• Journal of Veterinary Clinics
• /
• v.25 no.5
• /
• pp.363-369
• /
• 2008

The aim of this study was to establish an experiment animal model for easy diagnosis and monitoring effect of treatment of cholelithiasis by cholesterol and mixed gall stone. In 12 adult beagle dogs, five dogs there were in the control group and seven dogs in the experiment group with ligated cystic duct. General clinical signs were recorded, CBC and blood chemistry were examined. Control group and experiment group were evaluated every 2 weeks for a period of 20 weeks. The results were (1) Total blirubin, cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST) activity were significantly higher in the experiment group with ligated cystic duct than control group during 2-8 weeks. (2) Total alkaline phosphatase (TALP) activity was significantly higher when compare with control group during 2-8 weeks. Bone alkaline phosphatase(BALP) activity was increased slightly between 2 and 8 weeks but was decreased between 10 and 20 weeks. (3) Blood urea nitrogen (BUN) was decreased between 2 and 8 weeks. After 10 weeks, this was in normal range. (4) On complate blood count (CBC), $Ca^{2+}$ and P were not changed until 20 weeks. (5) On clinical signs in experimental group, they observed a depression, yellow color of mucus membrane and conjunctiva, xanthinuria and xanthochromic. The present study showed that the experimental animal model with ligated cystic duct was a useful model to study biliary tract disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.19 no.1
• /
• pp.1-11
• /
• 2016

Cholestasis results from impairment in the excretion of bile, which may be due to mechanical obstruction of bile flow or impairment of excretion of bile components into the bile canaliculus. When present, cholestasis warrants prompt diagnosis and treatment. The differential diagnosis of cholestasis beyond the neonatal period is broad and includes congenital and acquired etiologies. It is imperative that the clinician differentiates between intrahepatic and extrahepatic origin of cholestasis. Treatment may be supportive or curative and depends on the etiology. Recent literature shows that optimal nutritional and medical support also plays an integral role in the management of pediatric patients with chronic cholestasis. This review will provide a broad overview of the pathophysiology, diagnostic approach, and management of cholestasis beyond the neonatal and infancy periods.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.4
• /
• pp.1535-1538
• /
• 2015

Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy in unsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grossly abnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried out at a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomy cases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist for macroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious, abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the final histopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4 male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidental gallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associated with some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in 383 'macroscopically normal looking' gallbladders. Conclusions: Incidental finding of gall bladder cancer was not observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinoma gallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examination of only those gall bladders with some gross abnormality.

• The Journal of Internal Korean Medicine
• /
• v.24 no.1
• /
• pp.144-150
• /
• 2003

Back pains include pain in one or both side costa portion and lateral abdomen. There are different kinds of flank-related disease such as intercostal nerve pain, chronic gastritis, duodenitis, herpes zoster, pepticulcer, cholecystitis, cholelithiasis and so on. Back pain arises from pathological abnormal activities. On the other hand psychogenic pains are caused by psychogenic factors without pathological abnormal activities. This is similar to KiWol back pain, which resulted from psychogenic factors like stress, anxiety, anger and etc. In oriental medicine, KiWol is the state of depression of Ki, and Shihosogansan used to treat the back pain diagnosed as stagnation of the liver Ki. So, we decided to apply Shihosogansan to a patient who suffered from back pain diagnosed as stagnation of the liver Ki. Therefore the patient treated with Shihosogansan and improved in consciousness symptoms, so we report it for the better treatment.

• Parasites, Hosts and Diseases
• /
• v.31 no.1
• /
• pp.71-74
• /
• 1993

A 43-year-old Korean woman with billary ascariasis accompanied by cholellthiasis is reported. Her chief complaints were abdominal pain, nausea, and vomiting. She had the past history of several attacks of abdominal pain in her childhood. ciliary stones were recovered from the left hepatic duct after cholecystectomy, which contained degenerated cuticle or body wall, and numerous eggs of Ascaris lumbriooides. It is strongly suggested that the ciliary stones were formed from the dead Ascmis worm(s). This is a rare case of biliary ascariasis during the recent 5 years in Korea.

• The Korean Journal of Nuclear Medicine
• /
• v.24 no.1
• /
• pp.56-61
• /
• 1990

We evaluated 85 cases with atrophy of left lobe among 11,133 cases performed liver scan using $^{99m}Tc-phytate$ from January 1984 to January 1990 at Kyungpook National University Hospital in association with underlying causes and related conditions. Seventeen cases seemed to be due to biliary tract diseases, eg, cholelithiasis, cholangiocarcinoma, clonorchiasis and postcholecystectomy state. Fifteen cases were patients with primary and metastatic hepatic malignancies. One case had a history of hepatic irradiation. Thirty cases comprised acute hepatitis, chronic hepatitis, liver cirrhosis and fatty liver. However no causative abnormalities could be detected in 22 cases despite of meticulous diagnostic work-up.

• Korean Journal of Transplantation
• /
• v.28 no.3
• /
• pp.160-164
• /
• 2014

Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.23 no.5
• /
• pp.430-438
• /
• 2020

Purpose: We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. Methods: We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. Results: This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. Conclusion: Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.

• Journal of Preventive Medicine and Public Health
• /
• v.28 no.2 s.50
• /
• pp.325-333
• /
• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.6
• /
• pp.2857-2860
• /
• 2012

Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.