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 purpose of this study was to prospectively compare the clinical applicabillity of magnetic resonance cholangiography(MRC) with that of endoscopic retrograde cholangiography(ERC) in the evaluation of combined choledocholithiasis in patients with gall stones who were candidates for laparoscopic cholecystectomy. MATERIALS AND METHODS: Twenty-seven patients with gall stones underwent fast spin-echo MR cholangiography using the half-Fourier acquisition single-shot turbo spin echo(HASTE) method, and half-Fourier rapid acquisition using the relaxation enhancement(RARE) method. Within five hours the same patients underwent ERC. The results of MRC was reviewed by two radiologists blinded to the results of ERC. The number and size of CBD stones and gall stones, and the degree of CBD dilatation, as seen on HASTE and RARE images, were compared with the results of ERC. RESULTS: MRC depicted common bile duct stones in 10 of 11 patients shown by ERC to have stones, while in the 16 patients in whom ERC did not reveal stones, MRC demonstrated the same finding. The number of CBD stones was exactly demonstrated by HASTE imaging in eight of eleven patients(73%) and by RARE imaging in ten of eleven patients(91%) in whom ERC revealed choledocholithiasis. The size of common bile duct stones visualized by ERC correlated in nine of eleven patients(82%) on HASTE images and in seven of eleven(64%) on RARE images. MRC showed CBD dilatation in all patients in whom dilatation was demonstrated by ERC. CONCLUSION: For the evaluation of choledocholithiasis before laparoscopic cholecystectomy in patients with gall stones, MRC and ERC are equally accurate. A comparison of HASTE imaging with RARE imaging, as used in the diagnosis of choledocholithiasis, revealed no significant differences.
Bile Ducts ; Cholangiography* ; Cholecystectomy, Laparoscopic* ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Gallstones ; Humans ; Prospective Studies ; Relaxation

Gallstone pancreatitis is caused by migration of gallstones through the common bile duct and ampulla of Vater, where ohetruction or impaction may occur. Early detection and endoscopic treatment of impacted gallstones are very important for the amelieration of pancreatitis. Pancreatic imagings, such as conventional ultrasonography, computerised tomography(CT) and endoscopic retrograde cholangiypancreatography(ERCP) have beea used for the diagnosis of gallstone pancreatitis. But these imaging net are often unsatisfactory fordetection of the impacted gallstones in the common bile duct ampulla of Vater. Especially ERCP has been contraindicated in acute pancreatitis. Endoscopic ultrasonography(EUS), which was recently developed, has been known as highly accurate diagnostic tool in the diagnosis of biliary and pancreatic disease. The high resolution of EUS is capable of showing unique morphological detail in gallstone pancreatitis. We report 3 cases of gallstone pancreatitis which Was accurately diagnosed by EUS and successfully treated by endoscopic treatment.
Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Endosonography* ; Gallstones* ; Pancreatic Diseases ; Pancreatitis* ; Ultrasonography

While performing a laparoscopic cholecystectomy, a surgeon may occasionally drop a patient's gall stones into the intraperitoneal cavity or perforate a patient's gallbladder. However, most of the time, the dropped stones are spontaneously absorbed by the body. In some instances, the dropped gallstones may cause late complications in the patient, such as abscesses, the formation of fistulae, or adhesion in the intra-abdominal or extra-abdomial region. We report two cases of recurrent abdominal wall and perihepatic abscesses caused by dropped gall stones during a laparoscopic cholecystectomy with late diagnosis.
Abdominal Wall ; Abscess ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Delayed Diagnosis ; Fistula ; Gallbladder ; Gallstones ; Humans ; Postoperative Complications ; Recurrence

BACKGROUND/AIMS: Gallstone pancreatitis has showed higher mortality and morbidity rate as compared to other causes of pancreatitis, and the proper timing of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) is still controversial. But recent several trials reveals early ERCP/EST is safe procedure and can reduce mortality and complication rate in gallstone pancreatitis. METHODS: To assess the safety and effectiveness of early ERCP/EST, we perfomed ERCP and EST, if necessary, in 40 cases of acute gallstone pancreatitis. RESULTS: 1) Early ERCP group (in 72 hours) were 27 cases, delayed group were 13 cases, and 11 early EST group, 16 delayed EST group. No statistically significant difference was found between two groups in blood chemistry and the severity of pancreatitis according to Ranson's criteria, respectively. No remarkable complication due to ERCP or EST was noted, and the hospital days were shorter in early ERCP/EST group with statistical significance, 2) Duodenoscopic findings show 14 normal papillae, 20 papillary edema, hemorrhagic and lacerated papillae in 6 cases. CONCLUSION: In cases of gallstone pancreatitis, early ERCP and EST is considered as a safe and effective treatment modality.
Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Edema ; Gallstones* ; Mortality ; Pancreatitis* ; Sphincterotomy, Endoscopic

Various complications following laparoscopic cholecystectomy have been reported. We describe a case of intraabdominal abscess formation which was developed two months after the inadvertently spilling of gallstones laparoscopic cholecystectomy in a patient with acute cholelithiasis. The condition was initially found on computed tomography and the diagnosis was confirmed with ultrasound. Although this is a rare complication of laparoscopic cholecystectomy, the spilling of gallstones should be recognized as a potential source of intra-abdominal abscess formation even in a patient presenting months after laparoscopic cholecystectomy. We suggest that routine use of the specimen retrieval bag is highly recommended especially for beginners of laparoscopic cholecystectomy during their initial learning period.
Abdominal Abscess ; Abscess* ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Diagnosis ; Gallstones* ; Humans ; Learning ; Postoperative Complications ; Ultrasonography