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2018 DEC 29 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Biguanides - Metformin have been presented. According to news [...]

Cholecystectomy (removal of the gallbladder) is a commonly performed surgical procedure. Laparoscopic cholecystectomy, a minimally-invasive approach to remove the gallbladder, has been developed. This procedure is performed using several small abdominal incisions through which a laparoscope and trocars (sharply pointed instruments), fitted with surgical instruments, are inserted. Under laparoscopic visualization and video control the instruments manipulate and finally remove the gallbladder. The advantages of this procedure over the traditional cholecystectomy, which is major surgery involving a large upper abdominal incision, include: reduced hospital stay; discharge within an average of 24 hours after the procedure; return to work and normal activities (usually within fewer than seven days); and better cosmetic appearance of the abdomen. A technique is described that has been performed at one institution on over 800 patients. This technique uses intraoperative cholangiography (radiographic examination of the bile ducts), which permits the surgeon to evaluate the bile duct completely. The laparoscopic technique was feasible for all patients who were candidates for cholecystectomy. (Consumer Summary produced by Reliance Medical Information, Inc.)

TORONTO -- Magnetic resonance imaging is as effective for ruling out bile duct obstructions and stones as the conventional endoscopic method, based on results from a randomized study of 257 [...]

Cholangitis, inflammation of the bile ducts, may be caused by bacterial invasion or by obstruction of the ducts by stones or tumors. Antibiotic treatment may be unsuccessful in 15 to 30 percent of patients, thus requiring surgical intervention, which has a high morbidity and mortality. Patients with cholangitis caused by obstruction by stones, may possibly be treated with endoscopic drainage of the biliary system. Based on data obtained from 86 patients, five risk factors have been identified. These include the presence of other medical problems, changes in blood pH, high bilirubin levels, low platelet count, and low albumin concentrations. Aggressive endoscopic approach, including incision into the bile sphincter and stone extraction, should be reserved for patients with simple ductal pathology. Those patients having multiple ductal stones, may not require stone extraction; bile flow may be achieved by the introduction of a nasobiliary catheter for drainage. Forty patients treated in this manner achieved control of sepsis as rapidly as those treated with surgical intervention. All patients with severe acute cholangitis should have emergency cholangiogram performed to determine the exact pathology, which should be the basis of the decision for definitive treatment. It is suggested that patients with one or two risk factors be considered for emergency surgery. Endoscopic drainage may be best for patients who are high surgical risks. There is still uncertainty regarding the effectiveness of endoscopic drainage in the presence of thick purulent bile drainage, especially when accompanied by residual duct stones. (Consumer Summary produced by Reliance Medical Information, Inc.)

TORONTO -- A dose of morphine improves the ability of magnetic resonance to show biliary and pancreatic duct obstructions. Morphine distends these ducts, thereby enhancing visualization of the structures in [...]