Disease relevance of Choledocholithiasis

• CONCLUSIONS: In the absence of other hepatobiliary or pancreatic disease, choledocholithiasis can result in elevations in AST and/or ALT greater than 1,000 IU/L [1].
• In high risk but operable patients, EPT is a useful treatment in cases with choledocholithiasis and with papillary stenosis [2].
• Keywords for searching included choledocholithiasis, dissolution, mono-octanoin, common duct stones, MTBE, cholic acid, and gallstones [3].
• The rate of NKP in relation to EST varied depending on the different indications for EST: 22.8% NKP in classic indications like choledocholithiasis and over 40% in newer indications such as chronic pancreatitis [4].
• CONCLUSION: E. coli, K. pneumoniae, E. faecalis and Streptoccocus sp. were the most common bacteria isolated in the bile of patients with cholangitis and choledocholithiasis, which were sensitive to a simple therapeutic regimen, such as the combination of ampicilin and gentamicin [5].

High impact information on Choledocholithiasis

• Cholescintigraphy with 2,6-diethylphenylcarbahoylmethyl diacetic acid 99mTc was performed in 24 cholecystectomized patients with recurrent biliary-like pain, laboratory evidence of bile stasis, normal hepatocellular function tests, and no evidence of choledocholithiasis [6].
• The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients) [7].
• EXPERIMENTAL DESIGN: In an effort to evaluate the potential diagnostic role of p16INK4a and p14ARF promoter methylation in biliary disease, endoscopical obtained bile specimens of 71 patients were analyzed (26 choledocholithiasis, 6 with normal results, 23 bile duct carcinoma, 5 gall bladder carcinoma) [8].
• BACKGROUND: Choledocholithiasis causes elevations in levels of alkaline phosphatase out of proportion to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) [1].
• Sulindac-associated choledocholithiasis [9].

Chemical compound and disease context of Choledocholithiasis

• Bilirubin levels greater than or equal to 34 mumol/l were found in 60 per cent of patients with choledocholithiasis and relative anergy and in 80 per cent of those who were anergic (P less than 0.001) [10].
• Isolated marked elevation in AST and ALT levels over 1,000 IU/L has been reported infrequently in patients with choledocholithiasis [1].
• Ceftriaxone choledocholithiasis [11].
• Treatment of choledocholithiasis with oral chenodeoxycholic acid [12].
• One patient with extremely poor pulmonary status presented with choledocholithiasis and cholangitis, which was successfully treated with endoscopic sphincterotomy followed by ursodeoxycholic acid therapy [13].

Anatomical context of Choledocholithiasis

• CONCLUSIONS: Accurate estimates of choledocholithiasis risk can be made using maximum preoperative bilirubin, common bile duct diameter, AST, and alkaline phosphatase values [14].
• The causes of obstructive jaundice were carcinoma of the pancreas in 14 cases, carcinoma of the papilla of Vater in 12 cases, choledocholithiasis in 37 cases, carcinoma of the common bile duct in seven cases, hepatocellular carcinoma (HCC) in seven cases, intrahepatic cholestasis in three cases and miscellaneous causes in eight cases [15].

Gene context of Choledocholithiasis

• In 3 with residual choledocholithiasis, serum and bile CEA levels were 2.0 +/- 0.46 ng/ml and 13.1 +/- 6.47 ng/ml [16].
• Increased levels of PAI-1 may be an epiphenomenon of cholangitis rather than a factor in the pathogenesis of choledocholithiasis [17].
• Multivariable analysis subsequently identified bilirubin, common bile duct diameter, AST, alkaline phosphatase, and age as independent predictors of choledocholithiasis [14].
• Nine patients in the MLC group and 7 in the CLC group had concomitant choledocholithiasis and underwent endoscopic stone retrieval before operation [18].
• We evaluated the potential of octreotide, a long-acting somatostatin analogue, to prevent these complications in patients who underwent EST for choledocholithiasis [19].

Analytical, diagnostic and therapeutic context of Choledocholithiasis

• Retrospective chart review of 330 patients undergoing ERCP over a two-year period yielded five patients with choledocholithiasis whose serum liver enzyme and total bilirubin levels were repeatedly normal [20].
• EPT succeeded in all of the 29 patients with choledocholithiasis but open cholecystectomy was subsequently performed in four patients due to incomplete bile duct clearance (n = 3) or temporary bleeding after EPT (n = 1) [21].
• METHODS: In a clinical series of 55 patients with choledocholithiasis common-duct bile was aspirated, and the bilirubin conjugates analyzed with high-performance liquid chromatography [22].

References