A Complication of Gallbladder - Assignment Example

Exercise 1) Each will be required to compile a bibliography of 50 key references in a of their choice. It is wise to compile thison a topic that is closely related to your potential research project as this will assist you in the final assignment in this unit. Your submission must be preceded by a two-page introduction to the bibliography, which outlines the area of research chosen, the methods used to compile the bibliography, how the five most important references were chosen and the experience gained during this exercise. The list of bibliographic items must be in alphabetical order, and each item must include: Author(s) surname and initials, date of publication, full title, journal title, volume and number, and page range (if applicable) or title of book/report, publisher, city and country of publication. The references must be relevant to your subject and should consist of mainly peer-reviewed publications. Newspaper articles, wikipedia entries etc. will not be accepted. The format of the bibliographic items must be in the Chicago style adopted by Curtin. This is described on the Curtin Library website. You must be diligent in making sure the referencing is correct as a proportion of the final mark for this assignment is allocated to correct formatting and citation of references. Of these 50 bibliographic items, select what you consider to be the five most important references. For each of these, you should provide a 400-word critical analysis of the paper, which summarises the important points made by the author(s) and discusses the strengths and limitations in data acquisition, analysis of results and the conclusions given. In a further 100 words, justify why you consider this to be one of the five most important references in the field of research. Introduction: The biliary system consists of the gall bladder, bile ducts and associated system that are involved in the secretion and transportation of bile. The biliary systems main functions are to drain waste products from the liver into the duodenum and controlled release of bile to aid in digestion. The greenish-yellow bile is produced by liver cells and consists of cholesterol, bile salts and some waste products. Bile salts, particularly, help in digestion of fats and remove waste. Bile is then excreted out of the body in faeces. (Keus et al. 2006). A complication of gallbladder, Cholecystitis may be classified as acute or chronic. In acute cholecystitis (AC), the gall bladder is dilated and is edematous. Its wall is thickened and inflamed (Lack 2003). Acute acalculous cholecystitis seems to progress more rapidly to gangrene and perforation than acute calculous cholecystitis (gallstones induced cholecystitis). Thus a timely diagnosis involving combination of clinical signs, laboratory findings and imaging techniques is necessary. (Keus et al. 2006). Since the symptoms of cholecystitis are similar to other medical complications and at times typical signs of AC may be poorly distinguished in some scans as in Computed tomography (CT) which is not sensitive or specific for AC, therefore, an accurate diagnostic process with high specificity is required. Cholecystitis is an inflammation of the gallbladder wall and nearby abdominal lining. It is usually caused by a gallstone in the cystic duct, the duct that connects the gallbladder to the hepatic duct (calculous AC). Other causes of cholecystitis may include the bacterial infection in the bile duct system, tumor of the pancreas or liver , decreased blood supply to the gallbladder (Acalculous AC). Pregnant women may develop cholecystitis due to accumulation of thick layer of gallbladder sludge. It is made up of fine particles of material similar to gallstone. (Kimura et al. 2007) state that Acute cholecystitis also has other causes, besides the gallstones, such as ischemia; certain chemicals that enter biliary secretions; drug disorders; infections with microorganisms, protozoa, and parasites; collagen disease; and allergic reactions. Acute acalculous cholecystitis is also associated with a recent operation, trauma, burns, multisystem organ failure, and parenteral nutrition. Imaging modalities in association with medical history and clinical examination help in diagnosis of acute cholecystitis. Ultrasound or ultrasonography can also detect fluid around the gallbladder or thickening of its wall, which are typical of acute cholecystitis. Hepatobiliary scintigraphy is useful when acute cholecystitis is difficult to diagnose. In this test, if the radionuclide does not fill the gallbladder, the cystic duct is probably blocked by a gallstone. Cholangiography is the x-ray examination of the bile ducts using an intravenous (IV) dye. In percutaneous transhepatic cholangiography (PTC), a needle is introduced through the skin and into the liver where the dye (contrast) is deposited and the bile duct structures can be viewed by x-ray. Similarly, Endoscopic retrograde cholangiopancreatography (ERCP) examines the inside of these organs and detects any abnormalities. Computed tomography scan (CT or CAT scan) is a diagnostic imaging procedure using a combination of x-rays and computer technology to produce cross-sectional images or slices in different planes, of the body (Cheng et al. 2004). (Rosen et al. 2001) suggested choice of the sonographic Murphys sign, different from the clinical Murphys sign used during physical examination of gallbladder, to increase sensitivity of US to 91%. Physicians from the emergency department and admitting surgeons request both US and cholecystoscintigraphy for definitive diagnosis. (Kalimi et al. 2001) found HIDA to show 86% sensitivity while US was only 48%. Thus, they suggested HIDA could be used alone to diagnose AC. (Bingener et al. 2004) also reported 60% accuracy of US for AC detection. While sonography is very sensitive for the detection of gallstones, the ability to predict acute cholecystitis in patients with clinical symptoms appears limited. Vergel, Y. B., C. Jim, K. Eva, W. Stephen, B. Anthony, and T. Steven. 2006. Economic evaluation of MR cholangiopancreatography compared to diagnostic ERCP for the investigation of biliary tree obstruction. International Journal of Surgery 4: 12-19. (MRI) magnetic resonance had been used in many procedures due to its accurate diagnostic features. One of them is cholangiopancreatography (MRCP) to verify that the presence of biliary obstruction is nearly safe. However, unlike diagnostic endoscopic retrograde cholangiopancreatography (ERCP), no therapeutic option can be offered simultaneously with MRCP. The aim of the study is to assess the cost-effectiveness of MRCP when compared with the conventional practice of diagnostic ERCP for the investigation of biliary obstruction in adults. For the MRI examination the high cost always be in the mind. But in this case, we can measure cost-effectiveness analysis from the perspective of the health care provider. Sensitivity analysis includes presentation of a family of cost effectiveness acceptability curves and the impact of different risks of common bile duct stones associated with ultrasound and liver function test results. The main outcome measure is that cost per quality adjusted life year Baseline results, at 37% probability of common bile duct stones, shows that MRCP is the dominant strategy, with expected savings of the money and expected QALY gain of 1/1000 per case. The probability of avoiding unnecessary therapeutic ERCP is 30%. For patients at high risk of common bile duct stone, more than a half are done by ERCP whilst MRI can do it now with more accuracy and safety to the patient. The authors explain that the MRI is not always expensive modality when compared with ERCP which according to the paper, it is not cheaper than MRI. The paper went an extra mile to explain the experiment, the data involved in the experiment and the line chart. This provides the reader with the complete explanation and understanding of the experiment. It is valid, current and interesting because it tells the comparison between MRI and ERCP, and tells which is cheaper. This is a very important question that is often overlooked and not many students are aware of the difference. Upon a general question asked to the public, I believe at least 80 % of the people asked who did not read this article will come up with a wrong answer. Vlastimil V., Z. Kala, and P. Kysela. 2005. Biliary tree and cholecyst:post surgery imaging. European Journal of Radiology. 53: 433-440. The authors discuss the role of imaging in complications after biliary tree and gallbladder surgery such as Oral cholecystography which has largely been replaced by ultrasonography (US) for evaluation of cholelithiasis and complications like post-cholecystectomy fluid collections. The same methodology replaced the conventional intravenous cholangiography. Nowadays, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiography (MRCP) and ultrasound (US) have essential roles as primary imaging modalities after biliary tree and gallbladder surgery in the evaluation of associated complications and residual biliary stones. In recent times, with improvements in surgical techniques there has been a substantial reduction in the incidence of biliary complications of hepatobiliary surgery. However, bile duct injuries and other post-cholecystectomy complications are a serious problem and a major cause of the spreading of disease and death. Early complications may include bile duct injury caused by mistakenly placed clips, erroneous cutting of bile ducts based on misinterpretation of biliary anatomy, periodical bile leakage that causes edema, fibrosis, and ischemia due to injury to the right hepatic artery. Bile duct structures are the most common of the late complications and can develop a few months or many years after surgery. Early detection and accurate diagnosis have a fundamental importance for the successful treatment of these complications. Therefore, early and meaningful application of the imaging methods immediately after detection of the first symptoms is essential. Preoperative ultrasound and direct iodine contrast application into the biliary tree are highly important for immediate visualization of the complications during surgery. The best modality is Ultrasound that can be used to aid in identification of ductal structures and the internal anatomy. Also plain abdominal film could be made in the patients clinically after biliary surgery. The article is worth referring to because it comes from one of the most renowned sources in the field of medicine. It is valid and has a lot of details that make it useful to the researcher in the medical imaging and surgeon in the biliary system disease. It presents the information in a organized and well-sequenced manner that helps the reader understand the writer’s approach in the best way. The article provides the reader with a comprehensive knowledge and discussion of the medical imaging process and the best diagnostic modality that can be used by a surgeon both before and after the operation. Philip A. H., and M. Michael. 2007. Imaging of gastrointestinal and hepatic diseases during pregnancy. Best Practice & Research Clinical Gastroenterology. 21(5): 901–917. Imaging of the abdomen for suspected gastrointestinal and hepatic disease during pregnancy is high and might result in greater consequences. Approximating clinical estimation, imaging of the abdomen and pelvis is difficult but is really important to prevent delayed diagnosis or needless interventions. Also choice of imaging modality is influenced by factors which could impact on fetal safety such as the use of ionizing radiation and magnetic resonance imaging. This article is valid and has logical argument because the authors have discussed many important issues that are often encountered during the process of imaging of gastrointestinal and hepatic disease in pregnancy. It so happens because the pregnant woman feels pain in the abdomen during her pregnancy. This requires the physician to undergo a careful and thorough examination of the pregnant woman. If the physician does the investigation accurately and with correct modality, the hepatic and bile system disease should also not be ignored. Turner, M. A. 2002. The role of US and CT in pancreatitis. GASTROINTESTINAL ENDOSCOPY. 56(6): 241-245. The imaging examination of choice for moderate or severe acute pancreatitis is CT. Because CT provides comprehensive information, diagnoses of moderate or severe pancreatitis with high sensitivity and specificity, detects serious complications of pancreatitis such as hemorrhage or abscess, assesses extra pancreatic structures, and predicts disease severity. The normal pancreas on CT have a density similar to the normal liver. CT changes indicative of acute pancreatitis include glandular enlargement, contour abnormality, and inflammatory stranding in the perpancreatic fat and adjacent soft tissues. Intrapancreatic and per pancreatic fluid collections may also be seen. US has a limited role and is used to exclude gallstones in suspected gallstone pancreatitis; US is the diagnostic study of choice for the detection of stones in the gallbladder, with a sensitivity and specificity of 95% to 98%. 11-14 CT has a 75% to 80% sensitivity and a 90% to 97% specificity for the detection of gallbladder stones. US can also be used as an inexpensive way to follow up pseudo cysts. ERCP is used less for diagnosis in pancreatitis and is reserved primarily for healing procedures such as stone removal or sphincterotomy. ERCP may be necessary for diagnosis of stones in the ducts or other bile system changes when noninvasive tests are equivocal or no diagnostic. ERCP also is recommended to precisely depict and define complex duct anatomy, or to define biliary or pancreatic ducts drip or fistulas. This article is one of the most interesting articles that give the reader the full explanation with evidence to support the claims made in the article as per the fundamental beliefs of the writer on the subject matter. She starts with CT and US and compares them with one of the treatment and diagnostic procedures ERCP. Not only this, she puts forward various examples of different diseases to develop and logically structure the thoughtful approach of the article. Moreover, the article is strongly valid in that the medical imaging modalities still have some argumentation on their safety and cost, so we can use this role in diagnostic patients. Bodzioch,V., and M. R. Ogiela. 2009. New approach to gallbladder ultrasonic images analysis and lesions recognition. Computerized Medical Imaging and Graphics. 33: 154–170. This source narrates a new approach to the gallbladder ultrasonic image handing out and examination towards finding the disease symptoms on processed images. Primarily, in this paper, there is presented a new technique of filtering gallbladder contours from USG images. A main step in this filtration is to section and slice off areas engaged by the supposed organ. In the majority of cases, this method is based on filtration that plays an input role in the process of diagnosing pathological alters. Unfortunately, ultrasound images present the most troublesome methods of analysis owing to the echogenic variation of structures under examination. This paper presents for an inventive algorithm for the holistic removal of gallbladder image contours. The algorithm is based on rank filtration, as well as on the analysis of histogram sections on tested organs. The next part distresses observe lesion symptoms of the gallbladder. Computerizing a method of diagnosis at all times comes down to developing algorithms used to analyze the item of such diagnosis and validate the occurrence of symptoms related to the given affection. Usually the final stage is to make a diagnosis based on the detected signs. This final stage can be approved through either dedicated specialist schemes or more typical model analysis approach similar to using policies to determine illness basing on detected signs. This paper had been found legal and current because it discusses the pattern analysis algorithms for gallbladder image leading towards the arrangement of most common disease symptoms of this organ. Also, it uses interesting methods and patterns. Moreover, it provides useful information for the researchers and students. References: Bahram, M., and G. Ghada. 2010. The value of pre-operative magnetic resonance cholangiopancreatography (MRCP) in management of patients with gall stones. International Journal of Surgery 8: 342-345. Bellows, C. F., Berger D. H., Crass R. A. 2005. Management of gallstones. Am Fam Physician 72: 637–42. Bingener, J., W. H. Schwesinger, S. Chopra, M. L. Richards, and K. R. Shrinek. 2004. Does the correlation of acute cholecystitis on ultrasound and at surgery reflect a mirror image? The American Journal of Surgery 188: 703-707. Bodzioch,V., and M. R. Ogiela. 2009. New approach to gallbladder ultrasonic images analysis and lesions recognition. Computerized Medical Imaging and Graphics 33: 154–170. Carr-Locke, D. L. 2002. Therapeutic role of ERCP in the management of suspected common bile duct stones. Gastrointest Endosc. 56(l): S170–74. Cheng, S., Ng S., and Shih S. 2004. Hyperdense gallbladder wall sign: An overlooked sign of acute cholecystitis on unenhanced CT. Journal of Clinical Imaging 28(2): 128-131. Chen, C. Y., C. L. Lu, F. Y. Chang, and S. D. Lee. 1997. Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol 92: 2066–2068. Fitzgibbons, Jr. R. J, and G. C. Gardner. 2001. Laparoscopic surgery and the common bile duct. World J Surg 25: 1317–24. Freitas, M. L., R. L. Bell, and A. J. Duffy. 2006. Choledocholithiasis: evolving standards for diagnosis and management. World J Gastroenterology 12: 3162–7. Hayashi, Y., J. H. Liu, and H. Moriguchi, et al. 1996. Prevalence of polypoid lesions of the gallbladder in urban and rural areas of Japan: comparison between 1988 and 1993. J Clin Gastroenterol 23: 158–159. Heaton, K., F. Braddon, R. Mountford, A. Hughes, and P. Emmett. 1991. Symptomatic and silent gall stones in the community. Gut. 32: 316–20. Holzbach, R. T., M. Marsh, and P. Tang. 1977. Cholesterolosis: physical-chemical characteristics of human and diet-induced canine lesions. Exp Mol Pathol 27: 324–338. Jorgensen, T., and K. H. Jensen. 1990. Polyps in the gallbladder: a prevalence study. Scand J Gastroenterol 25: 281–286. Johnson, C. D. 2001. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. British Medical Journal 323: 1170–3. Jung, S., K. Huh, Y. Shin, J. K. Kim, C. Yun, C. Park, and J. Jang. 2009. Left-sided gallbladder: a complicated percutaneous cholecystostomy and subsequent hepatic embolisation. British Journal of Radiology 82(979): e141. Kalimi, R., G. R. Geselter, D. Caplin, M. Brickman, G. T. Tronco, C. Love et al. 2001. Combined sonography-cholescintigraphy. J Am Coll Surg.193(6): 609-613. Keus, F., I. A. M. J. Broeders, and C. J. H. M. van Laarhoven. 2006. Surgical aspects of symptomatic cholecystolithiasis and acute cholecystitis. Best Practice and l Research clinical gastroenterology 20(6): 1031-1051. Kim, S. Y., H. S. Lee, and Y. S. Lee, et al. 2006. Prevalence and risk factors of gallbladder polyp in adults living in Daegu and Gyeongbuk provinces. Korean J Gastroenterol 48: 344–350. Lack, E. E. 2003. Pathology of pancreas, gallbladder, extrahepatic biliary tract and ampullary region. New York: Oxford University Press, 2003. Landi, K., J. Sinard, J. Crawford, and M. Topazian. 2003. Cholesterol Crystal Morphology in Acalculous Gallbladder Disease. Journal of clinical gastroenterology 36(4): 364. Lim, S., K. S. Park, H. K. Lee, and S. I. Cho. 2005. Changes in the characteristics of metabolic syndrome in Korea over the period 1998-2001 as determined by Korean national health and nutrition examination surveys. Diabetes Care. 28: 1810–1812. Loud, P., R. C. Semelka, U. Kettritz, J. J. Brown, and C. Reinhold. 1996. MRI of acute cholecystitis: Comparison with the normal gall bladder and other entities. Magnetic Resonance Imaging 14(4): 349-355. Madan, A. K., S. Aliabadi-Wahle, D. Tesi, L. M. Flint, and S. M. Steinberg. 2002. How early is laparoscopictreatment of acute cholecyctitis. The American Journal of Surgery 183: 232-236. Majeski, J. A. 1986. Polyps of the gallbladder. J Surg Oncol 32: 16–18. Matthews, D. R., J. P. Hosker, A. S. Rudenski, B. A. Naylor, D. F. Treacher, and R. C. Turner. 1985. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28: 412–419. Mittal, B., and R. Mittal. 2002. Genetics of gallstone disease. Journal of postgraduate medicine 48(2): 149. McMahon, A. J., C. M. Fischbacher, S. H. Frame, and M. MacLeod. 2000. Impact of laparoscopic cholecystectomy: a population-based study. Lancet 356: 1632–7. Nuzzo, G., F. Giuliante, I. Giovannini, F. Ardito, F. D’Acapito, M. Vellone, M. Murazio, and G. Capelli. 2005. Bile duct injury during laparoscopic cholecystectomy. Results of an Italian National survey on 56 591 cholecystectomies. Arch Surg 140(10): 986-92. Okamoto, M., Z. Yamagata, Y. Takeda, Y. Yoda, K. Kobayashi, and M. A. Fujino. 2002. The relationship between gallbladder disease and smoking and drinking habits in middle-aged Japanease. J Gastroenterol 37: 455–462. Paran, H., R. Zissin, E. Rossenberg, I. Griton, E. Kots, and M. Gutman. 2006. Prospective evaluation of patients with acute cholecystitis treated with percutaneous cholecystostomy and interval laparoscopic cholecystectomy. International Journal of Surgery 4(2): 101-105. Park, W. H., S. O. Choi, and H. J. Lee. 1999. The Ultrasonographic ‘Triangular Cord’ Coupled With Gallbladder Images in the Diagnostic Prediction of Biliary Atresia From Infantile Intrahepatic Cholestasis. Journal of pediatricSurgery 34(11): 1706-1710. Pemberton, M., and A. D. Wells. 1997. The Mirizzi syndrome. Postgrad Med J 73: 487–90. Petelin, J. B. 2002. Surgical management of common bile duct stones. Gastrointest Endosc 56(l): S183–9. Philip, A. H., and M. M. Michael. 2007. Imaging of gastrointestinal and hepatic diseases during pregnancy. Best Practice & Research Clinical Gastroenterology 21(5): 901–917. Rosen, C. L., D. F. M. Brown, Y. Chang, C. Moore, and N. J. Averill et al. 2001. Ultrasonography by emergency physicians in patients with suspected cholecystitis. American Journal of Emergency Medicine 19(1). Schinchi, K., S. Kono, S. Honjo, K. Imanishi, and T. Hirohata. 1994. Epidemiology of gallbladder polyps: an ultrasonographic study of male self-defense officials in Japan. Scand J Gastroenterol. 29: 7–10. Segawa, K., T. Arisawa, and Y. Niwa et al. 1992. Prevalence of gallbladder polyps among apparently healthy Japanese: ultrasonographic study. Am J Gastroenterol 87: 630–633. Sharma, R., and P. A. D. Steel. 2009. Cholecystitis and Biliary Colic HYPERLINK. http://emedicine.medscape.com/article/774443-overview%20%20%20%5d28 (accessed September 9, 2010). Shanmugam, V., G. Beattie, S. R. Yule, W. Reid, and M. A. Loudon. 2005. Is magnetic resonance cholangiopancreatography the new gold standard in biliary imaging? Br J Radiol 78(934): 888-93. Shim, S. G., K. T. Lee, and J. K. Lee et al. 1999. Prevalence and risk factors of gallbladder polyps in health screening subjects. Korean J Med. 57: 1014–1020. Shi, F., X. Zhu, A. Harris, J. Zhang, and Q. Dai. 2003. Prospective study of the long-term effects of somatostatin analog (octreotide) on gallbladder function and gallstone formation in Chinese acromegalic patients. Journal of Clinical Endocrinology & Metabolism 76(1): 32-37. Spira, R. M., A. Nissan, O. Zamir, T. Cohen, S. I. Fields, and H. R. Freund. 2002. Percutaneous transhepatic cholecystostomy and delayed laparoscopic cholecystectomy in critically ill patients with acute calculus cholecystitis. The American Journal of Surgery 183(1): 62-66. Tilvis, R. S., J. Aro, T. E. Strandberg, M. Lempinen, and T. A. Miettinen. 1982. Lipid composition of bile and gallbladder mucosa in patients with acalculous cholesterolosis. Gastroenterology 82: 607–615. Turner, M. A. 2002. The role of US and CT in pancreatitis. GASTROINTESTINAL ENDOSCOPY 56(6): 241-245. Vergel, Y. B., C. Jim, K. Eva, W. Stephen, B. Anthony, and T. Steven. 2006. Economic evaluation of MR cholangiopancreatography compared to diagnostic ERCP for the investigation of biliary tree obstruction. International Journal of Surgery 4: 12-19. Vriesman, A. C. B., S. Robin, E. Dries van and Puylaert, J. B. C. M. 2006. Gallbladder: Wall Thickening. http://www.radiologyassistant.nl/en/43a0746accc5d (accessed September 7, 2010). Vlastimil, V., Z. Kala, and P. Kysela. 2005. Biliary tree and cholecyst:post surgery imaging. European Journal of Radiology. 53: 433-440. Watanabe, F., H. Hanai, and E. Kaneko. 1998. Increased AcylCoA-cholesterol ester acyltransferase activity in galllbladder mucosa in patients with gallbladder cholesterolosis. Am J Gastroenterol. 93: 1518–1523. Yasutoshi, K., T. Tadahiro, K. Yashifumi, N. Yuji, H. Koichi, and S. Miho et al. 2007. Definitions pathophysiology and epidemiology of acute cholangitis and cholecystitis. Journal Hepato-Billiary-Pancreatic Surgery 14(1): 15-26. Yuan-Ming, T., C. Chuang, H. Cheng, W. Chang, A. Kao, and C. Chen. 2005. Usefulness of Fatty-meal Stimulated Gallbladder Contractility by Ultrasonography in the Diagnosis of Acute Cholecystitis. Journal of Medical Ultrasound 13(4): 179-185. Read More