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Article ; Online: [The management of gastric polyps].

Andersen, Jesper Winkler / Jensen, Thomas Møller / Kjær, Daniel W / Oppfeldt, Asser Mathiassen

2022 Volume 184, Issue 18

Abstract: This review summarizes the work-up and treatment of gastric polyps. Fundic gland polyps can be identified macroscopically, and they generally bear no malignancy potential. Hyperplastic polyps and adenomas require histology to be diagnosed. Adenomas ... ...

Abstract	This review summarizes the work-up and treatment of gastric polyps. Fundic gland polyps can be identified macroscopically, and they generally bear no malignancy potential. Hyperplastic polyps and adenomas require histology to be diagnosed. Adenomas should always be resected, whereas resection of hyperplastic polyps is recommended if they bear atypical features. Eradication of concomitant Helicobacter pylori is recommended as it may causes regression of the polyp(s). Standardized biopsies from the surrounding mucosa should be taken on the smallest indication. The discovery of adenomas or dysplasia calls for a one-year followup.
MeSH term(s)	Adenoma/complications ; Adenomatous Polyps/complications ; Adenomatous Polyps/pathology ; Helicobacter Infections/complications ; Helicobacter Infections/diagnosis ; Helicobacter Infections/drug therapy ; Humans ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery
Language	Danish
Publishing date	2022-05-04
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	124102-3
ISSN	1603-6824 ; 0041-5782
ISSN (online)	1603-6824
ISSN	0041-5782
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Article ; Online: Individualised perioperative blood pressure and fluid therapy in oesophagectomy – study protocol for a randomised clinical trial

Hovgaard, Henrik Lynge / Vistisen, Simon / Enevoldsen, Johannes / de Paoli, Frank / Scheeren, Thomas Wl / Katballe, Niels / Kjaer, Daniel W / Linnemann, Gerhard / Jørgensen, Martin Rs / Karaliunaite, Zidryne / Jeppesen, Anni Nørgaard / Juhl-Olsen, Peter

Danish medical journal

2023 Volume 70, Issue 5

Abstract: Introduction: Oesophagectomy is the mainstay of curative treatment for oesophageal cancer, but it is associated with a high risk of major complications. Goal-directed fluid therapy and individualised blood pressure management may prevent complications ... ...

Abstract	Introduction: Oesophagectomy is the mainstay of curative treatment for oesophageal cancer, but it is associated with a high risk of major complications. Goal-directed fluid therapy and individualised blood pressure management may prevent complications after surgery. Extending goal-directed fluid therapy after surgery and applying an individual blood pressure target may have substantial benefit in oesophagectomy. This is a protocol for a clinical trial implementing a novel haemodynamic protocol from the start of anaesthesia to the next day with the patient's own night-time blood pressure as the lower threshold. Methods: This is a single-centre, single-blind, randomised, clinical trial. Oesophagectomy patients are randomised 1:1 for either perioperative haemodynamic management according to a goal-directed fluid therapy protocol with an individual target blood pressure or for standard care. The primary endpoint is the total burden of morbidity and mortality assessed by the Comprehensive Complication Index 30 days after surgery. Secondary endpoints are complications, reoperations, fluid and vasopressor dosage and quality of life at 90 days after surgery. Conclusions: The results from this trial provide an objective and easy-to-follow algorithm for fluid administration, which may improve patient-centred outcomes in oesophagectomy patients. Funding: The trial is supported by Aarhus University (1,293,400 DKK) and the Novo Nordisk Foundation (625,200 DKK). Trial registration: EudraCT number: 2021-002816-30.
MeSH term(s)	Humans ; Quality of Life ; Cardiovascular Diseases ; Single-Blind Method ; Hospitalization ; Oxygen ; Treatment Outcome ; Randomized Controlled Trials as Topic
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-04-24
Publishing country	Denmark
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article ; Online: Impact of Body Mass Index on Complications and Survival after Surgery for Esophageal and Gastro-Esophageal-Junction Cancer.

Kruhlikava, I / Kirkegård, J / Mortensen, F V / Kjær, D W

Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society

2017 Volume 106, Issue 4, Page(s) 305–310

Abstract: Background and aims: The impact of body mass index on complications and survival in patients undergoing esophagectomy has been extensively studied with conflicting results. In this study, we assess the impact of body mass index on complications and ... ...

Abstract	Background and aims: The impact of body mass index on complications and survival in patients undergoing esophagectomy has been extensively studied with conflicting results. In this study, we assess the impact of body mass index on complications and survival following surgery for esophageal and gastro-esophageal-junction cancer in a Danish population. Material and methods: We identified 285 consecutive patients, who underwent curative-intended treatment for esophageal and gastro-esophageal-junction cancer in the period 2003-2010. We manually reviewed the electronic medical records of all patients included in the study. Body mass index was calculated as weight in kilograms divided by height in meters squared. We grouped patients according to their body mass index, using the World Health Organization definition, as underweight (body mass index < 18.5 kg/m Results: Median age at surgery was 65 years (range: 27-84 years), of which 207 (72.6%) were males. Patients with the lowest body mass index and the obese patients seemed to have a higher frequency of minor complications. Anastomotic leakage occurred in less than 10% of the patients and was equally distributed across the groups as was the other major complications. There were no differences in the 1-, 2-, or 5-year survival rates between the four body mass index groups after adjustment for possible confounders. Five-year survival rates for the four body mass index groups were 31.8%, 28.7%, 27.9%, and 26.1%, respectively. Conclusion: Body mass index over 30 or under 18.5 does not seem to affect survival rates or the presence of serious postoperative complications following esophagectomy in patients with esophageal and gastro-esophageal-junction cancers not receiving neoadjuvant oncological treatment.
MeSH term(s)	Adenocarcinoma/mortality ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/surgery ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/surgery ; Esophagectomy/mortality ; Esophagogastric Junction/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Overweight/complications ; Overweight/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/mortality ; Stomach Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2017-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2077691-3
ISSN	1799-7267 ; 1457-4969
ISSN (online)	1799-7267
ISSN	1457-4969
DOI	10.1177/1457496916683097
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Article ; Online: Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013.

Kjaer, D W / Larsson, H / Svendsen, L B / Jensen, L S

The British journal of surgery

2017 Volume 104, Issue 10, Page(s) 1338–1345

Abstract: Background: Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database.: ... ...

Abstract	Background: Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database. Methods: All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included. Quality-of-care indicators, including number of lymph nodes removed, anastomotic leak rate, 30- and 90-day mortality, and 2- and 5-year overall survival, were assessed. To compare quality-of-care indicators over time, the relative risk (RR) was calculated using a multivariable log binomial regression model. Results: Some 6178 patients were included, of whom 1728 underwent oesophagectomy. The overall number of patients with 15 or more lymph nodes in the resection specimen increased from 38·1 per cent in 2004 to 88·7 per cent in 2013. The anastomotic leak rate decreased from 14·8 to 7·6 per cent (RR 0·66, 95 per cent c.i. 0·43 to 1·01). The 30-day mortality rate decreased from 4·5 to 1·7 per cent (RR 0·51, 0·22 to 1·15) and the 90-day mortality rate from 11·0 to 2·9 per cent (RR 0·46, 0·26 to 0·82). There were no statistically significant changes in 2- or 5-year survival rates over time. Conclusion: Indicators of quality of care have improved since the centralization of oesophageal cancer treatment in Denmark.
MeSH term(s)	Adenocarcinoma/mortality ; Adenocarcinoma/surgery ; Aged ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/surgery ; Centralized Hospital Services/standards ; Denmark ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/surgery ; Esophagectomy/mortality ; Esophagogastric Junction/surgery ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Quality Indicators, Health Care ; Stomach Neoplasms/mortality ; Stomach Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2017-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.10586
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Article ; Online: More patients should undergo surgery after sigmoid volvulus.

Ifversen, Anne Kathrine Wewer / Kjaer, Daniel Willy

World journal of gastroenterology

2014 Volume 20, Issue 48, Page(s) 18384–18389

Abstract: Aim: To assess the outcome of patients treated conservatively vs surgically during their first admission for sigmoid volvulus.: Methods: We conducted a retrospective study of 61 patients admitted to Aarhus University Hospital in Denmark between 1996 ... ...

Abstract	Aim: To assess the outcome of patients treated conservatively vs surgically during their first admission for sigmoid volvulus. Methods: We conducted a retrospective study of 61 patients admitted to Aarhus University Hospital in Denmark between 1996 and 2011 for their first incidence of sigmoid volvulus. The condition was diagnosed by radiography, sigmoidoscopy or surgery. Patients treated with surgery underwent either a sigmoid resection or a percutaneous endoscopic colostomy (PEC). Conservatively treated patients were managed without surgery. Data was recorded into a Microsoft Access database and calculations were performed with Microsoft Excel. Kaplan-Meier plotting and Mantel-Cox (log-rank) testing were performed using GraphPad Prism software. Mortality was defined as death within 30 d after intervention or surgery. Results: Among the total 61 patients, 4 underwent emergency surgery, 55 underwent endoscopy, 1 experienced resolution of the volvulus after contrast enema, and 1 died without treatment because of large bowel perforation. Following emergency treatment, 28 patients underwent sigmoid resection (semi-elective n = 18; elective n = 10). Two patients who were unfit for surgery underwent PEC and both died, 1 after 36 d and the other after 9 mo, respectively. The remaining 26 patients were managed conservatively without sigmoid resection. Patients treated conservatively on their first admission had a poorer survival rate than patients treated surgically on their first admission (95%CI: 3.67-14.37, P = 0.036). Sixty-three percent of the 26 conservatively treated patients had not experienced a recurrence 3 mo after treatment, but that number dropped to 24% 2 years after treatment. Eight of the 14 patients with recurrence after conservative treatment had surgery with no 30-d mortality. Conclusion: Surgically-treated sigmoid volvulus patients had a higher long-term survival rate than conservatively managed patients, indicating a benefit of surgical resection or PEC insertion if feasible.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colectomy/adverse effects ; Colectomy/mortality ; Colonoscopy/adverse effects ; Colonoscopy/methods ; Colonoscopy/mortality ; Colostomy/adverse effects ; Colostomy/methods ; Colostomy/mortality ; Denmark ; Emergencies ; Female ; Hospitals, University ; Humans ; Intestinal Volvulus/diagnosis ; Intestinal Volvulus/mortality ; Intestinal Volvulus/surgery ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Postoperative Complications/mortality ; Recurrence ; Retrospective Studies ; Risk Factors ; Sigmoid Diseases/diagnosis ; Sigmoid Diseases/mortality ; Sigmoid Diseases/surgery ; Survival Rate ; Time Factors ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2014-12-28
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v20.i48.18384
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Article ; Online: A bridging stent to surgery in patients with esophageal and gastroesophageal junction cancer has a dramatic negative impact on patient survival: A retrospective cohort study through data acquired from a prospectively maintained national database.

Kjaer, D W / Nassar, M / Jensen, L S / Svendsen, L B / Mortensen, F V

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus

2017 Volume 30, Issue 3, Page(s) 1–7

Abstract: This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0- ... ...

Abstract	This study aimed to assess the impact of esophageal stenting on postoperative complications and survival in patients with obstructing esophageal and gastroesophageal junction (GEJ) cancer. All patients treated without neoadjuvant therapy that had an R0-resection performed for esophageal and GEJ cancer between January 2003 and December 2010 were identified from a prospectively maintained database. Data on stenting, postoperative mortality, morbidity, recurrence-free survival, complications, and length of hospital stay were collected. Kaplan-Meier plots for survival and recurrence-free survival curves were constructed for R0 resected patients. Data were compared between the stent and no-stent group by nonparametric tests. Two hundred seventy three consecutive R0 resected patients with esophageal or GEJ cancer were identified. Of these patients, 63 had a stent as a bridge to surgery. The male/female ratio was 2.64 (198/75) with a median age in the stent group (SG) of 65.1 versus 64.3 in the no stent group (NSG). Patients were comparable with respect to gender, age, smoking, TNM-classification, oncological treatment, hospital stay, tumor location, and histology. The median survival in the SG was 11.6 months compared with 21.3 months for patients treated without a bridging stent (P < 0.001). There were no statistically significant differences in 30-day mortality between the two groups, but NSG patients exhibited a significantly better two-year survival (P = 0.017). The median recurrence-free survival was 9.1 months for the SG compared with 15.2 months for the NSG. The use of a stent as a bridging procedure to surgery in patients treated without neaoadjuvant therapy for an esophageal or GEJ cancer that later underwent R0 resection decreased the two year survival and the recurrence-free survival.
MeSH term(s)	Aged ; Combined Modality Therapy ; Databases, Factual ; Disease-Free Survival ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/surgery ; Esophagectomy/methods ; Esophagectomy/mortality ; Esophagogastric Junction/pathology ; Esophagogastric Junction/surgery ; Esophagoscopy/instrumentation ; Esophagoscopy/mortality ; Female ; Humans ; Kaplan-Meier Estimate ; Length of Stay ; Male ; Middle Aged ; Neoplasm Recurrence, Local/etiology ; Neoplasm Recurrence, Local/mortality ; Neoplasm Staging ; Prospective Studies ; Retrospective Studies ; Statistics, Nonparametric ; Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2017--01
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	639470-x
ISSN	1442-2050 ; 1120-8694
ISSN (online)	1442-2050
ISSN	1120-8694
DOI	10.1111/dote.12474
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Article ; Online: Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy.

Kristensen, Helle Ø / Kirkegård, Jakob / Kjær, Daniel Willy / Mortensen, Frank Viborg / Kunda, Rastislav / Bjerregaard, Niels Christian

Surgical endoscopy

2017 Volume 31, Issue 6, Page(s) 2596–2601

Abstract: Background: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown.! ...

Abstract	Background: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown. Methods: Using a local database, we identified patients with esophageal achalasia, who underwent POEM. We compared patients with a previous Heller myotomy to those, who had received none or only non-surgical therapy prior to the POEM procedure. We conducted follow-up examinations at 3, 12, and 24 months following the procedure. Results: We included 66 consecutive patients undergoing POEM for achalasia, of which 14 (21.2 %) had undergone a prior Heller myotomy. In both groups, the preoperative Eckardt score was 7. Postoperatively, the non-Heller group experienced a more pronounced symptom relief at both 3-, 12-, and 24-month follow-up compared with the Heller group, and there was a tendency for the effect of POEM to reduce over time. We suggest that there is a correlation between preoperative measurements of gastroesophageal sphincter pressures and the chance of a successful POEM. Conclusions: POEM has a place in the treatment of esophageal achalasia in patients with a prior Heller myotomy and persistent symptoms as it is a safe procedure with acceptable long-term results.
Language	English
Publishing date	2017-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-016-5267-1
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Article ; Online: Local Pressure Drives Low-Density Lipoprotein Accumulation and Coronary Atherosclerosis in Hypertensive Minipigs.

Al-Mashhadi, Rozh H / Al-Mashhadi, Ahmed L / Nasr, Zahra P / Mortensen, Martin Bødtker / Lewis, Esmeralda A / Camafeita, Emilio / Ravlo, Kristian / Al-Mashhadi, Zheer / Kjær, Daniel W / Palmfeldt, Johan / Bie, Peter / Jensen, Jesper M / Nørgaard, Bjarne L / Falk, Erling / Vázquez, Jesús / Bentzon, Jacob F

Journal of the American College of Cardiology

2021 Volume 77, Issue 5, Page(s) 575–589

Abstract: Background: The mechanisms by which hypertension accelerates coronary artery disease are poorly understood. Patients with hypertension often have confounding humoral changes, and to date, no experimental models have allowed analysis of the isolated ... ...

Abstract	Background: The mechanisms by which hypertension accelerates coronary artery disease are poorly understood. Patients with hypertension often have confounding humoral changes, and to date, no experimental models have allowed analysis of the isolated effect of pressure on atherosclerosis in a setting that recapitulates the dimensions and biomechanics of human coronary arteries. Objectives: This study sought to analyze the effect of pressure on coronary atherosclerosis and explore the underlying mechanisms. Methods: Using inflatable suprarenal aortic cuffs, we increased mean arterial pressure by >30 mm Hg in the cephalad body part of wild-type and hypercholesterolemic proprotein convertase subtilisin kexin type 9 (PCSK9) Results: Under hypercholesterolemic conditions in PCSK9 Conclusions: Increased pressure per se facilitates coronary atherosclerosis. Our data indicate that restructuring of the artery to match increased tensile forces in hypertension alters the passage of macromolecules and leads to increased intimal accumulation of low-density lipoproteins.
MeSH term(s)	Animals ; Animals, Genetically Modified ; Biomarkers/blood ; Blood Pressure/physiology ; Coronary Artery Disease/blood ; Coronary Artery Disease/etiology ; Coronary Artery Disease/physiopathology ; Disease Models, Animal ; Hypertension/blood ; Hypertension/complications ; Hypertension/physiopathology ; Lipoproteins, LDL/blood ; Regional Blood Flow/physiology ; Swine ; Swine, Miniature
Chemical Substances	Biomarkers ; Lipoproteins, LDL
Language	English
Publishing date	2021-02-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2020.11.059
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Zs.A 1846: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Endoscopic gallbladder drainage of patients with acute cholecystitis.

Kjaer, D W / Kruse, A / Funch-Jensen, P

Endoscopy

2007 Volume 39, Issue 4, Page(s) 304–308

Abstract: Background and study aim: The standard treatment for acute cholecystitis is early laparoscopic cholecystectomy. In cases of increased operative risk surgery may be postponed or rejected, and instead alternative methods, such as percutaneous or ... ...

Abstract	Background and study aim: The standard treatment for acute cholecystitis is early laparoscopic cholecystectomy. In cases of increased operative risk surgery may be postponed or rejected, and instead alternative methods, such as percutaneous or endoscopic drainage, may be attempted. This paper is a retrospective assessment of our results with endoscopic gallbladder drainage (EGBD) by means of endoscopic retrograde cholangiopancreatography (ERCP). Patients and methods: Over a 9-year period, data from all patients who underwent attempted EGBD, primarily referred for diagnosis and treatment of cholestasis by ERCP, were analyzed. EGBD was attempted in those patients who had concomitant acute cholecystitis. Results: EGBD was successful in 24 of 34 patients with acute cholecystitis (70.6%). The success rate rose from 50% during the first 4-year period to 89% during the subsequent 5-year period. Of the 24 patients in whom EBGD had been successful, 21 showed clinical improvement and 10 were finally managed nonoperatively. Of the 21 clinically improved patients, 14 underwent elective surgery a median of 24 days later. Of the 10 patients in whom EGBD failed nine underwent surgery four of whom required surgery within one week. Conclusion: Treatment of acute cholecystitis in patients could be done successfully by EGBD, and in 70% of cases cholecystectomy could then be carried out on an elective basis rather than as emergency surgery. Some patients could be treated with EGBD alone. Future prospective trials will clarify the role of EGBD in patients with acute cholecystitis.
MeSH term(s)	Acalculous Cholecystitis/surgery ; Adult ; Aged ; Aged, 80 and over ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis, Acute/surgery ; Cholecystolithiasis/surgery ; Drainage/methods ; Female ; Gallstones/surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies
Language	English
Publishing date	2007-04
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/s-2007-966335
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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Internal gallbladder drainage prevents development of acute cholecystitis in a pig model: a randomized study.

Kjaer, Daniel W / Mortensen, Frank V / Møller, Jens K / Hamilton-Dutoit, Stephen J / Funch-Jensen, Peter

Annals of surgical innovation and research

2010 Volume 4, Page(s) 4

Abstract: Background: Acute cholecystitis can be the result of retention of bile in the gallbladder with possible secondary infection and ischaemia. The aim of the present study was to investigate whether internal drainage of the gallbladder could protect against ...

Abstract	Background: Acute cholecystitis can be the result of retention of bile in the gallbladder with possible secondary infection and ischaemia. The aim of the present study was to investigate whether internal drainage of the gallbladder could protect against the development of acute cholecystitis in a pig model. Materials and methods: Twenty pigs were randomized to either internal drainage (drained) or not (undrained). Day 0 acute cholecystitis was induced by ligation of the cystic artery and duct together with inoculation of bacteria. Four days later the pigs were killed and the gallbladders were removed and histologically scored for the presence of cholecystitis. Bile and blood samples were collected for bacterial culturing and biochemical analyses. Results: The histological examination demonstrated statistical significant differences in acute cholecystitis development between groups, the degree of inflammation being highest in undrained pigs. There were no differences in bacterial cultures between the two groups. Conclusion: Internal drainage of the gallbladder protected against the development of acute cholecystitis in the present pig model. These findings support the theory that gallstone impaction of the cystic duct plays a crucial role as a pathogenetic mechanism in the development of acute cholecystitis and suggest that internal drainage may be a way to prevent and treat acute cholecystitis.
Language	English
Publishing date	2010-05-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2272346-8
ISSN	1750-1164 ; 1750-1164
ISSN (online)	1750-1164
ISSN	1750-1164
DOI	10.1186/1750-1164-4-4
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