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

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

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

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

Cholesterol gallstone formation is influenced by environmental and genetic factors. Cholesterol gallstone susceptible genes (Lith genes) are complex and show polygenic traits. Quantitative trait locus (QTL) analysis in inbred mice is a powerful method for identifying these genetic defects. More than 20 Lith genes were discovered by QTL in inbred mice models. The co-localized, candidate genes responsible for gallstone susceptible QTL can lead to the discovery of pathophysiologic functions of Lith (gallstone) genes. These genetic studies may reveal novel molecular targets for prevention and medical therapy. Presently, the only effective treament for gallstone is cholecystectomy. In the future, new drugs targeting Lith genes can be available not only for the treatment of gallstone disease, but also for "pre-stone" diagnosis.
Animals ; Cholecystectomy ; Cholesterol* ; Diagnosis ; Gallstones* ; Mice ; Molecular Biology* ; Multifactorial Inheritance ; Quantitative Trait Loci

Acute recurrent pancreatitis (ARP) refers to a clinical condition characterized by repeated episodes of acute pancreatitis, diagnosed retrospectively after at least the second episode of acute pancreatitis. It is still controversial that acute pancreatitis can progress to chronic pancreatitis, and acute, acute recurrent and chronic pancreatitis is a continuum of disease. The causes of ARP can be divided into mechanical, hereditary and metabolic factor. Despite recent advances in diagnostic technologies, the etiology of ARP still remains unknown in up to 30% of cases. Especially in recurrent episode of idiopathic pancreatitis, a clinician should be considered not only the common causes of ARP, such as gallstone disease and alcohol, but also rare causes of ARP. The common causes of 'idiopathic' recurrent pancreatitis are microlithiasis, sludge, sphincter of oddi dysfunction, pancreas divisum and hereditary pancreatitis. Various treatment options, such as cholecystectomy, endoscopic sphincterotomy, medical and surgery can be applied according to the identified etiology of ARP and treatment should be individualized. Currently, endoscopic treatment is increasingly performed and served as a curative treatment strategy. The medical treatment can be an option in microlithiasis and sludge, but it has limitation in terms of systemic side effect, efficacy and lack of long term outcome. Endoscopic treatment should be considered in selected patients with identifiable cause, and post procedural complication should be considered before endoscopic treatment.
Cholecystectomy ; Diagnosis ; Gallstones ; Humans ; Pancreas ; Pancreatitis* ; Pancreatitis, Chronic ; Retrospective Studies ; Sewage ; Sphincter of Oddi Dysfunction ; 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

INTRODUCTION AND AIM: Acute pancreatitis is an inflammatory process of varying severity, ranging from a mild, self-limiting form to severe acute pancreatitis, which leads to complications such as necrosis, pseudocyst formation, and organ failure. This highly lethal condition should be differentiated from acute abdomen caused by other diseases as early as possible so appropriate management can be carried out. PATIENTS AND METHODS: A survey was carried out to determine the current status of management for this particular disease in Korea. A total of 269 patients were collected from 13 university hospitals during a four and a half year period (January 2000 to June 2004). RESULTS: Of the 269 patients, 103 (38.3%) were managed with surgery, and 166 (61.7%) were managed with conservative treatment. The most commonly performed surgical procedure was debridement of necrotic tissue with closed drainage. The most common etiology was alcohol, with 143 cases (53.4%), followed by gallstones, with 48 cases (17.9%). E. coli was the most commonly cultured bacterium. The mortality rate in surgically managed patients was 9.7%. The mortality rate in conservatively treated patients was 7.2% . CONCLUSION: Patients with infected pancreatic necrosis should be managed with surgical necrosectomy and drainage. However, patients with sterile necrosis should be managed conservatively unless organ complications or severe clinical deterioration develops despite intensive therapy. Patient survival is improved through early diagnosis, followed by adequate drainage in combination with intensive care.
Abdomen, Acute ; Debridement ; Drainage ; Early Diagnosis ; Gallstones ; Hospitals, University ; Humans ; Korea ; Necrosis ; Pancreatitis

Biliary enteric fistulas which are caused by gallstone, peptic ulcer and carcinoma are an uncommon disease. Their incidence appears to increase recently with the advent of endoscopy. The usual types of the fistulas are choledochoduodenal, cholecystoduodenal and cholecystocolonic. But, cholecystogastric fistulas are very rare. Their symptoms are usually nonspecific and pneumobilia has been considered as a clue, but the diagnosis is difficult in most cases. At present, endoscopy is very helpful to the diagnosis. The treatment of asymptomatic fistulas is still in dispute. Endoscopic management is being used at times in recent days. We recently experienced a case of cholecystogastric fistula accidentally. During the evaluation for the cause of anemia, we suspected a fistula on endoscopy and confirmed it on endoscopic fistulography and managed it by endoscopic papillotomy and stone extraction.
Anemia ; Diagnosis ; Dissent and Disputes ; Endoscopy ; Fistula* ; Gallstones ; Incidence ; Peptic Ulcer ; Sphincterotomy, Endoscopic