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Timing of laparoscopic cholecystectomy

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https://www.readbyqxmd.com/read/29235252/closure-of-the-cystic-duct-orifice-in-laparoscopic-subtotal-cholecystectomy-for-severe-cholecystitis
#1
Tatsuki Matsumura, Shunichiro Komatsu, Kenichi Komaya, Keiichi Ando, Takashi Arikawa, Seiji Ishiguro, Takuya Saito, Takaaki Osawa, Shintaro Kurahashi, Tairin Uchino, Kohei Yasui, Shoko Kato, Kenta Suzuki, Yoko Kato, Tsuyoshi Sano
INTRODUCTION: Laparoscopic subtotal cholecystectomy (LSC) has been recognized as an alternative to conversion to laparotomy for severe cholecystitis. However, it may be associated with an increased risk of recurrent stones in the gallbladder remnant. The objective of this study was to evaluate the safety and feasibility of the complete removal of the gallbladder cavity in LSC for severe cholecystitis using the cystic duct orifice suturing (CDOS) technique. METHODS: In a consecutive series of 412 laparoscopic cholecystectomies that were performed from January 2015 to June 2017, 12 patients who underwent LSC with CDOS were enrolled in this retrospective study...
December 13, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29229482/selective-intraoperative-cholangiography-during-laparoscopic-cholecystectomy-in-children-is-justified
#2
Benjamin Martin, Evelyn Geok Peng Ong
AIMS: Intraoperative cholangiograms (IOC) during laparoscopic cholecystectomy have been advocated to detect biliary anomalies and intraductal calculi. However, IOC increases operative time and patient irradiation, and therefore is not universally used. We hypothesise selective IOC may be a valuable tool in children. METHODS: A retrospective case note review was performed of all children who underwent laparoscopic cholecystectomy at a single institution by a single surgeon between January 2011 and March 2017...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29226884/application-of-fluorescent-cholangiography-during-single-incision-laparoscopic-cholecystectomy-for-cholecystitis-with-a-right-sided-round-ligament-preliminary-experience
#3
Motoi Nojiri, Tsuyoshi Igami, Yoshitaka Toyoda, Tomoki Ebata, Yukihiro Yokoyama, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
An 82-year-old woman was diagnosed with cholecystitis with a right-sided round ligament. We planned a single-incision laparoscopic cholecystectomy. Based on the findings of fluorescent cholangiography, the running course of the common bile duct was confirmed before dissection of Calot's triangle, and the confluence between the cystic duct and the common bile duct was exposed after the dissection of Calot's triangle. The planned surgery was successful. The operative time and intraoperative blood loss were 157 min and 2 mL, respectively...
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29225744/a-comparison-between-ketorolac-and-nefopam-as-adjuvant-analgesics-for-postoperative-patient-controlled-analgesia-a-randomized-double-blind-prospective-study
#4
Ji-Seon Son, Aram Doo, Young-Jun Kwon, Young-Jin Han, Seonghoon Ko
Background: We compared the analgesic efficacy and side effects of ketorolac and nefopam that were co-administered with fentanyl via intravenous patient-controlled analgesia. Methods: One hundred and sixty patients scheduled for laparoscopic cholecystectomy were randomly assigned to ketorolac (Group K) or nefopam (Group N) groups. The anesthetic regimen was standardized for all patients. The analgesic solution contained fentanyl 600 µg and ketorolac 180 mg in Group K, and fentanyl 600 µg and nefopam 120 mg in Group N...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29218667/the-novel-trial-natural-orifice-versus-laparoscopic-cholecystectomy-a-prospective-randomized-evaluation
#5
Steven D Schwaitzberg, Kurt Roberts, John R Romanelli, David J Desilets, David Earle, Santiago Horgan, Lee Swanstrom, Eric Hungness, Nathaniel Soper, Michael L Kochman
INTRODUCTION: The evolution of Natural Orifice Translumenal Endoscopic Surgery® (NOTES®) represents a case study in surgical procedural evolution. Beginning in 2004 with preclinical feasibility studies, and followed by the creation of the NOSCAR® collaboration between The Society of American Gastrointestinal and Endoscopic Surgeons and the American Society for Gastrointestinal Endoscopy, procedural development followed a stepwise incremental pathway. The work of this consortium has included white paper analyses, obtaining outside independent funding for basic science and procedural development, and, ultimately, the initiation of a prospective randomized clinical trial comparing NOTES® cholecystectomy as an alternative procedure to laparoscopic cholecystectomy...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29218663/laparoscopic-extended-cholecystectomy-for-t3-gallbladder-cancer
#6
Sungho Kim, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, YoungRok Choi
BACKGROUND: Gallbladder cancer (GBC) has been contraindicated for laparoscopic surgery since this procedure was introduced [1, 2]. Recently, however, there have been several reports of laparoscopic extended cholecystectomy for GBC, but most cases involved early GBC confined to the GB [3, 4]. This video describes our technique of laparoscopic extended cholecystectomy for T3 GBC. METHODS: A 77-year-old female presented with a gallbladder mass, which was incidentally detected during evaluation of back pain...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29218659/single-site-robotic-assisted-laparoscopic-cholecystectomy-in-children-and-adolescents-a-report-of-20-cases
#7
Peter Mattei
BACKGROUND: Single-site laparoscopy is increasingly popular for straightforward operations like appendectomy. Due to limited triangulation and maneuverability, single-site cholecystectomy is riskier and more difficult. Robotics offer to make it easier and safer. METHODS: Twenty children and adolescents underwent robotic-assisted single-site cholecystectomy at a large academic children's hospital. Patients were not randomized; patients were offered the option of robotic-assisted single-site (SSR) or standard four-incision laparoscopic (LAP) cholecystectomy...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29217857/a-comparison-of-haemodynamic-responses-between-clinical-assessment-guided-tracheal-intubation-and-neuromuscular-block-monitoring-guided-tracheal-intubation-a-prospective-randomised-study
#8
Rudranil Nandi, Shekhar Ranjan Basu, Susanta Sarkar, Rakesh Garg
Background and Aims: Haemodynamic responses to laryngoscopy and endotracheal intubation and their hazards are well documented. The purpose of the study was to compare the effects of laryngoscopy and intubation on cardiovascular responses when the appropriate moment for intubation was directed by either clinical judgment or train-of-four assessment. Methods: A total of 68 patients, posted for laparoscopic cholecystectomy, were randomised into two groups. In Group M patients, the trachea was intubated after train of four counts became zero in adductor pollicis muscle, whereas in Group C patients, the trachea was intubated after the clinical judgment of jaw muscle relaxation...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29214888/minimally-invasive-surgical-approach-for-radicalization-of-incidental-post-cholecystectomy-gallbladder-carcinoma-safety-feasibility-and-outcomes
#9
Emanuele Sinagra, Stefano Garritano, Salvatore Marco Iacopinelli, Marco Messina, Dario Raimondo, Francesca Rossi, Massimiliano Spada, Guido Martorana, Marcello Giuseppe Spampinato
BACKGROUND AND AIMS: Gallbladder carcinoma is a rare but aggressive malignant neoplasm. The incidence of intra- or post-operative incidental gallbladder carcinoma diagnosis following laparoscopic cholecystectomy is estimated to be 1-2%. Aggressive re-resection is warranted as the majority of patients have residual disease either in the liver or the lymph nodes. However the use of a minimally invasive surgical approach (MISA) to perform a radicalization in these patients has not been investigated yet...
December 7, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/29209684/videolaparoscopic-cholecystectomy-in-patients-with-previous-abdominal-surgery-personal-experience-and-literature-review
#10
G Geraci, B D'Orazio, S Rizzuto, M Cajozzo, G Modica
OBJECTIVES: Laparoscopic cholecystectomy (LC) is today the "gold standard" treatment of gallbladder stones. Role of LC is still debated in the presence of abdominal scars due to the frequent post-operative adhesions which make access to the peritoneal cavity difficult. This study aim to assess role and outcomes of LC on a previous abdominal surgery on the scarred abdomen. MATERIALS AND METHODS: We have carried out a retrospective study on 499 consecutive patients who had undergone LC from 2009 to 2015; 21 of these (4...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29208884/role-of-oral-clonidine-premedication-on-intra-operative-haemodynamics-and-ponv-in-laparoscopic-cholecystectomy
#11
M Masud, S Yeasmeen, A K Haque, S Jahan, N C Saha, D Banik
Laparoscopic cholecystectomy is a gold standard surgical procedure for gallbladder operation. It causes altered haemodynamic responses due to pneumoperitoneum and surgical procedure also causes high incidence of postoperative nausea &vomiting. Clonidine has been shown to reduce intraoperative haemodynamic instability. This randomized prospective single blind clinical study was designed to evaluate the efficacy of oral clonidine premedication for attenuation of haemodynamic responses associated with pneumoperitoneum & also reduce the incidence of postoperative nausea & vomiting and carried out in the department of Anaesthesia Analgesia and Intensive care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2010 to June 2010...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29205609/effect-of-tamoxifen-on-fibrosis-collagen-content-and-transforming-growth-factor-%C3%AE-1-%C3%AE-2-and-%C3%AE-3-expression-in-common-bile-duct-anastomosis-of-pigs
#12
Orlando Hiroshi Kiono Siqueira, Karen Jesus Oliveira, Angela Cristina Gouvêa Carvalho, Antonio Claudio Lucas da Nóbrega, Renata Frauches Medeiros, Bruno Felix-Patrício, Fábio Otero Áscoli, Beni Olej
End-to-end anastomosis in the treatment for bile duct injury during laparoscopic cholecystectomy has been associated with stricture formation. The aim of this study was to experimentally investigate the effect of oral tamoxifen (tmx) treatment on fibrosis, collagen content and transforming growth factor-β1, -β2 and -β3 expression in common bile duct anastomosis of pigs. Twenty-six pigs were divided into three groups [sham (n = 8), control (n = 9) and tmx (n = 9)]. The common bile ducts were transected and anastomosed in the control and tmx groups...
December 4, 2017: International Journal of Experimental Pathology
https://www.readbyqxmd.com/read/29201178/analgesic-therapy-improves-arterial-endothelial-function-following-non-cardiovascular-surgery-a-randomized-placebo-controlled-trial
#13
Meng-Jun Wu, Meng-Chang Yang, Long-Qing Ran, Su-Mei Wei, Wen-Lai Zhou, Yong-Sheng Gou, Hai Yu
Pain subsequent to non-cardiac surgery may affect the endothelial function, which in turn contributes to myocardial injury (MI). The present study examined whether effective pain control is able to improve the postoperative endothelial function. Patients (n=160) undergoing laparoscopic cholecystectomy were randomly assigned into two groups, treated with tramadol analgesic or saline (placebo) following surgery. On preoperative day 1 (baseline) and postoperatively at 2 h, 1 day and 5 days, pain was assessed on a visual analogue scale (VAS), and B-mode ultrasound was used to measure brachial endothelium-dependent flow-mediated dilation (FMD) and nitroglycerin-induced dilation...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29187474/plasma-glutathione-peroxidase-gpx1-levels-and-oxidative-stress-in-gallstone-patients-operated-with-two-different-cholecystectomy-techniques-a-randomized-study-with-special-reference-to-cancer-patients
#14
Jari Kärkkäinen, Samuli Aspinen, Jukka Harju, Petri Juvonen, Kari Pulkki, Matti Eskelinen
BACKGROUND/AIM: The plasma glutathione peroxidase (GPX1) levels in gallstone patients operated with laparoscopic cholecystectomy (LC) or minicholecystectomy (MC) versus cancer patients is unknown. PATIENTS AND METHODS: Initially, 114 patients with symptomatic gallstone disease were randomized into LC (n=53) or MC (n=61) groups. Plasma levels of C-reactive protein (hs-CRP) and the oxidative stress marker GPX1 were measured at three time points; before (PRE), immediately after (POP1) and 6 hours after operation (POP2)...
December 2017: Anticancer Research
https://www.readbyqxmd.com/read/29183521/utility-of-laparoscopic-subtotal-cholecystectomy-with-or-without-cystic-duct-ligation-for-severe-cholecystitis
#15
Shoji Hirajima, Toshimori Koh, Tomohito Sakai, Taisuke Imamura, Shunji Kato, Yukihisa Nishimura, Koji Soga, Minoru Nishio, Atsushi Oguro, Noboru Nakagawa
We use open cholecystectomy (OC) to treat severe cholecystitis in cases in which we are worried that inflammation might cause anatomical changes in Calot's triangle. Furthermore, in cases of severe cholecystitis in which marked inflammation leads to fibrosis, we perform subtotal cholecystectomy (SC), i.e., incomplete gallbladder resection. Laparoscopic SC (LSC) without cystic duct dissection is considered to be effective at reducing the incidence of serious complications in patients with severe cholecystitis...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29183352/risk-factors-for-difficulty-of-laparoscopic-cholecystectomy-in-grade-ii-acute-cholecystitis-according-to-the-tokyo-guidelines-2013
#16
Koetsu Inoue, Tatsuya Ueno, Daisuke Douchi, Kentaro Shima, Shinji Goto, Michinaga Takahashi, Takanori Morikawa, Takeshi Naitoh, Chikashi Shibata, Hiroo Naito
BACKGROUND: The Tokyo Guidelines 2013 classifies acute cholecystitis (AC) into three grades and recommends appropriate therapy for each grade. For grade II AC, either early laparoscopic cholecystectomy (LC) or percutaneous transhepatic gallbladder drainage (PTGBD) should be performed. This study aimed to identify the risk factors for difficulty of LC for treating grade II AC. METHODS: Totally, 122 patients who underwent LC for grade II AC were enrolled and divided into difficult LC (DLC) and nondifficult LC (NDLC) groups...
November 28, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29180194/perioperative-complications-of-emergent-and-elective-procedures-in-psychiatric-patients
#17
Ayal Hassidim, Sharon Bratman Morag, Moshe Giladi, Yael Dagan, Roie Tzadok, Petachia Reissman, Amir Dagan
BACKGROUND: Patients with psychiatric disorders have an increased risk for morbidity and mortality from other medical conditions. METHODS: Medical records of all the patients undergoing appendectomy (n = 2594) and laparoscopic cholecystectomy (n = 2874) from 2009 to 2014 in one hospital were reviewed. For each patient with a documented psychiatric disorder undergoing surgery, four controls were matched. RESULTS: The final sample of patients undergoing appendectomy included 96 patients, whereas those undergoing laparoscopic cholecystectomy included 260 patients...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29173873/preoperative-factors-associated-with-technical-difficulties-of-laparoscopic-cholecystectomy-in-acute-cholecystitis
#18
Y E Izquierdo, N E Díaz Díaz, N Muñoz, O E Guzmán, I Contreras Bustos, J S Gutiérrez
OBJECTIVE: To identify preoperative factors associated with surgical time and conversion of the laparoscopic cholecystectomy (LC) to open surgery in subjects with acute cholecystitis (AC). METHOD: We developed a cross-sectional study that included 99 subjects older than 17 years with definitive diagnosis of AC who had undergone to LC. Preoperative variables such as clinical data, laboratory markers and ultrasound findings as wall thickness, the size of the major calculus and the presence of: perivesicular fluid, multiple cholelithiasis, biliary mud or microlithiasis were registered...
November 21, 2017: Radiología
https://www.readbyqxmd.com/read/29166696/-fluorescence-cholangiography-in-comparison-to-radiographic-cholangiography-during-laparoscopic-cholecystectomy
#19
Viktoria Pax, Sylke Schneider-Koriath, Martin Scholz, Reiko Wießner, Kaja Ludwig
Background The reported incidence rate of bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is 0.3%. However, routine use of intraoperative cholangiography (IOC) is a controversial, due to the additional cost and radiation exposure. The aim of this study was to assess the application of fluorescence cholangiography (FC) in comparison to IOC and to LC without any intraoperative imaging. Materials and Methods This prospective study included 230 patients undergoing LC in our institution. The subjects were divided into two groups...
November 22, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29143094/the-application-of-a-performance-based-self-administered-intra-procedural-checklist-on-surgical-trainees-during-laparoscopic-cholecystectomy
#20
Michael El Boghdady, Afshin Alijani
INTRODUCTION: Surgical checklists are in use to reduce errors for safer surgery. We aimed to study the effect of a previously designed performance-based self-administered intra-procedural checklist on the performance of trainees during elective laparoscopic cholecystectomy. METHODS: Twenty-four laparoscopic cholecystectomies were enrolled into the study. Six surgical trainees each performed four procedures, two without the checklist and directly followed by two procedures with the checklist...
November 15, 2017: World Journal of Surgery
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