICATION OF DISEASES AND INJURIES I. INFECTIOUS AND PARASITIC DISEASES (001-139) Includes: diseases generally recognized as communicable or transmissible as well as a few diseases of unknown but possibly infectious origin Excludes: acute respiratory infections (460-466) influenza (487. (cdc.gov)

As detailed in Table 49-1 , distinctions are drawn between intraluminal obturators such as foreign bodies or gallstones, intramural lesions such as tumors or intussusceptions, and extrinsic or extramural lesions such as adhesions. (basicmedicalkey.com)

It may occur as a complication of burns or multiple trauma, and patients are very ill on presentation. (learnsurgeryonline.com)

In the developed world, 10 to 15% of adults have gallstones. (wikipedia.org)
Children are more likely than adults to have acalculous gallstones. (medscape.com)
About 10-15% of adults in the developed world have gallstones. (wikizero.com)
Manual removal of a fecal impaction is often required with obese patients in traction, after a barium enema , and in poorly hydrated older adults. (iiab.me)

For patient education information, see eMedicineHealth's Digestive Disorders Center, as well as Gallstones. (medscape.com)

The most common gallstones symptom is pain in the middle or right side of the upper part of your tummy (abdomen), just under your ribs. (bupa.co.uk)
The most common triggers are gallstones and alcohol intake. (msdmanuals.com)

If gallstones were present, the patient is taught to reduce the risk of recurrence by maintaining normal body weight, exercising regularly, and eating three well-balanced meals daily, including fiber and calcium and avoiding alcohol and foods high in saturated fat. (unboundmedicine.com)

Anatomy7

Diseases26

Chemicals and Drugs3

Analytical, Diagnostic and Therapeutic Techniques and Equipment12

Health Care1

Geographicals1

Cholelithiasis5

Primary Sclerosing1

Pancreatitis33

Choledocholithiasis2

Acalculous cholecystitis2

Symptoms16

Cholecystectomy7

Cholangiocarcinoma6

Presence of gallstones2

Right upper qu2

Esophageal Varices1

Cirrhosis1

Cystic4

Sometimes gallstones2

Stones7

Asymptomatic6

Abdominal9

Jaundice3

Complications5

Pancreatic3

Disease6

Surgery7

Diagnosis6

Severe1

Ultrasound2

Cholecystitis include2

ERCP2

Bilirubin3

Liver3

Cholesterol2

Obstruction1

Secondary1

Sepsis1

Fistula1

Murphy's1

Infection1

Surgical1

Chronic1

Bile duct2

Sequelae1

Diabetes1

Endoscopic1

Irritation1

Patient's2

Mortality2

Infections1

Lesions1

Complication1

Adults4

Disorders Center1

Common2

Alcohol1