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Ann Hepatobiliary Pancreat Surg 2022 Jun 7. Epub 2022 Jun 7.

Unit of Gastronterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy.

Diverticula of the choledochus, better known as Todani type II cysts, are very rare and represent a predominantly pediatric pathology. Their identification by radiological methods, even if occasional, requires clinical doctors to request a surgical consultation, even for asymptomatic subjects, to proceed with their removal, given the risk of associated neoplasms. The laparoscopic approach for surgical treatment of these cysts has been recently introduced with excellent results. Read More

World J Clin Cases 2022 Apr;10(10):3306-3312

Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu 610044, Sichuan Province, China.

Background: Hemobilia occurs when there is a fistula between hepatic blood vessels and biliary radicles, and represents only a minority of upper gastrointestinal hemorrhages. Causes of hemobilia are varied, but liver abscess rarely causes hemobilia and only a few cases have been reported. Here, we present a case of atypical hemobilia caused by liver abscess that was successfully managed by endoscopic hepatobiliary intervention through endoscopic retrograde cholangiopancreatography (ERCP). Read More

J Neurol Surg A Cent Eur Neurosurg 2022 May 29. Epub 2022 May 29.

Department of Orthopedic Surgery, Albert Einstein College of Medicine/Montefiore Medical center, Bronx, New York, United States.

Background:  Spinal cord injury (SCI) is a significant medical condition associated with various secondary complications, including cholelithiasis. Cholelithiasis can cause biliary duct obstruction and result in acute cholecystitis. The development of acute cholecystitis in SCI patients has been well studied in the Taiwanese population, showing an increased risk of acute cholecystitis in patients with SCI. Read More

Br J Surg 2022 May 31. Epub 2022 May 31.

Department of Surgery, RadboudUMC, Nijmegen, the Netherlands.

Background: There is a lack of consensus in selecting patients who do or do not benefit from surgery when patients present with abdominal pain and gallbladder stones are present. This review aimed to give an overview of results from recent trials and available literature to improve treatment decisions in patients with uncomplicated cholecystolithiasis.

Methods: First, an overview of different symptom criteria for laparoscopic cholecystectomy in patients with uncomplicated cholecystolithiasis is given, based on national and international guidelines. Read More

Surg Endosc 2022 May 4. Epub 2022 May 4.

Laparoscopic Biliary Service, University Hospital Monklands, Monkscourt Avenue, Airdrie, Lanarkshire, ML6 0JS, Scotland, UK.

Background: The timing of laparoscopic cholecystectomy (LC) for emergency biliary admissions remains inconsistent with national and international guidelines. The perception that LC is difficult in acute cholecystitis and the popularity of the two-session approach to pancreatitis and suspected choledocholithiasis result in delayed management.

Methods: Analysis of prospectively maintained data in a unit adopting a policy of "intention to treat" during the index admission. Read More

J Laparoendosc Adv Surg Tech A 2022 Apr 11. Epub 2022 Apr 11.

Department of Pediatric Surgery, Wake Forest Baptist Medical Center, Brenner Children's Hospital, Winston-Salem, North Carolina, USA.

Biliary dyskinesia is typically defined as a gallbladder ejection fraction (EF) <35% on hepatobiliary iminodiacetic acid scan with cholecystokinin stimulation (CCK-HIDA) testing. Cholecystectomy often leads to resolution of associated biliary colic symptoms. Alternatively, there is a subset of symptomatic patients with normal gallbladder EF on CCK-HIDA. Read More

Int J Surg Case Rep 2022 May 4;94:107026. Epub 2022 Apr 4.

Pediatric Gastroenterology Department, Pediatric Service, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.

Introduction And Importance: Agenesis of the gallbladder is an underdiagnosed entity. It can be an asymptomatic pathology, usually diagnosed incidentally as a finding on imaging techniques or in necropsies. There are symptomatic cases presenting as biliary colic too, attributed to cholecystitis or cholangitis, leading to exploratory surgeries. Read More

Pol Przegl Chir 2021 Oct;93(0):19-24

Department of Surgery, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Poland.

<b>Introduction:</b> Currently, the standard treatment of gallstone disease is laparoscopic cholecystectomy. Considering its availability, reduction of postoperative pain and shortened stay in the hospital, a constant upward trend in the number of such procedures is observed. However, about one third of patients undergoing such treatment report pain and dyspeptic disorders following the surgery. Read More

Medicina (Kaunas) 2022 Mar 5;58(3). Epub 2022 Mar 5.

Northern Ireland Centre for Stratified Medicine, Ulster University, C-TRIC Building, Altnagelvin Hospital Campus, Glenshane Road, Derry BT47 6SB, Northern Ireland, UK.

Gallstones affect 20% of the Western population and will grow in clinical significance as obesity and metabolic diseases become more prevalent. Gallbladder removal (cholecystectomy) is a common treatment for diseases caused by gallstones, with 1.2 million surgeries in the US each year, each costing USD 10,000. Read More

Medicine (Baltimore) 2022 Feb;101(8):e28829

Department of General Surgery, Calvary Mater Newcastle, Australia.

Rationale: Gallbladder cancer is the most common malignancy of the biliary tree. Despite this, the only curative therapy remains surgical resection of the lesion achieving microscopically clear margins before malignant spread has occurred. Gallbladder duplication is an uncommon anatomical variance which occurs globally. Read More

Antibiotics (Basel) 2022 Feb 21;11(2). Epub 2022 Feb 21.

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Surgical site infections (SSIs), i.e., surgery-related infections that occur within 30 days after surgery without an implant and within one year if an implant is placed, complicate surgical procedures in up to 10% of cases, but an underestimation of the data is possible since about 50% of SSIs occur after the hospital discharge. Read More

Cureus 2022 Jan 19;14(1):e21400. Epub 2022 Jan 19.

College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Gallbladder disease is a very common condition that encompasses a heterogeneous group of diseases with a wide range of severity and clinical manifestations. Gallbladder disorders include biliary colic, acute cholecystitis, chronic cholecystitis, choledocholithiasis, Mirizzi syndrome, and gallstone ileus. We report the case of a 70-year-old man who presented to the emergency department complaining of worsening abdominal pain, located in the right upper quadrant and radiating to the right shoulder. Read More

Scand J Surg 2022 Jan-Mar;111(1):14574969211070389

Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå University Hospital, Umeå, Sweden.

Background: The SARS-CoV-2 pandemic has had a significant impact on healthcare delivery. As resources are reallocated, surgery for benign conditions such as gallstone disease is often given low priority. We do not know how this has affected the risk of patients with uncomplicated gallstone disease to develop acute cholecystitis, biliary pancreatitis, or obstructive jaundice. Read More

J Paediatr Child Health 2022 Feb 18. Epub 2022 Feb 18.

Pediatric Gastroenterology Unit, North Maternal and Child Center, Porto University Medical Center, Porto, Portugal.

ANZ J Surg 2022 Feb 16. Epub 2022 Feb 16.

Hepatobiliary Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.

Cureus 2022 Jan 13;14(1):e21187. Epub 2022 Jan 13.

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

Acute cholecystitis and cardiac ischemia can have a similar clinical presentation in some patients. Nonspecific electrocardiographic changes and arrhythmias can occur in acute cholecystitis and gallbladder disease that can confuse the treating physician leading to extensive cardiac workup. Emergency physicians and cardiologists should be aware of these changes so they can expedite the management of acute cholecystitis, which can lead to the resolution of these changes. Read More

J Visc Surg 2022 03 4;159(1S):S16-S21. Epub 2022 Feb 4.

Service de gastroentérologie, Hôpital Nord, Chemin des Bourrelys, 13915 Marseille cedex 20, France. Electronic address:

Sphincter of Oddi dysfunction (SOD) is a benign non-tumoral disorder of the major papilla. It occurs mainly after cholecystectomy but can also occur before surgery. Biliary pain and biliary colic are the most frequent symptoms although recurrent pancreatic pain or pancreatitis can also be presenting symptoms. Read More

Front Med (Lausanne) 2021 17;8:706844. Epub 2022 Jan 17.

Department of Anesthesiology, Shaoxing Peoples's Hospital, Shaoxing, China.

Objective: To compare the efficacy of intravenous (IV) lidocaine with standard analgesics (NSAIDS, opioids) for pain control due to any cause in the emergency department.

Methods: The electronic databases of PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar were explored from 1st January 2000 to 30th March 2021 and randomized controlled trials (RCTs) comparing IV lidocaine with a control group of standard analgesics were included.

Results: Twelve RCTs including 1,351 patients were included. Read More

Medicine (Baltimore) 2022 Jan;101(4):e28687

Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.

Abstract: Common bile duct (CBD) stone is a commonly encountered disease that is associated with various clinical presentations ranging from the mild form of biliary colic to the severe complication of acute cholangitis. Recently, diabetes mellitus (DM) has been linked to the development of biliary diseases; however, no data regarding the association of DM with acute cholangitis development in the setting of CBD stone exist. The aim of the current study was to investigate whether DM represents a risk factor for acute cholangitis in patients with CBD stone. Read More

J Clin Exp Hepatol 2022 Jan-Feb;12(1):129-134. Epub 2021 Mar 19.

SIMS Institute of Gastroenterology, Hepatology and Transplantation, SRM Institutes for Medical Science, India.

Background: Single-session endoscopic stone extraction (ESE) and laparoscopic cholecystectomy (LC) has the best outcome in managing concomitant cholelithiasis (gallstone disease [GSD]) and choledocholithiasis (common bile duct stone [CBDS]). Traditional rendezvous technique with an intraoperative cholangiogram is associated with various technical (bowel distention, frozen Calot's triangle, limitation of intraoperative cholangiogram and so on) and logistical difficulties (lack of trained personnel and equipment for ESE in the operating room). We modified our approach of ESE-LC (tandem ESE-LC) to study the safety of the approach and overcome these disadvantages of the traditional rendezvous approach. Read More

Nutrients 2022 Jan 17;14(2). Epub 2022 Jan 17.

INSERM U 1129, Pediatric Neurology, Necker-Enfants Malades Hospital, University of Paris Descartes, 75015 Paris, France.

The objective of the present research was to review the state of the art on the consequences of drinking coffee at the different levels of the gastrointestinal tract. At some steps of the digestive process, the effects of coffee consumption seem rather clear. This is the case for the stimulation of gastric acid secretion, the stimulation of biliary and pancreatic secretion, the reduction of gallstone risk, the stimulation of colic motility, and changes in the composition of gut microbiota. Read More

J Laparoendosc Adv Surg Tech A 2022 Jan 17. Epub 2022 Jan 17.

Department of Surgery, QEII Jubilee Hospital, Brisbane, Australia.

The implementation of the acute surgical unit (ASU) model has been demonstrated to improve care outcomes for the emergency general surgery patient in comparison to the traditional "on call" model. Currently, only few studies have evaluated surgical outcomes of the ASU model in patients with acute biliary pathologies. This is the first comparative study of two different emergency surgery structures in the acute management of patients with acute cholecystitis and biliary colic. Read More

Cureus 2021 Dec 10;13(12):e20338. Epub 2021 Dec 10.

College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Large bowel obstruction is a surgical emergency that requires prompt diagnosis and management. It is frequently caused by colon cancer. However, the common benign etiologies include volvulus, hernia, adhesions, and strictures. Read More

BMJ Open 2022 Jan 13;12(1):e050413. Epub 2022 Jan 13.

Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China

Introduction: As the main manifestation of gallstone disease, biliary colic (BC) is an episodic attack that brings patients severe pain in the right upper abdominal quadrant. Although acupuncture has been documented with significance to lead to pain relief, the immediate analgesia of acupuncture for BC still needs to be verified, and the underlying mechanism has yet to be covered. Therefore, this trial aims first to verify the immediate pain-alleviation characteristic of acupuncture for BC, then to explore its influence on the peripheral sensitised acupoint and central brain activity. Read More

Surg Endosc 2022 Jan 13. Epub 2022 Jan 13.

Department of General and Upper GI Surgery, Ninewells Hospital, University of Dundee, Dundee, UK.

Introduction: Patients undergoing elective laparoscopic cholecystectomy (ELLC) represent a heterogeneous group making it challenging to stratify risk. The aim of this paper is to identify pre-operative factors associated with adverse peri- and post-operative outcomes in patients undergoing ELLC. This knowledge will help stratify risk, guide surgical decision making and better inform the consent process. Read More

Cureus 2021 Nov 17;13(11):e19681. Epub 2021 Nov 17.

College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Small intestinal obstruction is a common indication for hospitalization and emergency surgeries. The most frequent etiologies are adhesions, hernia, and benign or malignant neoplasms. Abdominal imaging plays an important role in making the diagnosis and evaluating the complications of the obstruction. Read More

Acta Gastroenterol Belg 2021 Oct-Dec;84(4):563-569

Ankara Yildirim Beyazit University Faculty of Medicine Department of Gastroenterology, Ankara, Turkey.

Background And Study Aim: In European Society of Gastrointestinal Endoscopy guidelines, biliary cannulation of naive papillae is defined as difficult in the presence of more than 5 papilla contacts, more than 5min cannulation time or more than one unintended pancreatic duct cannulation or opacification. It is not known whether cholecystectomy is a cause of difficult biliary cannulation. This study aimed to investigate whether cholecystectomy (CCY) is a cause of difficult biliary cannulation in patients who have undergone Endoscopic Retrograde Cholangiopancreatography (ERCP) for choledocholithiasis. Read More

Am Surg 2021 Dec 7:31348211060440. Epub 2021 Dec 7.

General Surgery Residency Program Director, Department of Surgery, Cape Fear Valley Medical Center, Fayetteville, NC, USA.

Gallbladder agenesis is a congenital anomaly that often presents with symptoms of biliary colic. Due to the rarity of this condition, it is often difficult to diagnose pre-operatively. Here we present a case of a 33-yo female with a 6-month history of right upper quadrant abdominal pain and associated nausea. Read More

Cureus 2021 Oct 30;13(10):e19144. Epub 2021 Oct 30.

General Surgery, Western Reserve Hospital, Cuyahoga Falls, USA.

Mirizzi syndrome (MS) is a rare complication of chronic cholecystitis caused by the gallbladder wall compression of the common hepatic duct (MS1, based on McSherry classification) or as a cholecystocholedochal fistula (MS2). The incidence of MS in symptomatic cholelithiasis is very low. Patients often present with obstructive jaundice and right upper quadrant abdominal pain; symptoms not clinically unique from biliary colic or cholecystitis, and often misdiagnosed preoperatively. Read More

J Surg Case Rep 2021 Nov 30;2021(11):rjab521. Epub 2021 Nov 30.

Department of Surgery, University of Jeddah, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.

Omental infarction is a rare cause of pain and must be considered in the differential diagnosis of acute abdomen. It arises in any quadrant that contains omentum when a compromised blood supply takes place. We report a morbid obese 45-year-old male with Diabetes mellitus, dyslipidemia and coronavirus-disease-related pneumonia 2 months prior to his emergency presentation with acute epigastric and right upper quadrant pain. Read More