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acute cholecystitis

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https://www.readbyqxmd.com/read/28647046/assessment-of-emergency-general-surgery-care-based-on-formally-developed-quality-indicators
#1
Angela Ingraham, Avery Nathens, Andrew Peitzman, Allison Bode, Gina Dorlac, Warren Dorlac, Preston Miller, Mahsa Sadeghi, Deena D Wasserman, Karl Bilimoria
BACKGROUND: Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. METHODS: We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators...
June 21, 2017: Surgery
https://www.readbyqxmd.com/read/28643057/single-incision-laparoscopic-common-bile-duct-exploration-in-101-consecutive-patients-choledochotomy-transcystic-and-transfistulous-approaches
#2
Shu-Hung Chuang, Min-Chang Hung, Shih-Wei Huang, Dev-Aur Chou, Hurng-Sheng Wu
BACKGROUND: Laparoscopic surgery for choledocholithiasis is still evolving. Only a few reports of single-incision laparoscopic common bile duct exploration (LCBDE) have been published. METHODS: One hundred and one consecutive patients underwent single-incision LCBDE (SILCBDE) by one surgeon with straight instruments during a 42-month period. RESULTS: Choledochotomies were performed on 61 patients (60.4%). The success rate of intrahepatic duct exploration was 68...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28641193/acute-hemobilia-from-a-pseudoaneurysm-of-the-cystic-artery-arising-from-the-left-hepatic-artery-case-report-and-literature-review
#3
Claudia Trombatore, Roberto Scilletta, Noemi Bellavia, Pietro Trombatore, Vincenzo Magnano S Lio, Giuseppe Petrillo, Antonio Di Cataldo
INTRODUCTION: Hemobilia represents only 6% of all causes of upper gastrointestinal bleeding. PRESENTATION OF CASE: We report a rare case of a bleeding pseudoaneurysm of the cystic artery, due to a re-activation of a chronic cholecystitis, which arose with a mixed symptomatology: jaundices and hematemesis. DISCUSSION: The rarity of our patient is increased for some vascular anatomic variations detected by Computed Tomography that influenced the management of the disease...
June 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28638573/acute-intermittent-porphyria-a-test-of-clinical-acumen
#4
Rashmi Dhital, Sijan Basnet, Dilli Ram Poudel, Khema Raj Bhusal
Acute intermittent porphyria (AIP) is a rare autosomal dominant hepatic porphyria due to deficiency of hydroxymethylbilane synthase (HMBS), also known as porphobilinogen deaminase leading to accumulation of porphyrin precursors. However, gene defect alone is usually not sufficient to cause an acute attack, and many extrinsic factors play a role. Diagnostic tests are defined, but clinical suspicion is often delayed as symptoms mimic other common conditions. We report a case of a 18-year-old male with severe, persistent, and generalized abdominal pain along with marked hyponatremia, with subsequent development of altered mentation needing intensive care...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28637565/is-percutaneous-cholecystostomy-a-good-alternative-treatment-for-acute-cholecystitis-in-high-risk-patients
#5
Davide Papis, Eiman Khalifa, Ricky Bhogal, Amit Nair, Saboor Khan, Zaed Hamady, Jawad Ahmed, Gabriele Marangoni
Cholecystectomy is the treatment of choice for acute cholecystitis but the management of high-risk surgical patients is a difficult dilemma. Percutaneous cholecystostomy (PC) could represent a safer and less invasive option. The aim of the study was to assess the outcomes of PC in high-risk patients. This is a retrospective single-center study; data were collected from our hospital electronic record system. From February 2009 to March 2014, there were 753 patients admitted with acute cholecystitis. Of these 39 were considered high risk for surgery and underwent PC during their hospital stay...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28622085/c-reactive-protein-as-a-predictor-of-difficult-laparoscopic-cholecystectomy-in-patients-with-acute-calculous-cholecystitis-a-multivariate-analysis
#6
Aarón Díaz-Flores, Eduardo Cárdenas-Lailson, Adolfo Cuendis-Velázquez, Andrés Rodríguez-Parra, Mario E Trejo-Ávila
BACKGROUND: Laparoscopic cholecystectomy (LC) is the treatment of choice for mild and moderate acute cholecystitis. The aim of this study was to analyze the utility of C-reactive protein (CRP) as a predictor of difficult laparoscopic cholecystectomy (DLC) in patients with acute cholecystitis. MATERIALS AND METHODS: We conducted a prospective study. All patients included were treated with emergency LC. Patients were analyzed as DLC and nondifficult laparoscopic cholecystectomy (NDLC)...
June 16, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28621510/laparoscopic-cholecystectomy-for-acute-cholecystitis-an-analysis-of-early-versus-delayed-cholecystectomy-and-predictive-factors-for-conversion
#7
Joel C Goh, Jarrod K Tan, Janice W Lim, Iyer G Shridhar, Krishnakumar Madhavan, Alfred W Kow
BACKGROUND: There is an increasing preference for early laparoscopic cholecystectomy (ELC) as compared to delayed LC (DLC) in the management of acute cholecystitis (AC). Conversion to open cholecystectomy (LOC) remains an important outcome. We aim to compare ELC and DLC outcomes and identify LOC predictors. METHODS: Retrospective analysis of 466 patients who underwent LC for AC from June 2010 - June 2015 was performed. Patients were divided into ELC and DLC groups, defined as LC performed within 7 days and between 4 to 24 weeks of symptom onset respectively...
June 16, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28614170/implications-of-left-sided-gallbladder-in-the-emergency-setting-retrospective-review-and-top-tips-for-safe-laparoscopic-cholecystectomy
#8
Hariscine K Abongwa, Belinda De Simone, Laura Alberici, Maurizio Iaria, Gennaro Perrone, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Salomone Di Saverio, Massimo Sartelli, Federico Coccolini, Jennifer E Manegold, Luca Ansaloni, Fausto Catena
BACKGROUND: Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly. Clinical features and routine presurgical imaging could miss the anomalous position, thereby producing complications during surgery. Laparoscopic cholecystectomy can be performed safely, but the risk of bile duct injury (BDI) is greater than in cholecystectomy of the orthotopic gallbladder. We present a retrospective review of all scientific literature for diagnosed cases of LSG-woSVI undergoing cholecystectomy from 1996 to 2014...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28609109/accuracy-and-radiation-dose-reduction-of-limited-range-ct-in-the-evaluation-of-acute-appendicitis-in-pediatric-patients
#9
Michael Jin, Thomas R Sanchez, Ramit Lamba, Ghaneh Fananapazir, Michael T Corwin
OBJECTIVE: The purpose of this article is to determine the accuracy and radiation dose reduction of limited-range CT prescribed from the top of L2 to the top of the pubic symphysis in children with suspected acute appendicitis. MATERIALS AND METHODS: We performed a retrospective study of 210 consecutive pediatric patients from December 11, 2012, through December 11, 2014, who underwent abdominopelvic CT for suspected acute appendicitis. Two radiologists independently reviewed the theoretic limited scans from the superior L2 vertebral body to the top of the pubic symphysis, to assess for visualization of the appendix, acute appendicitis, alternative diagnoses, and incidental findings...
June 13, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28605108/perforation-of-the-gallbladder-in-a-patient-with-acute-cytomegalovirus-cholecystitis-shortly-following-renal-transplantation
#10
Yuki Imaoka, Masahiro Ohira, Kohei Ishiyama, Kentaro Ide, Tsuyoshi Kobayashi, Hiroyuki Tahara, Hideki Ohdan
A 74-year-old man with end-stage renal failure secondary to diabetes received a living donor renal transplant (cytomegalovirus [CMV]-seropositive recipient from a CMV-seropositive donor). Computed tomography scan revealed a gallbladder with hemorrhage. On postoperative day 27, cholecystography revealed gallbladder perforation; he underwent an emergency operation. Histological examination of the gallbladder wall was positive for multiple viral inclusion bodies. We report a very rare case of both hemorrhagic and perforated CMV cholecystitis within a month following renal transplantation...
June 12, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28604381/miniinvasive-surgical-interventions-in-management-of-cholelithiasis-a-retrospective-study
#11
Mamuka R Gurgenidze, Merab A Kiladze, Zurab A Beriashvili, Teimuraz U Tabucadze, Giorgi A Datuashvili
The aim of the present study is to analyze outcomes after laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) for gallstone disease and determine the algorithm of treatment for different groups of patients according to the age, severity of disease and comorbid conditions. This is a multicenter retrospective review of 2997 patients who underwent LC or MC between January 1, 2002 and December 31, 2008. The patients were categorized into LC (1479) and MC (1518) groups. When preoperative examination data were not reliable, we performed abdominal wall lifting with the retractors to visualise abdominal cavity with laparoscope during minilaparotomy...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28603823/early-versus-delayed-laparoscopic-cholecystectomy-for-lithiasic-acute-cholecystitis-during-emergency-admissions-results-of-a-monocentric-experience-and-review-of-the-literature
#12
Mohamed Salah Jarrar, Ibrahim Chouchène, Houssem Fadhl, Rafik Ghrissi, Amine Elghali, Fehmi Ferhi, Hedi Mraidha, Fehmi Hamila, Rached Letaief
BACKGROUND: It is established that the standard treatment for lithiasic acute cholecystitis is the laparoscopic cholecystectomie. However, the question of the timing of cholecystectomy remains controversial. AIM: To compare early laparoscopic cholecystectomies (within 72 hours of symptom onset) and delayed laparoscopic cholecystectomies (beyond 72 hours) for lithiasic acute cholecystitis in terms of intra-operative difficulties and post-operative complications. METHODS: The patients operated on for acute cholecystitis, between January 2007 and December 2012, were included in a retrospective study...
August 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28603584/acute-calculous-cholecystitis-review-of-current-best-practices
#13
REVIEW
Carlos Augusto Gomes, Cleber Soares Junior, Salomone Di Saveiro, Massimo Sartelli, Michael Denis Kelly, Camila Couto Gomes, Felipe Couto Gomes, Lívia Dornellas Corrêa, Camila Brandão Alves, Samuel de Fádel Guimarães
Acute calculous cholecystitis (ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical bedside decision-making strategies, aiming at a less demanding procedure and lower frequency of complications. In this regard, recommendations on the diagnosis supported by specific criteria and severity scores are being implemented, to prioritize patients eligible for urgency surgery...
May 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28599581/changing-management-of-gallstone-related-disease-in-pregnancy-a-retrospective-cohort-analysis
#14
Jonas Hedström, Johan Nilsson, Roland Andersson, Bodil Andersson
OBJECTIVES: Gallstone-related disease is the second most common non-obstetric cause, following appendicitis, for acute abdomen in pregnancy. This study aimed to investigate treatment strategies, changes over time and outcome. MATERIALS AND METHODS: All consecutive patients with symptomatic gallstone-related disease during pregnancy admitted to Skane University hospital in Lund and Malmö 2001-2015 were analysed retrospectively. Information regarding the patient, pregnancy and fetus/child was recorded...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597281/gangrenous-cholecystitis-innovative-laparoscopic-techniques-to-facilitate-subtotal-fenestrating-cholecystectomy-when-a-critical-view-of-safety-cannot-be-achieved
#15
Rebekah Kirkwood, Lauren Damon, Jennifer Wang, Esther Hong, Kimberly Kirkwood
BACKGROUND: Gangrenous cholecystitis is associated with a higher conversion rate of conversion from laparoscopic to open than acute non-gangrenous cholecystitis. New strategies and techniques are needed to decrease conversion rates and improve outcomes. METHODS: In this article, we provide a richly detailed, illustrated description of a modified fundus-first technique that we have developed over the last 15 years and now use routinely with rare conversions. We also compared outcomes of laparoscopic (LC) and open (OC) approaches for pathologically confirmed gangrenous cholecystitis in 146 patients during 1995-2005, the first 10 years during which these two approaches were performed contemporaneously at our institution on comparable patients...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28593410/xanthogranulomatous-cholecystitis-is-an-initial-laparoscopic-approach-feasible
#16
Jae Woo Park, Kee-Hwan Kim, Say-June Kim, Sang Kuon Lee
BACKGROUND: Xanthogranulomatous cholecystitis is an inflammatory disease with pathologically distinct characteristics such as accumulation of lipid-laden macrophages, fibrous tissue, and acute and chronic inflammatory cells. It often involves adjacent organs and mimics gallbladder cancer. The purpose of this study was to review the clinical findings of xanthogranulomatous cholecystitis and to determine the appropriate treatment plan. METHODS: We retrospectively analyzed clinical demographics, operation records, and postoperative results of 31 patients with a pathological diagnosis of xanthogranulomatous cholecystitis who underwent surgery between January 2010 and 2015 at two university hospitals...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28589185/damage-control-laparoscopic-partial-cholecystectomy-with-an-endoscopic-linear-stapler
#17
Beyza Özçınar, Ecem Memişoğlu, Ali Fuat Kaan Gök, Orhan Ağcaoğlu, Fatih Yanar, Mehmet İlhan, Hakan Teoman Yanar, Kayıhan Günay
OBJECTIVE: Several damage-control procedures have been described in the literature in case of severe Calot's triangle inflammation and fibrosis. In this report, we describe patients who underwent laparoscopic partial cholecystectomy using an endoscopic linear stapler. MATERIALS AND METHODS: Five patients with acute cholecystitis underwent laparoscopic partial cholecystectomy in our clinic between January - December 2011. All patients had severe fibrosis and inflammation of Calot's triangle...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28586152/right-upper-quadrant-pain-ultrasound-first
#18
Margarita V Revzin, Leslie M Scoutt, Joseph G Garner, Christopher L Moore
Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis...
June 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28576245/acalculous-cholecystitis-in-burn-patients-is-there-a-role-for-percutaneous-cholecystostomy
#19
REVIEW
Steven J Hermiz, Paul Diegidio, Roja Garimella, Shiara Ortiz-Pujols, Hyeon Yu, Ari Isaacson, Matthew A Mauro, Bruce A Cairns, Charles Scott Hultman
Although acute acalculous cholecystitis is uncommon in burn patients, this condition can be rapidly fatal due to delays in diagnosis and treatment and should always be considered in the differential diagnosis when burn patients become septic, develop abdominal pain, or have hemodynamic instability. This article reviews the use of percutaneous cholecystostomy in burn patients as both a diagnostic and therapeutic intervention.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28575571/-age-related-peculiarities-of-acute-cholecystitis
#20
M B Polyanskiy, D P Nazarenko, T A Ishunina
In the present study the analysis of dynamics of basic laboratory parameters of patients with acute cholecystitis (AC) in the four age groups subdivided according to the WHO classification into young, middle age, elderly and senile was carried out. The most pronounced changes were found in the senile age group in which the AC was accompanied by the decreased number of erythrocytes, low hemoglobin and total protein, leukocytosis, lower percentage of lymphocytes and the highest levels of ALT, AST, bilirubin and urea...
2017: Advances in Gerontology, Uspekhi Gerontologii
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