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Thesis submitted in full compliance with the requirements for the Masters in Technology Degree: Radiography, Durban University of Technology, 2006. / This study aimed at determining and evaluating the prevalence of gallstones in the Black population of District 28 (D28) in relation to age, gender, diet and body mass index (BMI) in order to identify people at high risk and advise them so that they can avoid the complications and decrease the morbidity rate. Blacks are thought to have increased prevalence of gallstones but there has been no systematic evaluation of its prevalence in D28. METHODS AND MATERIALS 389 Black people from D28 were selected from referrals (for many different radiological examinations) coming to the X-ray and ultrasound departments. Some of the respondents were staff members who also met the selection criteria for the study. An interview was conducted at Ngwelezane hospital using a structured questionnaire on health, social and diet history of the respondents. All information was entered into the data sheet. All respondents were then scanned using Mid-range ultrasound machines to establish the presence of gallstones and this information was thereafter documented on the data sheet. SPSS version 11.5 (SPSS Inc, Chicago, III) was used for data analysis. Prevalence and 95% confidence intervals were calculated using the Epitable module of Epi Info version 6.04 (CDC, 2001). Pearson's Chi square tests were used to assess associations between categorical variables and gall stones. Logistic regression analysis was applied to assess the independent effects of multiple risk factors on the development of gallstones. Backwards elimination method based on likelihood ratios was used with entry and exit probabilities set at 0.05 and 0.1 respectively / M

Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 6 uppsatser.

A cirurgia geral tem experimentado após a década de noventa, com o desenvolvimento da laparoscopia, espetacular melhoria em todos os resultados. Uma menor morbimortalidade se deve ao menor trauma cirúrgico causado pelas cirurgias feitas por pequenos orifícios. O desenvolvimento tecnológico de endoscópios rígidos e flexíveis, propiciou aos médicos um acesso direto às patologias abdominais sem a necessidade de grandes aberturas da cavidade celômica. Assim, houve grande melhoria não somente dos resultados estéticos, mas principalmente na redução de morbidade. Nas cirurgias das vias biliares isso não foi diferente. Com o aprimoramento da técnica cirúrgica laparoscópica, a via de acesso cirúrgico endoscópica passou a ser preferida. Entretanto, a realidade da laparoscopia em muitos locais não se faz presente no tratamento da coledocolitíase, principalmente quando tal patologia é tratada em centros com menor aporte de recursos financeiros. A retirada de cálculos da via biliar principal exige o uso de fibroscópios de alto custo, bem como dispositivos descartáveis de alto valor, forçando o cirurgião desprovido de tais recursos muitas vezes a realizar a cirurgia de maneira convencional ou, no mínimo, aumentado a dificuldade do procedimento por via laparoscópica. Com o intuito de equacionar tal dificuldade, propõe-se com este dispositivo, mais um conceito de abordagem para este problema, inédito, testado em macroambiente, com utilização de cateter contendo balão com polímero autoexpansivo capaz de apreender os cálculos da via biliar principal por meio de inclusão. Utilizando os preceitos da colangiografia per operatória, o novo método propõe a retirada dos cálculos da via biliar principal de maneira indireta com auxílio de métodos de imagem comuns à maioria dos hospitais de média complexidade. / General surgery has experienced after the nineties, with the development of laparoscopy, spectacular improvement in outcomes. Lower morbidity and mortality is due to less surgical trauma caused by surgeries performed by small orifices. The technological development of rigid and flexible endoscopes gave doctors direct access to abdominal pathologies without the need for large openings in the coelomic cavity. Thus, there was a great improvement not only in the aesthetic results, but mainly in the reduction of morbidity. In biliary surgeries this was not different. With the improvement of the laparoscopic surgical technique, the endoscopic cirurgical approach was favored. However, the reality of laparoscopy in many places is not present in the treatment of choledocholithiasis, especially when such pathology is treated in centers with lower financial resources. Removal of stones from the main biliary tract requires the use of high-cost fibroscopes as well as high-value disposable devices, forcing the surgeon devoid of such resources, many times undergoing conventional surgery or at a minimum, increasing the difficulty of the procedure by laparoscopic approach. With the purpose of equating this difficulty, it is proposed with this device, another concept of approach to this problem, novel, tested in macro environment, with the use of balloon catheter containing self expanding polymer capable of grasping the calculi of the common bile duct by inclusion. Using the trans-operative cholangiography precepts, the new method proposes to extract the principal biliary tract calculi indirectly with the help of imaging methods common to the most hospitals.