• Title/Summary/Keyword: Gallbladder

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Prognosis and Management for Gallbladder Cancer with Hepatic Invasion: Long-term Results of 139 Patients from a Single Center in China

  • Qu, Kai;Chang, Hu-Lin;Liu, Si-Nan;Liu, Chang;Xu, Xin-Sen;Wang, Rui-Tao;Zhou, Lei;Tian, Feng;Wei, Ji-Chao;Tai, Ming-Hui;Meng, Fan-Di
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.1015-1018
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    • 2012
  • Objective: To improve the diagnosis of primary gallbladder carcinoma (GBC) with/without hepatic metastases by analyzing our experience of different GBC treatment in our patients. Methods: A retrospective study was carried out to analyze the clinical data of the 139 patients with GBC who underwent hepatic resection in our unit from January 2003 to December 2007. Patients were divided into two groups according to whether they demonstrated hepatic invasion. Tumor presentation, surgical modes, and prognosis of each patient were retrospectively reviewed. Kaplan-Meier curves and log-rank tests were employed to compare the survival rates of those patients undergoing different surgical procedures. Results: Of the 139 patients, 46 were men and 93 were women with the male to female ratio of 1:2.0. Their ages were ranged from 35 to 86 years with a mean age of $62.8{\pm}10.4$ years. There were 73 patients complicated with hepatic invasion (group A), and no hepatic invasion occurred in the other 66 patients (group B). Compared with the group B, the patients with hepatic invasion suffered lower differentiation of tumor (p=0.000), more advanced Nevin staging (p=0.008) and poorer prognosis (p=0.013). Radical resection were more frequently performed in group B (75.76%) than in group A (45.20%) with better outcomes (p=0.000). Conclusion: GBC patients complicated with hepatic invasion had poorer prognosis than those without invasion in long-term follow-ups. Radical resection might result in a satisfied prognosis in patients without hepatic invasion, but appears less favorable than palliative resection in those who were complicated with hepatic invasion.

A CASE OF TYPE II7 MIRIZZI SYNDROME (Type II Mirizzi 증후군 1례)

  • Kim, Hong-Jin;Lee, Joo-Hyeong;Shin, Myeong-Jun;Kwun, Koing-Bo;Chang, Jae-Chun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.197-202
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    • 1990
  • Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

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The Comparative Study on the Physiological Theory of Hyun-Gok (Yun Gil-Young) and the Hyunsang (形象) Theory of Ji-San (Park In-Kyu) (현곡(玄谷)의 생리학설와 지산(芝山)의 형상학설의 비교 연구)

  • Kim, Gyeong-Cheol;Lee, Hai-Woong
    • The Journal of Korean Medical History
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    • v.32 no.2
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    • pp.19-27
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    • 2019
  • For the purpose of searching examination in the connection with clinical medicine and the basic theory of Korean Medicine, we comparatively studied on the physiological system of Hyun-Gok (1912~1987) and the Hyunsang system of Ji-San (1927~2000). The results are as follows. The metabolism of Yin and Yang is connected 'Gallbladder (膽)'-'Bladder (膀胱)' and Man (男), Woman (女), Old aged (老), Young child (小) style. Man and Woman are divided in the body form chacteristic not by the sex. 'Gallbladder (膽)'-'Bladder (膀胱)' style are divided in the body form chacteristic by the terms of Yin (陰) and Yang (陽). 'Gallbladder (膽)' style represents excessive Yang and deficient Yin, 'Bladder (膀胱)' style represents excessive Yin and deficient Yang. The four composition factor of the body is connected Material basis (精) type, Vital energy (氣) type, Mental faculties (神) type and Blood (血) type. In the diagnosis of body form on the Hyungsang Medicine, there are several types of body shape and categories of people. The Material basis (精) type, Vital energy (氣) type, Mental faculties (神) type and Blood (血) type are classified by the four composition factor of the body. The structural-mechanics organization of five Internal Organs (臟) is connected five Internal Organs (臟) types and the running-animal (走), bird (鳥), fish (魚), turtle (甲) types in the Hyunsang system. The five Internal Organs (臟) types are percived on the ears, eyes, nose, mouth and facial complexion. And the running-animal, bird, fish, turtle types are accorded to the individual personalities and the most-developed part in the body trunk by the Organ picture (藏象) theory. The six atmospheric influences (六氣) is connected the six Kyung types (六經形). The six Kyung types are regulated by the shape of eyes and nose representing for the relation of Vital energy (氣) and Blood (血). By the comparative study on the physiological system of Hyun-Gok and the Hyunsang system of Ji-San, we can search the connection with clinical medicine and the basic theory of Korean Medicine.

Comparisons of the prevalence of gallbladder polyps and clinical variables among residents between the urban and rural area on Jeju Island

  • Kwon, Oh-Sung;Kim, Young-Kyu
    • Journal of the Korea Society of Computer and Information
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    • v.27 no.2
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    • pp.195-201
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    • 2022
  • There was a report that the prevalence of gallbladder polyps (GBPs) and some clinical variables were different between the urban and rural area, which was performed in a mainland. Thus the previous report could have some confounding factors. Therefore, the purpose of this study was to compare the prevalence of GBPs and clinical variables on the isolated island to exclude extrinsic confounding factors. We compared the prevalence of GBPs and clinical variables among 21,734 residents who visited a single medical check-up center in Jeju National University Hospital from January 2010 to December 2019 according to their residences on Jeju Island. The prevalence of GBPs were 10.1% in the urban area 8.7%, respectively (P = 0.006). Among clinical variables, the rate of central obesity, the mean levels of fasting blood glucose, low density lipoprotein-cholesterol, alkaline phosphate and gamma-glutamyltransferase and the mean age among residents in the rural area was statically higher in the urban area; however, the mean total cholesterol level among residents in the urban area significantly higher than in the rural area. This study showed that the prevalence of GBPs and some clinical variables among residents were statistically different between the urban area on Jeju Island.

A Case of Unresectable Gallbladder Cancer Treated with Chemotherapy Followed by Extended Cholecystectomy (항암화학요법에 이은 확대 담낭절제술로 치료한 절제 불가능한 담낭암)

  • Kwang Hyun Chung;Jin Myung Park;Jae Min Lee;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.104-107
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    • 2013
  • Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.

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Incidence and Risk Factors of Acute Ischemic Cholecystitis after Transarterial Chemoembolization: Correlation with Cone Beam CT Findings (간동맥 화학 색전술 후 발생한 급성 담낭염의 발생률과 위험인자: Cone Beam CT 소견과의 상관관계)

  • Jong Yeong Kim;Jung Suk Oh;Ho Jong Chun;Su Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.363-371
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    • 2024
  • Purpose Acute cholecystitis is a complication of transarterial chemoembolization (TACE) that occasionally requires surgical intervention. We aimed to analyze the incidence and risk factors of cholecystitis requiring surgical intervention in patients with embolic material uptake on cone beam CT (CBCT) performed immediately after various TACE procedures. Materials and Methods After a retrospective review of 2633 TACE procedures performed over a 6-year period, 120 patients with embolic material retention in the gallbladder wall on CBCT immediately after TACE were selected. We analyzed the incidence of and risk factors for acute cholecystitis. Results The overall incidence of acute cholecystitis requiring surgical intervention was 0.45% (12 of 2633 TACE procedures); however, it was present in 10% (12 of 120) of procedures that showed high-density embolic material retention in the gallbladder wall on CBCT performed immediately after TACE. Acute cholecystitis requiring surgical intervention occurred in eight patients (66.7%) who underwent direct cystic arterial embolization. Surgical intervention was performed 15 days (mean) after TACE. Conclusion Most unintended chemolipiodol deposits in the gallbladder wall resolved without intervention or surgery. However, superselective direct cystic arterial chemoembolization was associated with a high incidence of acute cholecystitis requiring surgery, and patients who undergo this procedure should be closely monitored.

Ultimate outcomes of three modalities for non-surgical gallbladder drainage in acute cholecystitis with or without concomitant common bile duct stones

  • Wiriyaporn Ridtitid;Thanawat Luangsukrerk;Panida Piyachaturawat;Nicha Teeratorn;Phonthep Angsuwatcharakon;Pradermchai Kongkam;Rungsun Rerknimitr
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.104-112
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    • 2022
  • Backgrounds/Aims: In moderate and high-surgical risk patients with acute cholecystitis, studies comparing percutaneous cholecystostomy (PC) vs. endoscopic transpapillary gallbladder stenting (ETGS) vs. endoscopic ultrasound-guided transmural gallbladder stenting (EUGS) are limited. Thus, the aim of this study was to compare efficacy and recurrence of cholecystitis after PC, ETGS, or EUGS during follow-up. Methods: We reviewed 143 moderate and high-surgical risk patients with acute cholecystitis with or without concomitant common bile duct stones who underwent PC, ETGS, or EUGS at our hospital. Technical success rate (TSR), clinical success rate (CSR), and recurrence were compared. Results: TSR in PC or EUGS group was higher than that in the ETGS group for those with concomitant common bile duct stones (100% vs. 100% vs. 73.2%; p = 0.07) and for those without concomitant common bile duct stones (100% vs. 100% vs. 77.3%; p < 0.001). CSR in ETGS or EUGS group was higher than that in the PC group for those with concomitant common bile duct stones (96.2% vs. 100% vs. 87.5%; p = 0.41) and for those without concomitant common bile duct stones (94.1% vs. 100% vs. 63.0%; p = 0.006). Using Kaplan-Meier analysis, the overall recurrent risk was the highest in the PC group (p = 0.004). Conclusions: In moderate and high-surgical risk patients with acute cholecystitis, EUGS provides significantly higher CSR with comparable TSR to PC. Thus, ETGS should be the first choice in those with concomitant common bile duct stones. Among the three patient groups, those who received PC had the highest rate of recurrence.

A Ovine Case of Absence of Gallbladder (양의 담낭결여증 일례)

  • Kim Chong-Sup;Huh Chan-Kwen;Lee Byoung-O
    • Journal of the korean veterinary medical association
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    • v.28 no.8
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    • pp.491-494
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    • 1992
  • Absence of gallbadder in sheep, which had previously given birth to 6 normal lambs at 8-year-old was examined macroscopically and radiographically 1. Ductus biliferus dorsalis sinister, Ductus biliferus ventralis sinister, Ductus biliferus quadratus and D

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A Case Study on the Use of Ortho-Cellular Nutrition Therapy (OCNT) in Patients with Intestinal Metaplasia (세포교정영양요법(OCNT)을 이용한 장상피화생 환자 사례 연구)

  • Neung Soo, Cheon
    • CELLMED
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    • v.13 no.3
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    • pp.11.1-11.6
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    • 2023
  • Objective: A case report on intestinal metaplasia improvement using Ortho-Cellular Nutrition Therapy (OCNT) Methods: A 68-year-old Korean female shows symptoms of atrophic gastritis, indigestion, abdominal distention, and gallbladder pain, causing inconvenience in her daily life. Results: Symptoms of intestinal metaplasia improved after nutritional therapy Conclusion: Nutrition therapy can help improve symptoms and alleviate dyspepsia in patients with symptoms of intestinal metaplasia.

Xanthogranulomatous inflammation of the lower jaw bone: a rare case report

  • Hyesung Bae;Kil-Hwa Yoo;Min-Seok Oh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.360-364
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    • 2023
  • Xanthogranulomatous inflammation (XGI) is an uncommon type of chronic inflammation and is histologically characterized by foamy histiocytes and giant cells. The most common sites of occurrence are kidneys and gallbladder. The etiology remains controversial. Involvement of the lower jaw bone is rare. In this study, we report a case of XGI presenting in the lower jaw.