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https://www.readbyqxmd.com/read/28093301/protocol-driven-management-of-suspected-common-duct-stones
#1
Anthony Manning, Richard Frazee, Stephen Abernathy, Claire Isbell, Travis Isbell, Justin Regner, Yolanda Munoz Maldanado, Randall Smith
INTRO: Common duct stones can be diagnosed by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound/endoscopic retrograde cholangiopancreatography (EUS/ERCP), and intra-operative cholangiogram (IOC). In 2015, our group adopted a standard approach of preoperative EUS/ERCP followed by laparoscopic cholecystectomy for patients with an admission bilirubin over 4.0 (mg/dL). For bilirubin less than 4.0, laparoscopic cholecystectomy with IOC was the initial procedure. Post-operative EUS/ERCP with endoscopic sphincterotomy was pursued for positive IOC...
January 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28074277/patient-reported-outcomes-for-acute-gallstone-pathology
#2
Ed Parkin, Martyn Stott, Joy Brockbank, Simon Galloway, Ian Welch, Andrew Macdonald
BACKGROUND: A number of prominent surgical trials and clinical guidelines regard length of hospital stay and rates of daycase surgery as being of upmost importance following cholecystectomy. However, it is unclear whether these outcomes also matter to patients. This study aimed to identify the factors patients regard as most important when admitted with acute gallstone pathology. METHODS: A 41-item survey was produced by combining outcomes assessed in recent clinical trials with results from a preliminary patient questionnaire...
January 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28071655/effectiveness-of-guideline-recommended-cholecystectomy-to-prevent-recurrent-pancreatitis
#3
Ayesha Kamal, Eboselume Akhuemonkhan, Venkata S Akshintala, Vikesh K Singh, Anthony N Kalloo, Susan M Hutfless
OBJECTIVES: Cholecystectomy during or within 4 weeks of hospitalization for acute biliary pancreatitis is recommended by guidelines. We examined adherence to the guidelines for incident mild-to-moderate acute biliary pancreatitis and the effectiveness of cholecystectomy to prevent recurrent episodes of pancreatitis. METHODS: Individuals in the 2010-2013 MarketScan Commercial Claims & Encounters database with a hospitalization associated with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes of 577...
January 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28035552/small-gallstone-size-and-delayed-cholecystectomy-increase-the-risk-of-recurrent-pancreatobiliary-complications-after-resolved-acute-biliary-pancreatitis
#4
Sung Bum Kim, Tae Nyeun Kim, Hyun Hee Chung, Kook Hyun Kim
INTRODUCTION: Acute biliary pancreatitis (ABP) is a severe complication of gallstone disease with considerable mortality, and its recurrence rate is reported as 50-90% for ABP patients who do not undergo cholecystectomy. However, the incidence of and risk factors for recurrent pancreatobiliary complications after the initial improvement of ABP are not well established in the literature. The aims of this study were to determine the risk factors for recurrent pancreatobiliary complications and to compare the outcomes between early (within 2 weeks after onset of pancreatitis) and delayed cholecystectomy in patients with ABP...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28024730/-efficiency-of-laparoscopic-vs-endoscopic-management-in-cholelithiasis-and-choledocholithiasis-is-there-any-difference
#5
María de Los Angeles Herrera-Ramírez, Hugo López-Acevedo, Gustavo Adolfo Gómez-Peña, Carlos Javier Mata-Quintero
BACKGROUND: Concomitant cholelithiasis and choledocholithiasis is a disease where incidence increase with age and can have serious complications such as pancreatitis, cholangitis and liver abscesses, but its management is controversial, because there are minimally invasive laparoscopic and endoscopic surgical procedures. OBJECTIVE: To compare the efficiency in the management of cholelithiasis and choledocholithiasis with laparoscopic cholecystectomy with common bile duct exploration vs cholangiopancreatography endoscopic retrograde+laparoscopic cholecystectomy...
December 23, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28000653/laparoscopic-spleen-preserving-distal-pancreatectomy-for-a-primary-hydatid-cyst-mimicking-a-mucinous-cystic-neoplasia
#6
Tugan Tezcaner, Yahya Ekici, Onur Huseyin Aydın, Gonca Barit, Gökhan Moray
Pancreatic hydatid cysts are fairly rare. The disease can be encountered concurrently with systemic involvement or as an isolated pancreatic involvement. We report the first case of spleen-preserving laparoscopic distal pancreatectomy for a pancreatic hydatid cyst. There was no complication or recurrence. A 55-year-old woman was admitted to our centre with epigastric and back pain. Upper abdominal magnetic resonance imaging revealed a solitary cystic lesion with septations at the pancreatic tail level measuring 24 mm × 18 mm, which was initially thought to be a pancreatic mucinous cystic neoplasia...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27990758/factor-analysis-of-recurrent-biliary-events-in-long-term-follow-up-of-gallstone-pancreatitis
#7
Ji Min Lee, Woo Chul Chung, Hea Jung Sung, Yeon-Ji Kim, Gun Jung Youn, Yun Duk Jung, Sooa Choi, Eun Jung Jeon
OBJECTIVE: Recurrent attacks after acute gallstone pancreatitis (GSP) are a substantial problem with associated morbidity and mortality. The recommended therapies for recurrent attacks are cholecystectomy and endoscopic sphincterotomy (EST). This study aimed to evaluate the long-term results of cholecystectomy and EST after clinical improvement of GSP. METHODS: A consecutive series of patients who were admitted with GSP between January 2003 to December 2014 were analyzed...
December 18, 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27981825/laparo-endoscopic-rendez-vous-versus-sequential-delayed-approach-in-patients-with-choledocholithiasis
#8
Antonio Pesce, Gaetano LA Greca, Saverio Latteri, Vincenzo Guardabasso, Federica DI Marco, Michele DI Blasi, Domenico Russello, Stefano Puleo
BACKGROUND: To compare the efficacy and safety of synchronous laparoscopic cholecystectomy with laparo-endoscopic rendez-vous technique vs sequential "delayed" approach with the main goal to compare the conversion rate and post-operative complications. METHODS: Patients diagnosed as having gallstones and CBD stones or sludge were enrolled in this study. From January 2013 to June 2015, 43 consecutive patients were submitted to the sequential treatment (ERCP prior to laparoscopic cholecystectomy) and the next consecutive 46 patients were submitted to undergo the rendez-vous technique...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27981822/early-cholecystectomy-for-non-severe-acute-gallstone-pancreatitis-easier-said-than-done
#9
Simone Guadagni, Ismail Cengeli, Matteo Palmeri, Luca Bastiani, Andrea Bertolucci, Matteo Modesti, Christian Galatioto, Massimo Chiarugi
BACKGROUND: Laparoscopic cholecystectomy (LC) carried out within 3 days after an attack of non severe acute gallstone pancreatitis (NSAGP) is recommended to reduce hospital stay and overall costs. Aim of the study was to evaluate factors that may delay a timely surgical management of NSAGP and the consequences of this deviation. METHODS: We reviewed the charts of patients admitted for NSAGP and managed by LC during the last 14 years. 316 patients entered the study, 98 of whom underwent early LC...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27981312/unfused-liver-segments-a-case-report-of-an-unknown-phenotype-of-the-conradi-h%C3%A3-nermann-happle-syndrome
#10
Fabian Bartsch, Maximilian Ackermann, Hauke Lang, Stefan Heinrich
BACKGROUND: Since its description in 1957, Couinaud`s classification of the segmental organization of the liver has remained valid. However, recent investigations by 3-dimensional computed tomography suggest a significant variability of the vascular anatomy and segment volume. Here, we report a surprise finding during the laparoscopic cholecystectomy of a patient with Conradi-Hünermann-Happle syndrome, in whom the liver segments were not fused. CASE REPORT: Laparoscopic cholecystectomy was performed because of recurrent biliary pancreatitis in a 47 year-old male patient, who had been diagnosed with Conradi-Hünermann-Happle syndrome...
December 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/27977604/the-importance-of-igg4-screening-in-patients-diagnosed-with-primary-sclerosing-cholangitis-in-the-past-a-case-rediagnosed-as-igg4-sc-after-10-years
#11
Yanni Li, Lu Zhou, Xin Zhao, Wenjing Song, Nathasha Karunaratna, Bangmao Wang
RATIONALE: While primary sclerosing cholangitis (PSC) has been recognized for decades, immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) has been correctly diagnosed only in recent years. PSC and IgG4-SC show similar clinical symptoms, serologic markers, and imaging results, but the treatment strategies and prognosis of patients differ. PATIENT CONCERNS: Here, we present the case report of a patient diagnosed with PSC for 10 years and rediagnosed with IgG4-SC recently, to emphasize the importance of screening serum IgG4 levels in patients with previous diagnosis of PSC...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27957289/efficacy-of-endoscopic-ultrasonography-in-evaluation-of-undetermined-etiology-of-common-bile-duct-dilatation-on-abdominal-ultrasonography
#12
Rasoul Sotoudehmanesh, Naimeh Nejati, Maryam Farsinejad, Shadi Kolahdoozan
BACKGROUND The cause of common bile duct (CBD) dilatation cannot be determined by imaging modalities in many patients. The aim of this study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom ultrasonography could not demonstrate the cause of dilation. METHODS Prospectively, 152 consecutive patients who were referred for evaluation of dilated CBD (diameter ≥7 mm) of undetermined origin by ultrasonography were included in this study. All the patients underwent EUS...
October 2016: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27938531/pancreas-divisum-correlation-between-anatomical-abnormalities-and-bile-precipitation-in-the-gallbladder-in-seven-patients
#13
P Izzo, P Di Cello, F Pugliese, S Izzo, Romualdo Grande, F Biancucci, G Sinaimeri, F Razionale, U Costi, M Al Mansour, A Muneer, S Valabrega, L Izzo
Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder...
July 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27924386/cost-analysis-of-laparoendoscopic-rendezvous-versus-preoperative-ercp-and-laparoscopic-cholecystectomy-in-the-management-of-cholecystocholedocholithiasis
#14
Aldo Garbarini, Dario Reggio, Simone Arolfo, Marco Bruno, Roberto Passera, Giorgia Catalano, Claudio Barletti, Mauro Salizzoni, Mario Morino, Luca Petruzzelli, Alberto Arezzo
BACKGROUND: Evidence from controlled trials and meta-analyses suggests that laparoendoscopic rendezvous (LERV) is preferable to sequential treatment in the management of common bile duct stones. MATERIALS AND METHODS: With this retrospective analysis of a prospective database that included consecutive patients treated for cholecystocholedocholithiasis at our institution between January 2007 and July 2015, we compared LERV with sequential treatment. The primary endpoint was global cost, defined as the cost/patient/hospital stay, and the secondary end points were efficacy and morbidity...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27921055/acute-pancreatitis-caused-by-hemobilia-an-unusual-complication-of-laparoscopic-cholecystectomy
#15
Ameet Kumar, Dharmendra Kumar, Amandeep Singh, C K Jakhmola
Acute pancreatitis (AP) in the early postlaparoscopic cholecystectomy (LC) period is a rare complication. The cause is often a missed common bile duct stone. Having been reported only once before, we present a second case of AP after LC caused by hemobilia secondary to hepatic artery pseudoaneurysm. The management of this complication is distinctly different from the treatment for AP caused by a stone and must be done on an emergency basis.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27904310/laparoscopic-cholecystectomy-in-patients-with-history-of-gastrectomy
#16
Ming-Jie Zhang, Qiang Yan, Guo-Lei Zhang, Si-Yu Zhou, Wen-Bin Yuan, Hua-Ping Shen
BACKGROUND AND OBJECTIVES: Patients with previous gastrectomy have an increased incidence of gallstones and gallbladder morbidity requiring surgery. We investigated the possible risk factors that contribute to severe gallbladder disease in patients with previous gastrectomy and the role of laparoscopic cholecystectomy (LC) in the treatment of these patients. METHODS: In this retrospective study, we reviewed a database of patients who underwent LC in our hospital during the period January 1, 2010, through May 1, 2015...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27893641/routine-surveillance-cholangiography-after-percutaneous-cholecystostomy-delays-drain-removal-and-cholecystectomy
#17
Tyler J Loftus, Scott C Brakenridge, Frederick A Moore, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Alicia M Mohr
INTRODUCTION: Percutaneous cholecystostomy (PC) is often performed for patients with acute cholecystitis who are at high risk for operative morbidity and mortality. However, the necessity for routine cholangiography after PC remains unclear. We hypothesized that routine surveillance cholangiography (RSC) after PC would provide no benefit compared to on-demand cholangiography (ODC) triggered by signs or symptoms of biliary pathology. METHODS: We performed a 3-year retrospective cohort analysis of patients managed with PC for acute cholecystitis at two tertiary care hospitals...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27888858/novel-findings-in-the-management-of-acute-pancreatitis
#18
Federico Bolado, Enrique de-Madaria
Acute pancreatitis (AP) is a potentially serious disease whose incidence is on the increase. Pancreas divisum does not meet the required criteria to be considered an aetiological factor. Sphincter of Oddi dysfunction may be another cause of idiopathic AP. Less invasive methods cannot replace Sphincter of Oddi manometry in diagnosis. Almost half of patients with systemic inflammatory response syndrome develop organ failure, but the mechanisms involved are not completely understood. Obesity is a risk factor for severity in AP; the cause could be the presence of free unsaturated fatty acids, which have pro-inflammatory activity...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27847668/large-bowel-obstruction-a-delayed-complication-of-severe-gallstone-pancreatitis
#19
Neeraj Lal, John Whiting, Rahul Hejmadi, Sudarsanam Raman
Colonic complications are rare after acute pancreatitis but are associated with a high mortality. Possible complications include mechanical obstruction, ischaemic necrosis, haemorrhage, and fistula. We report a case of large bowel obstruction in a 31-year-old postpartum female, secondary to severe gallstone pancreatitis. The patient required emergency laparotomy and segmental bowel resection, as well as cholecystectomy. Presentation of obstruction occurs during the acute episode or can be delayed for several weeks...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27803243/pancreatic-pseudocyst-combined-single-incision-laparoscopic-cystogastrostomy-and-cholecystectomy-in-a-resource-poor-setting
#20
Yardesh Singh, Shamir O Cawich, Leyrone Olivier, Thivy Kuruvilla, Fawwaz Mohammed, Vijay Naraysingh
Laparoscopic cystogastrostomy is a well-accepted minimally invasive modality to treat pancreatic pseudocysts. There has been one prior report of cystogastrostomy via single incision laparoscopic surgery (SILS) in which specialized instrumentation and access platforms were used.We report the challenges encountered in a low resource setting with the SILS approach to drainage using only standard laparoscopic instruments. To the best of our knowledge this is the second report of SILS cystogastrostomy and the first to be performed in a resource poor setting without specialized instruments or platforms...
November 1, 2016: Journal of Surgical Case Reports
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