جستجوی مقالات مرتبط با کلیدواژه "gallstones" در نشریات گروه "پزشکی"

Pancreatic inflammation, also known as pancreatitis, occurs when exocrine pancreatic enzymes infiltrate the pancreas and cause pathological inflammation. Each case of acute pancreatitis is associated with a subset of causes, indicating the presence of known risk factors.

This paper aims to identify the common causes of pancreatitis and the factors affecting hospitalization and survival at the study site.

Data were collected from the hospital information systems (HIS) using the K85 code from the International Statistical Classification of Diseases 10 (ICD10) at a referral center in Ahvaz, Iran. Demographic information, comorbidities, laboratory parameters, and paraclinical information such as ultrasound documents and reports were gathered. The study focuses on demonstrating the common causes of pancreatitis and factors impacting hospitalization and survival rates from 2017 to 2020.

During this period, 84 patients were admitted. The highest number of admissions occurred in 2020, with the majority of patients being 40 - 60 years old, and women constituting a larger proportion. In total, 85.7% of patients were hospitalized for less than 10 days. About 92% were discharged with follow-up advice, while the rest were discharged against medical advice (DAMA). No deaths were recorded during this period due to pancreatitis.

The most common comorbidities in this study were gallstones, sludge, and a BMI exceeding 30. Additionally, elevated levels of glucose, creatinine, amylase, and lactate dehydrogenase were associated with prolonged hospitalization.

Gallstone disease, traditionally associated with older, overweight females, is increasingly being observed in younger individuals. This shift necessitates a closer examination of the unique characteristics and risk factors associated with gallstone development in this demographic. While conventional risk factors such as gender, age, and genetic predispositions continue to play a role, emerging trends suggest that modifiable factors, including dietary habits, lifestyle choices, and medical conditions, are also influential.

In this observational study conducted at Al Wahda Teaching Hospital in Derna, Libya, between January 2021 and January 2022, we retrospectively collected data from 182 patients diagnosed with gallbladder disease. The study focused on recording demographic information and assessing modifiable risk factors, including dietary habits, reproductive history, smoking, and associated chronic illnesses.

The majority of patients were female (92.3%), with the most commonly affected age group being 26 - 30 years. The average weight of the population was also notably high. Assessment of modifiable risk factors revealed a high prevalence of a high-fat diet (75.8%) and a sedentary lifestyle (73.6%), while surprisingly, 69.2% maintained a high-fiber diet. A range of chronic illnesses contributed to a small proportion of cases, including hemolytic anemia (13.2%), diabetes mellitus (5.5%), and liver disease (4.4%). The predominance of laparoscopic cholecystectomy (54.9%) indicates a shift in treatment approach. Complications were absent in the majority of cases (81.3%), suggesting a generally favorable outcome in gallstone disease management within this cohort.

The evolving nature of gallstone disease in younger populations calls for a reassessment of understanding and management strategies. The observed trends highlight the need for further research to better understand the changing landscape of gallstone disease and to develop targeted preventive measures for this demographic.

Triglyceride-glucose index is a product of triglycerides and fasting plasma glucose (FPG) and is a new index of insulin resistance found to correlate with direct measurements. This study aimed to evaluate the relationship between gallstones and triglyceride-glucose index (TGI).

A total of 210 patients were included in this retrospective study. Overall, 105 patients with gallstones were included in the patient group. Patients with diabetes mellitus, chronic diseases, malignant diseases, and patients using cholesterol-lowering drugs were excluded from the study. Healthy individuals (105 cases) were selected for the control group. TGI was calculated separately for each individual using the following formula: (TGI) = ln (fasting TG (mg/dL) x fasting glucose (mg/dL)/2)

Plasma triglyceride levels were significantly higher in patients with gallstones compared to the control group (P=0.001). Plasma HDL, LDL, and total cholesterol did not differ between the groups (P>0.05). Fasting blood glucose was significantly higher in patients with gallstones compared to the control group (P=0.001). The triglyceride glucose index was significantly higher in patients with gallstones compared to the control group (P<0.001). When the relationship between body mass index and TGI was analyzed, TGI was lower in patients with normal BMI compared to overweight or obese patients (P<0.001).

Increased triglyceride/glucose index in patients with gallstones is an indicator of insulin resistance. It is instrumental in demonstrating the presence of insulin resistance in patients with gallstones and may be a useful guide in earlier detection, prevention, and treatment of insulin resistance.

Lifestyle and nutritional transitions in the society driven by globalization have led to the rising burden of cholelithiasis. The present study was done to assess the impact of lifestyle, stress, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis.

A hospital‑based case–control study was conducted on young females of 18–45 years. Cases and age‑matched controls were compared on their lifestyle parameters like demography, marital status, occupation, educational status, family income, stress along with menstrual pattern, cardiometabolic parameters like anthropometric measures, blood pressure (BP), fasting blood sugar (FBS), and lipid profile. Chi‑square test and unpaired t‑test were used for the analysis of data using SPSS software, and P < 0.05 was considered statistically significant.

The majority of the cases were from rural areas, married, homemakers leading a comparatively sedentary lifestyle consuming more red meat, less literate, and belonged to a lower economic group with significantly more stress compared to controls. The age of menarche, neither the regularity nor irregularity of the menstrual cycle (regular cycle 21–35 days), showed any difference, but cases had significantly more pregnancies and usage of oral contraceptives compared to controls. Waist–height ratio, systolic BP, FBS, triglyceride, low‑density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were significantly higher in cases. Cases had a 14.4 times more risk of developing metabolic syndrome when compared with controls.

Married, rural, less literate Indian women leading a sedentary lifestyle, consuming more of red meat, and soft drinks with increased psychosomatic stress are more prone to develop cholelithiasis. Women who use hormonal contraceptives have increased occurrence of cholelithiasis and they were more prone to develop metabolic syndrome. The need for the hour is health education, to implement simple lifestyle changes, thereby decreasing the incidence of cholelithiasis in young females.

Nutrition‑related factors have been of great interest as one of risk factors of biliary stones. This study evaluated the association of dietary patterns with biliary stone among Iranians.

This is a hospital‑based case‑control study, which was conducted in a general hospital in Tehran, Iran. A total of 110 patients with gallstone or common bile duct (CBD) stone confirmed by Ultrasonography within the last 6 months before collecting data were recruited. Controls were age‑matched patients admitted to the other wards of the same hospital for a broad spectrum of disorders including traumas and orthopedic conditions, or elective surgeries, or throat/ear/nose disease and had no gallbladder disorders, participated in this study. We used a valid and reliable food frequency questionnaire to assess dietary intakes of participants. Dietary patterns were determined by factor analysis.

By design, age was similar in both groups (57.66 ± 16.39 years vs . 56.00 ± 10.64 years in cases and controls, respectively). Two dietary patterns were extracted; “Unhealthy” (high consumption of artificial juice, processed meats, refined grains, sweets and desserts, pickles, snacks, and red meats), and “Healthy” (high consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt). Participants in the highest tertile of “Healthy” dietary pattern were significantly less likely to have the gallstones disease (OR: 0.33, 95% CI = 0.120.89) compared to the reference group (low tertile of “Healthy” dietary pattern) (P = 0.02).

High consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt in context of healthy dietary pattern are inversely associated with risk of gallstones.

The exact mechanism of the formation of salivary gland stones is unknown. Elucidating pathophysiology of the formation of salivary stones might prevent both their formation and the need for implementing invasive surgical procedures. Therefore, this study aimed to evaluate the effects exerted by some etiological factors on the formation of salivary gland stones.

In this case–control study, the records of 80 patients with sialolithiasis were studied as a census from April 2011 to June 2019. These patients were referred to the Oral Medicine and the ENT departments of Tabriz University of Medical Sciences. The control group consisted of the same number of the patients with no sialolithiasis. Two groups were compared in terms of stone size, smoking, gallstones, and renal stones. Chi-squared, independent t-test, and Mann-Whitney U test were adopted to examine the quantitative variables. The data were analyzed using SPSS 17. Statistical significance was set at P<0.05.

Overall, 96.2% of sialoliths were found in the submandibular gland, of which 78.8% were single. Moreover, 32.5% of the patients with a history of sialolithiasis were smokers, whereas this frequency was 23.8% in the control group. In the case and control groups, 2.5% and 5% of the patients had a history of renal stones, respectively. Only one patient who had undergone a surgical procedure to remove salivary gland stones had a history of gallstones, while none of the patients in the control group had a history of gallstones.

The results showed that the formation of salivary gland stones was not associated with smoking, history of renal stones, and gallstones. Furthermore, it was found that the numbers and sizes of salivary stones were not affected by smoking

Cholelithiasis is one of the most prevalent diseases in gastroenterology. There are many factors in cholelithiasis, such as genetic, lack of physical activity, obesity, dietary, age, and other comorbidities. Commonly, cholelithiasis occurs asymptomatically; however, Murphy’s sign is one of the most frequent pathognomonic findings in abdominal examination. Ultrasonography is known as the gold standard imaging examination in diagnosing cholelithiasis. The management of cholelithiasis can be divided into two categories, such as medical treatment and surgical treatment, which depends on the patient’s condition..

Since the laparoscopic cholecystectomy was introduced first in 1990, the 4-port laparoscopic cholecystectomy was the gold standard. The 4-port (lateral) is used to hold gallbladder fundus and observe Calot's triangle. It is discussed that the 4-port technique is not required in many patients. Therefore, this study aimed to make a comparison between 3-port and 4-port laparoscopic cholecystectomy methods in the treatment of gallstone disease.

A double-blind clinical trial was performed on patients admitted to Imam Reza Hospital, Birjand, Iran. The patients with gallstone disease (n=60) were randomly assigned into the case (3-port) and control (4-port) groups using balanced block randomization and underwent 3- or 4-port laparoscopic cholecystectomy. Postoperative pain was measured by a visual analog scale four h after surgery. The amount of pain-killer, duration of surgery, as well as length of stay and scars were measured in this study. Data were analyzed statistically in SPSS software (version 18) through the Chi-square test and t-test. A p-value less than 0.05 was considered statistically significant.

The groups were compared in terms of demographic characteristics. There were 24 females (80%) and 6 males (20%) in the control group and 25 females (83.4%) and 5 males (16.7%) in the case group (P=0.739). Moreover, the mean ages of the control and case groups were 59.823±7.8 and 61.10±4.7, respectively, and there was no significant difference between the groups in this regard (P=0.348). Furthermore, length of operation (P=0.001) and analgesic consumption (P=0.001) in the 3-port laparoscopic cholecystectomy group were lower than those in the 4-port group; however, the hospital stay (P=0.896) was the same in both groups.

The 3-port laparoscopic cholecystectomy is a safe, reliable, and cost-effective method in patients who underwent laparoscopic cholecystectomy.

The role of Bacterial infections as one major cause of occurrence of gallstones has been admitted. Campylobacteraceae family consists of Helicobacter, Campylobacter and Arcobacter genus have been identified as significant bacteria in the appearance of gastric disorders. This study aimed to investigate the frequency of Campylobacteriaceae family bacteria in the gallstones of patients hospitalized in the surgery ward of Shahid Rajaei hospital in Tonekabon. Sample of gallbladder stone was collected form 36 patients. After culture in the BHI medium for the primary enrichment, DNA extraction was carried out and then, the presence of the desired bacteria was examined by PCR technique. The obtained data was analyzed by SPSS software (21) and Chi-square (x2) test. Of total 36 samples of the studied gallstone, 3 samples (8.33%) were positive from viewpoint of presence of Helicobacter, 5 samples (13.88%) were positive in terms of presence of Campylobacter and only 1 sample (2.77%) was positive with respect to the presence of Arcobacter. No significant relationship was observed between type of stone and presence of these bacteria. The results achieved from this research show the presence of DNA belonging to the Campylobacteraceae family in the gallbladder stone, using PCR technique. These bacteria have an etiological significance in the formation of the gallstones. Therefore, more studies are required to determine the role of these bacteria in the formation of gallbladder stone.

Dependence of ultrasonography on the operator’s skill plays a major role in the differences between various studies in reporting its diagnostic accuracy. Therefore, the present study was done with the aim of comparing the ultrasonography findings performed by emergency medicine resident and radiologist in evaluation of acute cholecystitis. The present diagnostic accuracy study has been carried out on patients presenting to the emergency department with complaint of pain in the right upper quadrant of abdomen suspected with acute cholecystitis. All the patients underwent gallbladder ultrasonography by a trained emergency medicine resident and a radiologist and their findings were compared with surgical and pathology findings regarding gallstone and increased gallbladder wall thickness. 51 patients with the mean age of 42.3±15.8 (17-81) years were analyzed (82.4% female). The overall agreement between emergency medicine resident and radiologist in ultrasonographic diagnosis of cholecystitis was 0.421 (95% CI: 0.118-0.724). Based on the pathology and surgical findings, acute cholecystitis was confirmed for all 51 (100%) patients. Meanwhile, based on the ultrasonographic report of radiologist and emergency medicine resident only 45 (88.2%) and 34 (66.7%) patients, respectively, were diagnosed with cholecystitis. Screening performance characteristics of ultrasonography by radiologist for detection of gallbladder stone (p = 0.010) and gallbladder wall thickness (p < 0.0001) were significantly better than emergency medicine resident. The screening performance characteristics of ultrasonography by radiologist in detection of gallstones and increased wall thickness of gallbladder were significantly better.

the aim of this study was evaluating the risk of cardiovascular disease in patients with gallstones. Gallstones is the most common Biliary System disorder which its prevalence is increasing. On other hand, cardiovascular disease is the most common cause of mortality in the world. The causes and risk factors of cardiovascular diseases and gallstones are in common. In this descriptive cross-sectional study, patient with gallstones who hospitalized in Taleghani Hospital of Shahid Beheshti University of medical sciences or referred to its clinics in 2017, shared their demographic information and their underlying diseases with us. In addition, more data was collected with clinical examination, blood test, echocardiography and ultrasonography. Data was analyzed by SPSS vs21 software. In addition, online software was used for calculating Framingham and ASCVD risk score for cardiovascular diseases. 105 patients with gallstones and 105 healthy people participated in this study. There was no significant difference between these two groups for existence of main risk factors, but the average amount of ALT, AST, and ALP enzymes in patients with gallstones were significantly more than the control group (P value<0.05). The average amount of Framingham score was not significantly different between these two groups and the average score of ASCVD was statistically lower in our case group. The risk of cardiovascular disease in patients with gallstones is not significantly more than the general population.

Open or laparoscopic surgical exploration of common bile duct (CBD) is performed when endoscopic approaches fail to extract CBD stones. Intraoperative cholangiography (IOC) through T -tube is performed in order to reduce the rate of retained stones. The aim of this study was to evaluate results of CBD exploration without IOC through T-tube and reviewing existing literature. A retrospective medical chart review of 392 patients who underwent surgical CBD exploration was performed. All patients had proven CBD stones and had previously undergone failed attempts of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES). T -tube insertion or biliary-enteric anastomosis was performed after open CBD exploration with regard to patient’s presentation and CBD diameter. IOC was not performed after T-tube insertion and cholangiography was postponed until 7th postoperative day. Postoperative retained stone and their management were reviewed. Of 392 patients with CBD explorations, T-tube was placed in 215 (54.8%) including 66 (30.7%) emergent biliary drainage and 149 (69.3%) elective operations. A number of 177 of 392 (45.2%) patients underwent biliary- enteric anastomosis. In 6 of 215 patients (2.8%) with T-tube placement, retained CBD stones were detected by T -tube cholangiography during postoperative period. All of them were treated successfully by ERCP. T-tube placement without IOC is accompanied by a low rate of retained stone. Omitting IOC may decrease the operation time which is especially important in emergent cases. Retained stones following CBD exploration and T-tube placement can be treated successfully using ERCP.

Context: Different approaches are routinely applied in the treatment of concomitant cholecystocholedocholithiasis. Most patients are treated by preoperative endoscopic sphincterotomy followed by laparoscopic cholecystectomy in a two-stage approach. However one-stage approach carrying out intraoperative endoscopic sphincterotomy (IOES) is emerging as a minimally invasive alternative option. Our review evaluates the outcomes and potential advantages of IOES compared to the other therapeutic options..Evidence Acquisition: An accurate enquiry for papers relating to IOES and the different available options was performed on different medical databases. Endpoints considered were: successful clearance of common bile duct stones, overall complication rate, procedure related morbidity, conversion rate, duration of hospital stay and costs.. Data were collected from 21 scientific papers including: 5 prospective randomized clinical trial, 4 Meta-analysis and 12 case series. Similar rates of successful clearance of common bile duct stones were reported between Intra Operative Endoscopic Sphincterotomy (IOES) and Pre Operative Endoscopic Sphincterotomy (POES) (96.9% versus 96.3). Overall morbidity showed no statistical significant differences between the two approaches (16.1% in two stage approach versus 19.9% in one stage approach). IOES resulted superior to two-stage approach regarding duration of hospital stay with a mean difference of 2.83 days. The shorter hospital stay ensued in a reduction of cost in most studies. No differences in conversion rate were observed between POES and IOES (3.8% versus 3.7%).. Intraoperative endoscopic retrograde cholangiography is a safe, effective and feasible treatment for patients with concomitant gallbladder stones and choledocholithiasis. This review highlighted the advantages of IOES as a minimally invasive, one-stage approach. However in order to guarantee the success of such approach a profound collaboration between surgeon and endoscopist is mandatory and an efficient logistic organization of the operating theatre is needed..