Surgical stress induces a marked and sustained increase of adrenal androgen secretion in postmenopausal women.

We analyzed the secretion of adrenal androgens in response to surgical stress in eight (8) postmenopausal women. ACTH, cortisol (F) and adrenal androgens, such as dehydroepiandrosterone (DHEA), delta 4-androstendione (delta 4-A), dehydroepiandrosterone sulfate (DHEA-S) and testosterone (T) were measured at 08:00 and 20:00 hr the day before and for three consecutive days after operation, as well as at 0, 15, 30, 60, 120 minutes during cholocystectomy. Basal levels of ACTH, F, DHEA, delta 4-A, DHEA-S and T were found within the normal range for this age group before surgery.

Endoscopic transpapillary catheterization of the gallbladder followed by external shock wave lithotripsy and solvent infusion for the treatment of gallstone disease.

Herein we describe the techniques and early results of attempted endoscopic transpapillary catheterization of the gallbladder (ETCG) in combination with external shock wave lithotripsy (ESWL) and solvent infusion in the treatment of 23 consecutive, symptomatic patients with gallstones. Despite anticipated difficulty in advancing wires and catheters through the cystic duct, impeded by tortuosity of its lumen, ETCG was successfully accomplished in 20 of the 23 patients (86.9%).