{"title":"Any Time Laparoscopic Cholecystectomy in Moderate to Severe Acute Cholecystitis without Septic Shock","authors":"Bhavin B Vasavada, H. Patel","doi":"10.12691/ijcd-9-3-1","DOIUrl":"https://doi.org/10.12691/ijcd-9-3-1","url":null,"abstract":"","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72871242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In Memory of Professor Marsh NM: The Researcher who Understood and Lived Celiac Disease","authors":"A. Lerner","doi":"10.12691/ijcd-9-3-6","DOIUrl":"https://doi.org/10.12691/ijcd-9-3-6","url":null,"abstract":"","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76290700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Appreciation of the Quality of Life of Patients with Atopic Dermatitis. Clinical and Laboratory Study","authors":"E. Duca, M. Pascal, G. Sur, Remus Gaga, L. Sur","doi":"10.12691/ijcd-9-3-8","DOIUrl":"https://doi.org/10.12691/ijcd-9-3-8","url":null,"abstract":"","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85037354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gluten can induce several conditions. However, a lot of people and even medical practitioners only associate gluten pathology with its most severe form neglecting other pathologies. In addition to this, clinical manifestations of celiac disease are not always classic and for this reason, many cases are diagnosed late, being characterized by intricate symptoms that can be attributed to other conditions. In the present study, we try to bring a systematization of the five major gluten-induced manifestations: celiac disease, non-celiac gluten sensitivity, wheat allergy, gluten ataxia, and dermatitis herpetiformis.
{"title":"More Than Celiac Disease - Five Gluten-induced Pathologies","authors":"Maria Lucia Sur, M. Pascal, Remus Gaga","doi":"10.12691/ijcd-9-3-7","DOIUrl":"https://doi.org/10.12691/ijcd-9-3-7","url":null,"abstract":"Gluten can induce several conditions. However, a lot of people and even medical practitioners only associate gluten pathology with its most severe form neglecting other pathologies. In addition to this, clinical manifestations of celiac disease are not always classic and for this reason, many cases are diagnosed late, being characterized by intricate symptoms that can be attributed to other conditions. In the present study, we try to bring a systematization of the five major gluten-induced manifestations: celiac disease, non-celiac gluten sensitivity, wheat allergy, gluten ataxia, and dermatitis herpetiformis.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89505782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Collagenous sprue is an unusual small intestinal mucosal disorder characterized by flattened small intestinal mucosa, unusual sub-epithelial collagen deposits, increased intra-epithelial lymphocytes, often denuded epithelial cells and resistance to therapy, including a gluten-free diet. The disorder is heterogeneous with several potential causes now identified. Similar to sprue-like intestinal disease, collagenous sprue may be caused or precipitated by different pharmaceutical agents. Olmesartan, an angiotensin II inhibitor, often employed in treatment of hypertension, may cause a drug-induced form of sprue-like small intestinal disease with the pathological features of untreated celiac disease refractory to gluten-free diet treatment. In addition, collagenous sprue may be precipitated by olmesartan. Recognition and cessation of the medication has led to resolution of the small intestinal mucosal disorder without steroids or other treatment.
{"title":"Drug-induced Collagenous Sprue: A Reversible Small Bowel Mucosal Disorder","authors":"H. Freeman","doi":"10.12691/IJCD-9-2-6","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-6","url":null,"abstract":"Collagenous sprue is an unusual small intestinal mucosal disorder characterized by flattened small intestinal mucosa, unusual sub-epithelial collagen deposits, increased intra-epithelial lymphocytes, often denuded epithelial cells and resistance to therapy, including a gluten-free diet. The disorder is heterogeneous with several potential causes now identified. Similar to sprue-like intestinal disease, collagenous sprue may be caused or precipitated by different pharmaceutical agents. Olmesartan, an angiotensin II inhibitor, often employed in treatment of hypertension, may cause a drug-induced form of sprue-like small intestinal disease with the pathological features of untreated celiac disease refractory to gluten-free diet treatment. In addition, collagenous sprue may be precipitated by olmesartan. Recognition and cessation of the medication has led to resolution of the small intestinal mucosal disorder without steroids or other treatment.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"388 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76450266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Water pollution is one of the most severe environmental problems that affect public health and can cause diseases as gastrointestinal diseases. Microbial pollution of Lake Manzala was studied in four main localities, Kapoty, Bashtier, Mataryia and Gamil areas which receive a high load of sewage, agricultural and industrial wastes from different sources. A total of 50 bacterial isolates from water and fish were identified using API 20E system, revealed that 20% of these bacterial strains, were related to Escherichia coli (E. coli), which has been subjected to different antibiotics, such as Ampicillin, Penicillin G, Streptomycin, tetracycline, Gentamycin, Chloramphenicol, rifampicin and Cefotaxime. All strains variation of resistance pattern, harboring Plasmid DNA are an indication of risk to human health in the communities around Manzala Lake, from such bacterial pathogens, which live in polluted and stressed environment.
{"title":"Antibiotic-Resistant Bacteria in Water and Fish: A Risk to Human Health","authors":"M. Zaky, S. M. E. Toubar, Ahmed Samy El-Shafey","doi":"10.12691/IJCD-9-2-2","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-2","url":null,"abstract":"Water pollution is one of the most severe environmental problems that affect public health and can cause diseases as gastrointestinal diseases. Microbial pollution of Lake Manzala was studied in four main localities, Kapoty, Bashtier, Mataryia and Gamil areas which receive a high load of sewage, agricultural and industrial wastes from different sources. A total of 50 bacterial isolates from water and fish were identified using API 20E system, revealed that 20% of these bacterial strains, were related to Escherichia coli (E. coli), which has been subjected to different antibiotics, such as Ampicillin, Penicillin G, Streptomycin, tetracycline, Gentamycin, Chloramphenicol, rifampicin and Cefotaxime. All strains variation of resistance pattern, harboring Plasmid DNA are an indication of risk to human health in the communities around Manzala Lake, from such bacterial pathogens, which live in polluted and stressed environment.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85217420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The El Pasoans fighting hunger (EPFH) food bank is a non-profit hunger relief organization that delivers food to partner groups which feed people who are food insecure within the city. The United States Department of Agriculture is the food bank main source of food, other food sources include Feeding America, grocery chains and food donors. While the EPFH food bank has been successful in fulfilling its mission, there has been renewed interest as to if the EPFH food bank takes interest in people with celiac disease by delivering gluten-free foods to them. This article focuses on food delivery with or without gluten, why healthy people order gluten-free products and explains if gluten-free food has beneficial effects on healthy people.
{"title":"An Example to Follow In the COVID-19 Pandemic: Together For Celiac Disease Patients","authors":"M. O. F. Barriguete","doi":"10.12691/IJCD-9-2-1","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-1","url":null,"abstract":"The El Pasoans fighting hunger (EPFH) food bank is a non-profit hunger relief organization that delivers food to partner groups which feed people who are food insecure within the city. The United States Department of Agriculture is the food bank main source of food, other food sources include Feeding America, grocery chains and food donors. While the EPFH food bank has been successful in fulfilling its mission, there has been renewed interest as to if the EPFH food bank takes interest in people with celiac disease by delivering gluten-free foods to them. This article focuses on food delivery with or without gluten, why healthy people order gluten-free products and explains if gluten-free food has beneficial effects on healthy people.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86409784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 16-year-old boy with nonresponsive celiac disease (NRCD), dermatitis herpetiformis, short stature, and failure to thrive, presented to this Functional Medicine practitioner because he had exceedingly high tissue transglutaminase (tTG) antibodies and poor growth, despite 10 months on a meticulous gluten-free diet (GFD). Immunological testing showed elevated antibody production against multiple peptides of wheat, food antigens, intestinal barrier dysfunction, lipopolysaccharide (LPS) antibodies, and polyreactive autoimmune reactions. An elimination diet, nutraceutical protocols to modulate the microbiome, address intestinal permeability, lower inflammation, and remove underlying bacterial infection were initiated. Global anti-inflammatory lifestyle modifications were recommended. Within 3 months of treatment, the patient’s tTG antibodies decreased by 14% for the first time since strict gluten elimination. Within 15 months, tTG IgG antibodies were nearly normal at 1.61 (0.03-1.60, ELISA Index). Test results improved dramatically in tandem with clinical progress. On a GFD and after initiating and maintaining these dietary and lifestyle changes, he gained 12 inches and 40 pounds. To our knowledge, this is the first published case of complete reversal of NRCD and failure to thrive by addressing endotoxin and lifestyle outside of a GFD.
{"title":"Nonresponsive Celiac Disease Treated with a Unique Functional Medical Approach","authors":"T. O'bryan, A. Lerner","doi":"10.12691/IJCD-9-2-7","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-7","url":null,"abstract":"A 16-year-old boy with nonresponsive celiac disease (NRCD), dermatitis herpetiformis, short stature, and failure to thrive, presented to this Functional Medicine practitioner because he had exceedingly high tissue transglutaminase (tTG) antibodies and poor growth, despite 10 months on a meticulous gluten-free diet (GFD). Immunological testing showed elevated antibody production against multiple peptides of wheat, food antigens, intestinal barrier dysfunction, lipopolysaccharide (LPS) antibodies, and polyreactive autoimmune reactions. An elimination diet, nutraceutical protocols to modulate the microbiome, address intestinal permeability, lower inflammation, and remove underlying bacterial infection were initiated. Global anti-inflammatory lifestyle modifications were recommended. Within 3 months of treatment, the patient’s tTG antibodies decreased by 14% for the first time since strict gluten elimination. Within 15 months, tTG IgG antibodies were nearly normal at 1.61 (0.03-1.60, ELISA Index). Test results improved dramatically in tandem with clinical progress. On a GFD and after initiating and maintaining these dietary and lifestyle changes, he gained 12 inches and 40 pounds. To our knowledge, this is the first published case of complete reversal of NRCD and failure to thrive by addressing endotoxin and lifestyle outside of a GFD.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89039262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Celiac disease (CD) is an immune-mediated systemic disorder triggered by dietary gluten and is considered one of the most common lifelong food-related disorders worldwide. The knowledge of CD among the general public in Saudi Arabia remains limited. Therefore, we aimed to assess the awareness and knowledge of CD among the general public in Saudi Arabia. Methods: A cross-sectional online survey including members of the general public was conducted in Saudi Arabia. The survey included questions assessing the public’s awareness about CD, gluten sensitivity, and peanut allergy, as well as celiac disease-related knowledge. Results: From a total of 1230 responses received, 76.7% (95% confidence interval [CI], 74.0%–79.4%) were females, 42.0% (95% CI, 37.7–46.3) were aged between 31–45 years, and 64.3% (95% CI, 61.0%–67.6%) had Bachelor’s degree. Less than half of the participants had heard of CD (48.4%; 95% CI, 44.4%–52.4%), but the majority had heard of peanut allergy (80.1%; 95% CI, 77.6%–82.6%) and gluten sensitivity (72.4%; 95% CI, 69.5%–75.3%). The prevalence of CD was estimated incorrectly by more than 80% of participants. Other questions on participants’ knowledge associated with CD were answered “Do not know” by the majority. Females demonstrated a greater awareness of CD, peanut allergy, and gluten sensitivity, and had a higher percentage of correct responses to questions related to CD than males. Conclusion: This study highlights the need to increase the awareness and knowledge of CD, especially in the recognition of its symptoms. Educational efforts toward increasing the awareness of the general public about CD could help optimize its diagnosis and management.
{"title":"Awareness of Celiac Disease among the General Public in Saudi Arabia","authors":"M. Alhussain","doi":"10.12691/IJCD-9-2-4","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-4","url":null,"abstract":"Background: Celiac disease (CD) is an immune-mediated systemic disorder triggered by dietary gluten and is considered one of the most common lifelong food-related disorders worldwide. The knowledge of CD among the general public in Saudi Arabia remains limited. Therefore, we aimed to assess the awareness and knowledge of CD among the general public in Saudi Arabia. Methods: A cross-sectional online survey including members of the general public was conducted in Saudi Arabia. The survey included questions assessing the public’s awareness about CD, gluten sensitivity, and peanut allergy, as well as celiac disease-related knowledge. Results: From a total of 1230 responses received, 76.7% (95% confidence interval [CI], 74.0%–79.4%) were females, 42.0% (95% CI, 37.7–46.3) were aged between 31–45 years, and 64.3% (95% CI, 61.0%–67.6%) had Bachelor’s degree. Less than half of the participants had heard of CD (48.4%; 95% CI, 44.4%–52.4%), but the majority had heard of peanut allergy (80.1%; 95% CI, 77.6%–82.6%) and gluten sensitivity (72.4%; 95% CI, 69.5%–75.3%). The prevalence of CD was estimated incorrectly by more than 80% of participants. Other questions on participants’ knowledge associated with CD were answered “Do not know” by the majority. Females demonstrated a greater awareness of CD, peanut allergy, and gluten sensitivity, and had a higher percentage of correct responses to questions related to CD than males. Conclusion: This study highlights the need to increase the awareness and knowledge of CD, especially in the recognition of its symptoms. Educational efforts toward increasing the awareness of the general public about CD could help optimize its diagnosis and management.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73138026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Single-dose antibiotics are recommended for laparoscopic cholecystectomy, for symptomatic gall stones. However, very few studies are there for subgroup grade-2 and grade-3 cholecystitis according to Tokyo guidelines 2018. Material and methods: We retrospectively analysed outcomes of our protocol of no post-operative antibiotics in grade-2 and grade 3 (moderate to severe) acute cholecystitis according to Tokyo guidelines. We perform laparoscopic cholecystectomies within the first 24 hours of presentation to us without considering time since attack if the patient is not in septic shock where we follow survival sepsis guidelines and also perform percutaneous cholecystostomy. All the data were prospectively analysed. Statistical evaluation was done using SPSS version 21(IBM). Results: We performed 101 laparoscopic cholecystectomies between April 2016 to January 2019. We prefer single dose pre-operative antibiotic (third-generation cephalosporins) in all laparoscopic cholecystectomies and no post-operative antibiotics. A total of 74 patients were having grade 2 or grade 3 cholecystitis. 64 patients were having grade 2 and 9 patients were having grade 3 cholecystitis. One patient was having grade 3 cholecystitis and was having septic shock so he was managed with percutaneous cholecystostomy and according to survival sepsis protocol and lap choly was done after 72 hours and hence excluded from the study. Out of 73 patients included in the study, 2 patients were converted to open; in two patients we performed lap subtotal cholecystectomy due to a difficult calot triangle. Out of this only 1 patient developed port site infection and two patient developed biloma which was managed by percutaneous drainage. All patients were discharged the same day or the next day. Only two patients with biloma were readmitted. Rest all of the patients had an uneventful recovery. Conclusion: Post-operative antibiotics are unnecessary even in grade-2, grade-3 acute cholecystitis without septic shock according to Tokyo guidelines.
介绍:单剂量抗生素推荐用于腹腔镜胆囊切除术，用于症状性胆结石。然而，根据2018年东京指南，很少有针对二级和三级胆囊炎亚组的研究。材料和方法:我们根据东京指南回顾性分析了我们的2级和3级(中重度)急性胆囊炎术后无抗生素治疗方案的结果。如果患者没有脓毒性休克，我们会在就诊后的24小时内进行腹腔镜胆囊切除术，而不考虑发作后的时间。如果患者没有脓毒性休克，我们会遵循脓毒症生存指南，并进行经皮胆囊造口术。所有资料进行前瞻性分析。采用SPSS version 21(IBM)进行统计评价。结果:我院于2016年4月至2019年1月共施行腹腔镜胆囊切除术101例。在所有腹腔镜胆囊切除术中，我们倾向于术前单剂量抗生素(第三代头孢菌素)，术后不使用抗生素。共有74例患者患有2级或3级胆囊炎。2级胆囊炎64例，3级胆囊炎9例。一名患者患有3级胆囊炎并患有感染性休克，因此他接受了经皮胆囊造口术，并根据生存败血症协议和72小时后进行了肝胆切除，因此被排除在研究之外。在纳入研究的73例患者中，2例患者转为开放;在两例患者中，由于胆囊三角形困难，我们进行了膝上胆囊次全切除术。其中只有1例患者发生端口感染，2例患者发生胆囊瘤，经皮引流治疗。所有患者均于当日或次日出院。只有2例胆囊瘤患者再次入院。其余的病人都顺利康复。结论:即使在没有感染性休克的2级、3级急性胆囊炎患者，根据东京指南，术后也不需要抗生素。
{"title":"Antibiotic Resistance in Acute Cholecystitis Graded According to Tokyo Guidelines 2018: The First Prospective Study","authors":"H. Patel, B. Vasavada","doi":"10.12691/IJCD-9-2-3","DOIUrl":"https://doi.org/10.12691/IJCD-9-2-3","url":null,"abstract":"Introduction: Single-dose antibiotics are recommended for laparoscopic cholecystectomy, for symptomatic gall stones. However, very few studies are there for subgroup grade-2 and grade-3 cholecystitis according to Tokyo guidelines 2018. Material and methods: We retrospectively analysed outcomes of our protocol of no post-operative antibiotics in grade-2 and grade 3 (moderate to severe) acute cholecystitis according to Tokyo guidelines. We perform laparoscopic cholecystectomies within the first 24 hours of presentation to us without considering time since attack if the patient is not in septic shock where we follow survival sepsis guidelines and also perform percutaneous cholecystostomy. All the data were prospectively analysed. Statistical evaluation was done using SPSS version 21(IBM). Results: We performed 101 laparoscopic cholecystectomies between April 2016 to January 2019. We prefer single dose pre-operative antibiotic (third-generation cephalosporins) in all laparoscopic cholecystectomies and no post-operative antibiotics. A total of 74 patients were having grade 2 or grade 3 cholecystitis. 64 patients were having grade 2 and 9 patients were having grade 3 cholecystitis. One patient was having grade 3 cholecystitis and was having septic shock so he was managed with percutaneous cholecystostomy and according to survival sepsis protocol and lap choly was done after 72 hours and hence excluded from the study. Out of 73 patients included in the study, 2 patients were converted to open; in two patients we performed lap subtotal cholecystectomy due to a difficult calot triangle. Out of this only 1 patient developed port site infection and two patient developed biloma which was managed by percutaneous drainage. All patients were discharged the same day or the next day. Only two patients with biloma were readmitted. Rest all of the patients had an uneventful recovery. Conclusion: Post-operative antibiotics are unnecessary even in grade-2, grade-3 acute cholecystitis without septic shock according to Tokyo guidelines.","PeriodicalId":13927,"journal":{"name":"International Journal of Celiac Disease","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85198981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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