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Laparoscopic cholecystectomy prophylaxis

Fabian Grass, Matthieu Cachemaille, Catherine Blanc, Nicolas Fournier, Nermin Halkic, Nicolas Demartines, Martin Hübner
BACKGROUND: Immediate laparoscopic cholecystectomy is the accepted standard for the treatment of acute cholecystitis. The aim of the present study was to evaluate the feasibility of a standardized approach with tailored care maps for pre- and postoperative care by comparing pain, nausea and patient satisfaction after elective and emergent laparoscopic cholecystectomy. METHODS: From January 2014 until April 2015, data on pain and nausea management were prospectively recorded for all elective and emergency procedures in the department of visceral surgery...
December 1, 2016: BMC Surgery
Kamal Awad, Hussien Ahmed, Abdelrahman Ibrahim Abushouk, Safwat Al Nahrawi, Mohammed Yasser Elsherbeny, Salma Muhammad Mustafa, Attia Attia
OBJECTIVE: A systematic review and meta-analysis of published randomized controlled trials was performed to update the present evidence about the safety and efficacy of dexamethasone combined with other antiemetics versus single antiemetics for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. METHODS: A computer literature search of PubMed, Scopus, Web of Science and Embase was conducted to identify the relevant randomized controlled trials...
October 25, 2016: International Journal of Surgery
Márcio Alexandre Terra Passos, Pedro Eder Portari-Filho
Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis. Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
D S Vasyhlchenko, V I Desyateryk, S O Sheyko, T I Zverevych
Results of examination and surgical tratment of 56 patients, suffering chronic calculous cholecystitis with concomitant schemic heart disease, were analyzed. In all the patients a laparoscopic cholecystectomy was performed. Monitoring of cardiovascular compli- cations was estimated with the help of a Helter recording of EGG intraoperatively and in the early postoperative period. Depending on a kind of preoperative preparation done, the patients were divided on two groups: those, to whom cardioprotection using a Vasopro preparation was conducted, and those without cardioprotection...
March 2016: Klinichna Khirurhiia
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Brazilian Journal of Anesthesiology
Maria Rita Araújo, Céline Marques, Sara Freitas, Rita Santa-Bárbara, Joana Alves, Célia Xavier
BACKGROUND: Marfan's Syndrome (MFS) is a disorder of connective tissue, mainly involving the cardiovascular, musculoskeletal, and ocular systems. The most severe problems include aortic root dilatation and dissection. Anesthetic management is vital for the improvement on perioperative morbidity. CASE REPORT: 61-year-old male with MFS, presenting mainly with pectus carinatum, scoliosis, ectopia lens, previous spontaneous pneumothorax and aortal aneurysm and dissection submitted to thoracoabdominal aortic prosthesis placement...
July 2016: Revista Brasileira de Anestesiologia
Jan Ulrych, Tomas Kvasnicka, Vladimir Fryba, Martin Komarc, Ivana Malikova, Filip Burget, Radka Brzezkova, Jan Kvasnicka, Zdenek Krska, Jan Kvasnicka
BACKGROUND: Surgery for benign disease is associated with a low-risk of developing venous thromboembolism (VTE). Despite a relatively low incidence of postoperative VTE in patients after elective cholecystectomy and abdominal hernia repair there are data proving hypercoagulability in the early postoperative period. We focused on assessment of the systemic inflammatory response and coagulation status in these surgical patients after hospital discharge. METHODS: Prospectively, patients who underwent surgery for benign disease were included...
2016: BMC Surgery
Bo Liang, Min Dai, Zhenhong Zou
BACKGROUND AND AIM: Owing to persistent controversy regarding the use of routine antibiotic prophylaxis in patients undergoing elective laparoscopic cholecystectomy and the availability of several new randomized controlled trials (RCTs), we conducted an up-to-date meta-analysis to provide the best current evidence. The aim of the article is to evaluate the safety and efficacy of routine antibiotic prophylaxis in low-risk patients undergoing elective laparoscopic cholecystectomy. METHODS: We conducted a comprehensive literature review of the PubMed, Embase, and Cochrane Library databases for RCTs that compared antibiotic prophylaxis versus placebo or no antibiotics in low-risk patients undergoing elective laparoscopic cholecystectomy...
May 2016: Journal of Gastroenterology and Hepatology
Mirko Muroni, Valeria Loi, François Lionnet, Robert Girot, Sidney Houry
INTRODUCTION: Prophylactic laparoscopic cholecystectomy remains controversial and has been discussed for selected subgroups of patients with asymptomatic cholelithiasis who are at high risk of developing complications such as chronic haemolytic conditions. Cholelithiasis is a frequent condition for patients with sickle cell disease (SCD). Complications from cholelithiasis may dramatically increase morbidity for these patients. Our objective was to evaluate the effectiveness of prophylactic cholecystectomy in SCD patients with asymptomatic gallbladder stones...
October 2015: International Journal of Surgery
Wasana Ko-Iam, Trichak Sandhu, Sahataya Paiboonworachat, Paisal Pongchairerks, Sunhawit Junrungsee, Anon Chotirosniramit, Narain Chotirosniramit, Kamtone Chandacham, Tidarat Jirapongcharoenlap
BACKGROUND: Postoperative nausea and vomiting (PONV) are significant problems in laparoscopic surgery. OBJECTIVE: Compare the prophylactic use of metoclopramide and its combination with dexamethasone in the prevention of PONV in patients undergoing laparoscopic cholecystectomy (LC). MATERIAL AND METHOD: One hundred patients aged 18 to 75 with American Society of Anesthesiologists (ASA) class 1-2 who candidates for elective LC at Chiang Mai University Hospital, were included in this double-blind, randomized controlled trial (parallel design)...
March 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Erasmo Spaziani, Marcello Picchio, Annalisa Di Filippo, Ettore Greco, Alessandra Cerioli, Maurizio Maragoni, Giuliano Faccì, Pierino Lucarelli, Giusppe Marino, Franco Stagnitti, Piero Narilli
AIM: We performed a prospective study to evaluate the effect of antibiotic prophylaxis (AP) on the incidence of infection in elective laparoscopic cholecystectomy (LC). MATERIAL OF STUDY: All patients were at low-medium anesthetic and infectious risk and underwent LC for benign disease. At induction of anesthesia 41 patients received ampicillin-sulbactam 3g, 40 patients received ciprofloxacin 400mg intravenously, and 53 patients received no AP. RESULTS: Postoperative infection was observed in 11 patients (8...
May 2015: Annali Italiani di Chirurgia
Yoichi Matsui, Sohei Satoi, Masaki Kaibori, Hideyoshi Toyokawa, Hiroaki Yanagimoto, Kosuke Matsui, Morihiko Ishizaki, A-Hon Kwon
BACKGROUND: Recent meta-analyses concluded that antibiotic prophylaxis is not warranted in low-risk laparoscopic cholecystectomy. However, most trials in the meta-analyses had a relatively small sample size and were statistically underpowered. In addition, many of the trials mentioned potential cost savings owing to the elimination of prophylactic antibiotics. However, no trial has statistically estimated the cost effectiveness. To evaluate the results of meta-analyses, we conducted a randomized controlled trial on the role of prophylactic antibiotics in low-risk laparoscopic cholecystectomy with an adequate sample size...
2014: PloS One
Muhammad Ali Naqvi, Adnan Mehraj, Raja Ejaz, Amer Mian
BACKGROUND: Elective cholecystectomy for symptomatic gall stone disease carries low risk of postoperative infective complications. Yet the routine use of prophylactic antibiotic is in vogue in many centres. The aim of this study was to find out the efficacy of antibiotic prophylaxis in preventing postoperative infective complications in low risk elective laparoscopic cholecystectomy patients. METHOD: Randomised controlled trial was carried out in our hospital from 1st Nov 2009 to 15th Oct 2011...
January 2013: Journal of Ayub Medical College, Abbottabad: JAMC
Sakchai Ruangsin, Supparerk Laohawiriyakamol, Somkiat Sunpaweravong, Somrit Mahattanobon
BACKGROUND: A prophylactic antibiotic is recommended in open cholecystectomy surgeries, but in laparoscopic cholecystectomies such prophylaxis is controversial. Recent reviews have not found conclusive evidence that routine prophylaxis, especially in low risk patients, is effective. This clinical trial was undertaken to evaluate the efficacy of cefazolin in reducing surgical site infection SSI in laparoscopic cholecystectomies in a sample not screened for high or low risk patients. METHODS: A randomized double-blind controlled trial was conducted in a single university hospital...
April 2015: Surgical Endoscopy
H E Graham, A Vasireddy, D Nehra
INTRODUCTION: Laparoscopic surgeons in Great Britain and Ireland were surveyed to assess their use of antibiotic prophylaxis in elective laparoscopic cholecystectomy. This followed a Cochrane review that found no evidence to support the use of antibiotic prophylaxis in routine cases. METHODS: Data were collected on routine use of antibiotics in elective laparoscopic cholecystectomy, and how that was influenced by factors such as bile spillage, patient co-morbidities and surgeons' experience...
July 2014: Annals of the Royal College of Surgeons of England
Xiao-Ying Si, Lu-Peng Wu, Xiu-Dong Li, Bin Li, Yan-Ming Zhou
BACKGROUND/OBJECTIVE: Postoperative nausea and vomiting (PONV) is one of the most common and distressing adverse events after laparoscopic cholecystectomy (LC). A meta-analysis of randomized clinical trials (RCTs) was performed to determine the efficacy and safety of dexamethasone combined with other antiemetic in the prevention of PONV in patients undergoing LC. METHODS: A systematic literature search was conducted to identify all relevant RCTs. The primary outcome was PONV in the early period (0-3 hours, 0-4 hours, or 0-6 hours), late period (>6 hours), and the overall period (0-24 hours)...
January 2015: Asian Journal of Surgery
Abdolreza Pazouki, Abbas Abdollahi, Mostafa Mehrabi Bahar, Ali Jangjoo, Masoud Pezeshki Rad, Mohsen Aliakbarian, Mehdi Jabbari Nooghabi
BACKGROUND AND AIM: Recently, an increasing number of reports in the literature have shown various complications of lost gallstones. This study aimed to evaluate patients with lost stones in the peritoneal cavity for any related complications for at least 12 months after the operation. MATERIALS AND METHODS: In a 3-year prospective study, of 900 patients with laparoscopic cholecystectomy, 50 patients with lost stones in the peritoneal cavity were enrolled as the case group...
June 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Azize Bestas, Selami Ates Onal, Mustafa Kemal Bayar, Asli Yildirim, Erhan Aygen
BACKGROUND: Postoperative nausea and vomiting (PONV) are common and potentially distressing adverse events (AEs) associated with surgery and anesthesia. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence of PONV can be as high as 72%. OBJECTIVE: The aim of this study was to investigate the prophylactic antiemetic effects of ondansetron and granisetron in patients undergoing LC when these agents are administered before the end of surgery...
September 2007: Current Therapeutic Research, Clinical and Experimental
Seth A Waits, Bradley N Reames, Robert W Krell, Benjamin Bryner, Terry Shih, Andrea T Obi, Peter K Henke, Rebecca M Minter, Michael J Englesbe, Sandra L Wong
OBJECTIVES: To meet the Accreditation Council for Graduate Medical Education core competency in Practice-Based Learning and Improvement, educational curricula need to address training in quality improvement (QI). We sought to establish a program to train residents in the principles of QI and to provide practical experiences in developing and implementing improvement projects. DESIGN: We present a novel approach for engaging students, residents, and faculty in QI efforts-Team Action Projects in Surgery (TAPS)...
March 2014: Journal of Surgical Education
M E Nechitaĭlo, L M Bulik, B F Iakovlev
The results of application of the antibacterial chinolone preparation maxicine in hepatobiliary surgery and gynecology in 28 patients were analyzed. In 6 patients the preparation was applied after reconstructive operations on biliary tructs (high hepaticojejunostomy for cicatricial stricture of biliary ducts), in 22--after laparoscopic operations (cholecystectomy, choledocholithotomy, excision of suppurated ovarian cysts). The spectrum of causative agents was presented. There was proved a high efficacy of the preparation for prophylaxis and treatment of the diseases and postoperative complications after interventions on the hepatobiliary zone organs and the ovarian cystic affection...
October 2013: Klinichna Khirurhiia
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