PURPOSE: Current lithotriptors use a dry treatment head that must be coupled to the patient with gel or oil. We determined how the quality of coupling affects stone breakage under conditions that simulated patient treatment. MATERIALS AND METHODS: Experiments were performed with a Dornier (DoLi-50 electromagnetic lithotriptor. The test tank ...

OBJECTIVE: To evaluate whether 1 week of ciprofloxacin before percutaneous nephrolithotomy (PCNL) in patients with stones of > or = 20 mm or pelvicalyceal dilatation, reduces urosepsis, as we previously reported that such patients have four times the risk of urosepsis after PCNL. PATIENTS AND METHODS: Patients undergoing PCNL, and ...

RATIONALE AND OBJECTIVES: To evaluate if contrast enhanced sonography (CES) can help to detect gallbladder inflammation and differentiate between acute and chronic cholecystitis. MATERIALS AND METHODS: Thirty-three patients with clinical suspicion of acute cholecystitis were examined with CES before cholecystectomy. Thirty patients with no history of gallbladder disease served as ...

Gallbladder stones are known to produce histopathological changes in the gallbladder. It is also one of the predisposing factors for the development of cancer of the gallbladder. Aim: This work was carried out to study the diverse histopathological changes in the gallbladder mucosa as a result of cholelithiasis in the ...

Background: Gallstones disease associated with biliary symptoms such as gallbladder dyspepsia (episgastric discomfort, flatulence, intermittent nausea with fat intolerance), and biliary colic (abdominal pain localised in the right upper quadrant) is commonly treated by cholecystectomy. In contrast, biliary symptoms in the absence of gallstones (acalculous biliary symptoms, ABS) often constitute ...

BACKGROUND: The aim of the present study was to evaluate gallbladder function in irritable bowel syndrome (IBS) patients. METHODS: The functions of gallbladder were investigated every 30 min for 4 h. In addition, ejection fraction of the gallbladder was calculated from the fasting and post-prandial volumes. RESULTS: In IBS patients ...

AIM: To evaluate the histopathological and radiological findings of the gallbladder in patients with autoimmune pancreatitis (AIP). METHODS: The radiological findings of the gallbladder of 19 AIP patients were retrospectively reviewed. Resected gallbladders of 8 AIP patients were examined histologically and were immunostained with anti-IgG4 antibody. Controls consisted of gallbladders ...

OBJECTIVES: To investigate the effect of pelvicaliceal anatomy on stone formation in patients with solitary upper caliceal stones. METHODS: The records of patients with solitary upper caliceal stones between 1996 and 2004 were reviewed. After the exclusion of patients with hydronephrosis, major anatomic abnormalities, noncalcium stones, metabolic abnormalities, history of ...

BACKGROUND: Routine use of intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) is a matter of debate. METHODS: Data from 2,130 consecutive LCs and patients' follow-up during 9 years were collected and analyzed. During the first 4 years of the study, 800 patients underwent LC, and IOC was performed selectively (SIOC). ...

Among 328 patients with dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), 14 (4 men and 10 women, median age 44 years) had acute abdomen. DHF/DSS was initially suspected in only 2 of these 14 patients. Presumptive diagnoses of acute cholecystitis (6 acalculus and 4 calculus cholecystitis) were made in 10 patients, ...

BACKGROUND: The main cause of iatrogenic bile duct injury is misidentification of the common bile duct as the cystic duct. In this article, we summarize the experience in the treatment of 112 patients with iatrogenic bile duct injury. METHOD: Clinical data of these patients treated at 10 hospitals of Songhua ...

BACKGROUND: The aim of this retrospective and monocentric study was to describe the magnetic resonance cholangiography (MRC) features of biliary abnormalities related to extrahepatic obstruction of the portal vein (EHOPV). METHODS: From September 2001 to May 2003, MRC was performed in 10 consecutive patients who had a portal thrombosis. RESULTS: ...

OBJECTIVE: To evaluate and compare the outcome of laparoscopic cholecystectomy (LC) in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion and hospital stay. METHODS: Between April 1999 and March 2004, we retrospectively evaluated all patients admitted for symptomatic gall bladder disease in the Department of ...

BACKGROUND: Percutaneous drainage or surgery is required when amebic liver abscess (ALA) fails to respond to medical management. In some of these patients, non-response may be due to communication of ALA with the biliary tree. This report describes our experience with the use of endoscopic biliary draining in such patients. ...

OBJECTIVE: The purpose of this study was to validate an algorithm recommended by current literature for the patients with acute flank pain and evaluate the validity of bedside ultrasonography (US) performed by emergency physicians (EP) as a part of this algorithm. Materials and METHODS: This prospective validation study was carried ...

Leishmaniasis infection may involve destruction of nasal tissues resulting in lacrimal drainage system alteration. PURPOSE: To evaluate the frequency of lacrimal excretory system sequelae in patients treated for leishmaniasis. METHODS: Forty-five leishmaniasis-treated patients (90 nasolacrimal ducts) were submitted to lacrimal excretory system evaluation. All were evaluated by Jones I test ...

PURPOSE: Renal calculi are a significant source of morbidity for patients with neurogenic bladder. Calculi from patients with NB have traditionally been composed primarily of struvite and carbonate apatite secondary to chronic urea-splitting bacteriuria. In the current era there have been great improvements in the urological rehabilitation of patients with ...

One hundred consecutive patients referred for active stone removal responded to a number of questions regarding their attitude to metabolic risk evaluation and recurrence prevention. Of the 74 men and 26 women all but one were interested in the cause of their disease. While 95% of the patients were motivated ...

BACKGROUND: In patients with primary sclerosing cholangitis, there are no reliable markers or imaging modalities to detect malignant changes or early cholangiocarcinoma when curative interventions may still be possible. METHODS: Clinical features and outcomes were evaluated for 47 patients who underwent 101 endoscopic retrograde cholangiopancreatography (ERCP) procedures with bile duct ...

BACKGROUND/AIMS: Although quantitative hepatobiliary scintigraphy (QHBS) was originally suggested as a promising method in the diagnosis of sphincter of Oddi dysfunction (SOD), it was recently claimed that QHBS displays poor reproducibility and specificity in cholecystectomized patients. The aim of the present study was to assess the reproducibility of QHBS in ...

We evaluated the possible effects of a calcium entry blocking agent "verapamil" on new stone formation and/or regrowth of residual fragments after shock wave lithotripsy (SWL) during long-term follow-up (>30 months) and compared the results with the success rates of adequate fluid intake. A total of 70 patients treated with ...

OBJECTIVES: Symptomatic cholelithiasis is a common disease in the general population with an increased prevalence in patients with cirrhosis. While cholecystectomy is the procedure of choice for the treatment of symptomatic cholelithiasis, cirrhotics have an increased risk of complications associated with this therapy. We have found that placement of an ...

PURPOSE: To present our experience with ureteroscopy and holmium laser lithotripsy in pregnant patients and discuss the need for stents postoperatively. PATIENTS AND METHODS: A retrospective analysis was performed on seven consecutive pregnant patients presenting with renal colic necessitating intervention between 1997 and 2003. One patient presented during the first, ...

OBJECTIVES: Assess the role of cholangioscopy in primary sclerosing cholangitis for 1) detection of cholangiocarcinoma using cholangioscopy-assisted biopsy 2) detection of stones not seen on cholangiography 3) stone removal with cholangioscopy-directed lithotripsy. METHODS: Prospective cohort of consecutive patients referred for cholangioscopy to evaluate dominant strictures or stones. A data collection ...

BACKGROUND: Inflammatory alterations of the gastric mucosa are commonly caused by Helicobacter pylori (Hp) infection in patients with symptomatic gallstone disease. However, the additional pathogenetic role of an impaired gallbladder function leading to an increased alkaline duodenogastric reflux is controversially discussed. AIM: To investigate the relation of gallbladder function and ...

PURPOSE: We aimed to investigate the probable effect of pelvicaliceal anatomical differences between stone bearing and normal contralateral kidneys on the etiology of stone formation in children with a solitary lower pole caliceal stone. MATERIALS AND METHODS: We reviewed the clinical records of 25 pediatric patients who underwent SWL for ...

BACKGROUND: The purpose of this study was to analyze the frequency and results of preoperative biliary and gastrointestinal (GI) evaluation of patients undergoing Roux-en-Y gastric bypass (RYGB). METHODS: Retrospective review of the preoperative evaluation of 144 consecutive RYGB patients. RESULTS: Cholecystectomy had already been performed in 43 (30%) patients; 22% ...

BACKGROUND AND PURPOSE: We report our initial experience with a prototype ureteroscope having the smallest tip diameter and shaft with an offset eyepiece for the treatment of ureteral stones. PATIENTS AND METHODS: A series of 21 male and 4 female patients between the ages of 1.5 and 57 years underwent ...

Background: Gallstones disease associated with biliary symptoms such as gallbladder dyspepsia (episgastric discomfort, flatulence, intermittent nausea with fat intolerance), and biliary colic (abdominal pain localised in the right upper quadrant) is commonly treated by cholecystectomy. In contrast, biliary symptoms in the absence of gallstones (acalculous biliary symptoms, ABS) often constitute ...

The aim of this study is to analyze our experience with the management of bile duct injuries (BDIs) following laparoscopic cholecystectomy (LC). From 1996 to 2004, 21 patients with BDI after LC were treated in our department. The BDIs were graded according to the classification of Strasberg. Ten patients had ...

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena ...

BACKGROUND: The Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome is a malformation of the female genitals (occurring in one in 4000 female live births) as a result of interrupted embryonic development of the Müllerian (paramesonephric) ducts. This retrospective study examined the issue of associated malformations, subtyping, and the frequency distribution of subtypes in MRKH ...

Primary sclerosing cholangitis (PSC) is a well-established indication for orthotopic liver transplantation (OLT), but post-OLT bile duct strictures complicate the outcome for these patients. These strictures might represent recurrent PSC (rPSC). To estimate the risk factors for post-OLT non-anastomotic bile duct strictures in PSC patients and to find their possible ...

BACKGROUND: Elderly male patients are thought to have a higher incidence of biliary infections. This demographic is common among veterans, so we analyzed the spectrum of gallstone disease in a large veteran population. METHODS: A total of 285 patients with gallstone disease were studied. There were 27 women and 258 ...

BACKGROUND: The role of liver function tests (LFTs) in evaluating common bile duct (CBD) stones in patients with cholelithiasis has been studied widely. However, it is not clear whether these predictive models are useful in inflammatory gallstone disease. METHODS: A review was undertaken of 385 consecutive patients admitted as an ...

BACKGROUND: Minimally invasive techniques are being used increasingly in patients with benign and malignant breast diseases. The purpose of this study was to compare the diagnostic yield of 2 groups of patients who underwent either minimally invasive microductectomy or major duct excision for pathologic nipple discharge. METHODS: Two hundred thirty-five ...

BACKGROUND AND OBJECTIVES: Laparoscopic cholecystectomy (LC) may result in the incidental diagnosis of early stage (T1 and T2) gallbladder cancer. LC is useful for T1 patients, however, its role in T2 patients remains controversial. We sought to determine the effect of initial LC on patient outcome in early-stage gallbladder cancer. ...

Prior investigators have proposed microlithiasis as a causative factor for occult gallbladder diseases. Endoscopic ultrasonography (EUS) is potentially far more sensitive than transabdominal ultrasonography (TUS) in visualizing small stones. The aim of this study was to investigate the role of endoscopic ultrasonography (EUS) in the diagnosis of microlithiasis in patients ...

INTRODUCTION: The exact role of copper and zinc in the etiology of carcinoma of the gallbladder is unclear. Some studies suggest the Cu/Zn ratio is a good indicator of the extent and prognosis in carcinoma of the gastrointestinal tract. The aim of the present study is to estimate the micronutrient ...

It has been shown that magnetic resonance cholangiopancreatography (MRCP) has a diagnostic accuracy comparable to that of ERCP. The aim of this study was to compare the diagnostic accuracy of MRCP in patients with suspected choledocholithiasis, but with negative ultrasonography findings. Among 404 patients undergoing videolaparocholecystectomy for cholelithiasis, 48 with ...

This study was conducted to evaluate the etiological and clinical characteristics of urolithiasis in Iraqi children. From 1999 to 2004, 204 children with renal calculi were evaluated. The age range of the patients was 4 months to 14 years, 61.3% of the patients were under 5 years. Male to female ...

Abnormalities involving smooth muscle function in different systems of the body have been reported in irritable bowel syndrome (IBS). There are a few studies on gallbladder function in this disorder with conflicting results. To investigate the motility of gallbladder in patients with IBS. Forty-eight patients (15 male and 33 female) ...

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the nonsurgical gold standard for the diagnosis and treatment of choledocholithiasis (CDL). Complications include a 0.1% to 1.3% mortality rate and a 5% to 19% morbidity rate, including a reported 1.8% to 6.7% incidence of postprocedure pancreatitis. Twenty-seven percent to 67% of ...

An experience with the diagnosis and treatment of patients with non-Oriental primary intrahepatic lithiasis (PIHL) is described. A group of 48 native Brazilian patients with symptomatic PIHL were studied, and the patients' characteristics, diagnoses, treatment protocols based on the presentation of the disease, prognostic factors, and late results were analyzed. ...

BACKGROUND: We investigated the mode of progression of intraductal papillary-mucinous neoplasm of the pancreas (IPMN) in patients who underwent follow-up in order to elucidate the characteristics of malignancy and to establish an effective treatment strategy. METHODS: Fifty-one patients with IPMN (branch-duct type, 47; main-duct type, 4) who had undergone follow-up ...

Laparoscopic cholecystectomy (LC) is the preferred treatment for symptomatic gallstone disease. Biliary injury during LC is still a serious problem. Knowledge of anatomic detail is important for not encountering the injury. Magnetic resonance cholangiography (MRC) is a noninvasive method for imaging the biliary ducts. However, MRC has many drawbacks such ...

BACKGROUND: Fluoroscopic intraoperative cholangiography (IOC) has been proposed as a safe and accurate screening method for choledocholithiasis, with a sensitivity and specificity of nearly 100% in selected cases. In the present study we retrospectively reviewed the diagnostic accuracy of IOC in cases highly suggestive of choledocholithiasis. MATERIALS AND METHODS: Between ...

Background: We have used the Amplatzer ductal occluder for transcatheter closure of large persistently patent arterial ducts, and used our experience to assess the safety and efficacy of the device in young children and infants. Methods and patients: We used the Amplatzer ductal occluder prospectively in 43 patients with large ...

BACKGROUND/AIMS: Patients with primary sclerosing cholangitis (PSC) have an increased risk of developing hepatobiliary tumors. The tumor marker CA19-9 was claimed to indicate the occurrence of bile duct carcinoma. This study aimed to assess whether increased serum levels of CA19-9 in PSC patients with dominant stenoses indicate bile duct carcinoma. ...

All children less than 18 years of age who were diagnosed with a first episode of kidney stones at pediatric referral centers in Iceland during the years 1995-2000 were studied retrospectively. The diagnosis was based on clinical features and results of imaging studies. Patients were invited for evaluation at the ...