Drainage of the Gallbladder in High-Risk Patients with Acute Cholecystitis: An Update on Management | Chapter 8 | An Overview of Disease and Health Research Vol. 1

Acute calculus cholecystitis is a very common condition, affecting 20% of all cases of symptomatic gallstone disease. Drainage of the gallbladder has been incorporated into the management of acute cholecystitis in high-risk surgical patients. This review examines various gallbladder drainage procedures, their indications, and complications in the management of acute cholecystitis in high-risk patients.

 

The Tokyo Guidelines have included drainage of the gallbladder for the management of patients in grade 3 to stabilise them and perform an interval cholecystectomy later. Percutaneous cholecystostomy is the most common drainage procedure. The procedure is easy to perform, and it is associated with minimal procedural side effects. The common problem is the care and maintenance of the tube. Endoscopic drainage procedures are often indicated for high-risk patients who would never undergo a cholecystectomy. Still, endoscopic drainage procedures have slowly emerged for drainage of the gallbladder. Endoscopic drainage includes endoscopic trans papillary gallbladder drainage (ETGBD) and endoscopic ultrasound gallbladder drainage (EUSGBD). While effective, these techniques require advanced endoscopic training and facilities, and this limits its use in resource-limited settings.

 

Author (s) Details

 

Kumar H.R.
Taylor's University School of Medicine and Health Science, 47500 Selangor, Malaysia.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v1/5478

 

Acute Cholecystitis: An Update | Chapter 11 | Recent Updates in Disease and Health Research Vol. 9

 

Acute cholecystitis is a complication of gallstone disease, and its severity can be graded according to the Tokyo Guidelines into grades one, two, and three. The management of acute cholecystitis can be divided into conservative treatment followed by delayed cholecystectomy. With the introduction of laparoscopic cholecystectomy, early cholecystectomy has slowly emerged as the treatment of choice. As there is no consensus on the management of acute cholecystitis, this chapter investigates the role of conservative treatment, timing of laparoscopic cholecystectomy and the role of percutaneous cholecystostomy.

 

Author (s) Details

 

Kumar Hari Rajah (Associate Professor)

Taylors University School of Medicine and Health Science, Malaysia.

 

 

Please see the book:-  https://doi.org/10.9734/bpi/rudhr/v9/956

A Review on Prevalence and Risk Factors of Gallstone Disease in Uganda | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 4

Introduction: Globally, the burden and complications from gallstone disease are a major public health issue. It contributes significantly to health care costs and is a common cause of surgical intervention. Most sickle cell disease (SCD) patients have radiolucent stones, probably of pigment type, containing little or no calcium. While most patients with gallstones are asymptomatic, only 20% after 10 years become symptomatic. The prevalence of gallstone disease varies among different populations. The purpose of this review is to understand the profile of gallstone disease patients in Uganda which may facilitate better treatment options and may reduce the complications of gallstone disease.

Discussion: In Uganda, the prevalence of gallstone disease is high in patients presenting to hospital. The risk factors for gallstone disease include a previous history of biliary symptoms and the use of hormonal contraceptives. SCD in Sub-Saharan Africa is also a major health problem and a risk factor for gallstone disease. Acute abdominal pain in SCD patients was thought to be due to sickle cell crises until the advent of ultrasonography. Differentiating between acute cholecystitis and sickle cell crises may be difficult. An increased production of unconjugated bilirubin from a sickle cell crisis may precipitate acute cholecystitis. While in SCD patients with acute cholecystitis, a haemolytic crisis may occur.

Conclusions: While the prevalence of gallstone disease in Uganda from hospital-based studies is high the majority of patients are symptomatic at presentation. In the general population, the prevalence of gallstones may be determined using abdominal ultrasound as a screening tool. Any SCD patient who has an abdominal crisis should have an abdominal ultrasound to prevent missing any episodes of acute cholecystitis.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13177