Progression and regression of biloma after laparoscopic cholecystectomy evaluated by computed tomography.

The natural course of biloma after laparoscopic cholecystectomy (LC) was successfully followed and evaluated by computed tomography (CT). Biloma is one of the major complications after LC. However, the processes of biloma progression and regression have not yet been reported in detail. We encountered a case of minor leakage of bile juice after LC. Unexpected injury of the Luschka duct (accessory bile duct) was suspected. We examined this patient periodically by CT, which is very reliable and easy to use for postoperative evaluation. Biloma gradually developed within 6 months as we suspected. We successfully detected the presence of the Luschka duct by bilomagraphy. The patient was symptomatically silent for the next 6 months as the size of the biloma spontaneously decreased. Therefore, it is not always necessary to carry out treatment for biloma after LC if the patient has no symptoms. This is the first report that shows the progression and regression of biloma evaluated precisely by CT.

Evaluation of blood supply to the parathyroid glands in secondary hyperparathyroidism compared with histopathology.

BACKGROUND: In chronic renal failure patients, the parathyroid glands progress from diffuse hyperplasia to nodular hyperplasia, and it is important to distinguish between these as the latter form is more aggressive. This progress can be confirmed histologically, but the present study aimed to determine whether the different types of hyperplasia could be distinguished by power-Doppler ultrasonography (US). METHODS: Twenty-one consecutive renal failure patients were scheduled to undergo parathyroidectomy (PTx). Of 70 resected parathyroid glands, 63 were assessed by pre-operative power-Doppler US, classified into four groups based on the flow signal pattern and then correlated with the post-operative histopathology. RESULTS: With power-Doppler US imaging, 60.0% of glands without a signal inside the gland were diagnosed as diffuse hyperplasia or diffuse hyperplasia with early nodularity. Of glands with in-gland signals, 83.7% were nodular or had a single nodule typical of nodular hyperplasia. Even when the focus was on parathyroid glands weighing