Presence or formation of GALLSTONES in the COMMON BILE DUCT.
Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin.
Fiberoptic endoscopy designed for duodenal observation and cannulation of VATER'S AMPULLA, in order to visualize the pancreatic and biliary duct system by retrograde injection of contrast media. Endoscopic (Vater) papillotomy (SPHINCTEROTOMY, ENDOSCOPIC) may be performed during this procedure.
Incision of Oddi's sphincter or Vater's ampulla performed by inserting a sphincterotome through an endoscope (DUODENOSCOPE) often following retrograde cholangiography (CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE). Endoscopic treatment by sphincterotomy is the preferred method of treatment for patients with retained or recurrent bile duct stones post-cholecystectomy, and for poor-surgical-risk patients that have the gallbladder still present.
The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT.
Presence or formation of GALLSTONES in the GALLBLADDER.
An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken.
Surgical removal of the GALLBLADDER.
Non-invasive diagnostic technique for visualizing the PANCREATIC DUCTS and BILE DUCTS without the use of injected CONTRAST MEDIA or x-ray. MRI scans provide excellent sensitivity for duct dilatation, biliary stricture, and intraductal abnormalities.
Inflammation of the biliary ductal system (BILE DUCTS); intrahepatic, extrahepatic, or both.
Excision of the gallbladder through an abdominal incision using a laparoscope.
Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS).
Surgical formation of an opening (stoma) into the COMMON BILE DUCT for drainage or for direct communication with a site in the small intestine, primarily the DUODENUM or JEJUNUM.
Surgery of the smooth muscle sphincter of the hepatopancreatic ampulla to relieve blocked biliary or pancreatic ducts.
Inflammation of the GALLBLADDER; generally caused by impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, or other diseases.
Diseases in any part of the BILIARY TRACT including the BILE DUCTS and the GALLBLADDER.
Diseases of the COMMON BILE DUCT including the AMPULLA OF VATER and the SPHINCTER OF ODDI.
A dilation of the duodenal papilla that is the opening of the juncture of the COMMON BILE DUCT and the MAIN PANCREATIC DUCT, also known as the hepatopancreatic ampulla.
Acute inflammation of the GALLBLADDER wall. It is characterized by the presence of ABDOMINAL PAIN; FEVER; and LEUKOCYTOSIS. Gallstone obstruction of the CYSTIC DUCT is present in approximately 90% of the cases.
Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously.
A pouch or sac developed from a tubular or saccular organ, such as the GASTROINTESTINAL TRACT.
Impairment of bile flow in the large BILE DUCTS by mechanical obstruction or stricture due to benign or malignant processes.
INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis.
Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).
Pathological conditions in the DUODENUM region of the small intestine (INTESTINE, SMALL).
Diseases in any part of the ductal system of the BILIARY TRACT from the smallest BILE CANALICULI to the largest COMMON BILE DUCT.
Organic or functional motility disorder involving the SPHINCTER OF ODDI and associated with biliary COLIC. Pathological changes are most often seen in the COMMON BILE DUCT sphincter, and less commonly the PANCREATIC DUCT sphincter.
The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.
The condition of an anatomical structure's being dilated beyond normal dimensions.
The channels that collect and transport the bile secretion from the BILE CANALICULI, the smallest branch of the BILIARY TRACT in the LIVER, through the bile ductules, the bile ducts out the liver, and to the GALLBLADDER for storage.
Jaundice, the condition with yellowish staining of the skin and mucous membranes, that is due to impaired BILE flow in the BILIARY TRACT, such as INTRAHEPATIC CHOLESTASIS, or EXTRAHEPATIC CHOLESTASIS.
The period during a surgical operation.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
The period before a surgical operation.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.
The return of a sign, symptom, or disease after a remission.
Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed)
An emulsifying agent produced in the LIVER and secreted into the DUODENUM. Its composition includes BILE ACIDS AND SALTS; CHOLESTEROL; and ELECTROLYTES. It aids DIGESTION of fats in the duodenum.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.

Promoter methylation of INK4a/ARF as detected in bile-significance for the differential diagnosis in biliary disease. (1/137)

PURPOSE: There is a need to enhance endobiliary cytotechniques by molecular marker lesions. This is of special significance for patients with primary sclerosing cholangitis, a disease predisposing for the development of cholangiocarcinoma. The INK4a/ADP ribosylation factor (ARF) locus encodes two tumor suppressor genes: p16INK4a and p14ARF. p16INK4a has been shown to be of major significance in cholangiocarcinoma. EXPERIMENTAL DESIGN: In an effort to evaluate the potential diagnostic role of p16INK4a and p14ARF promoter methylation in biliary disease, endoscopical obtained bile specimens of 71 patients were analyzed (26 choledocholithiasis, 6 with normal results, 23 bile duct carcinoma, 5 gall bladder carcinoma). Eleven patients with primary sclerosing cholangitis were enrolled. RESULTS: Merely 6% of specimens (2 of 32) obtained from patients without evidence for malignant biliary disease but 53.5% of malignancies (15 of 28) showed p16 promoter methylation (p14: 3 and 46.2%, respectively). The concordance of methylation rates detected in either bile or tissue specimens was high. In primary sclerosing cholangitis, a similar prevalence of methylation was detected as in malignant disease. CONCLUSIONS: This study demonstrates: (a) a high frequency and specificity of INK4a/ARF methylation in malignant biliary disease compared with mere cholangitis; and (b) the capability to detect these alterations reliably in endoscopically obtained bile. Thus, INK4a/ARF's promoter methylation status represents a candidate marker for the endoscopic diagnosis of biliary disease.  (+info)

Cholecysto-choledochostomy plus construction of subcutaneous cholecystic tunnel in treatment of choledocholith. (2/137)

OBJECTIVE: To avoid the pitfalls of choledochotomy with T-tube drainage in the treatment of choledocholith. METHODS: A novel operation was designed as cholecysto-choledochostomy plus construction of subcutaneous cholecystic tunnel. After the common bile duct was cut open and stones were removed, the gallbladder was appropriately dissociated and the cholecystic ampulla was incised. Then, the incision of the cholecystic ampulla was anastomosed to the opened common bile duct, and the cholecystic fundus was fixed out of the abdominal muscular stratum. RESULTS: Twenty-one patients with choledocholith underwent this operation successfully and recovered well without postoperative complications. One of them was diagnosed as having recurrent stones in 2 years and 3 months after operation. Consequently, the subcutaneous cholecystic tunnel was opened under local anesthesia to remove successfully the stones with choledochoscope. CONCLUSION: This operation provides a convenient way to remove postoperative recurrent stones with choledochoscope and avoid receliotomy.  (+info)

Prospective evaluation of magnetic resonance cholangiography in patients with suspected common bile duct stones before laparoscopic cholecystectomy. (3/137)

OBJECTIVE: To evaluate the predictive value of magnetic resonance cholangiography (MRC) in selected patients before laparoscopic cholecystectomy (LC). METHODS: Patients with risk factors for common bile duct (CBD) stones scheduled for elective LC from March 1999 to May 2001, underwent MRC followed by endoscopic retrograde cholangiography (ERC) to detect the stones and the accuracy of MRC. Selection of suspected patients was based on clinical, ultrasonographic, and laboratory criteria. RESULTS: During a 26-month period, a total of 267 patients were studied. Seventy-eight MRC identified patients were found to have CBD stones by ERC or laparoscopic cholangiography in the study. Seven of 78 patients were misdiagnosed as having CBD stones by MRC. In this study, MRC had a sensitivity of 100%, a specificity of 96.3%, a positive predictive value of 91.8%, and a negative predictive value of 100% for the detection of common bile duct stones. CONCLUSIONS: With the use of LC, ERC is frequently performed before LC to detect CBD stones; but it is invasive with a well-documented complication rate. MRC is a simple non-invasive method for preoperative screening for CBD stones in at-risk patients. In this study if ERC had been limited to patients with a positive MRC, it would have reduced the need for ERC by 68.2%, and the complications of preoperative examination would be minimized significantly.  (+info)

Platelet activation and the protective effect of aprotinin in hepatolithiasis patients. (4/137)

OBJECTIVE: To explore platelet activation and the protective effect of aprotinin in patients with hepatolithiasis. METHODS: The count of platelets and levels of CD62P and CD63 were measured by flow cytometry in 38 patients with hepatolithiasis. Several measurements were carried out after treatment with aprotinin. RESULTS: The levels of CD62P, CD63 in patients with hepatolithiasis were higher than those in patients with cholecystolithiasis (P<0.05), but the count of platelets was lower (P<0.05). After operation, the levels of CD62P, CD63 were significantly increased in patients with hepatolithiasis, but the count of platelets was lower (P<0.05). Postoperative levels of CD62P, CD63 were significantly lower in patients treated with aprotinin than in normal controls (P<0.05); but there was no significant change in the count of platelets in the two groups. CONCLUSION: Platelet activation occurs in patients with hepatolithiasis, and may be inhibited by aprotinin.  (+info)

Management of choledocholithiasis: comparison between laparoscopic common bile duct exploration and intraoperative endoscopic sphincterotomy. (5/137)

AIM: Choledocholithiasis is present in 5 to 10 percent of patients who have cholelithiasis. In the area of laparoscopic cholecystectomy (LC), laparoscopic common bile duct exploration (LCBDE) and intraoperative endoscopic sphincterotomy (IOES) have been used to treat choledocholithiasis. The purpose of this study was to compare the clinical outcomes and hospital costs of LCBDE with IOES. METHODS: Between November 1999 and October 2002, patients with choledocholithiasis undergoing LC plus LCBDE (Group A, n=45) were retrospectively compared to those undergoing LC plus IOES (Group B, n=57) at a single institution. RESULTS: Ductal stone clearance rates were equivalent for the two groups (88% versus 89%, P=0.436). The conversion rate was higher for Group B (8.8% versus 4.4%, P=0.381), as was the morbidity (12.3% versus 6.7%, P=0.336). There were no other significant differences between the two groups. The complications were mainly related to endoscopic sphincterotomy (ES), and the hospital costs were significantly increased in this subset of Group B (median, 23,910 versus 14,955 RMB yuan, P=0.03). Although hospital stay was longer in Group A (median, 7 versus 6 days, P=0.041), the patients in Group A had a significantly decreased cost of hospitalization compared with those in Group B (median, 11,362 versus 15,466 RMB yuan, P=0.000). CONCLUSION: The results demonstrate equivalent ductal stone clearance rates for the two groups. LCBDE management appears safer, and is associated with a significantly decreased hospital cost. The findings suggest LCBDE for choledocholithiasis is a better option.  (+info)

Rapid detection of K-ras mutations in bile by peptide nucleic acid-mediated PCR clamping and melting curve analysis: comparison with restriction fragment length polymorphism analysis. (6/137)

BACKGROUND: Current methods for detection of K-ras gene mutations are time-consuming. We aimed to develop a one-step PCR technique using fluorescent hybridization probes and competing peptide nucleic acid oligomers to detect K-ras mutations in bile and to compare the efficacy with restriction fragment length polymorphism (RFLP) analysis. METHODS: Bile samples were obtained from 116 patients with biliary obstruction, including gallstones (n = 64), benign biliary strictures (n = 6), pancreatic cancer (n = 20), and cholangiocarcinoma (n = 26). The DNA was extracted and subjected to K-ras mutation analysis by real-time PCR and RFLP analysis. Mutations were confirmed by direct sequencing. The sensitivity and specificity were calculated according to the clinical results. RESULTS: The analysis time for real-time PCR was <1 h, whereas RFLP analysis took more than 2 days. With the sensor probe designed for the GAT (G12D) mutant in codon 12 of the K-ras gene, the real-time PCR method also detected the GTT (G12V) mutant. In contrast, a specific sensor probe for the TGT (G12C) mutant detected GAT (G12D), AGT (G12S), and GTT (G12V) mutants in addition to the TGT mutant. The real-time PCR assay allowed the detection of mutation in a 3000-fold excess of wild-type bile DNA. In bile, K-ras codon 12 mutations were detected in 16 of 46 malignant cases by real-time PCR with the TGT probe and 15 by RFLP analysis. All benign cases were wild type. CONCLUSION: Real-time PCR with a cysteine-specific (TGT) sensor probe can rapidly detect K-ras gene mutations in bile and diagnose malignant biliary obstruction with high specificity.  (+info)

NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy. (7/137)

OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding the use of endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy. PARTICIPANTS: A non-Federal, non-advocate, 13-member panel representing the fields of gastroenterology, hepatology, clinical epidemiology, oncology, biostatistics, surgery, health services research, radiology, internal medicine, and the public. In addition, experts in these same fields presented data to the panel and to a conference audience of approximately 300. EVIDENCE: Presentations by experts; a systematic review of the medical literature provided by the Agency for Healthcare Research and Quality; and an extensive bibliography of ERCP research papers, prepared by the National Library of Medicine. Scientific evidence was given precedence over clinical anecdotal experience. CONFERENCE PROCESS: Answering predefined questions, the panel drafted a statement based on the scientific evidence presented in open forum and the scientific literature. The draft statement was read in its entirety on the final day of the conference and circulated to the experts and the audience for comment. The panel then met in executive session to consider these comments and released a revised statement at the end of the conference. The statement was made available on the World Wide Web at http://consensus.nih.gov immediately after the conference. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. CONCLUSIONS: In the diagnosis of choledocholithiasis, magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), and ERCP have comparable sensitivity and specificity. Patients undergoing cholecystectomy do not require ERCP preoperatively if there is low probability of having choledocholithiasis. Laparoscopic common bile duct exploration and postoperative ERCP are both safe and reliable in clearing common bile duct stones. ERCP with endoscopic sphincterotomy (ES) and stone removal is a valuable therapeutic modality in choledocholithiasis with jaundice, dilated common bile duct, acute pancreatitis, or cholangitis. In patients with pancreatic or biliary cancer, the principal advantage of ERCP is palliation of biliary obstruction when surgery is not elected. In patients who have pancreatic or biliary cancer and who are surgical candidates, there is no established role for preoperative biliary drainage by ERCP. Tissue sampling for patients with pancreatic or biliary cancer not undergoing surgery may be achieved by ERCP, but this is not always diagnostic. ERCP is the best means to diagnose ampullary cancers. ERCP has no role in the diagnosis of acute pancreatitis except when biliary pancreatitis is suspected. In patients with severe biliary pancreatitis, early intervention with ERCP reduces morbidity and mortality compared with delayed ERCP. ERCP with appropriate therapy is beneficial in selected patients who have either recurrent pancreatitis or pancreatic pseudocysts. Patients with type I sphincter of Oddi dysfunction (SOD) respond to endoscopic sphincterotomy (ES). Patients with type II SOD should not undergo diagnostic ERCP alone. If sphincter of Oddi manometer pressures are >40 mmHg, ES is beneficial in some patients. Avoidance of unnecessary ERCP is the best way to reduce the number of complications. ERCP should be avoided if there is a low likelihood of biliary stone or stricture, especially in women with recurrent pain, a normal bilirubin, and no other objective sign of biliary disease. Endoscopists performing ERCP should have appropriate training and expertise before performing advanced procedures. With newer diagnostic imaging technologies emerging, ERCP is evolving into a predominantly therapeutic procedure.  (+info)

Acute cholecystitis and severe ischemic cardiac disease: is laparoscopy indicated? (8/137)

BACKGROUND AND OBJECTIVES: Laparoscopy in patients with poor cardiac function has been the subject of controversy and is considered by many surgeons a relative contraindication. METHODS: We report the case of a patient who presented with acute cholecystitis and choledocholithiasis concurrent with unstable angina. Our experience in laparoscopic management of patients with calculous biliary disease and severe coronary artery disease is examined. RESULTS: The patient was managed by coronary angioplasty and stenting immediately followed by laparoscopic cholecystectomy and common bile duct exploration under close invasive hemodynamic monitoring and low-pressure pneumoperitoneum. Between 1996 and 2001, 39 patients with coronary artery disease and an ASA class of III or IV underwent laparoscopic cholecystectomy. Eight of these patients (20.5%) had common bile duct stones necessitating laparoscopic common bile duct exploration. No conversions were necessary, and no major morbidity or mortalities occurred. CONCLUSIONS: Laparoscopic cholecystectomy and common bile duct exploration can be safely performed in patients with severe ischemic cardiac disease under close hemodynamic monitoring and a low-pressure pneumoperitoneum (10 to 12 mm Hg).  (+info)

Choledocholithiasis is a medical condition characterized by the presence of one or more gallstones in the common bile duct, which is the tube that carries bile from the liver and gallbladder to the small intestine. Bile is a digestive fluid produced by the liver that helps break down fats in the small intestine. Gallstones are hardened deposits of digestive fluids that can form in the gallbladder or, less commonly, in the bile ducts.

Choledocholithiasis can cause a variety of symptoms, including abdominal pain, jaundice (yellowing of the skin and eyes), nausea, vomiting, and fever. If left untreated, it can lead to serious complications such as infection or inflammation of the bile ducts or pancreas, which can be life-threatening.

The condition is typically diagnosed through imaging tests such as ultrasound, CT scan, or MRI, and may require endoscopic or surgical intervention to remove the gallstones from the common bile duct.

Gallstones are small, hard deposits that form in the gallbladder, a small organ located under the liver. They can range in size from as small as a grain of sand to as large as a golf ball. Gallstones can be made of cholesterol, bile pigments, or calcium salts, or a combination of these substances.

There are two main types of gallstones: cholesterol stones and pigment stones. Cholesterol stones are the most common type and are usually yellow-green in color. They form when there is too much cholesterol in the bile, which causes it to become saturated and form crystals that eventually grow into stones. Pigment stones are smaller and darker in color, ranging from brown to black. They form when there is an excess of bilirubin, a waste product produced by the breakdown of red blood cells, in the bile.

Gallstones can cause symptoms such as abdominal pain, nausea, vomiting, and bloating, especially after eating fatty foods. In some cases, gallstones can lead to serious complications, such as inflammation of the gallbladder (cholecystitis), infection, or blockage of the bile ducts, which can cause jaundice, a yellowing of the skin and eyes.

The exact cause of gallstones is not fully understood, but risk factors include being female, older age, obesity, a family history of gallstones, rapid weight loss, diabetes, and certain medical conditions such as cirrhosis or sickle cell anemia. Treatment for gallstones may involve medication to dissolve the stones, shock wave therapy to break them up, or surgery to remove the gallbladder.

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that combines upper gastrointestinal (GI) endoscopy and fluoroscopy to diagnose and treat certain problems of the bile ducts and pancreas.

During ERCP, a flexible endoscope (a long, thin, lighted tube with a camera on the end) is passed through the patient's mouth and throat, then through the stomach and into the first part of the small intestine (duodenum). A narrow plastic tube (catheter) is then inserted through the endoscope and into the bile ducts and/or pancreatic duct. Contrast dye is injected through the catheter, and X-rays are taken to visualize the ducts.

ERCP can be used to diagnose a variety of conditions affecting the bile ducts and pancreas, including gallstones, tumors, strictures (narrowing of the ducts), and chronic pancreatitis. It can also be used to treat certain conditions, such as removing gallstones from the bile duct or placing stents to keep the ducts open in cases of stricture.

ERCP is an invasive procedure that carries a risk of complications, including pancreatitis, infection, bleeding, and perforation (a tear in the lining of the GI tract). It should only be performed by experienced medical professionals in a hospital setting.

Endoscopic sphincterotomy is a medical procedure that involves the use of an endoscope (a flexible tube with a light and camera) to cut the papilla of Vater, which contains the sphincter of Oddi muscle. This procedure is typically performed to treat gallstones or to manage other conditions related to the bile ducts or pancreatic ducts.

The sphincterotomy helps to widen the opening of the papilla, allowing stones or other obstructions to pass through more easily. It may also be used to relieve pressure and pain caused by spasms of the sphincter of Oddi muscle. The procedure is usually done under sedation or anesthesia and carries a risk of complications such as bleeding, infection, perforation, and pancreatitis.

The common bile duct is a duct that results from the union of the cystic duct (which drains bile from the gallbladder) and the common hepatic duct (which drains bile from the liver). The common bile duct transports bile, a digestive enzyme, from the liver and gallbladder to the duodenum, which is the first part of the small intestine.

The common bile duct runs through the head of the pancreas before emptying into the second part of the duodenum, either alone or in conjunction with the pancreatic duct, via a small opening called the ampulla of Vater. The common bile duct plays a crucial role in the digestion of fats by helping to break them down into smaller molecules that can be absorbed by the body.

Cholecystolithiasis is the medical term for the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located under the liver that stores and concentrates bile, a digestive fluid produced by the liver. Gallstones are hardened deposits that can form in the gallbladder when substances in the bile, such as cholesterol or bilirubin, become concentrated and crystallize.

Gallstones can vary in size, from tiny grains of sand to large stones several centimeters in diameter. Some people may have a single gallstone, while others may have many. Gallstones may cause no symptoms at all, but if they block the flow of bile out of the gallbladder, they can cause pain, inflammation, and infection.

Symptoms of cholecystolithiasis may include abdominal pain, often in the upper right or center of the abdomen, that may be sharp or crampy and may occur after eating fatty foods. Other symptoms may include nausea, vomiting, fever, and chills. If gallstones are left untreated, they can lead to serious complications such as cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or cholangitis (infection of the bile ducts). Treatment for cholecystolithiasis may include medication to dissolve the gallstones, shock wave lithotripsy to break up the stones, or surgery to remove the gallbladder.

Cholangiography is a medical procedure that involves taking X-ray images of the bile ducts (the tubes that carry bile from the liver to the small intestine). This is typically done by injecting a contrast dye into the bile ducts through an endoscope or a catheter that has been inserted into the body.

There are several types of cholangiography, including:

* Endoscopic retrograde cholangiopancreatography (ERCP): This procedure involves inserting an endoscope through the mouth and down the throat into the small intestine. A dye is then injected into the bile ducts through a small tube that is passed through the endoscope.
* Percutaneous transhepatic cholangiography (PTC): This procedure involves inserting a needle through the skin and into the liver to inject the contrast dye directly into the bile ducts.
* Operative cholangiography: This procedure is performed during surgery to examine the bile ducts for any abnormalities or blockages.

Cholangiography can help diagnose a variety of conditions that affect the bile ducts, such as gallstones, tumors, or inflammation. It can also be used to guide treatment decisions, such as whether surgery is necessary to remove a blockage.

Cholecystectomy is a medical procedure to remove the gallbladder, a small pear-shaped organ located on the right side of the abdomen, just beneath the liver. The primary function of the gallbladder is to store and concentrate bile, a digestive fluid produced by the liver. During a cholecystectomy, the surgeon removes the gallbladder, usually due to the presence of gallstones or inflammation that can cause pain, infection, or other complications.

There are two primary methods for performing a cholecystectomy:

1. Open Cholecystectomy: In this traditional surgical approach, the surgeon makes an incision in the abdomen to access and remove the gallbladder. This method is typically used when there are complications or unique circumstances that make laparoscopic surgery difficult or risky.
2. Laparoscopic Cholecystectomy: This is a minimally invasive surgical procedure where the surgeon makes several small incisions in the abdomen, through which a thin tube with a camera (laparoscope) and specialized surgical instruments are inserted. The surgeon then guides these tools to remove the gallbladder while viewing the internal structures on a video monitor.

After the gallbladder is removed, bile flows directly from the liver into the small intestine through the common bile duct, and the body continues to function normally without any significant issues.

Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive medical imaging technique that uses magnetic resonance imaging (MRI) to visualize the bile ducts and pancreatic duct. This diagnostic test does not use radiation like other imaging techniques such as computed tomography (CT) scans or endoscopic retrograde cholangiopancreatography (ERCP).

During an MRCP, the patient lies on a table that slides into the MRI machine. Contrast agents may be used to enhance the visibility of the ducts. The MRI machine uses a strong magnetic field and radio waves to produce detailed images of the internal structures, allowing radiologists to assess any abnormalities or blockages in the bile and pancreatic ducts.

MRCP is often used to diagnose conditions such as gallstones, tumors, inflammation, or strictures in the bile or pancreatic ducts. It can also be used to monitor the effectiveness of treatments for these conditions. However, it does not allow for therapeutic interventions like ERCP, which can remove stones or place stents.

Cholangitis is a medical condition characterized by inflammation of the bile ducts, which are the tubes that carry bile from the liver to the small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are two types of cholangitis: acute and chronic. Acute cholangitis is a sudden and severe infection that can cause symptoms such as abdominal pain, fever, jaundice (yellowing of the skin and eyes), and dark urine. It is usually caused by a bacterial infection that enters the bile ducts through a blockage or obstruction.

Chronic cholangitis, on the other hand, is a long-term inflammation of the bile ducts that can lead to scarring and narrowing of the ducts. This can cause symptoms such as abdominal pain, itching, and jaundice. Chronic cholangitis can be caused by various factors, including primary sclerosing cholangitis (an autoimmune disease), bile duct stones, or tumors in the bile ducts.

Treatment for cholangitis depends on the underlying cause of the condition. Antibiotics may be used to treat bacterial infections, and surgery may be necessary to remove blockages or obstructions in the bile ducts. In some cases, medications may be prescribed to manage symptoms and prevent further complications.

Laparoscopic cholecystectomy is a surgical procedure to remove the gallbladder using a laparoscope, a thin tube with a camera, which allows the surgeon to view the internal structures on a video monitor. The surgery is performed through several small incisions in the abdomen, rather than a single large incision used in open cholecystectomy. This approach results in less postoperative pain, fewer complications, and shorter recovery time compared to open cholecystectomy.

The procedure is typically indicated for symptomatic gallstones or chronic inflammation of the gallbladder (cholecystitis), which can cause severe abdominal pain, nausea, vomiting, and fever. Laparoscopic cholecystectomy has become the standard of care for gallbladder removal due to its minimally invasive nature and excellent outcomes.

Cholelithiasis is a medical term that refers to the presence of gallstones in the gallbladder. The gallbladder is a small pear-shaped organ located beneath the liver that stores bile, a digestive fluid produced by the liver. Gallstones are hardened deposits that can form in the gallbladder when substances in the bile, such as cholesterol or bilirubin, crystallize.

Gallstones can vary in size and may be as small as a grain of sand or as large as a golf ball. Some people with gallstones may not experience any symptoms, while others may have severe abdominal pain, nausea, vomiting, fever, and jaundice (yellowing of the skin and eyes) if the gallstones block the bile ducts.

Cholelithiasis is a common condition that affects millions of people worldwide, particularly women over the age of 40 and those with certain medical conditions such as obesity, diabetes, and rapid weight loss. If left untreated, gallstones can lead to serious complications such as inflammation of the gallbladder (cholecystitis), infection, or pancreatitis (inflammation of the pancreas). Treatment options for cholelithiasis include medication, shock wave lithotripsy (breaking up the gallstones with sound waves), and surgery to remove the gallbladder (cholecystectomy).

Choledochostomy is a surgical procedure that involves creating an opening (stoma) into the common bile duct, which carries bile from the liver and gallbladder to the small intestine. This procedure is typically performed to relieve obstructions or blockages in the bile duct, such as those caused by gallstones, tumors, or scar tissue.

During the choledochostomy procedure, a surgeon makes an incision in the abdomen and exposes the common bile duct. The duct is then cut open, and a small tube (catheter) is inserted into the duct to allow bile to drain out of the body. The catheter may be left in place temporarily or permanently, depending on the underlying condition causing the obstruction.

Choledochostomy is typically performed as an open surgical procedure, but it can also be done using minimally invasive techniques such as laparoscopy or robotic-assisted surgery. As with any surgical procedure, choledochostomy carries risks such as bleeding, infection, and damage to surrounding tissues. However, these risks are generally low in the hands of an experienced surgeon.

Transhepatic sphincterotomy is a medical procedure that involves the incision or cutting of the papilla of Vater, which is a small muscular structure located at the junction of the common bile duct and the main pancreatic duct, with the ampulla of Vater, within the second part of the duodenum. This procedure is performed using a special type of endoscope that is passed through the liver (transhepatically) to access the bile ducts.

The goal of transhepatic sphincterotomy is to relieve obstructions or blockages in the bile ducts, such as gallstones or tumors, that cannot be removed using other endoscopic techniques. This procedure is typically performed by an interventional radiologist or a gastroenterologist with specialized training in endoscopic retrograde cholangiopancreatography (ERCP).

Transhepatic sphincterotomy is considered a higher-risk procedure than traditional ERCP sphincterotomy due to the need for liver puncture and the potential complications associated with this approach, including bleeding, infection, and injury to surrounding organs. However, it may be necessary in certain situations where traditional ERCP is not feasible or has failed.

Cholecystitis is a medical condition characterized by inflammation of the gallbladder, a small pear-shaped organ located under the liver that stores and concentrates bile produced by the liver. Bile is a digestive fluid that helps break down fats in the small intestine during digestion.

Acute cholecystitis is a sudden inflammation of the gallbladder, often caused by the presence of gallstones that block the cystic duct, the tube that carries bile from the gallbladder to the common bile duct. This blockage can cause bile to build up in the gallbladder, leading to inflammation, swelling, and pain.

Chronic cholecystitis is a long-term inflammation of the gallbladder, often caused by repeated attacks of acute cholecystitis or the presence of gallstones that cause ongoing irritation and damage to the gallbladder wall. Over time, chronic cholecystitis can lead to thickening and scarring of the gallbladder wall, which can reduce its ability to function properly.

Symptoms of cholecystitis may include sudden and severe abdominal pain, often in the upper right or center of the abdomen, that may worsen after eating fatty foods; fever; nausea and vomiting; bloating and gas; and clay-colored stools. Treatment for cholecystitis typically involves antibiotics to treat any infection present, pain relief, and surgery to remove the gallbladder (cholecystectomy). In some cases, a nonsurgical procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be used to remove gallstones from the bile duct.

Biliary tract diseases refer to a group of medical conditions that affect the biliary system, which includes the gallbladder, bile ducts, and liver. Bile is a digestive juice produced by the liver, stored in the gallbladder, and released into the small intestine through the bile ducts to help digest fats.

Biliary tract diseases can cause various symptoms such as abdominal pain, jaundice, fever, nausea, vomiting, and changes in stool color. Some of the common biliary tract diseases include:

1. Gallstones: Small, hard deposits that form in the gallbladder or bile ducts made up of cholesterol or bilirubin.
2. Cholecystitis: Inflammation of the gallbladder, often caused by gallstones.
3. Cholangitis: Infection or inflammation of the bile ducts.
4. Biliary dyskinesia: A motility disorder that affects the contraction and relaxation of the muscles in the biliary system.
5. Primary sclerosing cholangitis: A chronic autoimmune disease that causes scarring and narrowing of the bile ducts.
6. Biliary tract cancer: Rare cancers that affect the gallbladder, bile ducts, or liver.

Treatment for biliary tract diseases varies depending on the specific condition and severity but may include medications, surgery, or a combination of both.

Common bile duct diseases refer to conditions that affect the common bile duct, a tube that carries bile from the liver and gallbladder into the small intestine. Some common examples of common bile duct diseases include:

1. Choledocholithiasis: This is the presence of stones (calculi) in the common bile duct, which can cause blockage, inflammation, and infection.
2. Cholangitis: This is an infection or inflammation of the common bile duct, often caused by obstruction due to stones, tumors, or strictures.
3. Common bile duct cancer (cholangiocarcinoma): This is a rare but aggressive cancer that arises from the cells lining the common bile duct.
4. Biliary strictures: These are narrowing or scarring of the common bile duct, which can be caused by injury, inflammation, or surgery.
5. Benign tumors: Non-cancerous growths in the common bile duct can also cause blockage and other symptoms.

Symptoms of common bile duct diseases may include abdominal pain, jaundice (yellowing of the skin and eyes), fever, chills, nausea, vomiting, and dark urine or light-colored stools. Treatment depends on the specific condition and severity but may include medications, endoscopic procedures, surgery, or a combination of these approaches.

The ampulla of Vater, also known as hepatopancreatic ampulla, is a dilated portion of the common bile duct where it joins the main pancreatic duct and empties into the second part of the duodenum. It serves as a conduit for both bile from the liver and digestive enzymes from the pancreas to reach the small intestine, facilitating the digestion and absorption of nutrients. The ampulla of Vater is surrounded by a muscular sphincter, the sphincter of Oddi, which controls the flow of these secretions into the duodenum.

Acute cholecystitis is a medical condition characterized by inflammation of the gallbladder (cholecystitis) that develops suddenly (acute). The gallbladder is a small pear-shaped organ located in the upper right part of the abdomen, beneath the liver. It stores bile, a digestive juice produced by the liver, which helps break down fats in the food we eat.

Acute cholecystitis occurs when the gallbladder becomes inflamed and irritated, often due to the presence of gallstones that block the cystic duct, the tube that carries bile from the gallbladder into the small intestine. When the cystic duct is obstructed, bile builds up in the gallbladder, causing it to become swollen, inflamed, and infected.

Symptoms of acute cholecystitis may include sudden and severe abdominal pain, often located in the upper right or middle part of the abdomen, that may radiate to the back or shoulder blade area. Other symptoms may include fever, nausea, vomiting, loss of appetite, and abdominal tenderness or swelling.

Acute cholecystitis is typically diagnosed through a combination of medical history, physical examination, laboratory tests, and imaging studies such as ultrasound or CT scan. Treatment may involve hospitalization, antibiotics to treat infection, pain relief medications, and surgery to remove the gallbladder (cholecystectomy). In some cases, nonsurgical treatments such as endoscopic sphincterotomy or percutaneous cholecystostomy may be used to relieve obstruction and inflammation.

Endosonography, also known as endoscopic ultrasound (EUS), is a medical procedure that combines endoscopy and ultrasound to obtain detailed images and information about the digestive tract and surrounding organs. An endoscope, which is a flexible tube with a light and camera at its tip, is inserted through the mouth or rectum to reach the area of interest. A high-frequency ultrasound transducer at the tip of the endoscope generates sound waves that bounce off body tissues and create echoes, which are then translated into detailed images by a computer.

Endosonography allows doctors to visualize structures such as the esophageal, stomach, and intestinal walls, lymph nodes, blood vessels, and organs like the pancreas, liver, and gallbladder. It can help diagnose conditions such as tumors, inflammation, and infections, and it can also be used to guide biopsies or fine-needle aspirations of suspicious lesions.

Overall, endosonography is a valuable tool for the diagnosis and management of various gastrointestinal and related disorders.

A diverticulum is a small sac or pouch that forms as a result of a weakness in the wall of a hollow organ, such as the intestine. These sacs can become inflamed or infected, leading to conditions like diverticulitis. Diverticula are common in the large intestine, particularly in the colon, and are more likely to develop with age. They are usually asymptomatic but can cause symptoms such as abdominal pain, bloating, constipation, or diarrhea if they become inflamed or infected.

Extrahepatic cholestasis is a medical condition characterized by the impaired flow of bile outside of the liver. Bile is a digestive fluid produced by the liver that helps in the absorption and digestion of fats. When the flow of bile is obstructed or blocked, it can lead to an accumulation of bile components, such as bilirubin, in the bloodstream, resulting in jaundice, dark urine, light-colored stools, and itching.

Extrahepatic cholestasis can be caused by various factors, including gallstones, tumors, strictures, or inflammation of the bile ducts. It is essential to diagnose and treat extrahepatic cholestasis promptly to prevent further complications, such as liver damage or infection. Treatment options may include medications, endoscopic procedures, or surgery, depending on the underlying cause of the condition.

Pancreatitis is a medical condition characterized by inflammation of the pancreas, a gland located in the abdomen that plays a crucial role in digestion and regulating blood sugar levels. The inflammation can be acute (sudden and severe) or chronic (persistent and recurring), and it can lead to various complications if left untreated.

Acute pancreatitis often results from gallstones or excessive alcohol consumption, while chronic pancreatitis may be caused by long-term alcohol abuse, genetic factors, autoimmune conditions, or metabolic disorders like high triglyceride levels. Symptoms of acute pancreatitis include severe abdominal pain, nausea, vomiting, fever, and increased heart rate, while chronic pancreatitis may present with ongoing abdominal pain, weight loss, diarrhea, and malabsorption issues due to impaired digestive enzyme production. Treatment typically involves supportive care, such as intravenous fluids, pain management, and addressing the underlying cause. In severe cases, hospitalization and surgery may be necessary.

Cholestasis is a medical condition characterized by the interruption or reduction of bile flow from the liver to the small intestine. Bile is a digestive fluid produced by the liver that helps in the breakdown and absorption of fats. When the flow of bile is blocked or reduced, it can lead to an accumulation of bile components, such as bilirubin, in the blood, which can cause jaundice, itching, and other symptoms.

Cholestasis can be caused by various factors, including liver diseases (such as hepatitis, cirrhosis, or cancer), gallstones, alcohol abuse, certain medications, pregnancy, and genetic disorders. Depending on the underlying cause, cholestasis may be acute or chronic, and it can range from mild to severe in its symptoms and consequences. Treatment for cholestasis typically involves addressing the underlying cause and managing the symptoms with supportive care.

Duodenal diseases refer to a range of medical conditions that affect the duodenum, which is the first part of the small intestine. Here are some examples of duodenal diseases:

1. Duodenitis: This is inflammation of the duodenum, which can cause symptoms such as abdominal pain, nausea, vomiting, and bloating. Duodenitis can be caused by bacterial or viral infections, excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), or chronic inflammation due to conditions like Crohn's disease.
2. Peptic ulcers: These are sores that develop in the lining of the duodenum, usually as a result of infection with Helicobacter pylori bacteria or long-term use of NSAIDs. Symptoms can include abdominal pain, bloating, and heartburn.
3. Duodenal cancer: This is a rare type of cancer that affects the duodenum. Symptoms can include abdominal pain, weight loss, and blood in the stool.
4. Celiac disease: This is an autoimmune disorder that causes the immune system to attack the lining of the small intestine in response to gluten, a protein found in wheat, barley, and rye. This can lead to inflammation and damage to the duodenum.
5. Duodenal diverticulosis: This is a condition in which small pouches form in the lining of the duodenum. While many people with duodenal diverticulosis do not experience symptoms, some may develop complications such as inflammation or infection.
6. Duodenal atresia: This is a congenital condition in which the duodenum does not form properly, leading to blockage of the intestine. This can cause symptoms such as vomiting and difficulty feeding in newborns.

Bile duct diseases refer to a group of medical conditions that affect the bile ducts, which are tiny tubes that carry bile from the liver to the gallbladder and small intestine. Bile is a digestive juice produced by the liver that helps break down fats in food.

There are several types of bile duct diseases, including:

1. Choledocholithiasis: This occurs when stones form in the common bile duct, causing blockage and leading to symptoms such as abdominal pain, jaundice, and fever.
2. Cholangitis: This is an infection of the bile ducts that can cause inflammation, pain, and fever. It can occur due to obstruction of the bile ducts or as a complication of other medical procedures.
3. Primary Biliary Cirrhosis (PBC): This is a chronic autoimmune disease that affects the bile ducts in the liver, causing inflammation and scarring that can lead to cirrhosis and liver failure.
4. Primary Sclerosing Cholangitis (PSC): This is another autoimmune disease that causes inflammation and scarring of the bile ducts, leading to liver damage and potential liver failure.
5. Bile Duct Cancer: Also known as cholangiocarcinoma, this is a rare form of cancer that affects the bile ducts and can cause jaundice, abdominal pain, and weight loss.
6. Benign Strictures: These are narrowing of the bile ducts that can occur due to injury, inflammation, or surgery, leading to blockage and potential infection.

Symptoms of bile duct diseases may include jaundice, abdominal pain, fever, itching, dark urine, and light-colored stools. Treatment depends on the specific condition and may involve medication, surgery, or other medical interventions.

Sphincter of Oddi dysfunction (SOD) is a condition characterized by abnormalities in the functioning of the Sphincter of Oddi, which is a muscular valve that controls the flow of bile and pancreatic juice from the pancreas and gallbladder into the duodenum (the first part of the small intestine).

In SOD, the sphincter may either fail to relax properly or become overactive, leading to a variety of symptoms such as abdominal pain, nausea, vomiting, bloating, and elevated liver enzymes. The condition can be classified into two types: Type I, which is associated with elevated liver enzymes and/or pancreatic enzymes, and Type II, which is characterized by abdominal pain without biochemical abnormalities.

The diagnosis of SOD typically involves a series of tests such as manometry (measuring the pressure inside the sphincter), endoscopic ultrasound, or magnetic resonance cholangiopancreatography (MRCP) to visualize the anatomy and function of the sphincter. Treatment options may include medications to relax the sphincter, endoscopic therapy to cut or stretch the muscle, or surgery in severe cases.

Drainage, in medical terms, refers to the removal of excess fluid or accumulated collections of fluids from various body parts or spaces. This is typically accomplished through the use of medical devices such as catheters, tubes, or drains. The purpose of drainage can be to prevent the buildup of fluids that may cause discomfort, infection, or other complications, or to treat existing collections of fluid such as abscesses, hematomas, or pleural effusions. Drainage may also be used as a diagnostic tool to analyze the type and composition of the fluid being removed.

Pathologic dilatation refers to an abnormal and excessive widening or enlargement of a body cavity or organ, which can result from various medical conditions. This abnormal dilation can occur in different parts of the body, including the blood vessels, digestive tract, airways, or heart chambers.

In the context of the cardiovascular system, pathologic dilatation may indicate a weakening or thinning of the heart muscle, leading to an enlarged chamber that can no longer pump blood efficiently. This condition is often associated with various heart diseases, such as cardiomyopathy, valvular heart disease, or long-standing high blood pressure.

In the gastrointestinal tract, pathologic dilatation may occur due to mechanical obstruction, neuromuscular disorders, or inflammatory conditions that affect the normal motility of the intestines. Examples include megacolon in Hirschsprung's disease, toxic megacolon in ulcerative colitis, or volvulus (twisting) of the bowel.

Pathologic dilatation can lead to various complications, such as reduced organ function, impaired circulation, and increased risk of infection or perforation. Treatment depends on the underlying cause and may involve medications, surgery, or other interventions to address the root problem and prevent further enlargement.

Bile ducts are tubular structures that carry bile from the liver to the gallbladder for storage or directly to the small intestine to aid in digestion. There are two types of bile ducts: intrahepatic and extrahepatic. Intrahepatic bile ducts are located within the liver and drain bile from liver cells, while extrahepatic bile ducts are outside the liver and include the common hepatic duct, cystic duct, and common bile duct. These ducts can become obstructed or inflamed, leading to various medical conditions such as cholestasis, cholecystitis, and gallstones.

Obstructive Jaundice is a medical condition characterized by the yellowing of the skin, sclera (whites of the eyes), and mucous membranes due to the accumulation of bilirubin in the bloodstream. This occurs when there is an obstruction or blockage in the bile ducts that transport bile from the liver to the small intestine.

Bile, which contains bilirubin, aids in digestion and is usually released from the liver into the small intestine. When the flow of bile is obstructed, bilirubin builds up in the blood, causing jaundice. The obstruction can be caused by various factors, such as gallstones, tumors, or strictures in the bile ducts.

Obstructive jaundice may present with additional symptoms like dark urine, light-colored stools, itching, abdominal pain, and weight loss, depending on the cause and severity of the obstruction. It is essential to seek medical attention if jaundice is observed, as timely diagnosis and management can prevent potential complications, such as liver damage or infection.

The intraoperative period is the phase of surgical treatment that refers to the time during which the surgery is being performed. It begins when the anesthesia is administered and the patient is prepared for the operation, and it ends when the surgery is completed, the anesthesia is discontinued, and the patient is transferred to the recovery room or intensive care unit (ICU).

During the intraoperative period, the surgical team, including surgeons, anesthesiologists, nurses, and other healthcare professionals, work together to carry out the surgical procedure safely and effectively. The anesthesiologist monitors the patient's vital signs, such as heart rate, blood pressure, oxygen saturation, and body temperature, throughout the surgery to ensure that the patient remains stable and does not experience any complications.

The surgeon performs the operation, using various surgical techniques and instruments to achieve the desired outcome. The surgical team also takes measures to prevent infection, control bleeding, and manage pain during and after the surgery.

Overall, the intraoperative period is a critical phase of surgical treatment that requires close collaboration and communication among members of the healthcare team to ensure the best possible outcomes for the patient.

Catheterization is a medical procedure in which a catheter (a flexible tube) is inserted into the body to treat various medical conditions or for diagnostic purposes. The specific definition can vary depending on the area of medicine and the particular procedure being discussed. Here are some common types of catheterization:

1. Urinary catheterization: This involves inserting a catheter through the urethra into the bladder to drain urine. It is often performed to manage urinary retention, monitor urine output in critically ill patients, or assist with surgical procedures.
2. Cardiac catheterization: A procedure where a catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the heart. This allows for various diagnostic tests and treatments, such as measuring pressures within the heart chambers, assessing blood flow, or performing angioplasty and stenting of narrowed coronary arteries.
3. Central venous catheterization: A catheter is inserted into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, or nutrition, or to monitor central venous pressure.
4. Peritoneal dialysis catheterization: A catheter is placed into the abdominal cavity for individuals undergoing peritoneal dialysis, a type of kidney replacement therapy.
5. Neurological catheterization: In some cases, a catheter may be inserted into the cerebrospinal fluid space (lumbar puncture) or the brain's ventricular system (ventriculostomy) to diagnose or treat various neurological conditions.

These are just a few examples of catheterization procedures in medicine. The specific definition and purpose will depend on the medical context and the particular organ or body system involved.

The preoperative period is the time period before a surgical procedure during which various preparations are made to ensure the best possible outcome for the surgery. This includes evaluating the patient's overall health status, identifying and managing any underlying medical conditions that could increase the risk of complications, obtaining informed consent from the patient, and providing preoperative instructions regarding medications, food and drink intake, and other aspects of preparation for the surgery.

The specific activities that occur during the preoperative period may vary depending on the type and complexity of the surgical procedure, as well as the individual needs and medical history of the patient. However, some common elements of the preoperative period include:

* A thorough medical history and physical examination to assess the patient's overall health status and identify any potential risk factors for complications
* Diagnostic tests such as blood tests, imaging studies, or electrocardiograms (ECGs) to provide additional information about the patient's health status
* Consultation with anesthesia providers to determine the appropriate type and dosage of anesthesia for the procedure
* Preoperative teaching to help the patient understand what to expect before, during, and after the surgery
* Management of any underlying medical conditions such as diabetes, heart disease, or lung disease to reduce the risk of complications
* Administration of medications such as antibiotics or anti-coagulants to prevent infection or bleeding
* Fasting instructions to ensure that the stomach is empty during the surgery and reduce the risk of aspiration (inhalation of stomach contents into the lungs)

Overall, the preoperative period is a critical time for ensuring the safety and success of surgical procedures. By taking a thorough and systematic approach to preparing patients for surgery, healthcare providers can help to minimize the risks of complications and ensure the best possible outcomes for their patients.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Laparoscopy is a surgical procedure that involves the insertion of a laparoscope, which is a thin tube with a light and camera attached to it, through small incisions in the abdomen. This allows the surgeon to view the internal organs without making large incisions. It's commonly used to diagnose and treat various conditions such as endometriosis, ovarian cysts, infertility, and appendicitis. The advantages of laparoscopy over traditional open surgery include smaller incisions, less pain, shorter hospital stays, and quicker recovery times.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

Preoperative care refers to the series of procedures, interventions, and preparations that are conducted before a surgical operation. The primary goal of preoperative care is to ensure the patient's well-being, optimize their physical condition, reduce potential risks, and prepare them mentally and emotionally for the upcoming surgery.

Preoperative care typically includes:

1. Preoperative assessment: A thorough evaluation of the patient's overall health status, including medical history, physical examination, laboratory tests, and diagnostic imaging, to identify any potential risk factors or comorbidities that may impact the surgical procedure and postoperative recovery.
2. Informed consent: The process of ensuring the patient understands the nature of the surgery, its purpose, associated risks, benefits, and alternative treatment options. The patient signs a consent form indicating they have been informed and voluntarily agree to undergo the surgery.
3. Preoperative instructions: Guidelines provided to the patient regarding their diet, medication use, and other activities in the days leading up to the surgery. These instructions may include fasting guidelines, discontinuing certain medications, or arranging for transportation after the procedure.
4. Anesthesia consultation: A meeting with the anesthesiologist to discuss the type of anesthesia that will be used during the surgery and address any concerns related to anesthesia risks, side effects, or postoperative pain management.
5. Preparation of the surgical site: Cleaning and shaving the area where the incision will be made, as well as administering appropriate antimicrobial agents to minimize the risk of infection.
6. Medical optimization: Addressing any underlying medical conditions or correcting abnormalities that may negatively impact the surgical outcome. This may involve adjusting medications, treating infections, or managing chronic diseases such as diabetes.
7. Emotional and psychological support: Providing counseling, reassurance, and education to help alleviate anxiety, fear, or emotional distress related to the surgery.
8. Preoperative holding area: The patient is transferred to a designated area near the operating room where they are prepared for surgery by changing into a gown, having intravenous (IV) lines inserted, and receiving monitoring equipment.

By following these preoperative care guidelines, healthcare professionals aim to ensure that patients undergo safe and successful surgical procedures with optimal outcomes.

Bile is a digestive fluid that is produced by the liver and stored in the gallbladder. It plays an essential role in the digestion and absorption of fats and fat-soluble vitamins in the small intestine. Bile consists of bile salts, bilirubin, cholesterol, phospholipids, electrolytes, and water.

Bile salts are amphipathic molecules that help to emulsify fats into smaller droplets, increasing their surface area and allowing for more efficient digestion by enzymes such as lipase. Bilirubin is a breakdown product of hemoglobin from red blood cells and gives bile its characteristic greenish-brown color.

Bile is released into the small intestine in response to food, particularly fats, entering the digestive tract. It helps to break down large fat molecules into smaller ones that can be absorbed through the walls of the intestines and transported to other parts of the body for energy or storage.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

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With conditions such as cholecystitis and choledocholithiasis, fever may be present. During the physical examination, the ... In regards to a suspected choledocholithiasis, a endoscopic retrograde cholangiopancreatography (ERCP) is used in both the ... If gallstones are blocking other biliary tract areas causing pancreatic gallstones or choledocholithiasis, elevated liver panel ... diagnosis and treatment as it can remove the stones that are blocking the bile ducts causing choledocholithiasis. In patients ...
If obstructed by a gallstone, a condition called choledocholithiasis can result. In this obstructed state, the duct is ...
This is better known as choledocholithiasis where gallstones become stuck in the common bile duct. Drugs may induce cholestasis ... Localization of pain to the upper right quadrant can be indicative of cholecystitis or choledocholithiasis, which can progress ... Patients can also request an elective cholecystectomy to prevent future cases of choledocholithiasis. In case of narrowing of ... Brady P (May 2016). "Commentary on "Prospective Evaluation of the Clinical Features of Choledocholithiasis: Focus on Abdominal ...
"Single-operator duodenoscope-assisted cholangioscopy is an effective alternative in the management of choledocholithiasis not ... Endoscopic Management of Fractured Dormia Basket During Endoscopic Retrograde Cholangiopancreatography for Choledocholithiasis ...
Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis. ...
This is a list of conditions that can cause posthepatic jaundice: Choledocholithiasis (common bile duct gallstones). It is the ...
... choledocholithiasis, and cholangiocarcinoma. These morbid conditions often prompt the diagnosis. Portal hypertension may be ...
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... resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis ...
Extraction of choledocholithiasis and/or intrahepatic stones: choledocholithiasis is the presence of gallstones within the ... choledocholithiasis), biliary or papillary strictures, sphincter of Oddi dysfunction, bile leaks, and others. In addition, it ...
... a condition called choledocholithiasis. Obstruction can also be due to duodenal inflammation in Crohn's disease. A gallstone ...
Crigler-Najjar syndrome Dubin-Johnson syndrome Choledocholithiasis (chronic or acute). Cirrhosis may cause normal, moderately ...
Obstruction of the bile ducts by gallstones (choledocholithiasis), primary sclerosing cholangitis, liver damage (intrahepatic ...
In patients with cholecysto-choledocholithiasis one-stage laparoscopic common bile duct exploration and cholecystectomy has ...
One possible complication of choledocholithiasis is an infection of the bile ducts between the liver and the gallstone lodged ... this condition is known as choledocholithiasis and is another indication for cholecystectomy. The common bile duct, commonly ...
... hepatolithiasis and choledocholithiasis may predispose to malignant change. Further, industrial exposure to asbestos and ...
... choledocholithiasis, perforated peptic ulcer, bowel infarction, small bowel obstruction, hepatitis, and mesenteric ischemia. ...
... choledocholithiasis, docholithiasis, and sialolithiasis, and acute inflammation caused by crystals in joints causes gout and ...
Detection of Choledocholithiasis with MR Cholangiography: Comparison of Three-Dimensional Fast SE, Single-Slice Half-Fourier ...
... it was suggested that it can result from insult to the biliary tree by obstructive cholangitis secondary to choledocholithiasis ...
... choledocholithiasis).: 977-978 Gallstones are a common cause of inflammation of the gallbladder, called cholecystitis. ...
Can progress to choledocholithiasis (gallstones in the bile duct) and gallstone pancreatitis (inflammation of the pancreas) ...
... choledocholithiasis), jaundice and in ruling out post-operative injury to the pancreas; provided that the diastase level is ...
... obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic ...
... choledocholithiasis MeSH C06.130.120.250.280 - common bile duct neoplasms MeSH C06.130.320.120 - bile duct neoplasms MeSH ... choledocholithiasis MeSH C06.130.564.263 - cholecystitis MeSH C06.130.564.263.249 - acalculous cholecystitis MeSH C06.130. ...

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