Hyperbilirubinemia without common bile duct abnormalities and hyperamylasemia without pancreatitis in patients with gallbladder disease
| Autor: | Charles H. Andrus, Steve M. Kurzweil, Virginia M. Herrmann, Donald L. Kaminski, Marc J. Shapiro, Catherine M. Wittgen |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Gallbladder disease Gallbladder Diseases Gallstones Gastroenterology Cholangiography Internal medicine Medicine Humans Cholecystectomy Prospective Studies Hyperbilirubinemia medicine.diagnostic_test Common bile duct business.industry Gallbladder medicine.disease Surgery medicine.anatomical_structure Pancreatitis Acute Disease Amylases Chronic Disease Cholecystitis Hyperamylasemia business |
| Zdroj: | Archives of surgery (Chicago, Ill. : 1960). 129(8) |
| ISSN: | 0004-0010 |
| Popis: | Objective: To determine the incidence of jaundice and hyperamylasemia in the absence of common bile duct abnormalities or clinical pancreatitis in patients undergoing cholecystectomy. Design: A continuous, prospective analysis of a consecutive case series was performed on all patients undergoing cholecystectomy. Setting: An urban, tertiary care university hospital. Patients: Adult patients with gallbladder disease. Intervention: All patients underwent cholecystectomy. Main Outcome Measures: The presence or absence of common bile duct abnormalities was evaluated by cholangiography, and pancreatitis was identified by clinical signs, imaging studies, and direct visual inspection during cholecystectomy. Results: All patients (N=1746) undergoing cholecystectomy were prospectively categorized as having chronic calculous (n=1410), acute calculous (n=217), chronic acalculous (n=70), or acute acalculous (n=49) gallbladder disease. It was uncommon for patients with chronic calculous cholecystitis to have an elevated bilirubin level with no choledocholithiasis and a normal common bile duct or to have hyperamylasemia without pancreatitis. Twenty-five percent of the patients with acute calculous cholecystitis had a serum bilirubin level between 34 and 86 μmol/L (2.0 and 5.0 mg/dL) with no common bile duct abnormality and 4% had hyperamylasemia without pancreatitis. Over one third of the patients with acute acalculous cholecystitis had an elevated bilirubin level with a normal common bile duct or an elevated amylase level without pancreatitis. Conclusion: Jaundice and hyperamylasemia can be produced by gallbladder disease alone. (Arch Surg. 1994;129:829-833) |
| Databáze: | OpenAIRE |
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