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Clin J Gastroenterol 2021 Jun 11. Epub 2021 Jun 11.

Consultant Upper GI Surgeon, North Cumbria University Hospitals NHS Trust, Carlisle, UK.

Biliary hyperkinesia is typically diagnosed in patients with biliary-like pain and no evidence of gall stones on imaging modalities but who have had biliary scintigraphy scan (HIDA) that shows ejection fraction ≥ 80%. This study aims to identify whether the removal of the gall bladder can alleviate the symptoms associated with biliary hyperkinesia. Systematic search following PRISMA guidelines was done from inception to January 2020 using PubMed/Medline, OVID, Embase, Cochrane database of systemic reviews, Cochrane central register of controlled trials, The Database of Abstracts of Reviews of Effects (DARE) and Cochrane library databases. Read More

Front Surg 2021 13;8:643077. Epub 2021 May 13.

Regional Hepato-Pancreato-Biliary Service, Manchester Royal Infirmary, Manchester, United Kingdom.

Index admission laparoscopic cholecystectomy is the standard of care for patients admitted to hospital with symptomatic acute cholecystitis. The same standard applies to patients suffering with mild acute biliary pancreatitis. Operating theatre capacity can be a significant constraint to same admission surgery. Read More

Int J Surg Protoc 2021 Apr 27;25(1):61-65. Epub 2021 Apr 27.

Department of Surgery, Gaston Berger University of Saint-Louis, Senegal.

Introduction: Gallstone disease is a disorder characterised by the formation of stones in the biliary tract. It is the most common biliary condition accounting for more than 98% of all gallbladder and biliary tract disorders. In Africa, previous studies have shown a relative rarity of this condition with a prevalence less than 5%; since it is between 2 and 5 times higher in other continents. Read More

Cureus 2021 Apr 25;13(4):e14676. Epub 2021 Apr 25.

Gastroenterology and Hepatology, University Hospitals of Morecambe Bay National Health Service Foundation Trust, Lancaster, GBR.

Gallbladder duplication refers to the splitting of "gallbladder primordium" during the early embryonic development in the fifth or early sixth week. Although it is a very rare congenital abnormality and most of the patients will be asymptomatic, yet the symptomatic cases present with abdominal complaints like nausea vomiting, abdominal pain leads to cholecystitis, cholangitis, biliary colic, or pancreatitis. Herein, we present a case report of duplication of the gallbladder, which was difficult to diagnose on radiology. Read More

J Minim Access Surg 2021 Apr 16. Epub 2021 Apr 16.

Department of General Surgery, William Harvey Hospital, Ashford, Kent, UK.

Background: Despite NICE/AUGIS recommendations, the practice of early laparoscopic cholecystectomy (ELC) has been particularly poor in the UK offered only by 11%-20% surgeons as compared to 33%-67% internationally, possibly due to financial constraints, logistical difficulties and shortage of expertise, thus, reflecting the varied provision of emergency general surgical care. To assess whether emergency general surgeons (EGS) could provide a 'Hot Gall Bladder Service' (HGS) with an acceptable outcome.

Patients And Methods: This was a prospective HGS observational study that was protocol driven with strict inclusion/exclusion criteria and secure online data collection in a district general hospital between July 2018 and June 2019. Read More

Pediatr Gastroenterol Hepatol Nutr 2021 Mar 4;24(2):164-172. Epub 2021 Mar 4.

Department of Gastroenterology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.

Purpose: The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood.

Methods: Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Read More

Int J Surg Case Rep 2021 Mar 4;80:105612. Epub 2021 Feb 4.

Beaumont, 28050 Grand River Avenue, Farmington Hills, MI, 48336, United States. Electronic address:

Background: Traditional oncologic pattern of spread of breast cancer is metastasis to axillary lymph nodes, lung, liver and bone (Doval et al., 2006 [1]). Here we present a case of unknown synchronous breast cancer in a patient that was revealed on histopathologic assessment following elective cholecystectomy. Read More

J Robot Surg 2021 Jan 5. Epub 2021 Jan 5.

Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

The robotic platform for cholecystectomy has been extensively studied in comparison to its laparoscopic counterpart with acceptable outcomes. However, wide acceptance of a robotic approach to cholecystectomy has been limited by increased operative room (OR) times and substantially higher cost. This is a single-institution retrospective review of Veteran patients presenting for elective laparoscopic (LC) and robotic (RC) cholecystectomies for benign biliary disease at the Dallas VA Medical Center. Read More

Asian J Endosc Surg 2021 Jan 3. Epub 2021 Jan 3.

Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Introduction: Laparoscopic cholecystectomy is a common surgery with a varying difficulty level. Difficult laparoscopic cholecystectomy may be experienced by many surgeons. If difficult procedures are predicted preoperatively, surgeons may be able to plan the surgical approach and treatment accordingly. Read More

Case Rep Surg 2020 16;2020:8883239. Epub 2020 Dec 16.

Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, TX, USA.

Introduction: Gallbladder agenesis (GA) is a rare congenital malformation, and majority are asymptomatic; however, symptomatic patients present with a clinical picture similar to biliary colic. Work up usually shows contracted gallbladder (GB) on ultrasound (US), and HIDA scan shows nonvisualization. Magnetic resonance cholangiopancreatography (MRCP) can be helpful in the diagnosis; however, the diagnosis without the latter can only be established intraoperatively. Read More

Int J Surg Case Rep 2021 Jan 16;78:223-227. Epub 2020 Dec 16.

Department of General Surgery, The Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Herston, Brisbane, Queensland, Australia. Electronic address:

Introduction: Acute severe cholecystitis with empyema presenting as a gallbladder mass, jaundice and Mirizzi Syndrome (MS) is a complex surgical problem both diagnostically and in terms of management as it mimics both xanthogranulomatous cholecystitis (XGC) and gallbladder carcinoma.

Presentation Of Case: A 48-year-old gentleman was referred to us with biliary colic and weight loss with ultrasound findings of gallstones. At subsequent follow-up he became deeply jaundiced with deranged liver function and a CT showing a gallbladder mass and dilated biliary tree. Read More

Int J Surg Case Rep 2021 Jan 23;78:116-119. Epub 2020 Nov 23.

Faculty of Medicine, Cairo University, Kasr Alainy St., Cairo, 11562, Egypt. Electronic address:

Introduction: Abnormal anatomy of the biliary tree predisposes patients to higher risks of ductal injury and postoperative complications. One of the extremely rare abnormalities of the cystic duct is the duplication of the cystic duct with a single gallbladder. The diagnosis is usually established during surgery. Read More

Surgery 2021 May 13;169(5):1086-1092. Epub 2020 Dec 13.

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA. Electronic address:

Background: A minimally invasive step-up approach to necrotizing biliary pancreatitis often requires multiple interventions, delaying cholecystectomy. The risk of gallstone-related complications during this time interval is unknown, as is the feasibility and safety of cholecystectomy after minimally invasive step-up treatment. In this paper, we analyzed both. Read More

ANZ J Surg 2020 12 31;90(12):2467-2471. Epub 2020 Jul 31.

Department of Radiology, Waitematā District Health Board, Auckland, New Zealand.

Background: Acute gallstone disease, primarily biliary colic and acute cholecystitis, represents a significant burden on surgical services. Prolonged waiting times for ultrasonography to confirm a diagnosis contributes to inefficiency and delays surgery. Bedside ultrasound offers an opportunity for clinicians make a diagnosis more promptly and streamline acute surgery. Read More

Cureus 2020 Oct 6;12(10):e10817. Epub 2020 Oct 6.

Surgery, Florida Atlantic University, Boca Raton, USA.

Introduction Acute calculus cholecystitis is one of the most common causes of acute abdominal pain in patients presenting to the emergency department, representing a third of all surgical emergency hospital admissions. Laparoscopic surgery is typically performed within 24 to 48 hours of hospital admission. Due to similarities in presentation, it is often difficult to differentiate between biliary colic and acute cholecystitis. Read More

Int J Surg Case Rep 2020 22;75:451-453. Epub 2020 Sep 22.

Henry Ford Wyandotte Hospital, Department of General Surgery, 2333 Biddle Ave, Wyandotte, MI, 48192, United States. Electronic address:

Introduction: Paragangliomas are tumors arising from paraganglia of the autonomic nervous system. They are rare tumors and occurrence inside the gallbladder is exceptionally rare. Biliary paragangliomas are thought to be associated with the parasymphathetic fibers and are therefore non-functioning and benign. Read More

Acad Pathol 2020 Jan-Dec;7:2374289520951902. Epub 2020 Sep 11.

Department of Pathology and Laboratory Medicine, West Virginia University, Morgantown, WV, USA.

http://journals.sagepub.com/doi/10. Read More

J Gastrointest Surg 2021 03 15;25(3):713-719. Epub 2020 Sep 15.

Department of Pediatric General Surgery and Liver Transplantation, Children's Hospital, Chongqing Medical University, 136 Zhongshan 2nd Rd., Chongqing, 400014, People's Republic of China.

Background: In patients with biliary colic, high-quality prospective data supporting the precise timing of cholecystectomy are lacking. The purpose of this study was to determine the effectiveness of early laparoscopic cholecystectomy in children with biliary colic.

Methods: A multicenter, parallel-group, randomized study was conducted in patients with biliary colic at 5 hospitals in China. Read More

Case Rep Gastrointest Med 2020 20;2020:8825167. Epub 2020 Aug 20.

General Surgery Department, Shahid Beheshti Hospital, Yasuj University of Medical Sciences, Yasuj, Iran.

Chronic cholecystitis or symptomatic gallbladder is a prolonged mechanical or functional disorder of abnormal gallbladder emptying. Most of the patients have recurrent pain attacks (acute biliary colic), but when pain lasts more than 24 hours, it requires urgent surgical intervention (acute cholecystitis). The length of a fully distended gallbladder is about 7 to 10 cm. Read More

Surg Case Rep 2020 Aug 3;6(1):193. Epub 2020 Aug 3.

Department of Laboratory Medicine & Surgical pathology, Kyushu Railway Memorial Hospital, 2-1-1 Takada, Kitakyushu, 800-0031, Japan.

Introduction: Multiple gallbladders represent a rare congenital disorder, and coexistence with carcinoma is extremely rare, leading to a high possibility of misdiagnosis and surgical complications. In this study, a case was reported and the literature was reviewed.

Case Presentation: An 80-year-old woman was diagnosed with acute cholecystitis via ultrasonography and was successfully treated with antibiotics. Read More

J Cyst Fibros 2021 May 29;20(3):506-510. Epub 2020 Jul 29.

Department of Medicine, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.

Individuals with cystic fibrosis (CF) have an increased risk for gallbladder abnormalities and biliary tract disease, but the reported incidence of these manifestations of CF varies widely in the literature. With the approval of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA), increasing numbers of CF patients have been initiated on highly effective cystic fibrosis transmembrane regulator (CFTR) modulator therapy. While elevations in hepatic panel are known potential side effects of CFTR modulators, there have been no published cases of biliary disease or acute cholecystitis attributed to these medications. Read More

Surgery 2021 02 24;169(2):227-231. Epub 2020 Jul 24.

Department of Surgery, Anne Arundel Medical Center, Annapolis, MD. Electronic address:

Background: The use of indocyanine green during laparoscopic cholecystectomy has been postulated to help to define anatomy. Studies have not specifically evaluated patients with acute cholecystitis. We sought to assess whether use of indocyanine green can decrease the rate of bail-out operation (subtotal cholecystectomy or conversion to an open operation) in an acute care surgery population where acute cholecystitis is more frequent. Read More

BMC Gastroenterol 2020 Jul 17;20(1):229. Epub 2020 Jul 17.

Hepatobiliary Surgery, The third Hospital of Mianyang·Sichuan Mental Health Center, Mianyang, Sichuan Province, China.

Background: Endoscopic sphincterotomy (ES) is the standard treatment for common bile duct stones. The reported findings regarding complications, such as biliary pancreatitis and cholangitis, differ between cholecystectomy after ES. The purpose of this study is to compare cholecystectomy outcomes after endoscopic treatment of common bile duct stones whether or not the incidence of recurrent pancreatitis and cholangitis is reduced, especially in high-risk patients. Read More

Surg Endosc 2021 Jul 6;35(7):3244-3248. Epub 2020 Jul 6.

Department of Surgery, St Vincent Indianapolis, Indianapolis, IN, USA.

Background: The main indications for laparoscopic cholecystectomy are stone-related diseases in adults. With a normal abdominal ultrasound (US), a hepatobiliary iminodiacetic acid (HIDA) scan with ejection fraction (EF) is recommended to evaluate gallbladder function. Biliary dyskinesia or low gallbladder EF (EF < 35%) is a recognized indication for cholecystectomy. Read More

Recent Pat Inflamm Allergy Drug Discov 2020 ;14(2):133-145

Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Shatin, Hong Kong.

Background: Ascaris lumbricoides is the most common helminthic infection. More than 1.2 billion people have ascariasis worldwide. Read More

Surg Case Rep 2020 Jun 23;6(1):146. Epub 2020 Jun 23.

Department of Digestive and General Surgery, Gyoda General Hospital, 376, Motida, Gyoda-shi, Saitama, 361-1156, Japan.

Background: The recurrence of symptoms present before cholecystectomy may be caused by a cystic duct remnant. The resolution of cystic duct remnant syndrome may require surgical resection, but identification of the duct remnant during laparoscopic surgery may be difficult because of adhesions following the previous procedure. Open surgery, which is more invasive than laparoscopic surgery, is frequently chosen to avoid bile duct injury. Read More

Surg Infect (Larchmt) 2021 Mar 29;22(2):121-130. Epub 2020 May 29.

Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Gallstones and cholecystitis are common clinical problems. There is a wide spectrum of disease severity, from rare symptoms of biliary colic to severe cholecystitis with marked gallbladder infection and inflammation that can cause life-threatening sepsis. The care of such patients is similarly varied and multi-disciplinary. Read More

J Hepatobiliary Pancreat Sci 2020 Nov 14;27(11):839-850. Epub 2020 May 14.

Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

Background/purpose: The aim of the present study was to investigate the relationship between hepatobiliary scintigraphy findings and histopathological results in patients with recurrent biliary colic.

Methods: We retrospectively enrolled 107 patients who underwent hepatobiliary scintigraphy for recurrent biliary colic and subsequent cholecystectomy. According to the hepatobiliary scintigraphy findings, patients were categorized into a nonvisualization of gallbladder activity (nonvisualized GB) group, low gallbladder ejection fraction (GBEF) group, and normal GBEF group. Read More

Can J Surg 2020 01 9;63(1):E9-E12. Epub 2020 Jan 9.

From the Division of Emergency Medicine, Western University, London, Ont. (Thompson, Myslik); the Department of Surgery, Western University, London, Ont. (Koichopolos, Leeper); the Division of Critical Care Medicine, Western University, London, Ont. (Leeper); and the Schulich School of Medicine and Dentistry, Western University, London, Ont. (Vandelinde).

Summary: Multiple studies confirm that point of care ultrasound (PoCUS) has a high sensitivity and specificity for cholelithiasis and cholecystitis. However, there is poor perceived reliability of biliary PoCUS by surgeons. This survey was performed to assess surgeons’ opinions on using PoCUS in gallstone disease and barriers that exist for its institution. Read More