Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
1.
Article in English | IMSEAR | ID: sea-42595

ABSTRACT

BACKGROUND: Laparoscopic cholecystectomy (LC) has become the treatment of choice for patients with symptomatic cholelithiasis. About 8-15 per cent of patients with symptomatic gallstones may bear associated common bile duct (CBD) stones, The management of choledocholithiasis in the laparoscopic era remain debatable. Although pre-operative endoscopic cholangiopancreatography (ERCP) is available and highly accurate in the detection of CBD stones, its routine use is controversial because of its inherent disadvantages. OBJECTIVE: The aim of this retrospective study was to generate an effective predictive model for bile duct stones detection by pre-operative ERCP. METHOD: Twelve pre-operative clinical, biochemical and sonographic variables from 206 consecutive patients who underwent pre-operative ERCP with LC for gallstones with/without CBD stones from October 1998 to December 2000 were retrospectively analysed RESULTS: 143 of the 206 patients with gallstones were found to have CBD stones. The mean age was 61 (20-93) yr old, and 55.9 per cent were female. Multivariate analysis showed a high predictive value for the presence of CBD stones in patients aged > or = 55 yr old (Odd radio (OR) 1.03, 95% confidence interval (95% CI) 1.01-1.05), jaundice (OR 2.7, 95% CI 1.7-4.8), elevated alkaline phosphatase (OR 1.002, 95% CI 1.000-1.005), CBD dilatation on ultrasound (OR 3.8, 95% CI 1.8-8) and CBD stone on ultrasound. CONCLUSION: The important clinical presentations and investigating could allow more appropriate use of pre-operative ERCP in patients who have symptomatic gallstones with a suspected CBD stone prior to cholecystectomy.


Subject(s)
Adult , Age Distribution , Aged , Aged, 80 and over , Analysis of Variance , Cholangiopancreatography, Endoscopic Retrograde/methods , Cholecystectomy, Laparoscopic/methods , Choledocholithiasis/epidemiology , Cholelithiasis/epidemiology , Cohort Studies , Comorbidity , Female , Follow-Up Studies , Humans , Incidence , Logistic Models , Male , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Preoperative Care/methods , Probability , Retrospective Studies , Risk Assessment , Severity of Illness Index , Sex Distribution , Thailand/epidemiology , Treatment Outcome
2.
Article in English | IMSEAR | ID: sea-137701

ABSTRACT

Background : Chronic diarrhoea remains a major gastroenterological problem in Thailand Data regarding investigation, diagnosis and treatment of chronic diarrhoea varies from one country to another. Socio-economic status including sanitation and hygiene may also affect etiology and the clinical course of disease. There data may be misleading for practitioners facing the problem in Thailand. To date, few studies on chronic diarrhoea in Thailand are available. Objectives : To find the causes and clinical courses of chronic diarrhoea. To determine the frequency of various causes. Finally, to see if simple guidelines can be developed to help investigators in Thailand reach a final diagnosis. Methods : Thirty-four in-patients with chronic diarrhoea at Siriraj Hospital were worked up using a systematic scheme for evaluation of chronic diarrhoea by prospective study. Close follow-ups were monitored for an average period of six months. Results : Among the 34 cases, a definite diagnosis was reached in 21 cases (62%) : parasitic infestation seven cases (33%), carcinoma of colon four cases (19%), lymphoma there cases (14%), radiation proctitis two cases (9%), malabsorption and/or maldigestion two cases (9%), tuberculous peritonitis one cases (5%) hyperthyroidism one case (5%) and villous adenoma one case (5%). Conclusion : Our study suggests that a simple investigation using complete blood count, stool examination, and especially concentration methods and sigmoidoscopy in all patients can usually find in up to 38 per cent, while further investigations can detect causes in up to 62 per cent. Of the 13 patients for whom no definite diagnosis was reached, spontaneous remission of chronic diarrhoea was found in four cases (31%).

3.
Article in English | IMSEAR | ID: sea-137797

ABSTRACT

Although dyspepsia frequently occurs in general population, its causes are poorly understood. This study is aimed at determining the role of Helicobacter pylori in non-ulcer dyspepsia (NUD) and evaluating the efficacy of dual therapies for H.pylori. Two groups totaling of 39 patients with endoscopically-proven NUD participated in the study. One group, comprising of 23 patients, received 300 mg of ranitidine daily for 4 weeks together with 500 mg of amoxicillin four time a day for two weeks. The second group, comprising of 16 patients, received GacidaTM 1 tablet for 4 weeks together with 500 mg of amoxicillin four time a day for 2 weeks respectively. H.pylori status was determined by histology and CLO testTM before and in the fourth and eighth week after treatment. Thirty-six patients completed the study, 21 in the ranitidine treatment group and 15 in the GacidaTM group H.pylori was successfully eradication in 47.3 percent (9/21) of ranitidine treatment group. Symptom relief at the second and sixth weeks was significantly higher under ranitidine regimen at 90.47 percent (19/21) and 100 percent (21/21) respectively, compared with the gacida regimen at 46.66 percent (7/15) and 53.33 percent (8/15) respectively. The number of patients who were symptom-free at the sixth week of treatment was significantly higher in the ranitidine group at 71.4 percent (15/21), compared with the gacida group at 20 percent (3/15). We concluded that the ranitidine regimen can relief the symptoms of NUD patients with H.pylori infection. However, the role of H.pylori needs further studies.

SELECTION OF CITATIONS
SEARCH DETAIL