Cholecytectomy

BACKGROUND: Normal saline gained wide popularity in abdominal surgery as a basic compound used in intraoperative drainage of the peritoneal cavity. However, recent studies have revealed that saline solution is not quite biocompatible with the intraperitoneal enviroment and may promote peritoneal adhesions. OBJECTIVES: The aim of the study was to evaluate the function and viability of human mesothelial cells cultured in vitro in 0.9% NaCl solution from intraperitoneal lavage carried out during laparoscopic cholecytectomies...

While complicated acute cholecystitis (ACH) course the focus of infection constitutes one of the main causes of the endogenic intoxication (EI) occurrence, what leads to ischemic and hypoxic myocardial damage. There were presented the treatment results analysis in 213 patients, ageing 60 years old and older, managed for an ACH, complicated by peritonitis, paravesical abscess, with concurrent cardiac insufficiency of ischemic genesis, to whom laparoscopic cholecytectomy (LCHE) was conducted. Microflora of the abdominal cavity exudates in the patients, suffering an ACH of various severity, was studied...

Annular pancreas is a rare congenital abnormality. This entity can rarely be symptomatic. Patients can present with gastrointestinal obstruction or acute pancreatitis. We report a case with a rich iconography, of an annular pancreas discovered intraoperatively. A 46-year-old woman was operated with the diagnosis of acute cholecystitis with common bile duct stones. At operation, a strip of pancreatic tissue (2 cm) completely encircled the second duodenum. Open cholecytectomy with choledocotomy and stones extractionwas done...

Incidentally discovered gallbladder cancer (IGBC) is defined as the gallbladder cancer (GBC) diagnosed during or after the cholecystectomy done for unsuspected benign gallbladder disease. Laparoscopic cholecystectomy (LC) is the most common procedure performed for benign gallbladder disease worldwide. Majority of GBC patients have associated gallstones. With the advent of ultrasonography more patients are being diagnosed with gallstones and are being subjected to cholecytectomy. IGBC is found in 0.2-2.9 % of all cholecytectomies done for gallstone disease...

OBJECTIVES: To determine whether the routine use of intraoperative cholangiography can improve survival from complications related to bile duct injuries. DESIGN: Population based cohort study. SETTING: Prospectively collected data from the Swedish national registry of gallstone surgery and endoscopic retrograde cholangiopancreatography, GallRiks. Multivariate analysis done by Cox regression. POPULATION: All cholecystectomies recorded in GallRiks between 1 May 2005 and 31 December 2010...

INTRODUCTION: Laparoendoscopic single-site (LESS) surgery has emerged as a viable and widely applicable minimally invasive technique. Presented here are the steps necessary to perform LESS cholecystectomy using a readily available gelport device. METHODS: To perform LESS cholecystectomy we make a 2 cm incision through the umbilicus until the fascia is identified. The fascia is opened 2 cm and a wound protector is inserted. Through the gelport we insert a 5 mm trocar with a balloon tip for the insufflation and three 5 mm trocars as working ports...

BACKGROUND AND OBJECTIVES: The aim of the study is to assess the characteristics, TNM stage and survival rate of incidental gallbladder carcinoma in patients who underwent open cholecystectomy in regional clinical centre. PATIENTS AND METHODS: We retrospectively analyzed all consecutive cholecystectomies during four years period in surgery department and determined incidence, pathological stage and survival rate of incidental gallbladder cancer. Demographics data, surgical management, adjuvant therapy, death or last follow-up...

BACKGROUND AND AIMS: The purpose of the present study was to determine the clinical characteristics of subjects with gallbladder polyps and cholelithiasis compared with those with gallbladder polyps only. METHODS: Between August 1999 and December 2005, 176 subjects with gallbladder polyps and cholelithiasis (study group) by transabdominal ultrasonography performed during a medical check-up at our institution were recruited and compared with a control group of 185 subjects who had gallbladder polyps only...

BACKGROUND: There is scarcity of knowledge about the development of gallbladder cancer. AIM: To study the features of development and progression of gallbladder cancer. MATERIAL AND METHODS: Review of histopathological studies of gallbladder obtained in 25,971 cholecytectomies performed in patients aged 45+/- 16 years, 79% females, between 1993 and 2004. Among these, 210 had a dysplasia not associated to cancer and 1,039 had a gallbladder cancer Clinical and morphological parameters of preneoplastic and neoplastic lesions were analyzed...

Morphological study of 345 cholecytectomies revealed gall bladder cholesterosis in 173 cases. Network form of cholesterosis was most frequent (73.8%), polyposis-network was in 18.5% and only 8.7% polypoid form of cholesterosis was found. The frequency was similar in males and females, the polypoid form prevailed in males, reticular form in females. Main site of cholesterosis was the gall bladder body. Combination of cholesterosis with cholelithiasis was in 151 cases (87.3%), adenomyomatosis occurred in 33 patients (19%)...

OBJECTIVE: To investigate the risk factors of gallstone disease in female population in Taicang. METHODS: A case - control study conducted on 144 cases and 371 controls aged 35 - 79 years in five villages. Diagnosis of gallstone disease was assessed by real - time ultrasonography. The case was considered as presence of gallstones at echograph and previous cholecytectomy. The controls were selected from a random sample of female participates. RESULTS: Through univariate and multivariate analysis, gallstone disease was significantly associated with age (OR = 1...

Traditionally, cholecystectomy in cirrhotic patients has been reserved for patients with severe biliary disease, because of the high morbidity and mortality in cirrhotic patients undergoing this procedure. Laparoscopic cholecytectomy (LC) was originally contraindicated in cirrhotic patients because of the associated portal hypertension and coagulopathy. This study examined the safety of LC in Child's class A patients.A review was conducted of all patients with cirrhosis who underwent cholecystectomy at our hospital between 1990 and 1998...

A statewide report card system for cholecystectomy as a surgical tracer has been established in Westfalia-Lippe as part of a program of external quality assurance. 74,400 data between 1993 and 1997 were analyzed. Pathologic findings in preoperative diagnostics (sonography, elevated bilirubin) do not lead to therapeutic splitting in a sufficient number of cases. Removal of bile duct stones should happen at the latest during cholecytectomy. Preoperative gastroscopy is performed in just about 40%. Higher rates of morbidity and lethality in the aged favour an early elective operation of symptomatic stones...

To study the clinical value of minor incision for cholecystectomy, compared conventional open cholecystectomy (300 patients, group A), alparoscopic cholecytectomy (300 patients, group B), and minor-incision cholecystectomy (300 patients, group C) with regard to duration (day) of operation, amount of intraoperative bleeding, complications, time (day) of gastrointestinal function recovery, intravenous infusion, and expense and time (day) of hospitalization. The results showed that the operating time, amount of bleeding, duration of intravenous infusion, time of gastrointestinal function recovery and hospitalization in group A were significantly different from those in group B and C (P < 0...

Plasma scalpel SUPR-M was used in operative treatment of calculous cholecystitis. Two variants of cholecystectomy with plasma scalpel have been worked out in experiment. It was determined, that the influence of plasma spurt is innocuous for hepatic tissues, it helps to achieve complete demucosation of the mucous membrane of the gall bladder in atypical variants of cholecystectomy, prevents bleeding and bile leakage from the bladder bead in typical cholecytectomy. In clinics the operation procedures were carried out in 176 patients, in 20 of them cholecystectomy was performed atypically, leaving gall bladder wall, adjacent to hepatic surface, in place...

Our purpose was to prospectively compare MRI findings with histopathologic findings in the evaluation of suspected acute cholecystitis. Fourteen patients with clinically suspected acute cholecystitis were entered into the study. MR sequences included T1-weighted fat-suppression and breath-hold spoiled gradient echo (SGE) before and after intravenous gadolinium chelate administration. Percent contrast enhancement (%CE) of the gallbladder wall and gallbladder wall thickness (WT) were measured and liver enhancement patterns determined prospectively on MR images...

Removal of the gallbladder with commencement of dissection at the fundus is well recognized as a safe technique during difficult "open" cholecystectomy because it minimizes the risks of damage to the structures in or around Calot's triangle. We report here the routine employment of liver retractors and fundus-first dissection during laparoscopic cholecystectomy (LC) as an alternative to techniques previously described. Retraction of the liver and "fundus-first" dissection was used in 53 patients who underwent laparoscopic cholecytectomy...

We report a patient in whom haemobilia occurred after percutaneous liver biopsy. Selective hepatic arteriography showed a fistula between hepatic artery and portal venous system, with appearance of contrast in the biliary tract. Intrahepatic bleeding was stopped by arterial embolisation with a mixture of gelatine foam and sterile dura mater. Cholecytectomy was subsequently required as a haemocholecyst developed. The technique of arteriography and embolisation allows accurate localisation of intrahepatic bleeding sites and may avoid the need for a direct surgical approach to this problem...

The part played by surgery in the treatment of gallbladder cancer is conditioned by the delay in diagnosis and the rapid spread of the disease to non operable structures rather than to any particularly intrinsic malignity. In the face of a clinically ascertained cancer or one recognized at surgical exploration, exeresis is essential if possible. Cholecytectomy completed by cuneiform hepatic resection and extensive locoregional lymphadenectomy offers adequate radicality with acceptable risk. Vaster operations have high operative mortality which is out of proportion to the results possible, 43 personal cases are reported...