The optimal timing of laparoscopic cholecystectomy in patients with mild gallstone pancreatitis: A meta-analysis

Conclusion: Early laparoscopic cholecystectomy is safe and effective for patients with MAGP, but the indications and contraindications must be strictly controlled.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

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CONCLUSIONS: Amylase measurement was not necessary in the diagnosis and management of 88% of patients with acute pancreatitis. Of patients for whom amylase was ordered, it was common for these patients to be those referred to surgical procedures, possibly because amylase normalization may be documented faster than that of lipase. PMID: 31899279 [PubMed - as supplied by publisher]
Source: Clinical Biochemistry - Category: Biochemistry Authors: Tags: Clin Biochem Source Type: research
AbstractUltrasound plays an essential role in the initial evaluation of patients with suspected or confirmed acute pancreatitis. In addition to evaluation of the pancreatic parenchyma, ultrasound is used for assessment of the gallbladder, biliary tree, peripancreatic tissues, and regional vascular structures. While enlarged and edematous pancreas are classic sonographic features of acute pancreatitis, the pancreas may appear sonographically normal in the setting of acute pancreatitis. Nonetheless, sonographic evaluation in this setting is valuable because assessment for etiologic factors such as gallstones or evidence of b...
Source: Abdominal Imaging - Category: Radiology Source Type: research
This study was designed to investigate characteristics of the disease to predict recurrence.Methods: We retrospectively analyzed 617 patients that experienced a first AP attack between January 2009 and December 2014. Based on reviews of clinical and follow-up data, we attempted to identify risk factors of recurrence using Cox regression analysis.Results: During a median follow-up of 3.2 years (range 3-72 months), 100(16.2%) of the 617 study subjects experienced one or more episodes of recurrent acute pancreatitis (RAP). Of these 100 patients, 75(75%) experienced one relapse, 12(12%) two relapses, and 13(13%) ...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Gallstone disease is the term commonly used to refer to gallstones that cause symptoms. There is a myriad of complications that can arise from gallstones: acute cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder wall perforations, pericholecystic abscesses, Mirizzi syndrome, cholecystoenteric fistulas, choledocholithiasis, gallstone pancreatitis, porcelain gallbladder, gallbladder malignancies, and many more. The aim of this pictorial review is to revisit how multimodality imaging can help with the diagnosis of gallstone disease.
Source: Clinical Imaging - Category: Radiology Authors: Tags: Body Imaging Source Type: research
Acute pancreatitis is one of the most common causes for hospital admissions among gastrointestinal (GI) disorders in the United States, leading to approximately 280,000 patient admissions each year.1 During much of the past 2 decades, the incidence of acute pancreatitis has been rising, perhaps driven by an increased incidence of gallstone disease that may be associated with the obesity epidemic.2,3 Acute pancreatitis is associated with significant morbidity, especially when severe, and with mortality rates greater than 1%.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Practice Management: The Road Ahead Source Type: research
AbstractIn patients with acute pancreatitis (AP), diagnostic imaging is performed for various reasons, including the detection of the etiology (e.g., biliary obstruction caused by gallstones), diagnosis of pancreatitis in an unclear clinical setting, assessment of the severity of the process, and evaluation of its complications. In spite of the potential benefits of these imaging studies in the setting of AP, especially economic consequences but also medical risks are associated with diagnostic imaging, including increase of the effective radiation dose received by patients with AP and rising health care costs, frequently ...
Source: Abdominal Imaging - Category: Radiology Source Type: research
AbstractThe biliary tree and the pancreatic ducts originate from different buds of the primitive foregut. A plethora of anatomical variants and congenital anomalies have been described for both the biliary and the pancreatic duct systems, although they are usually asymptomatic. However, in some cases, these abnormalities can lead to serious clinical scenarios, especially when involving the biliopancreatic junction, with consequent mixing and reflux of the two different juices. To the best of our knowledge, we present the first case of pancreas divisum ducts draining into a choledochal cyst, with the lower third of the chol...
Source: Surgical and Radiologic Anatomy - Category: Anatomy Source Type: research
In this study, an accurate, sensitive, and selective analytical method was developed and successfully applied to assess the pharmacokinetic behavior of trepibutone in rats. Trepibutone and carbamazepine (internal standard, IS) were quantified using multiple reaction monitoring (MRM) mode with the transitions of m/z 311.09→265.08 and m/z 237.06→194.08, respectively. The linearity, precision, accuracy, extraction recovery, matrix effect, and stability of the established method were all excellent within acceptable range. A total of 30 metabolites were identified in plasma and urine by Q-Exactive high resolution mass...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Publication date: November 2019Source: Journal of the American College of Radiology, Volume 16, Issue 11, SupplementAuthor(s): Expert Panel on Gastrointestinal Imaging, Kristin K. Porter, Atif Zaheer, Ihab R. Kamel, Jeanne M. Horowitz, Hina Arif-Tiwari, Twyla B. Bartel, Mustafa R. Bashir, Marc A. Camacho, Brooks D. Cash, Victoria Chernyak, Alan Goldstein, Joseph R. Grajo, Samir Gupta, Nicole M. Hindman, Aya Kamaya, Michelle M. McNamara, Laura R. CarucciAbstractAcute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and sev...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
Acute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and severe, depending on the presence and persistence of organ failure and local or systemic complications. The revised Atlanta classification divides the clinical course of AP into an early (first week) and late phase (after first week) and the clinical phase determines the role of imaging. Imaging has a limited role in the early phase. In the early phase with typical presentations of AP, ultrasound is usually the only appropriate modality and is used for the detection of gallstones.
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Appropriate use criteria Source Type: research
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