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Ben Schwab, Deborah M Rooney, Eric S Hungness, Katherine A Barsness
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) decreases overall costs and length of stay in patients with choledocolithiasis. However, utilization of LCBDE remains low. We sought to evaluate a previously developed general surgery LCBDE simulator among a cohort of pediatric surgical trainees. The study purpose was to evaluate the content validity of an LCBDE simulator to support or refute its use in pediatric surgery education. MATERIALS AND METHODS: After IRB exempt determination, 30 participants performed a transcystic LCBDE using a previously developed simulator and evaluated the simulator using a self-reported 28-item instrument...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mousalreza Hosseini, Payman Shalchiantabrizi, Khadijeh Yektaroudy, Maliheh Dadgarmoghaddam, Masoumeh Salari
BACKGROUND: Acute Post ERCP Pancreatitis (PEP) is the most common major complication of Endoscopic retrograde cholangiopancreatography (ERCP). The aim of the current study was to assess the utility of single dose rectal indomethacin with and without  intravenous perfusion of normal saline to prevent acute pancreatitis. METHODS: In this randomized clinical trial, 406 patients with choledocolithiasis underwent ERCP. Based on computer-generated  numbers, the patients were allocated into 4 groups, each group receiving a different intervention prior to the ERCP procedure...
August 2016: Archives of Iranian Medicine
Kemal Beksac, Nihan Turhan, Ergun Karaagaoglu, Osman Abbasoglu
INTRODUCTION: Although laparoscopic cholecystectomy is currently the standard treatment for benign gallbladder pathologies, some cases still require conversion to open cholecystectomy. Since open cholecystectomy has a significantly higher morbidity rate and a lengthier stay in the hospital compared with laparoscopic surgery, predicting this conversion would grant a great advantage in the management of cholecystitis. Therefore, in this study, we aimed to develop a predictive statistical model...
September 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Chadli Dziri, Imen Samaali, Samia Ben Osman, A Fingerhut, Riadh Bédoui, Youssef Chaker, Ibtissem Bouasker, Ramzi Nouira
BACKGROUND: The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis. METHODS: Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009...
August 2015: La Tunisie Médicale
Ali Riza Koksal, Salih Boga, Huseyin Alkim, Mehmet Bayram, Meltem Ergun, Canan Alkim
BACKGROUND AND AIMS: The relationship between insulin resistance and post-ERCP pancreatitis (PEP) is not known. We aimed to determine the relation between pre-ERCP insulin resistance and risk of PEP, and to evaluate the relationship of insulin resistance with well-established risk factors for PEP. METHODS: Consecutive patients who underwent ERCP with the diagnosis of choledocolithiasis between January and December 2013 were enrolled in this prospective study. Pre-procedural insulin resistance state and other risk factors were evaluated according to PEP development...
August 2016: Digestive Diseases and Sciences
Chadli Dziri, Imen Samaali, Samia Ben Osman, A Fingerhut, Riadh Bédoui, Youssef Chaker, Ibtissem Bouasker, Ramzi Nouira
BACKGROUND: The ideal way to show treatment effectiveness is through randomized controlled trials the 'gold standard' in evidence-based surgery. Indeed, not all surgical studies can be designed as randomized trials, sometimes for ethical and otherwise, for practical reasons. This article aimed to compare laparoscopic cholecystectomy to open cholecystectomy, according to data from an administrative database, managed by a propensity matched analysis. METHODS: Were included all patients with cholelithiasis admitted in Department B between June 1st, 2008 and December 31st, 2009...
August 2015: La Tunisie Médicale
R N Bălănescu, L Bălănescu, G Drăgan, A Moga, R Caragaţă
Although biliary lithiasis has been considered a less common pathology in the pediatric population than in adults, in recent years, it has increasingly been diagnosed in children, with a prevalence of between 0.13 to 0.22. The elective treatment of symptomatic biliary lithiasis is cholecystectomy, the laparoscopic approach being considered the œgold standard. We present 3 cases referred to our clinic with biliary lithiasis, in which we performed laparoscopic cholecystectomy. We performed intraoperative cholangiography with a 4 Fr transcystic catheter...
November 2015: Chirurgia
Hassan Taheri, Naser Ghemian, Yaser Taghavi, Javad Shokry-Shirani
BACKGROUND: Cholangiocarcinoma is an invasive biliary malignancy with poor prognosis. Diagnostic accuracy of conventional methods is low which is mainly due to the specific anatomy of the disease. The aim of this study was to evaluate the diagnostic value of biochemical profile and tumor marker of the bile in patients with malignant cholestasis compared to that of choledocholithiasis. METHODS: In this cross-sectional study, 46 patients with extrahepatic cholestasis were enrolled (20 patients with malignant cholestasis and 26 patients with choledocolithiasis) A definitive diagnosis of cholangiocarcinoma was made by imaging, cytology and biopsy...
2015: Caspian Journal of Internal Medicine
Joana Tozatti, André Luiz Parizi Mello, Orli Frazon
BACKGROUND: The choledocolithiasis has an incidence of 8-20% in patients with cholecystolithiasis. The preoperative diagnosis guides the interventional treatment on the bile duct AIM: To evaluate the sensitivity and specificity of the laboratory markers and imaging studies for choledocholithiasis preoperatively. METHODS: The study comprised 254 patients divided into two groups: the control group (207 patients), patients without choledocholithiasis intraoperatively and cases group (47 patients), that enrolled the patients with choledocholithiasis intra-operatively...
April 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Martín Guidi, Hui Jer Hwang, Cecilia Curvale, Gonzalo Souto, Julio De María, Fernando Ragone, Esteban Promenzio, Raúl Matano
INTRODUCTION: The American Society of Gastroenterology (ASGE) and the American College of Gastroenterolog (ACG) have established indicators to recognize high-quality studies in endoscopic retrograde cholagiopancreatography (ERCP). The indicators were: a) Pre-procedure: adequate indication, informed consent, assessment of the degree of difficulty of the procedure and antibiotic prophylaxis. b) Intraprocedure: cannulation, choledocholithiasis extraction and stents placement rates. c) Postprocedure: full documentation and complications rates...
March 2015: Acta Gastroenterologica Latinoamericana
Joana Magalhães, Bruno Rosa, José Cotter
AIM: To study the practical applicability of the American Society for Gastrointestinal Endoscopy guidelines in suspected cases of choledocholithiasis. METHODS: This was a retrospective single center study, covering a 4-year period, from January 2010 to December 2013. All patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis were included. Based on the presence or absence of predictors of choledocholithiasis (clinical ascending cholangitis, common bile duct (CBD) stones on ultrasonography (US), total bilirubin > 4 mg/dL, dilated CBD on US, total bilirubin 1...
February 16, 2015: World Journal of Gastrointestinal Endoscopy
Monoarul Haque, Farah Kamal, Shahanaz Chowdhury, Monir Uzzaman, Itrat Aziz
OBJECTIVE: To identify the non-obstetric causes and presentation of acute abdomen among pregnant women. MATERIALS AND METHODS: This was a cross sectional hospital-based study among 128 pregnant women by face to face interview using a semi-structured questionnaire. This study was conducted at the Gynecology & Obstetric Ward of 250 Bed General Hospital, Noakhali, Bangladesh, from January to August 2013. Data were analyzed by a software package used for statistical analysis (SPSS) version 11...
September 2014: Journal of Family & Reproductive Health
Valeriu Şurlin, Adrian Săftoiu, Daniela Dumitrescu
Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis (ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct (CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography (US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension...
November 28, 2014: World Journal of Gastroenterology: WJG
Manash Ranjan Sahoo, Anil T Kumar, Aashish Patnaik
INTRODUCTION: The 'Rendezvous' technique consists of laparoscopic cholecystectomy (LC) standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. MATERIALS AND METHODS: From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis...
July 2014: Journal of Minimal Access Surgery
M Zippi, I De Felici, R Pica, G Occhigrossi, G Traversa
BACKGROUND: Choledocholithiasis is increasing in elderly subjects. The introduction of endoscopic retrograde cholangiopancreatography with biliary sphincterotomy has almost replaced surgery in the treatment of this condition. The aim of the present study was to evaluate the rates of successful clearance of common bile duct stones and the endoscopic techniques used in a population aged 75 years or older compared with those in a younger age group. MATERIALS AND METHODS: A retrospective analysis was made of data related patients who underwent endoscopic retrograde cholangiopancreatography for choledocolithiasis in the period 2010-2011...
2013: La Clinica Terapeutica
Alex Augusto Silva, Carlos Augusto Canteras Raposo Camara, Aiodair Martins, Celso Júnior Oliveira Teles, Júverson Alves Terra, Eduardo Crema
PURPOSE: To investigate clinical, laboratory and ultrasonographic parameters in patients with and without preoperative criteria for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy in order to define predictive factors of choledocolithiasis. METHODS: As a criterion for inclusion in the study the patients should present chronic calculous cholecystitis in the presence or absence of any recent clinical, laboratory of ultrasonographic finding suggesting choledocolithiasis, who were therefore submitted to cholangiography during surgery...
October 2013: Acta Cirúrgica Brasileira
Oussama Baraket, Makrem Moussa, Atef Ben Taher, Mohamed Chaari, Brahim Kort, Samy Bouchoucha
BACKGROUND: laparoscopic exploration is one of the modalities of treatment of choledocolithiasis. Modalities of biliary decompression after laparoscopic common bile duct exploration are controversial. AIM: to assess the benefits, the efficacity and harms of trancystic biliary drainage following laparoscopic common bile duct stone exploration methods: we report retrospectively twenty patients which were operated in our department by laparoscopy and have done a transcystic biliary drainage...
May 2013: La Tunisie Médicale
Luis Lazo Molina, Renato Garrido Acedo, Bertha Cárdenas Ramírez, Juan Torreblanca Nava
We report two cases of biliary fascioliasis in patients from the highlands of Peru; with several months of symptoms characterized for biliary-type pain, dark urine and jaundice in one case. Both of them referred to the department of Gastroenterology of the Hospital Nacional Guillermo Almenara Irigoyen for suspicious of choledocolithiasis. Laboratory tests were performed which showed variable high levels of functional liver tests (cholestasis) and marked eosinophilia in one case. Magnetic resonance cholangiography (CRMN) was performed and then informed as an apparent image of biliary stone in choledocus in both cases...
January 2013: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Dario D'Antonio, Boris Franzato, Grazia Fusco, Mariangela Ruperto, Aldo Dal Pozzo
Laparoscopic approach for cholecystectomy is, actually, the gold standard for gallbladder surgical benign diseases. Single transumbilical incision can further reduce abdominal wall trauma. Two main related issues are still to be enlighten: difficulty in obtaining a clear exposure of the Calot's triangle and routinely use of intra-operative cholangiography (IOC). A standardized technique of double incision laparoscopic cholecystectomy (DILC) with routine IOC is described. Between January and May 2012, 30 consecutive patients scheduled for elective cholecystectomy underwent DILC with IOC...
June 2013: Updates in Surgery
Ana Cristina A Tannuri, Antonio José Gonçalves Leal, Manoel Carlos Prieto Velhote, Manoel Ernesto Peçanha Gonlçalves, Uenis Tannuri
BACKGROUND/PURPOSE: Gallstones and cholelithiasis are being increasingly diagnosed in children owing to the widespread use of ultrasonography. The treatment of choice is cholecystectomy, and routine intraoperative cholangiography is recommended to explore the common bile duct. The objectives of this study were to describe our experience with the management of gallstone disease in childhood over the last 18 years and to propose an algorithm to guide the approach to cholelithiasis in children based on clinical and ultrasonographic findings...
November 2012: Journal of Pediatric Surgery
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