Pathogenese der Choledocholithiasis

Neubrand, Michael; Sauerbruch, T.

doi:10.1159/000063340

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Gallengangsteine werden entweder primär im Gallengang gebildet (meist braune Pigmentsteine), oder sie sind aus der Gallenblase in den Gallengang eingewandert (primäre Cholesterinsteine, die häufig eine Pigmentschale haben) [36]. Der natürliche Verlauf von Gallengangsteinen ist nicht hinreichend geklärt [37].…”

Section: Gallengangsteineunclassified

Natürlicher Verlauf der Cholelithiasis

Terjung¹,

Sauerbruch²

2001

Visc Med

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Natural History of Cholelithiasis The natural history of cholelithiasis, further subdivided into cholecystolithiasis and choledocholithiasis, is essentially influenced by the incidence of symptoms and complications, the size and localization of the gallstones, certain conditions which bear an increased risk for developing gallbladder cancer, and various exogenous factors such as rapid weight loss, eating habits and physical activity. 60–80% of the patients with gallbladder stones remain asymptomatic during their disease course. Per year, about 2–4% of these asymptomatic patients will suffer from episodes of acute biliary pain within 10 years after the first diagnosis of gallbladder stones, afterwards the yearly rate of acute biliary pain drops to 1–2%. Complications from gallbladder stones occur ten times less frequently than symptoms. Compared to gallbladder stones, little is known about the natural history of bile duct stones. The first diagnosis of common bile duct stones is frequently not made because of acute biliary pain, but because of common bile duct-related complications such as jaundice, cholangitis or pancreatitis.

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Section: Gallengangsteineunclassified

Natürlicher Verlauf der Cholelithiasis

Terjung¹,

Sauerbruch²

2001

Visc Med

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“…В последние годы подчёркивается особая роль микроэлементов в формировании жёлчных камней [4,11]. Между тем, существующая информация по изучению изменений концентрации микроэлементов в жёлчи носит противоречивый характер.…”

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The effectiveness of ursodeoxycholic acid and «Uvinskaya» mineral water in the treatment of cholelithiasis and concomitant motor-tonic disturbances of the gallbladder

et al. 2012

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Aim. To optimize the conservative treatment of patients with cholelithiasis. Methods. Conducted was a comprehensive in-depth examination and treatment of 87 patients with gallstone disease (cholelithiasis) at the stage of biliary sludge (in the initial physicochemical stage - before stone formation) with associated hypokinesia of the gallbladder. The diagnosis was verified by the means of ultrasound investigation, multifractional duodenal probing and the intensity of biliary sludge was determined by the content of cholesterol, bile acids (spectrophotometrically) and cholate-cholesterol coefficient in the bile. The content of microelements in the bile was estimated by the method of atomic emission spectroscopy with inductively coupled plasma. The spectrum of bile acids in the bile was determined by the method of matrix laser desorption ionization. The acid-producing function of the stomach was evaluated by the means of intragastric pH-metry. During endoscopy investigation a targeted biopsy of the mucous membrane of the anterior and posterior walls of the stomach was performed, followed by morphological examination of biopsy specimens. The patients were divided into two groups. Sulfate sodium-calcium mineral water «Uvinskaya» (Udmurtia) and ursodeoxycholic acid (Ursosan) was used in the treatment of patients of the observation group. In the comparison group monotherapy with ursodeoxycholic acid at a dose of 15 mg/kg body weight was conducted. Hydrotherapy in the observation group was conducted for 24 days, while medicinal treatment in both groups was continued for another 2 months. The control group consisted of 15 practically healthy individuals. Results. In the course of treatment a marked decrease in the pain in the right hypochondrium, the disappearance or reduction of dyspeptic complaints, loss of echo-positive particulates in the gall bladder and an increase in its contractility was noted in all patients of the observation group, at the same time the signs of inflammation also disappeared and the cholate-cholesterol coefficient increased. Registered was a favourable dynamics of the content of microelements in the bile. Conclusion. The combined use of the «Uvinskaya» mineral water and ursodeoxycholic acid for the treatment of cholelithiasis with biliary sludge promotes the most rapid elimination of clinical symptoms of the disease, improves the functional state of the gall bladder, reduces the lithogenic properties and normalizes the content of microelements in the bile.

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“…Während beim asymptomatischen Steinträger das Risiko, eine Komplikation zu erleiden, bei nur 0,1 % liegt, steigt es auf das 10fache nach konkrementbedingten Beschwerden [4]. Die Choledocholithiasis entsteht entweder durch Bildung von Gallensteinen im Gallengang oder Steinabgang aus der Gallenblase und manifestiert sich neben der "klassischen" Kolik vorwiegend durch Komplikationen wie Ikterus, Cholangitis oder Pankreatitis [5].…”

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Laparoscopic Cholecystektomy

Birth¹,

Keller²,

Bruch³

2003

Viszeralchirurgie

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EinleitungErkrankungen der Gallenblase durch Gallensteine zählen zu den häufigsten Erkrankungen in Europa. Die Prävalenz von Gallenblasensteinen in sonographischen Screeninguntersuchungen zeigt dabei deutliche regionale Unterschiede. Hohe Prävalenzzahlen liegen in Europa und den USA vor, in der dritten Welt sind diese deutlich niedriger [1]. Im Gebiet der neuen Bundes-länder wurde die Prävalenz 1989 mit 24,5 % für Frauen und 13,1 % für Männer angegeben [2]. Eine Studie in Süddeutschland stellte bei 10,5 % der Frauen und 4,9 % der Männer Gallensteine fest [1].Gallenblasensteine entstehen durch eine gestörte Gallesekretion. In 80 % der Fälle handelt es sich um Cholesterinsteine, die in Folge einer gestörten biliären Cholesterinhomöostase entstehen. Als Pathomechanismus werden eine Übersättigung der Gal-

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Pathogenese der Choledocholithiasis

Cited by 4 publications

References 18 publications

Natürlicher Verlauf der Cholelithiasis

Natürlicher Verlauf der Cholelithiasis

The effectiveness of ursodeoxycholic acid and «Uvinskaya» mineral water in the treatment of cholelithiasis and concomitant motor-tonic disturbances of the gallbladder

Laparoscopic Cholecystektomy

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