ABSTRACT
Objective To compare the effect of emergency abdominal surgery and emergency endoscopic treatment of acute obstructive suppurative cholangitis stone.Methods A retrospective analysis of acute obstructive suppurative cholangitis stones were carried out within 30 cases.Among them,15 patients underwent emergency laparotomy choledocholithotomy + T-tube drainage,15 underwent routine emergency laparotomy choledocholithotomy + T tube drainage and cholecystectomy.Results All patients were successfully implemented treatment.In resection group,blood loss was (128.32 ±46.17) mL,with average length of stay (7.3 ±3.6) days.Blood loss was significantly higher than the amount retained (148.13 ± 2.07) mL(t =13.75,P ＜ 0.05) ; average length of stay (8.5 ± 2.9) days (t =8.73,P ＜ 0.05),the difference was statistically significant.Conclusion Emergency laparotomy choledocholithotomy + T tube drainage and cholecystectomy is not superior efficacy of emergency laparotomy choledocholithotomy + T tube drainage treatment.
ABSTRACT
PURPOSE: This study was conducted to compared unenhanced helical computerized tomography (CT) with intravenous urography (IVU) in the evaluation of acute flank pain. MATERIALS AND MTHODS: Between April 2000 and April 2001, 59 patients with acute flank pain suspected of having urolithiasis underwent an unenhanced helical CT followed by an IVU. Two independent consultation urologic radiologists randomly assessed these patients for the presence, size and location of the calculus, ureteral dilatation and secondary sign of a ureteral obstruction. Of the 59 patients, 45 had a calculus confirmed on removal or a documented passage of a stone. The absence of a calculus was based on a clinical and radiological follow up with clinical resolution. RESULTS: CT revealed all 62 calculi from 45 patients and no calculus in 14 of the patients with a 98.4% sensitivity and a 100% specificity. IVU demonstrated 36 calculi from 35 patients and no calculus in 14 of the patients with a 57.1% sensitivity and a 100% specificity. Both CT and IVU demonstrated the secondary signs of a ureteral obstruction in 34 and 31 patients, respectively. The cost of the helical CT was 4-5 times higher than that of the IVU. CONCLUSIONS: Unenhanced helical CT is an accurate, safe, and a rapid technique for assessing acute flank pain and evaluate the choice for patients who would otherwise require a IVU for diagnosis but with a lower cost.
Subject(s)
Humans , Calculi , Diagnosis , Dilatation , Flank Pain , Follow-Up Studies , Sensitivity and Specificity , Tomography, Spiral Computed , Ureteral Calculi , Ureteral Obstruction , Urography , UrolithiasisABSTRACT
PURPOSE: This study was conducted to compared unenhanced helical computerized tomography (CT) with intravenous urography (IVU) in the evaluation of acute flank pain. MATERIALS AND MTHODS: Between April 2000 and April 2001, 59 patients with acute flank pain suspected of having urolithiasis underwent an unenhanced helical CT followed by an IVU. Two independent consultation urologic radiologists randomly assessed these patients for the presence, size and location of the calculus, ureteral dilatation and secondary sign of a ureteral obstruction. Of the 59 patients, 45 had a calculus confirmed on removal or a documented passage of a stone. The absence of a calculus was based on a clinical and radiological follow up with clinical resolution. RESULTS: CT revealed all 62 calculi from 45 patients and no calculus in 14 of the patients with a 98.4% sensitivity and a 100% specificity. IVU demonstrated 36 calculi from 35 patients and no calculus in 14 of the patients with a 57.1% sensitivity and a 100% specificity. Both CT and IVU demonstrated the secondary signs of a ureteral obstruction in 34 and 31 patients, respectively. The cost of the helical CT was 4-5 times higher than that of the IVU. CONCLUSIONS: Unenhanced helical CT is an accurate, safe, and a rapid technique for assessing acute flank pain and evaluate the choice for patients who would otherwise require a IVU for diagnosis but with a lower cost.
Subject(s)
Humans , Calculi , Diagnosis , Dilatation , Flank Pain , Follow-Up Studies , Sensitivity and Specificity , Tomography, Spiral Computed , Ureteral Calculi , Ureteral Obstruction , Urography , UrolithiasisABSTRACT
Objective To explore the diagnosis and treatment of pancreatic duct stones. MethodsClinical data of 29 cases of pancreatic duct stones were analyzed retrospectively. ResultsChronic pancreatitis was complicated in 21 cases, cholelithiasis in 12, pancreatic cancer in 2 . The correct diagnosis rate of ultrosonography, CT, ERCP and MRCP was 89.7%(26/29), 65.0%( 13/20 ),100%(6/6) and 100%(4/4) respectively. Six cases underwent EST,16 cases did transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy, Three cases did sphincteroplasty, pancreaticoduodenectomy and exploratory laparotomy were performed in one each. ConclusionsChronic panreatitis cholelithiasis is the main causes of pancreatic duct stones. Imaging examinations help to make diagnosis preoperatively. Transpancreatic duct lithotomy plus Roux-en-Y pancreaticojejunostomy is the therapy of choices for patients with pancreatic duct stones.