PURPOSE: South Korea has a high prevalence of gallstones, the type of which could be influenced by changes in diet and socioeconomic status. Here we aimed to investigate the epidemiological characteristics and changing patterns of gallstones over the past 20 years in Korea. METHODS: A total of 5,808 patients who underwent cholecystectomy due to gallstones at Seoul National University Hospital between 1996 and 2015 were analyzed. Patients were divided into 4 subgroups: period 1 (1996–2000, n = 792), period 2 (2001–2005, n = 1,215), period 3 (2006–2010, n = 1,525), period 4 (2011–2015, n = 2,276). Gallstones were classified by type: pure cholesterol (PC), mixed cholesterol (MC), calcium bilirubinate (CB), black pigment (BP), and combination (COM). RESULTS: The female to male ratio was 1.16 with mean ages of 53.6 and 55.3 years old, respectively. The ratio of cholesterol stones to pigment stones was 0.96:1. The mean age and male to female ratio of the patients increased over time. The proportion of cholesterol vs pigment stone did not differ significantly. Proportions of PC and MC stone subtypes did not change notably, whereas proportion of BP stones increased (34.0% to 45.5%), and CB stones decreased (20.7% to 5.3%). CONCLUSION: Gallstone types and occurrences were affected by environmental changes, and pigment stones remained common in Korea. Although no distinct increase in cholesterol stones was noted, the proportion of CB stones decreased. As the mean age at gallstone presentation increases, BP stones could become more prevalent.
Bilirubin ; Cholecystectomy ; Cholecystolithiasis ; Cholelithiasis ; Cholesterol ; Classification ; Diet ; Female ; Gallstones ; Humans ; Korea ; Male ; Prevalence ; Seoul ; Social Class

No abstract available.
Choledocholithiasis* ; Cholelithiasis* ; Humans

Gallstone ileus is a well-known complication of cholelithiasis, but is relatively rare. Most ectopic gallstones are located in the small bowel; they are rarely found in the stomach and duodenum. We describe the imaging findings of a case of intragastric gallstone, as well as a case in which duodenal obstruction was caused by a large gallstone (Bouveret's syndrome).
Cholelithiasis ; Duodenal Obstruction ; Duodenum ; Gallstones* ; Ileus ; Stomach

Introduction: Gallstones disease is a common disorder and symptomatic disease is usually managed with surgery while those with common bile duct stones are usually managed with endoscopic intervention before proceeding to surgery. This study was intended to assess the rate of cholecystectomy among patients who had undergone ERC interventions, the reasons for not proceeding to cholecystectomy and related complications. Materials and Methods: Patients who had intact gallbladder and had undergone ERC for stones related complications over a two year period were retrospectively identified from the Endoscopic Unit Registry. Detailed case note reviews were conducted. Results: The overall cholecystectomy rate post-ERC interventions was 36.9% (48/130). Cholecystectomy was offered to 59.2% (n=77) and the uptake was only 58.4% (n=45/77). Among those who agreed for cholecystectomy, 11.1% (n=5/45) failed to turn up for their scheduled surgery. Three patients (6.7%) had symptoms recurrence before their scheduled surgery: two subsequently underwent cholecystectomy without ERC intervention and one who was pregnant was managed conservatively with holecystectomy. Among the patients who had declined cholecystectomy, 18.8% (n=6/32) had symptoms recurrence. Four patients required repeat ERC interventions and eventually all had cholecystectomy subsequently. The most common reason for declining cholecystectomy was 'not keen' and already asymptomatic (46.9%, n=15/32). Among patients who were not offerred cholecystectomy (n=53/130), symptoms recurrence occurred in 15.2% (n=7/53). Four patients required repeat ERC interventions and three subsequently underwent cholecystectomy. Conclusions: The cholecystectomy rate remains low after ERC interventions. Recurrence of symptoms necessating re-interventions occurred in patients offerred and not offerred cholecystectomy. The uptake rate should be improved and delay to cholecystectomy should be reduced to avoid symptoms recurrence. Patients not undergoing interventions should be advised regarding symptoms recurrence and should be monitored.
Choledocholithiasis ; Cholecystectomy ; Cholangiopancreatography, Endoscopic Retrograde ; CHOLELITHIASIS

No abstract available.
Cholelithiasis* ; Korea*

No abstract available.
Cholelithiasis* ; Diverticulum*

162 cases with cholelithiasis received endosurgery for cholelithotomy in which rate of relapsed cholelithotomy was 21% and rate of intrahepatic cholelithiasis was 58.8%. For relapsed cholelithiasis, prepared operation (73.5%) found better than emergency operation. The endoscopy helped the biliary examination and found the residue of stone in the liver. The bilio-intestinal anastomosis type Y (11.8%) indicated for cholelithiasis combined with oddi stenosid, many repeated cholelithotomy and much intrahepatic cholelithiasis.
Cholelithiasis ; surgery

Study on 87 patients of cholelithiasis (52 males, 35 females) who were reoperated in Hospital No 7, Hi D­ng (1996 - 2000) has shown that: Ultrasonography and X-ray should be performed before and post-operation. The patients, who were reoperated many times, should be indicated for choledoco enteroanastomosis.
Cholelithiasis ; Reoperation

OBJECTIVETo explore the feasibility of single-incision laparoscopic cholecystectomy using a three-dimensional (3D) laparoscopic system.

METHODSTwo patients with benign gallbladder disease with a history of recurrent abdominal pain were selected to undergo the surgery. Gallstones were diagnosed by B ultrasound examination. All the operations were performed through the umbilical incision with the 3D laparoscopic system.

RESULTSThe 2 operations were completed successfully with a operative time of 35 min and 50 min. Both of the patients were ambulatory 8 h after the surgery, began to have a normal diet 1 day after operation, and were discharged 2 days postoperatively without any clinical symptoms.

CONCLUSIONS3D single-incision laparoscopic operation can well reveal the tissue anatomy in the operative field especially for some important structures such as the Calot's triangle with an improved safety compared to conventional laparoscopic operations.

We report a case of gallbladder stone receiving three-dimensional (3D) laparoscopic cholecystectomy, which allowed 3D visualization of the laparoscopic operative field and faithfully displayed the 3D anatomic structures of the abdominal organs and the gallbladder triangle. The operation was successfully completed in 32 min without intraoperative complications. 3D laparoscopic surgery allows more precise operation with reduced complications and helps to shorten the operative time, and is suitable for more complex laparoscopic surgery.
Abdominal Cavity ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; surgery ; Gallstones ; Humans ; Intraoperative Complications