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The instantaneous and time-averaged heat transfer coefficients in
the regions near the wall
and at the center and average gas holdups were measured in a 0.28 m
diameter slurry bubble
column for the air−water and air−water−glass beads (35 μm)
system. The effects of high gas
velocities (up to 0.35 m/s) and high solids concentrations (up to 40
vol %) were investigated.
Gas holdup decreased with increasing slurry concentrations; the
rate of decline was rapid at
high gas velocities. The instantaneous local heat transfer
measurements were analyzed to study
the bubble behavior in the regions near the wall and at the center for
different solids
concentrations. Larger bubbles were detected in the wall region in
slurry systems compared to
the solid-free system. The average heat transfer coefficient
decreased with increasing slurry
concentrations. The heat transfer coefficient was always lower at
the wall than at the center.
Backgrounds/AimsA residual gallbladder (RGB) following a partial/subtotal cholecystectomy may cause symptoms that require its removal. We present our large study regarding the problem of a RGB over a 15 year period.MethodsThis study involved a retrospective analysis of patients managed for symptomatic RGB from January 2000 to December 2015.ResultsA RGB was observed in 93 patients, who had a median age of 45 (25–70) years, and were comprised of 69 (74.2%) females. The most common presentation was recurrence pain (n=64, 68.8%). Associated choledocholithiasis was present in 23 patients (24.7%). An ultrasonography (USG) failed to diagnose RGB calculi in 10 (11%) patients; whereas, magnetic resonance cholangio-pancreatography (MRCP) accurately diagnosed RGB calculi in all the cases except for 2 (4%) and, additionally, detected common bile duct (CBD) stones in 12 patients. Completion cholecystectomy was performed in all patients (open 45 [48.4%]; laparoscopic 48 [51.6%] and 19 [20.4%] patients required a conversion to open). The RGB pathology included stones in 90 (96.8%), Mirizzi's syndrome in 10 (10.8%) and an internal fistula in 9 (9.7%) patients. Additional procedures included CBD exploration (n=6); Choledocho-duodenostomy (n=4) and Roux-en-Y hepatico-jejunostomy (n=3). The mortality and morbidity were nil and 11% (all wound infection), respectively. Two patients developed incisional hernia during follow up. The mean follow up duration was 23.1 months (3–108) in 65 patients and the outcome was excellent and good in 97% of the patients.ConclusionsPost-cholecystectomy recurrent biliary colic should raise suspicion of RGB. MRCP is a useful investigation for the diagnosis and assessment of any associated problems and provides a roadmap for surgery. Laparoscopic completion cholecystectomy is feasible, but is technically difficult and has a high conversion rate.
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