AIM To summarize the experience in the clinical treatment of the biliary ductal strictures complicating localized left hepatolithiasis in recent two decades.
AIM： To investigate the effect of chronic inflammatory bowel disease （CIBD） specific risk factors for cholecystolithiasis, as duration and involvement pattern of the disease and prior surgery in patients with Crohn...AIM： To investigate the effect of chronic inflammatory bowel disease （CIBD） specific risk factors for cholecystolithiasis, as duration and involvement pattern of the disease and prior surgery in patients with Crohn＇s disease （CD） and ulcerative colitis （UC）. METHODS： A total of 222 patients with CD （135 females, 87 males, average age, 35.8±11.8 years; range 17-81 years） and 88 patients with UC （39 females, 49 males; average age, 37.2±13.6 years; range 16-81 years） underwent clinical and ultrasound examinations. Besides age, sex and degree of obesity, patients＇ CIBD specific parameters, including duration and extent of disease and prior operations were documented and evaluated statistically using logistic regression. RESLTLTS： The overall prevalence of gallbladder stone disease in patients with CD was 13% （n = 30）. Only age could be shown to be an independent risk factor （P = 0.014）. Compared to a collective representative for the general population in the same geographic region, the prevalence of cholecystolithiasis was higher in all corresponding age groups. Patients with UC showed an overall prevalence of gallbladder stone disease of only 4.6%. CONCLUSION：Only age but not disease-specific factors such as duration and extent of disease, and prior surgery are independent risk factors for the development of cholecystolithiasis in patients with CIBD.展开更多
AIM:To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively,...AIM:To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study. RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identifi ed as risk factors in men while, in females, the only risk factors were increasing age and a high BMI.Increasing age and pain in the right hypocondrium in men and increasing age in females were identifi ed as predictors of gallstones. Pain in the epigastrium/ right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain. CONCLUSION:Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confi rmed as the only symptom related to gallstones.展开更多
AIM： To analyze the indications, efficacy and safety of sphincteroplasty in our centre.METHODS： A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure...AIM： To analyze the indications, efficacy and safety of sphincteroplasty in our centre.METHODS： A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure consisted of duodenoscopy with Olympus TJF 145 Videoduodenoscope, approach to the biliary tract using a catheter with a guidewire, and dilatation of the papilla with a dilatation balloon catheter using a syringe with a manometer for control of the filling pressure.RESULTS： The indications included intradiverticular papilla in 26 patients （49%）, stenosis of a previous sphincterotomy in 19 patients （35.8%）, small size of the papilla in 4 patients （7.5%）, Billroth R gastrectomy in 3 patients （5.6%）, and coagulopathy in one patient （1.9%）. The efficacy was 97.8%, with all the calculi extracted from the common bile duct in 84.4% of the patients, even though 21 of the patients （39.6%） had calculi with a diameter equal to or greater than 10 ram. Seven patients （13.2%） presented complications： haemorrhage in 1 patient （1.9%） and mild pancreatitis in 6 patients （11.3%）. The mean hospital stay in case of complications was of 3 ± 0.63 d.CONCLUSION： Sphincteroplasty is highly effective, with a compllcation rate similar to that of sphincterotomy, furthermore, the complications are of low clinical importance. The use of the 10 mm balloon makes it possible to extract calculi with a diameter of over 15 mm and to extract more than 3 calculi without increasing the rate of complications and reduces the need to resort to lithotripsy or rescue sphincterotomy.展开更多
Objective To obtain a general overview of gallstone disease in Shanghai. Methods 3415citizens aged >20 in the community of Shanghai were randomly selected to undergo a clinical epidemiological study and an ultrasou...Objective To obtain a general overview of gallstone disease in Shanghai. Methods 3415citizens aged >20 in the community of Shanghai were randomly selected to undergo a clinical epidemiological study and an ultrasound examination to screen for cholelithiasis. Results Overall prevalence rate of gallstones was 6.5% (8.6% in women and 5.1% in men). Among the 3415 persons investigated, 65 had already undergone cholecystectomy. The percentage of asymptomatic gallstone was 70 .5% . Prevalence of gallstone diseases (gallstones plus cholecystectomy) increased with age significantly. Conclusion Compared to the research in Shanghai ten years ago, especially for the persons older than 50 years, the gallstone disease has become more frequent. The proportion of asymptomatic gallstones and the awareness is increasing.展开更多
We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray.Contrast studies demonstrated small bowel d...We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray.Contrast studies demonstrated small bowel diverticulosis.At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate.This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).展开更多
Objective:To summarize and analyze the clinical and histopathological features of chronic acalculous cholecystitis (CAC) and to investigate the diagnosis and surgical treatment of chronic acalculous cholecystit.Method...Objective:To summarize and analyze the clinical and histopathological features of chronic acalculous cholecystitis (CAC) and to investigate the diagnosis and surgical treatment of chronic acalculous cholecystit.Methods:The study subjects were 39 patients with chronic biliary symptoms but no evidence of stones in the gallbladder by B ultrasonography and magnetic resonance cholopancreatography (MRCP) (CAC group).The CCC group consisted of 66 patients taken randomly from concurrent all patients of chronic calculous cholecystitis (CCC).All patients accepted fibergastroscopy,B ultrasonography,MRCP,laboratory examination preoperatively.We retrospectively analyzed the clinical features,B ultrasonography and MRCP findings,histopathological results and clinical outcomes between the two groups.Results:All the 39 patients were diagnosed by clinical symptoms,B ultrasonography,fatty meal gallbladder contractability studies under ultrasound,fibergastroscopy and magnetic resonance cholangiopancreatography (MRCP),what's more,they were pathologically verified postoperatively.In all patients,there was a complete absence of gallbladder wall contractability.Mucosa epithelial defect was found in 21 patients in CAC group (53.8%) and 16 patients in CCC group (24.2%) respectively (P<0.005).Thickened arteriole wall was found in 29 patients in CAC group (74.4%) and none patient in CCC group (P<0.0001).Thickened gallbladder wall (4 mm or more in thickness) was found in 33 patients in CAC group (84.6%) and 28 patients in CCC group (42.4%) respectively (P<0.005).Bile stasis was found in 23 patients in CAC group (59.0%) and 14 patients in CCC group (21.2%) respectively by ultrasonography preoperatively and confirmed in operation (P<0.005).The outcomes of cholecystectomy,expressed as total or near total relief,was similar in the two groups.No statistically significant differences were observed between patients with CAC (90%) and CCC (80%),the P-value >0.05.Conclusion:Chronic acalculous cholecystitis could be diagnosed by symptoms,ultrasound,fatty meal gallbladder contractability studies under untrasoundand MRCP.The optimal treatment of chronic acalculous cholecystitis characterized by thickened arteriole wall and mucosa epithelial defect is cholecystectomy.展开更多
Objective: We explored the expression of coxsackie and adenovirus receptor (CAR) in small cell lung cancer (SCLC) tissue. Methods: CAR expression in 31 SCLC was assessed in formaldehyde-fixed, paraffin-embedded tissue...Objective: We explored the expression of coxsackie and adenovirus receptor (CAR) in small cell lung cancer (SCLC) tissue. Methods: CAR expression in 31 SCLC was assessed in formaldehyde-fixed, paraffin-embedded tissue according to the EnVision immunohistochemistry procedure, while 3 samples of surgical specimens of non-malignant lung disease were taken as the negative control. Results: We observed that the expression of CAR was detectable positive in all the 31 cases from the small cell lung cancer tissue, in contrasting that non-malignant lung tissue control. Conclusion: The high expression of CAR appeared in SCLC tissue indicates that it play an important role in of adenovirus vector-based gene therapy in SCLC.展开更多
文摘AIM To summarize the experience in the clinical treatment of the biliary ductal strictures complicating localized left hepatolithiasis in recent two decades.
文摘AIM： To investigate the effect of chronic inflammatory bowel disease （CIBD） specific risk factors for cholecystolithiasis, as duration and involvement pattern of the disease and prior surgery in patients with Crohn＇s disease （CD） and ulcerative colitis （UC）. METHODS： A total of 222 patients with CD （135 females, 87 males, average age, 35.8±11.8 years; range 17-81 years） and 88 patients with UC （39 females, 49 males; average age, 37.2±13.6 years; range 16-81 years） underwent clinical and ultrasound examinations. Besides age, sex and degree of obesity, patients＇ CIBD specific parameters, including duration and extent of disease and prior operations were documented and evaluated statistically using logistic regression. RESLTLTS： The overall prevalence of gallbladder stone disease in patients with CD was 13% （n = 30）. Only age could be shown to be an independent risk factor （P = 0.014）. Compared to a collective representative for the general population in the same geographic region, the prevalence of cholecystolithiasis was higher in all corresponding age groups. Patients with UC showed an overall prevalence of gallbladder stone disease of only 4.6%. CONCLUSION：Only age but not disease-specific factors such as duration and extent of disease, and prior surgery are independent risk factors for the development of cholecystolithiasis in patients with CIBD.
文摘AIM:To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study. RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identifi ed as risk factors in men while, in females, the only risk factors were increasing age and a high BMI.Increasing age and pain in the right hypocondrium in men and increasing age in females were identifi ed as predictors of gallstones. Pain in the epigastrium/ right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain. CONCLUSION:Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confi rmed as the only symptom related to gallstones.
文摘AIM： To analyze the indications, efficacy and safety of sphincteroplasty in our centre.METHODS： A retrospective study of sphincteroplasty in 53 cases of papilla at high risk was performed in 2004-2006. The procedure consisted of duodenoscopy with Olympus TJF 145 Videoduodenoscope, approach to the biliary tract using a catheter with a guidewire, and dilatation of the papilla with a dilatation balloon catheter using a syringe with a manometer for control of the filling pressure.RESULTS： The indications included intradiverticular papilla in 26 patients （49%）, stenosis of a previous sphincterotomy in 19 patients （35.8%）, small size of the papilla in 4 patients （7.5%）, Billroth R gastrectomy in 3 patients （5.6%）, and coagulopathy in one patient （1.9%）. The efficacy was 97.8%, with all the calculi extracted from the common bile duct in 84.4% of the patients, even though 21 of the patients （39.6%） had calculi with a diameter equal to or greater than 10 ram. Seven patients （13.2%） presented complications： haemorrhage in 1 patient （1.9%） and mild pancreatitis in 6 patients （11.3%）. The mean hospital stay in case of complications was of 3 ± 0.63 d.CONCLUSION： Sphincteroplasty is highly effective, with a compllcation rate similar to that of sphincterotomy, furthermore, the complications are of low clinical importance. The use of the 10 mm balloon makes it possible to extract calculi with a diameter of over 15 mm and to extract more than 3 calculi without increasing the rate of complications and reduces the need to resort to lithotripsy or rescue sphincterotomy.
文摘Objective To obtain a general overview of gallstone disease in Shanghai. Methods 3415citizens aged >20 in the community of Shanghai were randomly selected to undergo a clinical epidemiological study and an ultrasound examination to screen for cholelithiasis. Results Overall prevalence rate of gallstones was 6.5% (8.6% in women and 5.1% in men). Among the 3415 persons investigated, 65 had already undergone cholecystectomy. The percentage of asymptomatic gallstone was 70 .5% . Prevalence of gallstone diseases (gallstones plus cholecystectomy) increased with age significantly. Conclusion Compared to the research in Shanghai ten years ago, especially for the persons older than 50 years, the gallstone disease has become more frequent. The proportion of asymptomatic gallstones and the awareness is increasing.
文摘We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray.Contrast studies demonstrated small bowel diverticulosis.At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate.This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).
文摘Objective:To summarize and analyze the clinical and histopathological features of chronic acalculous cholecystitis (CAC) and to investigate the diagnosis and surgical treatment of chronic acalculous cholecystit.Methods:The study subjects were 39 patients with chronic biliary symptoms but no evidence of stones in the gallbladder by B ultrasonography and magnetic resonance cholopancreatography (MRCP) (CAC group).The CCC group consisted of 66 patients taken randomly from concurrent all patients of chronic calculous cholecystitis (CCC).All patients accepted fibergastroscopy,B ultrasonography,MRCP,laboratory examination preoperatively.We retrospectively analyzed the clinical features,B ultrasonography and MRCP findings,histopathological results and clinical outcomes between the two groups.Results:All the 39 patients were diagnosed by clinical symptoms,B ultrasonography,fatty meal gallbladder contractability studies under ultrasound,fibergastroscopy and magnetic resonance cholangiopancreatography (MRCP),what's more,they were pathologically verified postoperatively.In all patients,there was a complete absence of gallbladder wall contractability.Mucosa epithelial defect was found in 21 patients in CAC group (53.8%) and 16 patients in CCC group (24.2%) respectively (P<0.005).Thickened arteriole wall was found in 29 patients in CAC group (74.4%) and none patient in CCC group (P<0.0001).Thickened gallbladder wall (4 mm or more in thickness) was found in 33 patients in CAC group (84.6%) and 28 patients in CCC group (42.4%) respectively (P<0.005).Bile stasis was found in 23 patients in CAC group (59.0%) and 14 patients in CCC group (21.2%) respectively by ultrasonography preoperatively and confirmed in operation (P<0.005).The outcomes of cholecystectomy,expressed as total or near total relief,was similar in the two groups.No statistically significant differences were observed between patients with CAC (90%) and CCC (80%),the P-value >0.05.Conclusion:Chronic acalculous cholecystitis could be diagnosed by symptoms,ultrasound,fatty meal gallbladder contractability studies under untrasoundand MRCP.The optimal treatment of chronic acalculous cholecystitis characterized by thickened arteriole wall and mucosa epithelial defect is cholecystectomy.
基金Supported by a grant from the Society Development Foundation of Jiangsu (No. BS2007025)
文摘Objective: We explored the expression of coxsackie and adenovirus receptor (CAR) in small cell lung cancer (SCLC) tissue. Methods: CAR expression in 31 SCLC was assessed in formaldehyde-fixed, paraffin-embedded tissue according to the EnVision immunohistochemistry procedure, while 3 samples of surgical specimens of non-malignant lung disease were taken as the negative control. Results: We observed that the expression of CAR was detectable positive in all the 31 cases from the small cell lung cancer tissue, in contrasting that non-malignant lung tissue control. Conclusion: The high expression of CAR appeared in SCLC tissue indicates that it play an important role in of adenovirus vector-based gene therapy in SCLC.
