[Cholecystectomy: a choice technique in biliary microlithiasis]. / La colecistectomía: técnica de elección en la microlitiasis biliar.

The purpose of our study is to show results obtained after a cholecystectomy on 25 patients in order to present a suggestive clinic of bile origin and a positive result for determination of microcrystals in the bile probe even in the case of negative radiologic diagnoses (echography, cholecystography). Out of 25 patients operated on the following results were obtained: microscopic cholelithiasis in 12, granular cholelithiasis in 3, acute cholecystitis in 2, cholesterolosis in 2 and without pathologic findings in 6 patients after an observation period of 24 months following the operation it was demonstrated that almost all the patients (96%) had no symptoms. On the other hand, the above mentioned results are compared to the findings obtained during an observation period of a group of 34 patients with positive probe results with the same clinic characteristics and not having been operated on refusing the operation suggested.

[Diagnostic value of duodenal drainage in patients with biliary symptoms and negative imaging test]. / Valor diagnóstico del sondaje duodenal en pacientes con clínica biliar y test de imagen negativo.

A group of patients with clinical manifestations suggesting biliary origin in whom diagnostic imaging techniques were negative were studied by duodenal biliary drainage with the aim of identifying whether microcalculi were present in the bilis being responsible for the symptomatology. The problem group was made up of 96 patients with the results being compared with those of a control group (without biliary disease) including 45 subjects. Duodenal biliary drainage was analyzed for the detection of microlithiasis in the biliary sediment in all the subjects. The analysis was positive in 46 (47.9%) of the patients with biliary clinical manifestations while analysis was positive in only 5 (11.2%) of the control group with the differences being statistically significant. Seventeen of the 46 positive patients underwent surgery demonstrating biliary disease in all (chronic cholecystitis). All these patients remained asymptomatic except one on follow up with 94.1% cure by cholecystectomy being achieved. The authors conclude that duodenal biliary drainage is a highly profitable, complication-free and easily performed diagnostic technique for the detection of microlithiasis which should be regularly used in patients with symptoms suggestive of biliary origin and complementary negative explorations.

[Biliary drainage in the diagnosis of acute idiopathic pancreatitis]. / El sondaje biliar en el diagnóstico de las pancreatitis agudas idiopáticas.

The identification of a casual agent in the so-called "idiopatic acute pancreatitis" is of great interest in relationship with the prognosis and the election of correct therapy. We have performed a duodenal drainage for the microscopic study of the bile, looking for cholesterol crystals and bilirrubinate's in a group of 19 patients with idiopatic acute pancreatitis. The results have been compared with a control group composed by 45 assymptomatic individuals. In the patients group drainage results were abnormal in 11 cases (57.9%) vs. 11.2% in the control group (difference statistically significant). In 4 of the 11 cases, a cholecystectomy was performed showing biliary pathology. Patients at follow-up were assymptomatic. Duodenal drainage is an easy method without risks that must be used always in idiopatic acute pancreatitis. It allows the diagnosis of microlithiasis and may help in the therapeutic indication of cholecystectomy.