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gallstone recurrence after successful percutaneous cholecystolithotomy:a 10-year follow-up of 439 cases

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Hepatobiliary & Pancreatic Diseases International 2007年第2期6卷 199-203页

作者： Zou, Yi-Ping Du, Ji-Dong Li, Wei-Min Xiao, Yin-Qi Xu, Hong-Bin Zheng, Fang Huang, Hui Liu, Hao-Run Li, Hu-Cheng Beijing PLA 309 Hosp Dept Hepatobiliary Surg Beijing 100091 Peoples R China

BACKGROUND: Stone recurrence is a major problem in the medication of gallstones with gallbladder preservation. The aim of this study was to determine the long-term recurrence rate of gallstones and the clinical outcome after successful percutaneous cholecystolithotomy (PCCL) treatment, and to investigate the possible risk factors for gallstone recurrence. METHODS: After successful PCCL for gallstones, 439 patients were followed up during a 10-year period. The long-term gallstone recurrence rate and clinical outcome were evaluated. Risk factors associated with stone recurrence were identified. RESULTS: gallstone recurrence was detected in 182 of 439 PCCL patients, giving an overall recurrence rate of 41.46%. The cumulative gallstone recurrence rate for each of the 10 post-operative years was 9.57%, 18.91%, 27.33%, 34.14%, 37.59%, 39.86%, 41.90%, 42.73%, 42.85%, and 43.21%, respectively. Among these recurrent patients, 94 were asymptomatic, 80 suffered from nonspecific upper gastrointestinal symptoms and 8 suffered from abdominal pain or biliary colic. Thirty-eight of the 182 patients were retreated with cholecystectomy. The risk factors for stone recurrence included a family history of gallstones, preference for fatty food, accompanying liver disease, multiple stones and poor gallbladder function pre-PCCL. CONCLUSIONS: In this study, the overall recurrence rate of gallstone was 41.46% during a 10-year period. The highest frequency of gallstone recurrence was during the 5th to 6th postoperative years and then continued to slowly increase. Risk factors for stone recurrence varied. We suggest that the use of PCCL in patients with gallstones should be considered carefully because of stone recurrence.

关键词： gallstone percutaneous cholecystolithotomy recurrence risk factors

Progress in the study on the composition and formation mechanism of gallstone

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Science China Chemistry 2001年第5期44卷 449-456页

作者：孙颖杨展澜申国荣周勇周孝思吴瑾光徐光宪 1. College of Chemistry and Molecular Engineering Department of Chemical Biology Peking University 100871 Beijing China 2. College of Medicine Peking University 100871 Beijing China

Our serial studies from {dy1970}s on chemical composition, structure determination and formation mechanism of gallstones were reviewed. The chemical component investigation of brown-pigment gallstone demonstrated that it consists of macromolecules such as proteins, glycoproteins, polysaccharides, bilirubin polymers and pigment polymers, and biomolecules such as cholesterol, bile salts, calcium salts of carbonate, phosphate, fatty acids and bilirubinate as well as various metal ions. The binding of metal ions with bile salts and bilirubin plays important roles in gallstone formation, i.e., calcium bilirubinate complex is the major constitute of brown-pigment gallstones, and copper bilirubinate complex is critical in the black color appearance of black-pigment gallstone. The cross section of many gallstones exhibits a concentric ring structure composed of various small particles with a fractal character. This is nonlinear phenomenon in gallstone formation. Atypical model system of metal ions-deoxycholate (or cholate)-gel was chosen to mimic an in vitro pattern formation system. The experimental results suggested that a nonlinear scientific concept should be considered in understanding gallstone formation. Minor changes in the chemical composition and/or the microenvironment may lead to very different precipitate patterns with a variety of shapes, colors, appearances, and structures. A new model was suggested that periodical templets of periodical and fractal patterns were formed in the initial stage, then the spatio-temporal patterns grew gradually on it. Furthermore, the interaction between divalent metal ions and bile saltsin vitro was investigated, and the results indicated that non-stoichiometric M(DC)2-NaDC mixed complexes with mixed micelles structure can be formed in physiological condition.

关键词： gallstone mechanism of formation periodic precipitation fractal pattern bile salts

gallstone ANALYSIS BY EPR SPECTROSCOPY

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Chinese Science Bulletin 1989年第23期34卷 1996-2000页

作者：吴恩刘文天刘涛晏懋洵付贤波刘会洲毛晋昌刘佛岸杜永昌石景升 DAVIDMARTINI 周孝思 Roger D.Soloway 吴瑾光徐光宪 Department of Physics Peking University Beijing 100871 PRC Department of Chemistry Peking University Beijing 100871 PRC The Third Hospital Attached to Beijing Medical University Beijing 100083 PRC The First Hospital Attached to Xi'an Medical University Xi'an 710002 PRC. University of Texas Medical Branch Galveston TX U. S. A.

Cholelithiasis is a common disease in China. It is reported that the incidence of this disease is about 7％ and increases with advancing age. The components of gallstones and the mechanism of formation and growth are ... 详细信息

关键词： EPR IR gallstone free radical

XbaⅠpolymorphisms of apolipoprotein B gene:Another risk factor of gallstone formation after radical gastrectomy

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World Journal of Gastroenterology 2010年第20期16卷 2549-2553页

作者： Feng-Lin Liu,Wen-Bin Lu,Wei-Xin Niu,Department of General Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China Department of General Surgery Zhongshan Hospital Fudan University #180 Fenglin Road Shanghai 200032 China.

AIM:To prospectively investigate the association between the XbaⅠpolymorphisms of apolipoprotein B (APOB)gene and gallstone formation following ***:The study was conducted between January 2005 and December 2006.A total of 186 gastric cancer patients who had undergone radical gastrectomy were grouped according to XbaⅠpolymorphisms of APOB gene(X+X-group,n=24 and X-X-group,n =162)and *** XbaⅠpolymorphisms of APOB gene were detected by polymerase chain reaction-restriction fragment length polymorphism(PCRRFLP).RESULTS:The incidence of gallstone was significantly higher in the X + X-group than in the X-X-group[54.2% vs 9.3%,RR=5.85(2.23-15.32),Pgallstone besides the gallbladder motility disorder after surgery.

关键词： Gastric cancer Gastrectomy gallstone Apolipoprotein B gene Polymorphism

Albiflorin Granule significantly decreased the cholesterol gallstone formation by the regulation of insulin transduction signal

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Asian Pacific Journal of Tropical Medicine 2016年第9期9卷 856-860页

作者： Bang-Jiang Fang Jun-Yi Shen Hua Zhang Shuang Zhou Chuan-Zhu Lyu Yi-Qiang Xie Emergency Department Long Hua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Traumatology Department Affiliated Hospital of Hainan Medical University Changhai Hospital of Traditional Chinese Medicine Second Military University College of Traditional Chinese Medicine Hainan Medical University

Objective:To study the mechanism of insulin resistance in the cholesterol gallstone formation from insulin signal transduction pathway so as to reveal the possible mechanism and the effective role of Albiflorin Granule on preventing the cholesterol ***:Serum triglycerides(TG),free fatty acid(FFA),and total cholesterol(TC) from different groups were measured and liver cells Ins R,PKB,IKK-β protein expression levels were detected by western ***:Albiflorin significantly decreased the cholesterol gallstone formation rate,increased glucose infusion rate in gallstone guinea pigs and improved insulin *** with the normal group,insulin receptor and PKB protein expression in GS group were significantly ***-β protein in the GS group increased significantly and Albiflorin could reduce IKK-β protein expression in guinea pig liver ***:The model of insulin resistance in cholesterol gallstone guinea pig was successfully established,which plays an important role in the cholesterol gallstone *** aspects of insulin signaling pathway are involved in gallstone *** can regulate various aspects of insulin signal transduction pathway to prevent the formation of gallbladder.

关键词： Cholesterol gallstone Albiflorin Insulin resistance Insulin signal transduction

Morphologic factors of biliary trees are associated with gallstone-related biliary events

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World Journal of Gastroenterology 2015年第1期21卷 276-282页

作者： Jin-Seok Park Don Haeng Lee Jun Hyeok Lim Seok Jeong Young Sun Jeon Department of Internal Medicine Digestive Disease CenterInha University School of MedicineIncheon 400-711South Korea Department of Radiology Inha University School of MedicineIncheon 400-711South Korea

AIM: To determine the risk factors for gallstone-related biliary ***: This retrospective cohort study evaluated magnetic resonance cholangiopancreatography imagesfrom 141 symptomatic and 39 asymptomatic gallstone patients who presented at a single tertiary hospital between January 2005 and December ***: Logistic regression analysis showed significant differences between symptomatic and asymptomatic patients with gallstones in relation to the number of gallstones,the angle between the long axis of the gallbladder and the cystic duct,and the cystic duct *** analysis showed that the number of gallstones(OR = 1.27,95%CI: 1.03-1.57; P = 0.026),the angle between the long axis of the gallbladder and the cystic duct(OR = 1.02,95%CI: 1.00-1.03; P = 0.015),and the diameter of the cystic duct(OR = 0.819,95%CI: 0.69-0.97; P = 0.018) were significantly associated with biliary *** incidence of biliary events was significantly elevated in patients who had the presence of more than two gallstones,an angle of > 92° between the gallbladder and the cystic duct,and a cystic duct diameter gallstones who exhibit these characteristics.

关键词： Cystic duct Gallbladder gallstone disease Magnetic

Economic and medical benefits of ultrasound screenings for gallstone disease

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World Journal of Gastroenterology 2015年第11期21卷 3337-3343页

作者： Hung-Ju Shen Chung-Te Hsu Tao-Hsin Tung Cheng Hsin General Hospital Faculty of Public Health School of MedicineFu-Jen Catholic University Department of Nursing Kang-Ning Junior College of Medical Care and Management

AIM:To investigate whether screening for gallstone disease was economically feasible and clinically ***:This clinical study was initially conducted in2002 in Taipei,*** study cohort total included2386 healthy adults who were voluntarily admitted to a regional teaching hospital for a physical *** follow-up screening with ultrasound sonography for gallstone disease continued until December 31,2007.A decision analysis using the Markov Decision Model was constructed to compare different screening regimes for gallstone *** economic evaluation included estimates of both the cost-effectiveness and cost-utility of screening for gallstone ***:Direct costs included the cost of screening,regular clinical fees,laparoscopic cholecystectomy,and *** costs represent the loss of productivity attributable to the patient’s disease state,and were estimated using the gross domestic product for 2011 in *** time intervals in screening for gallstone disease were associated with the reduced efficacy and utility of screening and with increased *** cost per life-year gained(average cost-effectiveness ratio)for annual screening,biennial screening,3-year screening,4-year screening,5-year screening,and no-screening was new Taiwan dollars(NTD)39076,NTD 58059,NTD 72168,NTD 104488,NTD 126941,and NTD 197473,respectively(Pgallstone disease is both medically and economically *** screening for gallstone disease should be recommended.

关键词： Decision analysis gallstone disease Economic evalu

Successful endoscopic treatment of a large impacted gallstone in the duodenum using laser lithotripsy,Bouveret’s syndrome:A case report

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World Journal of Gastroenterology 2020年第19期26卷 2458-2463页

作者： Sofie Hendriks Mareille Maria Verseveld Egbert Roeland Boevé Robert Roomer Department of Gastroenterology Franciscus Gasthuis&VlietlandRotterdam 3045 PMZuid-HollandNetherlands Department of Surgery Franciscus Gasthuis&VlietlandRotterdam 3045 PMZuid-HollandNetherlands Department of Urology Franciscus Gasthuis&VlietlandRotterdam 3045 PMZuid-HollandNetherlands

BACKGROUND Bouveret´s syndrome is defined as a gastric outlet obstruction after passage of a gallstone through a fistula into the *** to its rarity,the diagnosis of Bouveret’s syndrome is often delayed and causes a high morbidity and mortality *** SUMMARY A 93-year-old female presented with worsening pain in the right upper abdomen and vomiting.A gastroscopy revealed fluid retention caused by a massive obstructive stone in the *** laser lithotripsy of the impacted stone was planned after multidisciplinary consultation.A Dornier Medilas H Solvo lithotripsy 350μm laser fiber(10 Hz,2 Joules)was used to disintegrate the stone into smaller *** patient recovered *** A mechanical obstruction due to a gallstone that has entered the gastrointestinal tract is a complication that appears in 0.3%-0.5%of patients who have *** larger than 2 cm can become impacted in the digestive tract,which occurs mostly in the terminal *** approximately 1%-3%of cases,the stones cause obstruction in the *** phenomenon is called Bouveret’s *** this condition is mostly observed in elderly individuals with multiple comorbidities,treatment by an open surgical approach is *** removal is the preferred *** benefit of using laser lithotripsy is the precise targeting of energy onto the stone with minimal tissue *** laser lithotripsy is a safe and feasible treatment option for Bouveret’s syndrome.

关键词： Bouveret’s syndrome Laser lithotripsy Endoscopy gallstone Case report

Commentary on "gallstone associated celiac trunk thromboembolisms complicated with splenic infarction: A case report"

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World Journal of Clinical Cases 2022年第32期10卷 12059-12061页

作者： Oguzhan Tokur Sonay Aydın Mecit Kantarci Department of Radiology Ankara Training and Research HospitalAnkara 06230Turkey Department of Radiology Erzincan University Medicine FacultyErzincan 24100Turkey

The present letter to the editor is related to the study titled "gallstone associatedceliac trunk thromboembolisms complicated with splenic infarction: A casereport". Although gallstones are relatively common diseases, its association withthromboembolism is not fully understood. We aim to emphasize the potentialmechanism of this relationship in this letter. In addition, we wanted to contributeto the causes of the spleen infarction and celiac trunk pathologies.

关键词： gallstone Spleen Infarct Thrombosis Pain