A homozygous ABCB4 mutation causing an LPAC syndrome evolves into cholangiocarcinoma
Publication date: August 2019Source: Clinica Chimica Acta, Volume 495Author(s): Boudour Khabou, Ayman Trigui, Tahya Sellami Boudawara, Leila Keskes, Hassen Kamoun, Véronique Barbu, Faiza FakhfakhAbstractLow phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and low biliary phospholipid concentration with symptomatic and recurring cholelithiasis. In the present study, we reported a case of a 63-year-old woman, who presented a biliary pain beginning at the age of 30, recurrent after cholecystectomy, along with “comet-tail shadows” revealed by ultrasonograph...
Source: Clinica Chimica Acta - June 14, 2019 Category: Laboratory Medicine Source Type: research

Gallstone ileus of upper gastrointestinal tract: A case series
AbstractThree patients with gallstone ileus are presented here. All of them were diagnosed on the basis of clinical presentation, endoscopy, and abdominal ultrasonography (USG) findings. We, therefore, propose that presence of the triad, i.e. cholecystoduodenal fistula on endoscopy, diseased gallbladder on USG, and clinical and radiological features of luminal obstruction should point to the diagnosis of gallstone ileus. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - June 12, 2019 Category: Gastroenterology Source Type: research

Efficacy and safety of a novel topical agent for gallstone dissolution: 2-methoxy-6-methylpyridine
Although methyl-tertiary butyl ether (MTBE) is the only clinical topical agent for gallstone dissolution, its use is limited by its side effects mostly arising from a relatively low boiling point (55 °C). In t... (Source: Journal of Translational Medicine)
Source: Journal of Translational Medicine - June 10, 2019 Category: Research Authors: Ho Joong Choi, Suk Joon Cho, Ok-Hee Kim, Jin Sook Song, Ha-Eun Hong, Sang Chul Lee, Kee-Hwan Kim, Sang Kuon Lee, Young Kyoung You, Tae Ho Hong, Eun Young Kim, Jung Hyun Park, Gun Hyung Na, Dong Do You, Jae Hyun Han, Jae Woo Park & hellip; Tags: Research Source Type: research

A homozygous ABCB4 mutation causing an LPAC syndrome evolves into cholangiocarcinoma.
Abstract Low phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and low biliary phospholipid concentration with symptomatic and recurring cholelithiasis. In the present study, we reported a case of a 63-year-old woman, who presented a biliary pain beginning at the age of 30, recurrent after cholecystectomy, along with "comet-tail shadows" revealed by ultrasonography thus, fulfilling the diagnosis of LPAC. This disease evolved into a cholangiocarcinoma. To understand the molecular basis of this phenotype, we performed the ABCB4 gene sequencing, followed by...
Source: International Journal of Clinical Chemistry - June 7, 2019 Category: Chemistry Authors: Khabou B, Trigui A, Boudawara TS, Keskes L, Kamoun H, Barbu V, Fakhfakh F Tags: Clin Chim Acta Source Type: research

The unwanted third wheel in the Calot & #39;s triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
Conclusions: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. A meticulous knowledge of the hepatobiliary triangle in association with all elements of 'Culture of Safety in Cholecystectomy' is mandatory for surgeons facing more than two structures within Calot's triangle. (Source: Journal of Minimal Access Surgery)
Source: Journal of Minimal Access Surgery - June 4, 2019 Category: Surgery Authors: Luigi Marano Alberto Bartoli Karol Polom Raffaele Bellochi Alessandro Spaziani Giampaolo Castagnoli Source Type: research

The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis: is magnetic resonance cholangiopancreatography needed?
CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay. PMID: 31155897 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - June 3, 2019 Category: Surgery Authors: Thacoor A, Pike TW, Pathak S, Dixon J, Macutkiewicz C, Smith AM Tags: Ann R Coll Surg Engl Source Type: research

Laparoscopic Cholecystectomy in Situs Inversus Totalis: Case Report with Review of Techniques
CONCLUSIONThe anatomical variation in SIT can influence the localization of symptoms in patient with cholelithiasis leading to a delay in diagnosis and management. Laparoscopic cholecystectomy can be safely performed in these cases. However, it is considered technically challenging procedure and often requires alteration in the technique. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - June 1, 2019 Category: Surgery Source Type: research

Tu1408 CAN WE DO BETTER? DIAGNOSTIC ACCURACY OF ASGE GUIDELINES IN COMPARISON TO EARLY EUS FOR SUSPECTED CHOLEDOCHOLITHIASIS
Gallstone disease is a common clinical problem that leads to pancreatitis and cholangitis if left undiagnosed. Guidelines from the American Society for Gastrointestinal Endoscopy (ASGE) categorize patients with suspected choledocholithiasis (CDL) into 3 risk categories (low, intermediate, high) based on prognostic indicators. When compared to endoscopic ultrasound (EUS), these guidelines may result in unnecessary endoscopic retrograde cholangiopancreatographies (ERCPs) and associated complications. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - June 1, 2019 Category: Gastroenterology Authors: Jake Jacob, Michelle E. Lee, Erin Chew, Aaron P. Thrift, Robert Sealock Tags: Tuesday abstract Source Type: research

Mo1700 INCIDENCE OF CHOLELITHIASIS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
The relationship between inflammatory bowel disease (IBD) and gallstones has been recognized. There have been few studies comparing the incidence of cholelithiasis bewteen ulcerative colitis and Crohn ’s disease. The aim of this study was to evaluate the incidence and risk factors of cholelithiasis in IBD patients. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - June 1, 2019 Category: Gastroenterology Authors: Soo yeong Kwak, Kook Hyun Kim, Joon Hyun Cho, Sung Bum Kim, Kyeong Ok Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim Tags: Monday abstract Source Type: research

Sa1470 RISK ESTIMATION, MACHINE LEARNING BASED ERCP DECISION-MAKING TOOL FOR SUSPECTED CHOLEDOCHOLITHIASIS
Gallstone disease affects more than 20 million Americans annually and up to 18 % undergoing cholecystectomy for gallstones have concomitant common bile duct stone(s) (BDS). Prior studies have demonstrated that existing societal risk stratification guidelines to predict the presence of BDS lack accuracy, leading to overutilization of ERCP. Improved stratification allows appropriate patient selection for ERCP and vis-a-vis lower risk modalities such as EUS, MRCP. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - June 1, 2019 Category: Gastroenterology Authors: Venkata S. Akshintala, Bohao Tang, Ayesha Kamal, James L. Buxbaum, B. Joseph Elmunzer, Sachin B. Wani, Chung Yao Yu, Alan H. Tieu, Anthony N. Kalloo, Vikesh Singh, Brian Caffo, Mouen A. Khashab Tags: Saturday abstract Source Type: research

Sa1426 EVALUATING THE ACCURACY OF THE ASGE PROPOSED PREDICTIVE RISK FACTORS FOR CHOLEDOCHOLITHIASIS. TIME FOR REVISION?
ERCP is recommended for patients considered high risk for choledocholithiasis after biochemical testing and abdominal US. We sought to assess the American Society for Gastrointestinal Endoscopy (ASGE) proposed strategy to assign risk of choledocholithiasis in patients with symptomatic cholelithiasis. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - June 1, 2019 Category: Gastroenterology Authors: C. Roberto Simons-Linares, James S. Ramey, Tyler Stevens, John J. Vargo, Prabhleen Chahal Tags: Saturday abstract Source Type: research

Sa1425 INCIDENCE AND RISK FACTORS FOR GALLSTONE FORMATION AFTER SURGICAL AND ENDOSCOPIC THERAPY FOR GASTRIC CANCER
Prevalence of gallstones is increased after gastrectomy. However, study comparing incidence of gallstone between endoscopic therapy and gastrectomy has been scarce. The aim of this study was to compare incidence of gallstone formation after endoscopic submucosal dissection(ESD) and gastrectomy for treatment of gastric cancer patients during a 5-year follow-up period and to evaluate the risk factors for gallstones formation development after treatment of gastric cancer. (Source: Gastrointestinal Endoscopy)
Source: Gastrointestinal Endoscopy - June 1, 2019 Category: Gastroenterology Authors: Soyeong Kim, Kook Hyun Kim, Joon Hyun Cho, Sung Bum Kim, Kyeong Ok Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim Tags: Saturday abstract Source Type: research

Subvesical Bile Duct and the Importance of The Critical View of Safety: Report of A Case
ConclusionApplication of the critical view of safety principle may assist in intra-operative detection of aberrant biliary anatomy, thus preventing iatrogenic injury. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - May 28, 2019 Category: Surgery Source Type: research

Biliary sphincterotomy reduces the risk of acute gallstone pancreatitis recurrence in non-candidates for cholecystectomy
Population aging and comorbidity are leading to an increase in patients unfit for cholecystectomy. (Source: Digestive and Liver Disease)
Source: Digestive and Liver Disease - May 28, 2019 Category: Gastroenterology Authors: Irene Garc ía de la Filia Molina, Ana García García de Paredes, Antonio Martínez Ortega, Natalia Marcos Carrasco, Enrique Rodríguez De Santiago, Rubén Sánchez Aldehuelo, Jose Ramón Foruny Olcina, Juan Ángel González Martin, Sergio López Duran, Tags: Digestive Endoscopy Source Type: research

Oxidative stress and deregulations in base excision repair pathway as contributors to gallbladder anomalies and carcinoma - a study involving North-East Indian population.
This study involved patients from the North-East Indian population, where the numbers of reported cases are increasing rapidly and alarmingly. Oxidative stress, based on 8-OH-dG levels, was found to be significantly higher in gallbladder anomalies (cholelithiasis [CL] and cholecystitis [CS]) and GBC at the plasma and DNA level, and was associated with GBC severity. The expressions of key BER pathway genes were downregulated in gallbladder anomalies and GBC compared to controls, and in GBC compared to both non-neoplastic controls and gallbladder anomalies. Expression of XRCC1 and hOGG1 was significantly associated with both...
Source: Free Radical Research - May 25, 2019 Category: Research Tags: Free Radic Res Source Type: research

The effect of concomitant cholecystectomy and sleeve gastrectomy on morbidity in high-risk obese patients with symptomatic gallstones.
Authors: Dincer M, Dogan F Abstract Introduction: Obesity is an independent risk factor for gallstones. In obese patients, gallstone is more symptomatic than in non-obese people. Aim: To present the early results of laparoscopic sleeve gastrectomy (LSG) and concomitant cholecystectomy (CC) performed in patients with symptomatic gallstone accompanied by at least one additional systemic disease to obesity and to investigate its effect on morbidity. Material and methods: Patients undergoing sleeve gastrectomy for morbid obesity between January 2016 and August 2018 were retrospectively studied. Twenty-seven pat...
Source: Videosurgery and Other Miniinvasive Techniques - May 25, 2019 Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research

[Hepatobiliary Manifestation of Inflammatory Bowel Disease].
Abstract The hepatobiliary system is one of the most common sites of extraintestinal manifestation in patients with inflammatory bowel disease (IBD). The progression of IBD can lead to a primary hepatobiliary manifestation and can occur secondary to multiple drugs or accompanying viral infections. Primary sclerosing cholangitis is the representative hepatobiliary manifestation of IBD, particularly in ulcerative colitis. Although most agents used in the treatment of IBD are potentially hepatotoxic, the risk of serious hepatitis or liver failure is low. The prevalence of HBV and HCV in IBD is similar to the general ...
Source: Korean J Gastroenter... - May 25, 2019 Category: Gastroenterology Authors: Seo KI, Kang SB Tags: Korean J Gastroenterol Source Type: research

Biliary Tract Disease in Girls and Young Women With Rett Syndrome
Objective: We reviewed medical records and conducted a nationwide survey to characterize the clinical features and determine the prevalence of biliary tract disease in girls and women with Rett syndrome (RTT). Methods: Sixty-two individuals with RTT and biliary tract disease were identified from the membership of Rett Syndrome Organization and patient files of the principal investigator. Medical records of 46 individuals were reviewed for presenting features, diagnostic tests, and treatment outcomes of biliary tract disease. We designed a questionnaire that probed the frequency of risk factors and treatment outcomes o...
Source: Journal of Pediatric Gastroenterology and Nutrition - May 24, 2019 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Etiologies of Long-Term Postcholecystectomy Symptoms: A Systematic Review.
Conclusion: Long-term postcholecystectomy symptoms vary amongst patients, arise from different etiologies, and require specific diagnostic and treatment strategies. Most symptoms after cholecystectomy seem to be caused by coexistent diseases and physiological changes due to cholecystectomy. The outcome of this research is summarized in a decision tree to give clinical guidance on the treatment of patients with symptoms after cholecystectomy. PMID: 31110517 [PubMed] (Source: Gastroenterology Research and Practice)
Source: Gastroenterology Research and Practice - May 23, 2019 Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research

Bouveret ’s syndrome: A rare form of gallstone ileus
A 67-year-old female presented with 3 weeks of epigastric pain, multiple episodes of emesis, and weight loss. Physical examination was notable for mild tenderness in the epigastrium. Laboratory evaluation revealed an elevated alkaline phosphatase and transaminitis. A contrast-based computed tomography of the abdomen displayed a dilated fluid-filled stomach and proximal duodenum containing a 4.8-cm calcified structure, thickening of the gallbladder wall with pericholecystic fluid, pneumobilia, and external biliary ductal dilatation secondary to mass effect (Fig 1, A). (Source: Surgery)
Source: Surgery - May 15, 2019 Category: Surgery Authors: Brandon M. Wojcik, Norah E. Liang, Motaz Qadan Source Type: research

Risk stratification for complications of laparoscopic cholecystectomy based on associations with sociodemographic and clinical variables in a public hospital
Cholelithiasis is the most common disease of the biliary tract. We aimed to associate complications resulting from laparoscopic cholecystectomy with patients ’ sociodemographic and clinical data, stratifying risk based on this association. (Source: American Journal of Surgery)
Source: American Journal of Surgery - May 15, 2019 Category: Surgery Authors: Matheus Bartolomei de Siqueira Corradi, Ronaldo D` Ávila, Etienne Duim, Cibele Isaac Saad Rodrigues Source Type: research

Association of Common Single Nucleotide Polymorphisms of Candidate Genes with Gallstone Disease: A Meta-Analysis
AbstractNumerous studies have investigated the relationship between various candidate gene polymorphisms and gallbladder stone disease (GSD) across ethnic populations; however, the results are often inconsistent. This meta-analysis aims to comprehensively evaluate the influence of common ABCG8 T400K, ABCG8 D19H, ABCG8 C54Y, ApoB100 EcoRI, ApoB100 XbaI, ApoE HhaI, CETP TaqI, CYP7A1 Bsa, LRPAP1 I/D and TNF- α A308G polymorphisms on the risk of gallbladder stone disease. 33 Full-text articles with 9250 cases and 12,029 healthy controls (total 21,279 subjects) were analyzed using the RevMan software (V5.1) and the Compre...
Source: Indian Journal of Clinical Biochemistry - May 15, 2019 Category: Biochemistry Source Type: research

Retained Gallbladder Secondary to Retrieval Bag Rupture During Laparoscopic Cholecystectomy—A Case Report
ConclusionRetrieval bags should be inspected following removal to ensure it is completely intact. Surgeons should consider extending the fascial incision if there is any difficulty during removal. Any damage to the retrieval bag mandates immediate pneumoperitoneum for further exploration of retained products. Governance bodies should incorporate practice guidelines related to retrieval bag rupture as these are currently not present. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - May 10, 2019 Category: Surgery Source Type: research

Siphon-Like Gall Bladder Hydrops in Chronic Cholelithiasis.
Authors: Reinehr R, Matthies A PMID: 31064646 [PubMed - in process] (Source: Deutsches Arzteblatt International)
Source: Deutsches Arzteblatt International - May 10, 2019 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

Point-of-care ultrasound in management of gallstone ileus - a case report.
Authors: Rotaru MI, Necula AH, Caraiani CN, Badea AF, Tantau MV, Badea RI Abstract Point-of-care ultrasound has become of utmost importance in the management of critically ill patients, changing everyday clinical practice. With this case report, we highlight the role of abdominal ultrasound in the management of elderly patientswith gallstone ileus (a rare cause of intestinal obstructions caused by a cholecysto-duodenal fistula) and with contraindications for contrast-enhanced CT scan. PMID: 31063526 [PubMed - in process] (Source: Medical Ultrasonography)
Source: Medical Ultrasonography - May 9, 2019 Category: Radiology Tags: Med Ultrason Source Type: research

Long-term incisional hernia rate after single-incision laparoscopic cholecystectomy is significantly higher than that after standard three-port laparoscopy: a cohort study
ConclusionSILC is associated with a statistically significantly higher long-term incisional hernia rate at the umbilical port site than the standard multiport laparoscopic cholecystectomy. Our data show there was no relevant advantage regarding the postoperative course, hospital stay or cosmetic satisfaction. To date, widespread use of SILC cannot be recommended. Registration number: NCT03768661 (https://www.clinicaltrials.gov).Trial registrationThis study has been registered atwww.clinicaltrials.gov. The clinicaltrials.gov ID number is: NCT03768661. (Source: Hernia)
Source: Hernia - May 9, 2019 Category: Sports Medicine Source Type: research

[Quality Assurance Using Administrative/Routine Data for Cholelithiasis - Changes Over Time and Current Status].
CD Abstract Quality assurance using administrative/routine data (QSR) is a relatively new measure to assess outcome quality. This approach is methodologically distinct from external quality assurance, as well as from quality assurance based upon registries. Since 2011, QSR for cholelithiasis within AOK patients has been overseen by the Scientific Institute of the AOK (WIdO). Following the introduction of an expert panel in 2013, numerous changes were put into place, whereby the indicator rates for transfusion/bleeding, various complications as well as the overall indicator were reduced. Interestingly, the risk ad...
Source: Zentralblatt fur Chirurgie - May 9, 2019 Category: Surgery Authors: Jeschke E, Günster C, Fahlenbrach C, Heller G, Maneck M, Meyer HJ, Rolle U, Schuler E, Waibel B, Heidecke CD Tags: Zentralbl Chir Source Type: research

Case series of cancer patients who developed cholecystitis related to immune checkpoint inhibitor treatment
AbstractBackgroundImmune checkpoint inhibitors (ICIs) represent a promising novel class of cancer therapy, but immune-mediated adverse events can complicate ICI treatment. Acute cholecystitis in patients receiving ICI therapy has not been characterized. We aimed to describe the clinical features of patients who developed ICI-related cholecystitis.MethodsWe evaluated a case series of patients at a tertiary cancer center who received ICI therapy and developed cholecystitis, diagnosed by clinical presentation and diagnostic imaging, during 2010 –2018. Patients with a history of chronic cholecystitis or other etiologies ...
Source: Journal for Immunotherapy of Cancer - May 3, 2019 Category: Cancer & Oncology Source Type: research

ACR Appropriateness Criteria® Jaundice
Publication date: May 2019Source: Journal of the American College of Radiology, Volume 16, Issue 5, SupplementAuthor(s): Expert Panel on Gastrointestinal Imaging:, Nicole M. Hindman, Hina Arif-Tiwari, Ihab R. Kamel, Waddah B. Al-Refaie, Twyla B. Bartel, Brooks D. Cash, Victoria Chernyak, Alan Goldstein, Joseph R. Grajo, Jeanne M. Horowitz, Aya Kamaya, Michelle M. McNamara, Kristin K. Porter, Pavan K. Srivastava, Atif Zaheer, Laura R. CarucciAbstractJaundice is the end result of myriad causes, which makes the role of imaging in this setting particularly challenging. In the United States, the most common causes of all types ...
Source: Journal of the American College of Radiology - May 2, 2019 Category: Radiology Source Type: research

Incidental metastases and lymphoma of the gallbladder - an analysis of ten rare cases identified from a large national database.
CONCLUSION: Metastases and lymphoma of the gallbladder are rare. Traditional imaging methods prior to cholecystectomy may miss gallbladder malignancies. A liberal approach of histopathological analysis of the gallbladder should be applied. PMID: 31035806 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Gastroenterology)
Source: Scandinavian Journal of Gastroenterology - May 2, 2019 Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

A novel mutation in SPTA1 identified by whole exome sequencing in a Chinese family for hereditary elliptocytosis presenting with hyperbilirubinemia: A case report
Rationale: Hereditary elliptocytosis is an inherited disorder characterized by the elliptical red blood cells (RBCs) on the peripheral blood smear and related hemolysis, mainly results from a heterozygous mutation in the genes that encode protein 4.1, α-spectrin, β-spectrin. Mutations of SPTA1 are the most common. Patient concerns: A 21-year-old female presented with left epigastric pain and jaundice with numerous elliptical RBCs on blood film. The family history review discovered jaundice in her sibling. Diagnosis: A novel heterozygous mutation of SPTA1 was detected in the proband, her brother and fathe...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Increased risk of gallstones after gastrectomy: A longitudinal follow-up study using a national sample cohort in korea
This study sought to evaluate the association between gastrectomy and the occurrence of gallstones using a national sample cohort from Korea. Data from 2002 to 2013 were collected for individuals ≥20 years of age in the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC). We extracted data for patients who had undergone gastrectomy (n = 1998) and a 1:4 matched control group (n = 7992) and then analyzed the occurrence of gallstones. The patients were matched according to age, sex, income, region of residence, hypertension, diabetes mellitus, and history of dyslipidemia. Gastrectomies were ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Fatty liver increases gallstone disease risk in younger Chinese patients
We investigated possible associations between fatty liver and gallstone disease (GD) in a Chinese population. This cross-sectional study included 897 people who visited the clinical center and underwent ultrasonography at The First Hospital of Jilin University between January 2018 and June 2018. The overall prevalence of GD was 8.8%; the between-sex difference (9.3% in men, 8.4% in women) was not statistically significant. The risk of GD was similar for men and women across all age groups. GD prevalence increased steadily with increasing age, from 2.1% in patients ≤30 years of age to 15.4% in those>70 years of age....
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Identification of LIFR, PIK3R1, and MMP12 as Novel Prognostic Signatures in Gallbladder Cancer Using Network-Based Module Analysis
Conclusions: We found a highly reliable FI network, which revealed LIFR, PIK3R1, and MMP12 as novel prognostic biomarker candidates for GBC. These findings could accelerate biomarker discovery and therapeutic development in this cancer. Introduction Gallbladder cancer (GBC), the sixth most common gastrointestinal cancer, is an uncommon but challenging disease. Its incidence has recently increased highly worldwide (1). The risk factors for GBC include sex, aging, obesity, chronic cholecystitis, and cholelithiasis (2, 3). Because of the lack of an effective early diagnostic method, the disease often is not diagnosed ...
Source: Frontiers in Oncology - May 1, 2019 Category: Cancer & Oncology Source Type: research

ACR Appropriateness Criteria ® Jaundice
Jaundice is the end result of myriad causes, which makes the role of imaging in this setting particularly challenging. In the United States, the most common causes of all types of jaundice fall into four categories including hepatitis, alcoholic liver disease, blockage of the common bile duct by a gallstone or tumor, and toxic reaction to a drug or medicinal herb. Clinically, differentiating between the various potential etiologies of jaundice requires a detailed history, targeted physical examination, and pertinent laboratory studies, the results of which allow the physician to categorize the type of jaundice into mechani...
Source: Journal of the American College of Radiology : JACR - May 1, 2019 Category: Radiology Authors: Expert Panel on Gastrointestinal Imaging:, Nicole M. Hindman, Hina Arif-Tiwari, Ihab R. Kamel, Waddah B. Al-Refaie, Twyla B. Bartel, Brooks D. Cash, Victoria Chernyak, Alan Goldstein, Joseph R. Grajo, Jeanne M. Horowitz, Aya Kamaya, Michelle M. McNamara, Tags: Appropriate use criteria Source Type: research

Acute biliary pancreatitis during pregnancy and in the post-delivery period.
CONCLUSION: Acute biliary pancreatitis related to pregnancy is not limited to pregnant women, and the incidence of these cases was greater than expected. Acute biliary pancreatitis related to pregnancy can be successfully managed with conservative treatment because it usually has a mild to moderate clinical course. However, the surgeon should keep an early cholecystectomy in mind for patients other than those in the first trimester. PMID: 31135938 [PubMed - in process] (Source: Turkish Journal of Trauma and Emergency Surgery : TJTES)
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - May 1, 2019 Category: Emergency Medicine Authors: Hot S, Eğin S, Gökçek B, Yeşiltaş M, Karakaş DÖ Tags: Ulus Travma Acil Cerrahi Derg Source Type: research

Pain after cholecystectomy for symptomatic gallstones
Publication date: Available online 27 April 2019Source: The LancetAuthor(s): Rachel V Guest, Kjetil Søreide (Source: The Lancet)
Source: The Lancet - April 29, 2019 Category: General Medicine Source Type: research

Restrictive strategy versus usual care for cholecystectomy in patients with gallstones and abdominal pain (SECURE): a multicentre, randomised, parallel-arm, non-inferiority trial
Publication date: Available online 27 April 2019Source: The LancetAuthor(s): Aafke H van Dijk, Sarah Z Wennmacker, Philip R de Reuver, Carmen S S Latenstein, Otmar Buyne, Sandra C Donkervoort, Quirijn A J Eijsbouts, Joos Heisterkamp, Klass H in het Hof, Jan Janssen, Vincent B Nieuwenhuijs, Henk M Schaap, Pascal Steenvoorde, Hein B A C Stockmann, Djamila Boerma, Gert P Westert, Joost P H Drenth, Marcel G W Dijkgraaf, Marja A Boermeester, Cornelius J H M van LaarhovenSummaryBackgroundInternational guidelines advise laparoscopic cholecystectomy to treat symptomatic, uncomplicated gallstones. Usual care regarding cholecystecto...
Source: The Lancet - April 29, 2019 Category: General Medicine Source Type: research

Potential Role of Biofilm Formation in the Development of Digestive Tract Cancer With Special Reference to Helicobacter pylori Infection
Cosmeri Rizzato1, Javier Torres2, Elena Kasamatsu3, Margarita Camorlinga-Ponce2, Maria Mercedes Bravo4, Federico Canzian5 and Ikuko Kato6* 1Department of Translation Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy 2Unidad de Investigación en Enfermedades Infecciosas, Unidades Médicas de Alta Especialidad Pediatría, Instituto Mexicano del Seguro Social, Mexico City, Mexico 3Instituto de Investigaciones en Ciencias de la Salud, National University of Asunción, Asunción, Paraguay 4Grupo de Investigación en Biología del C&aacut...
Source: Frontiers in Microbiology - April 29, 2019 Category: Microbiology Source Type: research

Utilization of Virtual Non-Contrast Images Derived from Dual-Energy CT in Evaluation of Biliary Stone Disease: Virtual non-contrast image can replace True non-contrast image regarding biliary stone detection
ConclusionsThe VNC images derived from DECT were comparable to the TNC images for the detection of biliary stones and may replace the TNC images to reduce radiation dose. (Source: European Journal of Radiology)
Source: European Journal of Radiology - April 26, 2019 Category: Radiology Source Type: research

Final height and endorine complications in patients with β-thalasssemia intermedia: our experience in non-transfused versus infrequently transfused patients and correlations with liver iron content
Conclusions: A significant number of TI patients have high LIC, short stature and endocrine disorders. Patients who require occasional transfusions have more liver iron overload and higher hepatic dysfunction. Females appear to attain better final adult height and have higher IGF1- SDS versus males. Our data emphasize the need for long term surveillance for identification of organ-specific risk factors and early disease manifestations.We also recommend a close monitoring of endocrine and other complications, according to the international guidelines. (Source: Mediterranean Journal of Hematology and Infectious Diseases)
Source: Mediterranean Journal of Hematology and Infectious Diseases - April 25, 2019 Category: Hematology Source Type: research

Evaluation of genetic association of 40 SNPs in candidate genes with cholesterol gallstone disease in north Indian population
ConclusionsOur study suggests that FGFR4, CYP7A1, APOE, TM4SF4, NR1H2, IL10, PLCE1, CYP1A1, SLC10A2, MMP2, CYP8B1 genetic variants confer significant risk for gallstone disease in North Indian population. The association of many genes with disease risk was found to be sex-specific. (Source: Meta Gene)
Source: Meta Gene - April 25, 2019 Category: Genetics & Stem Cells Source Type: research

Comparative Analysis of Serum Lipid Profiles in Patients with and without Gallstones: A Prospective Cross-Sectional Study
The objective of this study was to compare serum lipid profile of gallstone patients with the controls.MethodsThis prospective cross-sectional study was conducted in the Surgical Department of the Services Institute of Medical Sciences from August 2017 to August 2018. A total of 50 patients were included in the study after screening through the inclusion criteria. A control group of 50 inpatients with no personal or family history of gallstones were also recruited for comparison. Results were expressed as mean with standard deviation. Students t-test was used to compare the data between the patients and the control groups (p
Source: Annals of Medicine and Surgery - April 25, 2019 Category: General Medicine Source Type: research

Polyp size of 1  cm is insufficient to discriminate neoplastic and non-neoplastic gallbladder polyps
This study assessed a national cohort of histopathologically proven gallbladder polyps to distinguish neoplastic from non-neoplastic polyps.MethodsPALGA, the nationwide network and registry of histo- and cytopathology, was searched to identify all histopathologically proven gallbladder polyps between 2003 and 2013. All polyps and (focal) wall thickenings  >  5 mm were included, and classified as neoplastic or non-neoplastic. Polyp subtype, size, distribution, presentation as wall thickening or protruding polyp, and presence of gallstones were assessed for neoplastic and non-neoplastic polyps. A decisi...
Source: Surgical Endoscopy - April 25, 2019 Category: Surgery Source Type: research

Bouveret's Syndrome: A rare cause of gastric outlet obstruction
Bouveret's Syndrome is a rare cause of gastric outlet obstruction secondary to the impaction of a gallstone within a cholecystogastric or cholecystoduodenal fistula. It is a rare variant of gallstone ileus. Prompt diagnosis, appropriate investigations and proper treatment are essential. The aim of the present case report was to review the currently ‐available literature regarding Bouveret's syndrome management approach and to share our experience. A 69‐year‐old man presented to our surgical unit with a 1‐week history of upper gastrointestinal bleeding and gastric outlet obstruction symptoms. The diagnosis of Bouver...
Source: Surgical Practice - April 22, 2019 Category: Surgery Authors: Robin Lok ‐Man Sheung, Dennis Chin‐Tou Lam, David Kai‐Wing Leung Tags: CASE REPORT Source Type: research

Acute pancreatitis
This article reviews the definition, aetiology, pathophysiology, therapeutic strategies and outcomes in light of recent evidence and guidelines. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - April 19, 2019 Category: Surgery Source Type: research

1st report of unexpected true left-sided gallbladder treated with robotic approach
ConclusionNo change of port setting was required with the robotic approach. The ICG-aided cholangiography improved surgeon’s ability to recognize the concomitant vascular and biliary anomalies. However, no definitive conclusion can be drown until further experience and volume are achieved. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - April 17, 2019 Category: Surgery Source Type: research

Acute pancreatitis
This article reviews the definition, aetiology, pathophysiology, therapeutic strategies and outcomes in light of recent evidence and guidelines. (Source: Surgery (Medicine Publishing))
Source: Surgery (Medicine Publishing) - April 17, 2019 Category: Surgery Authors: Sarah. C. Thomasset, C. Ross Carter Tags: Pancreas and spleen Source Type: research

Incidence and Risk Factors for Cholelithiasis After Bariatric Surgery
ConclusionsIncidence of CL was up to one-third of the patients followed up for 12  months after BS. Excessive weight loss and other variables studied did not increase risk. Hypertension seems to be protective against gallstone formation, but this result needs further analysis. (Source: Obesity Surgery)
Source: Obesity Surgery - April 17, 2019 Category: Surgery Source Type: research

Refeeding Syndrome as a Possible Cause of Very Early Mortality in Acute Pancreatitis.
Conclusions: : The findings of current study emphasize that clinicians should be awareof the possibility of RFS in malnourished AP patients with electrolyte imbalances. PMID: 30970437 [PubMed - as supplied by publisher] (Source: Gut and Liver)
Source: Gut and Liver - April 13, 2019 Category: Gastroenterology Tags: Gut Liver Source Type: research