tetracycline and Cholelithiasis

The gallbladder ejection fraction (GBEF) obtained with Tc-99m-pyridoxyl-5-methyl-tryptophan (99mTc-PMT) hepatobiliary scintigraphy has been used as a parameter of gallbladder function. To determine the accuracy of GBEF, the relationship with the contraction ratio of the gallbladder (GBCR) obtained with three-dimensional helical computed tomography (3D-CT) was studied.. A normal volunteer, 8 patients suffering from cholecystolithiasis and a patient with gallbladder dyskinesia were examined. The percent initial dose (%ID) for the gallbladder and GBEF with hepatobiliary scintigraphy were used to compare the volume of the gallbladder and GBCR which was measured by 3D-CT.. The %ID of the gallbladder was correlated with the volume of the gallbladder by 3D-CT (Y = 1.000X - 1.818, r = 0.928). GBEF was correlated well with GBCR by 3D-CT (Y = 0.916X + 6.296, r = 0.975).. The %ID of the gallbladder obtained with hepatobiliary scintigraphy may be a good indicator of the volume of the gallbladder. The accuracy of GBEF was confirmed by comparison with 3D-CT examination. GBEF is considered a useful parameter of pathophysiological gallbladder function.

Topics: Adult; Aged; Cholecystography; Cholelithiasis; Female; Gallbladder; Gallbladder Diseases; Gallbladder Emptying; Humans; Male; Middle Aged; Organotechnetium Compounds; Pyrrolidines; Radionuclide Imaging; Tetracycline; Tomography, X-Ray Computed

A 41-year-old woman underwent laparoscopic cholecystectomy for the treatment of gallstone and adenomyomatosis. One month after laparoscopic cholecystectomy, hepatobiliary scintigraphy was performed with 99mTc-Sn-N-pyridoxyl-5-methyltryptophan (PMT) to evaluate the presence of a bile leak and/or other complication. A biliary extravasation was noted in the left upper quadrant within 60 minutes. At five hours post injection, a progressive accumulation of 99mTc-PMT was noted in the lesser sac, the right and left paracolic gutter and in the pouch of Douglas. A diagnosis of biliary leakage was made. The patient underwent exploratory laparotomy to repair the leak from the cystic duct stump.

Topics: Adult; Bile Duct Diseases; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Humans; Organotechnetium Compounds; Pyrrolidines; Radionuclide Imaging; Tetracycline; Tetracyclines

Topics: Adult; Aged; Aged, 80 and over; Cholelithiasis; Combined Modality Therapy; Ethanol; Female; Gallbladder; Humans; Male; Middle Aged; Sclerotherapy; Tetracycline; Ultrasonography

'Chemical cholecystectomy' has been proposed as an alternative to removal of the gallbladder. This study assessed cystic duct obliteration using bipolar electrocoagulation (with sham cannulation controls) and gallbladder mucosal treatment with tetracycline (or saline controls) in 29 mongrel dogs. Cystic duct obstruction was assessed by tube cholecystography at day 14, and epithelial damage by histology at day 42. Electrocoagulation by duct diathermy effectively occluded the cystic duct in 14 of 19 animals; however, this was associated with mucocele formation unless mucosal treatment with tetracycline was also performed. Immediate instillation of tetracycline after duct electrocoagulation produced only partial epithelial damage. The combination of duct electrocoagulation and delayed tetracycline instillation at 14 days produced complete destruction of all gallbladder epithelium and an effective chemical cholecystectomy.

Topics: Animals; Cholecystography; Cholelithiasis; Combined Modality Therapy; Dogs; Electrocoagulation; Gallbladder; Male; Mucous Membrane; Tetracycline

Fabry's disease is a rare, sex-linked disorder of glycolipid metabolism. We describe a patient with watery diarrhea, early satiety, and asymptomatic cholelithiasis. The jejunal aspirate demonstrated bacterial overgrowth; sigmoidoscopy showed rectal angiokeratoma corpora diffusum. The gastric emptying rate measured with 99mTc-sulfur colloid was markedly prolonged and the fasting gastrin was elevated at 276 pg/ml. The (14C)glycocholate breath test demonstrated a markedly elevated peak at 4 h, associated with an increased fecal bile acid loss of 0.82 g/day. Oral cholecystogram showed a solitary radiolucent stone in a functioning gallbladder. The bile acid pool size and lithogenic index were normal. Light microscopy of small bowel and rectal biopsy specimens revealed normal surface epithelium, but enlarged and vacuolated ganglion cells in Meissner's plexus. Electron microscopy showed laminated and amorphous osmiophilic deposits within ganglion cells of the submucosal plexus, within smooth muscle cells of the muscularis mucosae, and within endothelial cells lining arterioles, venules, and capillaries, but not in autonomic nerve fibers or enterocytes. The diarrhea and early satiety responded promptly to metoclopramide and to tetracycline. The early satiety was likely on the basis of delayed gastric emptying due to deposition of sphingolipid within ganglion cells of the autonomic nervous system; the diarrhea was likely on the basis of intestinal stasis with bacterial overgrowth and bile salt wastage.

Topics: Adult; Bile; Biopsy; Cholelithiasis; Diarrhea; Fabry Disease; Gastric Emptying; Humans; Jejunum; Male; Metoclopramide; Rectum; Satiation; Tetracycline

The symptomless bacterial contamination of the biliary tree is apt to be the origin of general or local postoperative complications. The present retrospective study of 369 bilary operations with intraoperative bacteriologica investigations yielded the following results: septic wound complications were found in 9% of the cases with bacteriocholia against 3.5% in the cases with abacterial bile. In geriatric patients with complicated gallstone disease the bacterial contamination of the bile exceeds 50% of all cases. The importance of an adequate antibiotic treatment for this group, starting intraoperatively, is stressed.

Topics: Adult; Aged; Anti-Bacterial Agents; Biliary Tract; Biliary Tract Diseases; Cholangitis; Cholelithiasis; Drug Resistance, Microbial; Humans; Middle Aged; Postoperative Complications; Retrospective Studies; Sepsis; Sulfamethoxazole; Surgical Wound Infection; Tetracycline; Trimethoprim

Topics: Adult; Age Factors; Aged; Ampicillin; Anti-Bacterial Agents; Bacterial Infections; Bile; Cephalosporins; Chloramphenicol; Cholecystectomy; Cholecystitis; Cholelithiasis; Clostridium perfringens; Colistin; Enterobacteriaceae; Escherichia coli; Female; Gentamicins; Humans; Kanamycin; Klebsiella; Male; Middle Aged; Penicillin Resistance; Prospective Studies; Proteus; Streptococcus; Streptomycin; Surgical Wound Infection; Tetracycline

Topics: Aged; Bile; Carcinoma, Hepatocellular; Cholelithiasis; Humans; Infusions, Parenteral; Liver Neoplasms; Male; Middle Aged; Minocycline; Postoperative Complications; Tetracycline; Time Factors

Topics: Adult; Aged; Bacteria; Cholecystitis; Cholelithiasis; Enterobacter; Enterobacteriaceae; Enterococcus faecalis; Escherichia coli; Escherichia coli Infections; Female; Gallbladder; Humans; Klebsiella; Liver; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Staphylococcus; Tetracycline; Wound Infection

Topics: Abortion, Therapeutic; Adult; Cholelithiasis; Female; Fetal Death; Hepatitis A; Humans; Infant, Newborn; Jaundice; Maternal Mortality; Obstetric Labor, Premature; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Retrospective Studies; Tetracycline

Topics: Acute Disease; Cholecystitis; Cholelithiasis; Drainage; Postoperative Complications; Preoperative Care; Tetracycline

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Bile; Biliary Tract Diseases; Child; Chloramphenicol; Cholecystitis; Cholelithiasis; Chronic Disease; Common Bile Duct; Enterobacteriaceae; Escherichia coli; Female; Humans; Klebsiella; Male; Middle Aged; Penicillins; Staphylococcus; Tetracycline

Topics: Adult; Age Factors; Biliary Tract Diseases; Chloramphenicol; Cholecystitis; Cholelithiasis; Female; Humans; Male; Middle Aged; Novobiocin; Oleandomycin; Sulfonamides; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Cholecystectomy; Cholelithiasis; Humans; Paratyphoid Fever; Penicillin G; Penicillins; Salmonella; Tetracycline; Typhoid Fever

Topics: Anti-Bacterial Agents; Bile; Body Fluids; Cholelithiasis; Humans; Protein Synthesis Inhibitors; Tetracycline