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Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy (gallbladder removal). Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, [1] and can be transient, persistent or lifelong. [2] [3] The chronic condition is diagnosed in approximately 10% of postcholecystectomy ...
Biliary sludge has been associated with pregnancy, rapid weight loss, total parenteral nutrition, drugs such as ceftriaxone and octreotide, solid organ transplantation, and gastric surgery. [1] [2] In many of these conditions, it is thought that the impairment in the contractility of the gallbladder leads to the formation of the sludge. [2]
Biliary microlithiasis refers to the creation of small gallstones less than 3 mm in diameter in the biliary duct or gallbladder. It has been suggested [1] as a cause of postcholecystectomy syndrome, or PCS, the symptoms of which include: Upset stomach, nausea, and vomiting. Gas, bloating, and diarrhea. Persistent pain in the upper right abdomen ...
[2] [3] Ceftriaxone has been frequently associated with biliary sludge or biliary pseudolithiasis in subsequent reports. [3] Ceftriaxone is excreted primarily through the urine , but also through the bile, up to 40% of its excretion, with concentrations in the bile 20-150 times higher than in the serum.
If the patient must have the gallbladder removed for gallstones, the surgeon may choose to proceed with the surgery, and obtain a cholangiogram during the surgery. If the cholangiogram shows a stone in the bile duct, the surgeon may attempt to treat the problem by flushing the stone into the intestine or retrieve the stone back through the ...
In people unable to have surgery, gallbladder drainage may be tried. [5] About 10–15% of adults in the developed world have gallstones. [5] Women more commonly have stones than men and they occur more commonly after age 40. [4] Certain ethnic groups are more often affected; for example, 48% of American Indians have gallstones. [4]
The presence of gallstones, usually visualized by ultrasound, generally necessitates a surgical treatment (removal of the gall bladder, typically via laparoscopy). [ 27 ] Removal of the gallbladder with surgery, known as a cholecystectomy , is the definitive surgical treatment for biliary colic.
Although they may not drain any liver parenchyma, they can be a source of a bile leak or biliary peritonitis after cholecystectomy in both adults and children. If an accessory bile duct goes unrecognized at the time of the gallbladder removal, 5–7 days post-operative the patient will develop bile peritonitis, [10] an easily treatable complication with a morbidity rate of 44% if left untreated.