ABSTRACT
Recently introduced treatment alternatives for gallstones include peroral pharmacological chemolysis plus shock wave lithotripsy and percutaneous cholecystolithotomy. Herein we report on the treatment preferences of 23 patients with symptomatic gallstones and our initial experience with percutaneous cholecystolithotomy in 6 of these patients. All patients were rendered stone free after one procedure. Percutaneous cholecystolithotomy, which is applicable to all types of gallstones, is a safe, practical, low-morbidity alternative to cholecystectomy in selected patients.
Subject(s)
Cholelithiasis/surgery , Adult , Cholecystectomy , Cholelithiasis/drug therapy , Female , Humans , Lithotripsy , Male , Methods , Middle AgedABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the utility of indium-111 leukocyte (In-111 WBC) scintigraphy in a large number of patients with suspected bowel ischemia. METHODS: All patients who underwent In-111 WBC scintigraphy for possible bowel ischemia over a 4-yr period and had subsequent endoscopic or surgical biopsy were retrospectively evaluated. Early (1-4 h postinjection) and late (18-24 h postinjection) images were obtained. Any study with tracer activity in the bowel on early or late images was considered positive for bowel ischemia. RESULTS: Fifty-nine patients were included in the analysis. In-111 WBC scintigraphy detected 23 of 24 cases of bowel ischemia (sensitivity = 96%). Of 35 cases without ischemia, 16 had a negative In-111 WBC scintiscan (specificity = 46%). Negative and positive predictive values for the diagnosis of bowel ischemia were 94% and 55%, respectively. Of the 19 cases without bowel ischemia and a positive scintiscan, 15 had another intraabdominal process responsible for the patients' symptomatology. CONCLUSIONS: In-111 WBC scintigraphy is a highly sensitive diagnostic tool for bowel ischemia. A normal In-111 WBC scintiscan strongly suggests that this disease is not present.