Tuberculosis of the gall bladder

An unusual presentation of tuberculous involvement of gall bladder in the absence of clinically detectable tuberculosis elsewhere is described. Tuberculosis, a rare lesion in the gall bladder was seen in a case associated with chronic cholecystitis with acute exacerbation. This organ is supposed not to be involved by tuberculosis due to high concentration of bile-acids in pure bile. The mode of spread in the present case remains speculative.     

胆囊切除、胆总管引流术后致胆漏20例分析

目的 探讨胆道探查术、胆汁性腹膜炎预防及治疗措施.方法 回顾性分析我院20例探讨胆道探查术后致胆漏的诊治经验.结果 20例中有12例通过保守治疗,8例重置T管引流术,均顺利恢复痊愈.结论 预防是关键,术前、术中需要了解病人全身情况及特殊胆道解剖位置.     

胆囊切除、胆总管引流术后致胆漏20例分析

目的 探讨胆道探查术、胆汁性腹膜炎预防及治疗措施.方法 回顾性分析我院20例探讨胆道探查术后致胆漏的诊治经验.结果 20例中有12例通过保守治疗,8例重置T管引流术,均顺利恢复痊愈.结论 预防是关键,术前、术中需要了解病人全身情况及特殊胆道解剖位置.     

Enteric perforation of the gall bladder

A case of enteric perforation of the gall bladder in a 20-year-old male is reported. The patient recovered after cholecystostomy with closure of the perforation.     

The gall bladder in adult Zambians

The morphology of the gall bladder, the length and mode of termination of the cystic duct, and the origin and distribution of the cystic artery were studied in 88 adult Zambians (61 men, 27 women). The origin of the cystic artery was the right hepatic artery (53%), and the common hepatic artery (41%). Hartmann's pouch was observed in 44% of gall bladders. The cystic duct usually opened into the common hepatic duct (91%); its average length was 2 cm.     

Costs of waiting for gall bladder surgery

Laparoscopic cholecystectomy is one of the most commonly awaited general surgical procedures in the UK. However, many patients awaiting a cholecystectomy are admitted with recurrent gallstone related symptoms while on the waiting list, resulting in significant morbidity. The aim of this study was to quantify this problem, and also to analyse the cost implications of these admissions for the NHS. A retrospective study was performed of all patients who underwent an elective cholecystectomy by three consultants in a district general hospital between January 1999 and January 2000. The demographic details, indications for surgery, details of the emergency admissions while on the waiting list, and the treatment given during these episodes were recorded. One hundred and fifty six patients were included in the study, of which 122 (78%) were females. The mean (SD) age of the patients was 54 (5) years. The mean waiting time for surgery in these patients was 12 (3) months. Thirty seven patients (23.7%) were admitted as an emergency due to gallstone related symptoms and complications while awaiting surgery. There were 47 episodes of admissions in total, of which 32 were for biliary colic, 13 were for acute cholecystitis, and two were for acute pancreatitis. In addition to routine blood tests, 20 abdominal radiographs, 10 chest radiographs, three endoscopic retrograde cholangiopancreatography tests, five ultrasonograms, and one computed tomogram were carried out in these patients. The mean duration of each episode of admission was three days. The cost of treatment per episode was pound 946 and the total cost of treating the 37 patients was calculated to be pound 44 462. Performing early laparoscopic cholecystectomy for acute cholecystitis may help to reduce costs by preventing recurrent emergency admissions in these patients. Further studies to identify risk factors associated with recurrent symptoms and complications in patients with gallstone disease may help to prioritize them for early surgery.