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Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones? Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy.

https://arctichealth.org/en/permalink/ahliterature132934
Source
HPB (Oxford). 2011 Aug;13(8):519-27
Publication Type
Article
Date
Aug-2011
Author
Per Videhult
Gabriel Sandblom
Claes Rudberg
Ib Christian Rasmussen
Author Affiliation
Department of Surgery, Central Hospital, Västerås, Sweden. pervidehult@yahoo.se
Source
HPB (Oxford). 2011 Aug;13(8):519-27
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Alkaline Phosphatase - blood
Bilirubin - blood
Biological Markers - blood
Cholangiography
Cholecystectomy
Cholecystitis - diagnosis - epidemiology - surgery
False Negative Reactions
False Positive Reactions
Female
Gallstones - diagnosis - epidemiology - surgery
Humans
Liver Function Tests
Logistic Models
Male
Middle Aged
Odds Ratio
Pancreatitis - diagnosis - epidemiology
Predictive value of tests
Prospective Studies
Registries
Risk assessment
Risk factors
Sex Factors
Sweden - epidemiology
Abstract
The purpose of this study was to explore the accuracy of elevated liver function values, age, gender, pancreatitis and cholecystitis as predictors of common bile duct stones (CBDS).
All patients operated on for gallstone disease over a period of 3 years in a Swedish county of 302,564 citizens were registered prospectively. Intraoperative cholangiography (IOC) was used to detect CBDS.
A total of 1171 patients were registered; 95% of these patients underwent IOC. Common bile duct stones were found in 42% of patients with elevated liver function values, 20% of patients with a history of pancreatitis and 9% of patients with cholecystitis. The presence of CBDS was significantly predicted by elevated liver function values, but not by age, gender, history of acute pancreatitis or cholecystitis. A total of 93% of patients with normal liver function tests had a normal IOC. The best agreement between elevated liver function values and CBDS was seen in patients undergoing elective surgery without a history of acute pancreatitis or cholecystitis.
Although alkaline phosphatase (ALP) and bilirubin levels represented the most reliable predictors of CBDS, false positive and false negative values were common, especially in patients with a history of cholecystitis or pancreatitis, which indicates that other mechanisms were responsible for elevated liver function values in these patients.
Notes
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PubMed ID
21762294 View in PubMed
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Biliary microflora in patients undergoing cholecystectomy.

https://arctichealth.org/en/permalink/ahliterature260257
Source
Surg Infect (Larchmt). 2014 Jun;15(3):262-5
Publication Type
Article
Date
Jun-2014
Author
Bahman Darkahi
Gabriel Sandblom
Håkan Liljeholm
Per Videhult
Åsa Melhus
Ib Christian Rasmussen
Source
Surg Infect (Larchmt). 2014 Jun;15(3):262-5
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Aged
Bacteria - classification - isolation & purification
Bacterial Infections - epidemiology - microbiology
Bile - microbiology
Cholecystectomy
Female
Gallbladder - microbiology
Humans
Male
Middle Aged
Prevalence
Sweden
Abstract
The management of acute cholecystitis requires a sound knowledge of the biliary microflora.
Bile samples were taken for culture according to a standard routine during all cholecystectomies performed from April 2007 to February 2009 in the Department of Surgery at Enköping Hospital. The use of antibiotics within the 3-mo period before surgery, indication for surgery, prophylactic antibiotics, and post-operative complications were recorded prospectively.
Altogether, 246 procedures were performed during the study period, of which 149 (62%) were done on women. The mean (±SD) age of the study subjects was 49±16?y. Bacterial growth was seen in cultures from 34 (14%) of the subjects. The mean age of subjects with positive cultures was 64?y and that of subjects with negative cultures was 47?y (p
PubMed ID
24801654 View in PubMed
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[How competently are HSAN errands proceeded?]

https://arctichealth.org/en/permalink/ahliterature19255
Source
Lakartidningen. 2002 Feb 14;99(7):637-41
Publication Type
Article
Date
Feb-14-2002

Mortality after a cholecystectomy: a population-based study.

https://arctichealth.org/en/permalink/ahliterature267798
Source
HPB (Oxford). 2015 Mar;17(3):239-43
Publication Type
Article
Date
Mar-2015
Author
Gabriel Sandblom
Per Videhult
Ylva Crona Guterstam
Annika Svenner
Omid Sadr-Azodi
Source
HPB (Oxford). 2015 Mar;17(3):239-43
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cause of Death
Cholangiopancreatography, Endoscopic Retrograde - methods
Cholecystectomy - methods - mortality
Cholecystectomy, Laparoscopic - methods - mortality
Cholelithiasis - diagnosis - mortality - surgery
Cohort Studies
Female
Follow-Up Studies
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Postoperative Complications - mortality - physiopathology
Registries
Retrospective Studies
Risk assessment
Severity of Illness Index
Sex Factors
Sweden
Treatment Outcome
Abstract
The trade-off between the benefits of surgery for gallstone disease for a large population and the risk of lethal outcome in a small minority requires knowledge of the overall mortality.
Between 2007 and 2010, 47?912 cholecystectomies for gallstone disease were registered in the Swedish Register for Cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) (GallRiks). By linkage to the Swedish Death Register, the 30-day mortality after surgery was determined. The age- and sex-standardized mortality ratio (SMR) was estimated by dividing the observed mortality with the expected mortality rate in the Swedish general population 2007. The Charlson Comorbidity Index (CCI) was estimated by International Classification of Diseases (ICD) codes retrieved from the National Patient Register.
Within 30 days after surgery, 72 (0.15%) patients died. The 30-day mortality was close [SMR = 2.58; 95% confidence interval (CI): 2.02-3.25] to that of the Swedish general population. In multivariable logistic regression analysis, predictors of 30-day mortality were age >70 years [odds ratio (OR) 7.04, CI: 2.23-22.26], CCI > 2 (OR 1.93, CI: 1.06-3.51), American Society of Anesthesiologists (ASA) > 2 (OR 13.28, CI: 4.64-38.02), acute surgery (OR 10.05, CI:2.41-41.95), open surgical approach (OR 2.20, CI: 1.55-4.69) and peri-operative complications (OR 3.27, CI: 1.74-6.15).
Mortality after cholecystectomy is low. Co-morbidity and peri-operative complications may, however, increase mortality substantially. The increased mortality risk associated with open cholecystectomy could be explained by confounding factors influencing the decision to perform open surgery.
Notes
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PubMed ID
25363135 View in PubMed
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Validation of Gastrointestinal Quality of Life Index in Swedish for assessing the impact of gallstones on health-related quality of life.

https://arctichealth.org/en/permalink/ahliterature147403
Source
Value Health. 2009 Jan-Feb;12(1):181-4
Publication Type
Article
Author
Gabriel Sandblom
Per Videhult
Britt-Marie Karlson
Staffan Wollert
Mikael Ljungdahl
Bahman Darkahi
Haakan Liljeholm
Ib Christian Rasmussen
Author Affiliation
Department of Surgery, University Hospital of Lund, Lund, Sweden. gabriel.sandblom@med.lu.se
Source
Value Health. 2009 Jan-Feb;12(1):181-4
Language
English
Publication Type
Article
Keywords
Adult
Cost of Illness
Female
Gallstones
Humans
Male
Middle Aged
Quality of Life
Questionnaires
Reproducibility of Results
Sweden
Young Adult
Abstract
The aim of the present study was to validate a Swedish translation of the Gastrointestinal Quality of Life Index (GIQLI) questionnaire in patients with gallstone disease.
Sensitivity to change, internal consistency, and test-retest stability were tested in 187 consecutive patients who underwent planned cholecystectomy. Construct validity was assessed by comparing the GIQLI score with the bodily pain scale of SF-36 and four single-item questions in a separate group of 104 patients.
A significant increase in all five domains as well as in the overall GIQLI score 6 months after surgery (all P
PubMed ID
19911447 View in PubMed
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