• Title/Summary/Keyword: Gallstone

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Determination of Chemical Composition of Gallbladder Stones and their Association with Induction of Cholangiocarcinoma

  • Hussain, Saad Muhmood;Al-Jashamy, Karim Alwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6257-6260
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    • 2013
  • Gallstone disease is a major surgical problem in many populations; it is probably related to diet, especially excessive consumption of meat. The objective of this study was to determine the chemical composition of gallstones and their association with neoplastic changes including cholangiocarcinomas in cholecystectomised patients. The chemical composition of gallstones from 40 patients (8 males and 32 females) was analyzed. This is a prospective study performed in Baquba teaching hospital in the period from 1/10/2012 to 1/1/2013 in which we collected the gallstones for the patients who underwent cholecystectomy, whether open or laparoscopic. The stones were classified according to their chemical composition as a mixed stones (MS), and examined using a stone analysis set (chemical qualitative method) for calcium, magnesium, phosphate, uric acid and oxalate which was used reagent for qualitative determination of main individual components of stones. The results of this study showed the highest incidence of gallstones in the age group 40-49 was 13 cases followed by 11, 8 and 4 cases for age groups 30-39, 50-59, 20-29 and 60 and above, respectively. The chemical analysis showed the majority of gallstones were mixed, 38 containing calcium followed by 37 cases with uric acid, 28 with magnesium, and 25 and 22 stones with oxalate and phosphate, respectively. Microscopically, we confirmed neoplastic changes (17.5%) as cholangiocarcinomas (CCCs) (7.55%) and dysplastic cells of carcinoma in situ in 4 (10%), 31 (77.5%) cases were chronic cholecystitis and 2 (5%) cases were acute cholecystitis with empyema out of bile duct disorders patients. In conclusion, majority of cases had mixed gallstones that involved five and four of inorganic chemicals of calcium, magnesium and phosphate, the highest incidence of gallstones in age group 40-49 years old was 13 cases, and neoplastic changes were confirmed (17.5%) including CCCs, (7.5%) and dysplastic cells of carcinoma in situ (10%), while 31 (77.5%) cases were chronic cholecystitis.

Factors for Postoperative Gallstone Occurrence in Patients with Gastric Cancer: a Meta-analysis

  • Chen, Xiang-Jun;Li, Nian;Huang, Ying-De;Ren, Shuang;Liu, Fang;Chen, Lian;Wang, Yong;Chen, Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.877-881
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    • 2014
  • Objective: To evaluate risk factors for gallstones after gastrectomy. Methods: To identify documents published from 1990 to 2011 the Pubmed, Cochrane Library, Springer Link, CBM and WanFang databases were searched and a meta-analysis was performed with RevMan 5.2 software for odds ratios and 95%CIs. Results: Fifteen studies were selected for the meta-analysis. The pooled ORs [95%CIs] were 0.56 [0.43, 0.73], (P<0.0001) for digestive tract reconstruction, 0.80 [0.54, 1.17], (P=0.25) for pylorus preservation, 0.33[0.15, 0.75], (P=0.008) for resection scope of stomach, 0.33 [0.15, 0.75], (P=0.008) for lymphadenectomy, and 0.13 [0.05, 0.33], (P<0.0001) for vagotomy. Conclusions: Digestive tract physical reconstruction and vagus nerve preservation can reduce the morbidity of gallstones after gastrectomy. Total gastrectomy can add to the morbidity of galltones as does increasing the degree of lymph node dissection. There was no significant difference in gallstones with or without pylorus preservation.

Simultaneous Determination of Biliary Free and Phospholipid Fatty Acids Using Gas Chromatography-Mass Spectrometry (GC-MS를 이용한 담즙내 유리 지방산 및 인지질 지방산들의 동시 분석)

  • Yang, Yoon Jung;Lee, Seon Hwa;Chung, Bong Chul
    • Analytical Science and Technology
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    • v.13 no.5
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    • pp.592-600
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    • 2000
  • The concentration of free fatty acids and fatty acid composition as well as cholesterol supersaturation in bile may be an important factor in the gallstone formation. Therefore, we simultaneously determinded 23 fatty acids in bile by selected ion monitoring (SIM) method of gas chromatography-mass spectrometry (GC-MS). Biliary fatty acids were extracted by aminopropyl column and the extracts with (phospholipid fraction) or without (free fatty acid fraction) alkaline hydrolysis of phospholipid were derivatized with MSTFA/TMCS (N-methyl-N-trimethylsilyl-trifluoroacetamide/trimethylsilylchloride) mixture in order to be detected on the GC-MS. The recovery range of this method was 61.1-99.0% and the RSD value of within-a-day and day-to-day test were 3.1-25.6% and 3.8-27.0%, respectively. Using this method, biliary profile was investigated in the bile of normal controls and patients with gallstones. The amounts and their distribution of free and phospholipid fatty acids showed different pattern between normal subjects and patients.

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A Study on the Sasang Constitutional Characteristics of Obese Middle-Aged Women (중년비만여성의 사상체질별 특성에 관한 연구)

  • Lim, Jinny;Lee, In-Soon;Koh, Byung-Hee;Song, Il-Byung;Lee, Soo-Kyung
    • Journal of Sasang Constitutional Medicine
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    • v.16 no.3
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    • pp.59-69
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    • 2004
  • 1. Objectives This research is to ascertain relations between the Sasang Constitution and characteristics of the eating attitudes, mental state, body composition, various examination results of obese middle-aged women. 2. Methods The subjects were 31 female patients whose BMI(Body Mass Index) was over $25kg/m^2$ and age was 35~55. It was analysed statistically the results of EAT(The Eating Attitudes Test), DEBQ(Dutch Eating Behavior Questionnaire), BDI(Beck Depression Inventory), STAI(State-Trait Anxiety Inventory), body composition analyser, biochemistry, abdominal ultrasonography, mammography which was surveyed from them. 3. Results and Conclusions 1)There was no relation between the Sasang Constitution and the eating attitudes, eating behaviors. But Taeumin got statistically lower score than Non-Taeumin in 23rd question for emotional eating and 33rd question for environmental eating of DEBQ 2)On the mental state, Taeumin got statistically lower score than Non-Taeumin in BDI, STAI-S 3)On the body composition, Taeumin got statistically higher value than Non-Taeumin in BMI. Soyangin got statistically lower value than Non-Soyangin in BMI, left upper limb water, soft lean mass, body water, trunk water. 4)On the various examinations, Taeumin got statistically lower value than Non-Taeumin in serum albumin. Soyangin got statistically lower value in BMI and higher frequency in gallstone, breast nodule than Non-Soyangin. 5)It was thought that Taeumin's obesity is managed by controling physical factor such as excessive 'Gathering Qi(吸聚之氣)' rather than eating attitudes and psychological factor.

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Pylorus-Preserving Gastrectomy for Gastric Cancer

  • Oh, Seung-Young;Lee, Hyuk-Joon;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.16 no.2
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    • pp.63-71
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    • 2016
  • Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.

A Case of Ceftriaxone Associated Biliary Sludge (Ceftriaxone과 연관된 소아의 담도 오니(biliary sludge) 1례)

  • Yoon, Jae Kyun;Lee, Hyun Hee;Shin, Young Kyoo;Choung, Ji Tae;Tockgo, Young Chang
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.308-313
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    • 1997
  • Ceftriaxone, an effective third generation cephalosporin with a wide range of antimicrobial activity, has become widely used by pediatricians for a variety of bacterial infections including meningitis. It has been associated with the development of sludge or stone in the gallbladder of some patients treated with this drug. Ceftriaxone associated biliary sludge has unusual acoustic characteristics and resembles gallstone. The sludge can cause symptoms such as cramping abdominal pain, and disappears after stopping ceftriaxone administration. Because of these seemingly confusing observations, it is important for the clinicians to recognize these findings that ceftriaxone treatment can cause. We report a case of ceftriaxone associated biliary sludge in Korean children. A 6-year-old girl who was treated for meningitis with ceftriaxone (100mg/kg/day) developed cramping upper abdominal pain from 5th hospital day. Physical examination, liver function tests and X-ray revealed no specific abnormal findings. But abdominal ultrasound revealed high amplitude echogenic sludge with prominent post-acoustic shadow in gallbladder and its diameter was 1.5cm. We stopped ceftriaxone administration and tried conservative care. Abdominal cramping pain subsided after 3 days of ceftriaxone removal. Second abdominal ultrasound confirmed the disappearance of sludge at 3 weeks later.

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Aqueous Extract of Lysimachia christinae Hance Prevents Cholesterol Gallstone in Mice by Affecting the Intestinal Microflora

  • Liu, Shijia;Luorong, Quji;Hu, Kaizhi;Cao, Weiguo;Tao, Wei;Liu, Handeng;Zhang, Dan
    • Journal of Microbiology and Biotechnology
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    • v.31 no.9
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    • pp.1272-1280
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    • 2021
  • With changes in human dietary patterns, the proportion of high-fat and high-cholesterol foods in the daily diet has increased. As a result, the incidence rate of cholelithiasis is increasing rapidly. Many studies have reported on the crucial role that the intestinal microflora plays in the progression of gallstones. Although the whole herb of Lysimachia christinae, a traditional Chinese medicine, has long been extensively used as a remedy for cholelithiasis in China, its effects on the intestinal microflora remain unknown. Hence, in this study, we investigated the ability of the aqueous extract of L. christinae (LAE) to prevent cholesterol gallstones (CGSs) in model animals by affecting the intestinal microflora. The effects of LAE on body weight, serum lipid profile, visceral organ indexes, and histomorphology were studied in male C57BL/6J mice, which were induced by a lithogenic diet. After the 8-week study, CGSs formation was greatly reduced after LAE treatment. LAE also reduced body weight gain and hyperlipidemia and restored the histomorphological changes. Moreover, the intestinal microflora exhibited significant variation. In the model group fed the lithogenic diet, the abundances of the genera unclassified Porphyromonadaceae, Lactobacillus and Alloprevotella decreased, but in contrast, Akkermansia dramatically increased compared with the control check group, which was fed a normal diet; the administration of LAE reversed these changes. These results imply that L. christinae can be considered an efficient therapy for eliminating CGSs induced by a high-fat and high-cholesterol diet, which may be achieved by influencing the intestinal microflora.

A rare case report of Mirizzi syndrome type III treatment algorithm in situs inversus totalis, large ventricular septal defect and transposition of great arteries in a young diabetic patient

  • Raju Badipati;Samali Maity;Muralidharsai Maddasani;Syed Mazhar Galib Ali;Farha Naaz Khatoon;Lakshmi Durga Kasinikota;Kushal Gunturu;Gopu Prameela
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.322-327
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    • 2023
  • Situs inversus totalis (SIT) is a rare condition in which cardiac and abdominal organs are inverted from their normal left-sided orientation. Mirizzi syndrome, characterized by the obstruction of the common hepatic duct or the common bile duct by gallstone, is a rare condition. Mirizzi syndrome co-occurrence in SIT patients is rare. Gallbladder in sinistroposition is extremely uncommon in SIT patients. We report a known case of diabetes, ventricular septal defect with transposition of the great arteries in a 32-year-old female who presented with jaundice, cholangitis, chills, and fever that had lasted for 10 days. She was confirmed to have SIT with type III Mirizzi syndrome following a series of diagnostic procedures. Primarily, endoscopic retrograde cholangiopancreatography along with common bile duct stenting was performed to initially reduce cholangitis. After an eight-week follow-up after the reduction of cholangitis, surgery was conducted. Mirror-imaged ports were used for the laparoscopic procedure, and the surgeon was on the patient's right side rather than the usual left side. The patient was discharged from the hospital following two days of uneventful healing.

Prevalence and Risk Factors of Gallstones in Adult Health Screening Population (건강한 성인의 담석 유병률과 위험인자)

  • Lee, Mi-Hwa;Kwon, Duck-Moon;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.287-294
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    • 2014
  • Gallstone is the most common disease of the biliary system. Korean has experienced an increase in the percentage of cholesterol gallstones. The major risk factors associated with cholesterol gallstones are age, gender as well as obesity. This study was designed to determine the prevalence of gallstones in the last three years and evaluate the associated risk factors in the population who underwent health screening. The study population consisted of 2,484 males and 2,212 females who visited the health promotion center in Dalseogu, Daegu in Korea from January 2011 to December 2013. Each participant in the study had their biliary system gallbladder examined using ultrasonography. Classified as underweight, normal weight or overweight using the population of obese according to the body mass index, and classified according to mood diagnosis of diabetes presented by the American Diabetes Association. Fasting blood glucose and number of liver function, the divided the control group by referring to the normal liver function values used herein. The geological map, I was classified as NCEP APT III. A showed of total 148 people were found to have gallstones. The prevalence of sex among 148 patients (3.15%) 84 men (1.79%) and 64 women 1.36%) which shows significantly there is little difference. 1.84% 40 years and below, 3.38% 40's showed age prevalence was 4.66% in 50's and above. In addition, Total-cholesterol was at the most in 52 people, LDL-cholesterol in 398 people, Triglyceride in 36 people, HDL-cholesterol in 19 people. The abnormal group, was created from the total-cholesterol categories from a physical examination of a subject that has been found to be gallstones in the gallbladder. A result of conducting the univariate analysis shows the prevalence of gallstones, a correlation that is meaningful. The logistic regression analysis of multiple ages was chosen to show risk factors age independent cholelithiasis. In spite of the conclusion, gallstones are not displayed in relation to the metabolic syndrome but in order to clarify this, not only the subject of a health examination is needed but, a further study of the general public when possible.

Analysis of the prescription for persons of Taiyin constitution (太陰人 Tae-eum) in the herbal formulas and cases found in classic texts (태음인 처방의 본초 조합 용례 분석 - 중요 고문헌을 중심으로 -)

  • Kim, SungWon;Lee, ByungWook;Kim, KiWook
    • The Journal of Korean Medical History
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    • v.33 no.1
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    • pp.31-41
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    • 2020
  • Purpose : This study compares prescriptions in the 1901 edition of the Donguisusebowon (東醫壽世保元) and the 1901 edition of 24 Revised Tae-eum constitution prescriptions (新定太陰人病應用要藥二十四方) (1901PCDT) with medical herbs found in classical texts. This study also examines whether to include patterns which compose medical herbs for the person of Tae-eum constitution (太陰人). Method : The prescriptions for Tae-eum-in in the Shinchukbon and the ingredients of medical herbs of the prescriptions of the Complete Works of Zhang Jingyue (景岳全書), Secret Works of Universal Benefit (廣濟秘笈), Treasured Mirror of Eastern Medicine (東醫寶鑑), Comprised Edition for Formulas (方藥合編), Protecting Essence for Longevity (壽世保元), Introduction to Medicine (醫學入門), New Book for Saving People (濟衆新編 ENGLISH), and Compendium of Local Medicinals and Formulas (鄕藥集成方) were input into a database. The prescriptions were examined and combinations of medical herbs used to treat the person of Tae-eum constitution were noted. Result : Among the prescriptions for the person of Tae-eum constitution, similar examples of the 17 prescriptions of Kudzu Decoction to Relieve the Muscles (葛根解肌湯), Regulate the Stomach and Coordinate the Purity Decoction (調胃升淸湯), Clear the Heart and Lotus Pip Decoction (淸心蓮子湯), Decoction for Stabilizing Asthma with Ephedra (麻黃定喘湯), Profuse Heat and Sparse Cold Decoction (熱多寒少湯), Decoction for Coordinating Qi with Kudzu (葛根承氣湯), Major Decoction for Coordinating Qi with Kudzu (葛根大承氣湯), Minor Decoction for Coordinating Qi with Kudzu (葛根小承氣湯), Decoction for Dispersing the Exterior with Ephedra (麻黃發表湯), Boost the Lung Essence Decoction (補肺元湯), Major Supplementing Decoction with Deer Antler Velvet (鹿茸大補湯), Boosting Black Essence Pill (拱辰黑元丹), Honeylocust Fruit and Rhubarb Decoction (皂角大黃湯), Kudza and Duckweed Decoction (葛根浮萍湯), Sweet Flag and Polygala Powder (石菖蒲遠志散), Liriopis and Polygala Decoction Powder (麥門冬遠志散), and Cattle Gallstone Formula to Clear the Heart (牛黃淸心元) were found in important ancient literature and Dried Chestnut and Holotrichia Decoction (乾栗蠐螬湯) and Dried Chestnut and Tree of Heaven Root Bark Decoction (乾栗樗根皮湯) are the combination originally set by Lee Jema. Conclusion : Because 70.8% of the prescriptions in 1901PCDT could be found in literature which were pervasive in the period of the Joseon Dynasty (the period of Ming and Qing), it corresponds with Lee Jema's view that medical men in the Song, Yuan, and Ming Dynasties disclosed half of the prescriptions for Tae-eum person by studying these texts more.