Background: Oddi sphincter plays an important role in preventing reflux cholangitis. There exists the controversy on application of choledochoduodenostomy in hepatolithiasis management. The present study aimed at evaluating long-term outcomes of choledochoduodenostomy for the treatment of hepatolithiasis.
Methods: Forty-six consecutive cases of hepatolithiasis who underwent choledochoduodenostomy were analyzed retrospectively. The pre- and postoperative rates of recurrent cholangitis and acute cholangitis severe type were compared. Paired chi-square test was applied.
Results: The mean follow-up time was 17.3 years ranging from 1.6 to 40 years with a follow-up rate of 97.8% (45/46). High rates of remnant stones (39.1%, 18/46), recurrent stones (31.1%, 14/45), uncorrected strictures (85%, 17/20), and mortality (24.4%, 11/45) were observed in this group. Regurgitation of food debris and duodenal content into the biliary tract through the anastomosis was observed. The rate of recurrent cholangitis was equal to the preoperative period (93.3%, 42/45). The rate of acute cholangitis severe type after choledochoduodenostomy (46.7%, 21/45) increased significantly (P<0.01) when compared to the preoperative period (20.0%, 9/45).
Conclusions: Choledochoduodenostomy did not entirely achieve the goal of clearance of stones, correction of strictures, and removing of hepatobiliary lesions by itself. Choledochoduodenostomy without cholangioplasty resulted in an increase of severe reflux cholangitis due to the loss of the anti-reflux function of the sphincter of Oddi. Therefore, choledochoduodenostomy is not an ideal approach to reduce cholangitis in hepatolithiasis and is not the best choice in the management of hepatolithiasis.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Masquelet technique combined with concentrated growth factors for the reconstruction of rabbit mandibular marginal bone defect.
Clin Oral Investig
January 2025
Fujian Key Laboratory of Oral Diseases & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian Province, 350002, China.
Objective: Both the Masquelet technique (MT) and concentrated growth factors (CGF) reduce early graft loss and improve bone regeneration. This study aims to explore the efficacy of combining MT with CGF for mandibular defect repair by characterizing the induced membrane and assessing in vivo osteogenesis.
Materials And Methods: Three experimental groups were compared: negative control (NC), MT, and Masquelet combined with CGF (MTC).
Effectiveness of high intensity laser treatment in partial supraspinatus tendon tears: a randomised controlled trial.
Lasers Med Sci
January 2025
Ankara Bilkent City Hospital Physical Therapy and Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Ankara, Türkiye.
The most common cause of rotator cuff injury is supraspinatus tendon tears (STTs). High-intensity laser therapy (HILT) has recently emerged as an important conservative treatment option. This study was designed as a randomised controlled trial in patients with partial STTs to compare the effects of HILT with those of ultrasound (US) therapy.
View Article and Find Full Text PDF[Guiding significance of intra-articular sagittal reduction in the treatment of tibial plateau fractures].
Zhongguo Gu Shang
January 2025
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia.
View Article and Find Full Text PDFPrevalence, Diagnosis, and Management of Stress Urinary Incontinence in Women: A Collaborative Review.
Eur Urol
January 2025
Department of Urology, Freeman Hospital Newcastle-upon-Tyne UK; Translational and Clinical Research Institute, Newcastle University Newcastle-upon-Tyne UK.
Background And Objective: Stress urinary incontinence (SUI), defined as any involuntary leakage of urine associated with physical activity, remains underdiagnosed and undertreated. This review aims to provide an updated overview of the prevalence, diagnosis, and treatment of SUI in women, drawing upon recent evidence-based literature and clinical guidelines.
Methods: A systematic search of the MEDLINE database was conducted to identify only the most up-to-date and relevant studies published up to February 26, 2024, including the reference ESTER systematic review.
Incidence and Outcomes of Secondary Bladder Cancer Following Radiation Therapy for Prostate Cancer: A Systematic Review and Meta-analysis.
Eur Urol Focus
January 2025
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Semmelweis University, Budapest, Hungary; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia; Division of Urology, Department of Special Surgery, University of Jordan, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Research Center for Evidence Medicine, Urology Department, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:
Background And Objective: There is an established association between secondary bladder cancers (SBCs) and radiotherapy (RT) for prostate cancer (PC), which remains a significant concern. Our aim was to update the evidence on SBC incidence across different RT modalities and to compare oncological outcomes for patients diagnosed with SBC to those diagnosed with primary bladder cancer (PBC).
Methods: We searched MEDLINE, Scopus, and Web of Science for studies on SBC following PC.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!