Study 759 patients who had gallstone surgery from May 1993 to May 2003. Result: gallstone is common. There is an increase of patients day by day. Female: 25,31% is more than male: 47,69%, the age from 21 to 83. Clinical signals are almost charcot symtom in 80%, relevant with the case of infected gall, OMC calculaus combining with calculaus in lung with high percentage (50,59%). Diagnostic ultrasonic results in high accuracy 89,33% which is convenient, simple, harmless, and quick. Treatment applied is surgery withdrawing kehr calculaus
Gallstones ; Bile ; diagnosis ; Therapeutics ; surgery

Twenty cases of polypoid lesions of the gallbladder were reviewed. Seven were benign lesions. Among them, there were 4 (20%) adenomas and 3 (15%) adenomatous hyperplasias. All of the benign lesions were less than 1 cm in diameter. Thirteen cases involved a carcinoma of the gallbladder, of which 92% were more than 1 cm in diameter, 76.9% were over 60 years of age, and 38.5% were associated with gallstones. The accuracy of the preoperative ultrasonographic diagnosis of the polypoid lesions of the gallbladder was 80%. The spread and the size of the tumor showed a close correlation. Therefore, the size of the tumor is a vital indicator for the treatment of polypoid lesions of the gallbladder; lesions between 0.6~1 cm in diameter should be followed up by ultrasonography. An operation may be considered if stones are present. Lesions bigger than 1 cm should be resected since malignancy can not be excluded.
Adenoma ; Diagnosis ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Hyperplasia ; Polyps ; Ultrasonography

Although the ultrasonography has been regarded as a main procedure in the diagnosis of gallbladder diseases, no many papers concerning the ultrasonographic findings of gallbladder empyema appeared in the literature. Twenty-four cases of surgically proven gallbladder empyema were studied by ultrasonography in our hospital during last 15 months. The results were as follows; 1. The size of gallbladder was enlarged in 18 cases. 2. The thicknessof gallbladder wall was more than 3mm in 16 cases. 3. The echogenicity of gallbladder wall was diminished in all cases. the inner margin of gallblaldder wall was also ill-defined in all cases. These findings are considered to be important in the diagnosis of gallbladder empyema. 4. The internal echogenicity of gallbladder (diffuse or localized) was positive in 16 cases and negative in the remainders. The echo genility was thought to beproportional to the amount of pus in gallbladder. 5. The 7 cases presented periocholecystic sonolucent area hadperforation of gallbladder and pericholecystic abscess. 6. Gallstone was found in 17 cases.
Abscess ; Cholecystitis ; Diagnosis ; Gallbladder Diseases ; Gallbladder ; Gallstones ; Suppuration ; Ultrasonography

BACKGROUND/AIMS: The early diagnosis of possible cancer in thickened gallbladder wall is very important. This study was aimed to confirm the usefulness of endoscopic ultrasonography in differential diagnosis of gallbladder cancer in thickened gallbladder wall, and to find out the findings of endoscopic ultrasonography which favor malignancy. METHODS: We reviewed 67 cases of patients who underwent cholecystectomies and who also showed thickened gallbladder wall in their preoperative endoscopic ultrasonography. According to the post-surgical pathologic diagnosis, the cases were classified into malignant and benign diseases, and they were statistically compared with several findings of endoscopic ultrasonography of thickened gallbladder wall. RESULTS: Pathologic diagnosis included 10 cancers and 57 benign diseases. The sensitivity (90%) and specificity (98%) of endoscopic ultrasonography for diagnosis of gallbladder cancer were superior to those of other techniques. Wall thickness, associations of gallstones, loss or preservation of layered structure and irregularity of inner surface of thickened wall were significant variables in the differential diagnosis between malignant and benign causes of thickened gallbladder wall (p<0.05). CONCLUSIONS: Endoscopic ultrasonography is useful to diagnose gallbladder cancer within thickened wall. Loss of layered structure and irregular inner surface of thickened wall are independent predictive factor of gallbladder cancer.
Cholecystectomy ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Endosonography ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Humans ; Sensitivity and Specificity

Aged, 80 and over ; Gallstones ; complications ; diagnosis ; Gastric Outlet Obstruction ; diagnosis ; etiology ; Humans ; Male

PURPOSE: The aim of this study was to investigate the clinical and laboratory findings of hereditary spherocytosis comparing those of different age groups. METHODS: The clinical and laboratory findings of hereditary spherocytosis from June 1989 to August 1998 at Asan Medical Center were analyzed retrospectively according to two different age groups, Group I (9 patients diagnosed under 10 years of age) and Group II (19 patients diagnosed at or over 10 years of age). RESULTS: 1) Mean age at diagnosis was 2.4+/-1.97 and 28.2+/-18.81 years, and family history was positive in 44% and 47% in Group I and II patients respectively. 2) Splenectomy was carried out in 33% and 79% of Group I and II patients respectively, and accessory spleen was found in 100% and 20% of splenectomized patients respectively. 3) Gallstone was found in 11% and 42% of Group I and II patients respectively, and aplastic crisis developed in 0% and 10% respectively. 4) Post-splenectomy hematological parameters improved as follows: Group I; from hemoglobin at diagnosis of 8.5+/-3.59 g/dL to post-splenectomy level of 12.6+/-0.86 g/dL, hematocrit 24.5+/-10.25% to 38.1+/-4.86%, corrected reticulocyte 9.0+/-4.16% to 1.2+/-0.84%, total bilirubin 3.2+/-1.53 mg/dL to 2.2+/-1.34 mg/dL. Group II ; from hemoglobin at diagnosis of 8.9+/-2.95 g/dL to post-splenectomy level of 12.6+/-1.27 g/dL, hematocrit 24.9+/-7.85% to 37.4+/-2.89%, corrected reticulocyte 4.8+/-2.74% to 2.0+/-1.12%, total bilirubin 5.2+/-5.05 mg/dL to 1.1+/-0.49 mg/dL. CONCLUSION: There were no age related differences in hematologic findings at diagnosis and many of the patients with milder form of the disease could be detected later in adult life. The frequency of gallstone was up to 42% in patients whose diagnosis was delayed after 10 years of age, and aplastic crisis was a rare complication. Splenectomy was an effective treatment leading to normal hemoglobin concentrations in all patients. Accessory spleen was found in 33% of splenectomized patients, which emphasizes the necessity of spleen scan before splenectomy.
Adult ; Bilirubin ; Chungcheongnam-do ; Diagnosis ; Gallstones ; Hematocrit ; Humans ; Reticulocytes ; Retrospective Studies ; Spleen ; Splenectomy

Peri-vater divertieula may interfere with the normal flow of biliary and pancreatic secretion, thus leading to pancreatobiliary diseasa and the very presence of juxtapapillary diverticulum makes cannulation technically difficult and contributes to the low success rate. In this present series, the relationship between duodenal diverticula and age, sex, and biliary-pancreatic pathology was stud.ied in 1400 patients examined with ERCP. The results are as follows. 1) Duodenal diverticula was demonstrated in 73 of 1400 patients(5, 2%). 2) The incidence of duodenal divertieular increased with age and they were more frequent in men. 3) The cannulation of one or both duct system was suecessful in 69 of the 73 patients, the success rate was 94. 5%. 4) The biliary pathology was found in 41 of the 73 patients and the pancreatic pathology in 6 of the 73 patients. The rnost common finding was biliary calculi which were demonstrated in 35 patients(47. 9%).
Catheterization ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Diverticulum* ; Gallstones ; Humans ; Incidence ; Male ; Pathology

PURPOSE: Acute gangrenous cholecystitis (AGC) is a severe advanced form of cholecystitis, and it has a higher morbidity and mortality rate than that that of acute nongangrenous cholecystitis (ANGC). Identifying the CT findings of gangrenous cholecystitis will enable physicians to make an early diagnosis and administer aggressive treatment. METHODS: From January 2005 to October 2007, the CT scans in 277 patients (80 with AGC, 149 with ANGC and 45 with normal gallbladder (NGB)) were retrospectively reviewed by 2 radiologists. We evaluated the findings that included wall thickening (>3mm), distension (transverse diameter > 5cm), gallstones, pericholecystic fluid, pericholecystic inflammation, mural striation, adjacent hepatic enhancement, pericholecystic abscess, an intraluminal membrane, an irregular or absent wall, gas in the wall or lumen, and intraperitoneal fluid. The sensitivity and specificity of the each CT finding for diagnosing AGC were calculated. The dimension and wall thickness of the gallbladder were also measured. RESULTS: The sensitivity, specificity and accuracy of CT for diagnosing AGC were 27%, 94% and 74%, respectively. The findings with the highest specificity for AGC were gas in the wall or lumen (100%), intraluminal membranes (99.5%), pericholecystic abscess (99.5%), an irregular or absent wall (98.5%), adjacent hepatic enhancement (97.9%), intraperitoneal fluid (96.9%), pericholecystitic fluid (95.6%), and mural striation (93.8%). The difference of the mean gallbladder wall thickness between the groups was statistically significant. CONCLUSION: These specific CT findings, including the GB wall thickness, will assist clinicians in making an earlier and more exact diagnosis of gangrenous cholecystitis
Abscess ; Cholecystitis ; Early Diagnosis ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Membranes ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: Polypoid lesions of the gall bladder (PLG) have a variety of pathologies. Problems exist in the selection of patients for operation and in the operative approach used. We studied the accuracy of the preoperative radiologic diagnosis and suspected risk factors. METHODS: 121 polypoid lesions of gallbladder were sugically treated during 10 years. Preoperative radiologic diagnosis, age, gender, related symptoms, concurrent gallstone, size, shape, number and histologic diagnosis of the ployps were retrospectively reviewed. RESULTS: The average size of malignancy was 23.0 mm, and that of benign tumors was 7.1 mm (P=0.000). The mean age of patients with a malignancy was significant higher than that of those with benign tumor (P=0.000). The preoperative sensitivity of computed tomography for a malignancy was 67.7%. The patients with malignancy more frequently had related symptoms. CONCLUSION: A CT must be considered, for patients with risk factors, even if the ultrasonographic diagnosis was benign. An Age greater than 60 years, a tumor size greater than 10 mm, a solitary polyp, sessile shape, and related symptoms are predictive factors of a malignancy.
Diagnosis ; Gallbladder* ; Gallstones ; Humans ; Pathology ; Polyps ; Retrospective Studies ; Risk Factors ; Urinary Bladder

BACKGROUND: Due to its high diagnostic accuracy, preoperative sonographic evaluation of gallbladder disease is accepted as the most reliable and effective procedure. However we have encountered, though not so often, cases in which the sonographic tumor revealed only sludge material in reality. METHODS: A retrospective review of 11 cases that had been preoperatively diagnosed as a gallbladder mass or stone focused on the features of the patients and the characteristics of the sonographic findings. RESULTS: Of the cholecystectomized 2486 cases in which gallstones or gallbladder polyps had been preoperatively diagnosed, 0.4% had only sludge in reality. Symptomatic patients were 7 (64%). Pseudo- tumorous lesions of the gallbladder resembled the shapes of the stones, as well as the shapes of polyps, in their echogenic characteristics. CONCLUSIONS: Gallbladder sludge alone can make the sonographic image of a stone or a polyp. The application of more advanced sonography, such as contrast-enhanced Doppler sonography, may contribute to the differential diagnosis of pseudo-tumorous lesions of the gallbladder; however, an indefinite lesion on sonography always deserves operative intervention.
Diagnosis, Differential ; Gallbladder Diseases ; Gallbladder* ; Gallstones ; Humans ; Polyps ; Retrospective Studies ; Sewage* ; Ultrasonography*