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Timing of laparoscopic cholecystectomy

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https://www.readbyqxmd.com/read/29435758/laptrain-multi-modality-training-curriculum-for-laparoscopic-cholecystectomy-results-of-a-randomized-controlled-trial
#1
K F Kowalewski, C R Garrow, T Proctor, A A Preukschas, M Friedrich, P C Müller, H G Kenngott, L Fischer, B P Müller-Stich, F Nickel
BACKGROUND: Multiple training modalities for laparoscopy have different advantages, but little research has been conducted on the benefit of a training program that includes multiple different training methods compared to one method only. This study aimed to evaluate benefits of a combined multi-modality training program for surgical residents. METHODS: Laparoscopic cholecystectomy (LC) was performed on a porcine liver as the pre-test. Randomization was stratified for experience to the multi-modality Training group (12 h of training on Virtual Reality (VR) and box trainer) or Control group (no training)...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29432055/minimally-invasive-pediatric-cholecystectomy-a-comparison-of-robotic-and-laparoscopic-single-and-multiport-techniques
#2
Heather Nolan, Joshua Glenn
BACKGROUND: Pediatric laparoscopic cholecystectomy is the current standard of care for gallbladder pathology. Single-incision and multiport procedures, as well as robotic and minimally invasive platforms, have been described; however, there is no head-to-head assessment of these interventions in the existing literature. The purpose of our study was to directly compare the minimally invasive cholecystectomy techniques of laparoscopic multiport (LMP), laparoscopic single incision (LSI), robotic multiport (RMP), and robotic single incision (RSI)...
February 12, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29428693/do-acute-care-surgeons-need-bariatric-surgical-training-to-ensure-optimal-outcomes-in-obese-patients-with-nonbariatric-emergencies
#3
Andrea Pakula, Ruby Skinner
INTRODUCTION: Acute care surgeons care for the entire breadth of the American adult population, including obese patients. As the population gets heavier, more patients will present to acute case surgeons with nonbariatric surgical emergencies. Do these surgeons need bariatric training to properly care for obese population? OBJECTIVES: To evaluate our experience in obese population requiring acute surgery and compare outcomes based on surgeon expertise in bariatric surgery...
December 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29428040/evaluation-of-the-safety-and-efficacy-of-percutaneous-transhepatic-gallbladder-drainage-combined-with-laparoscopic-cholecystectomy-for-treating-acute-complicated-cholecystitis
#4
Baoxing Jia, Kai Liu, Ludong Tan, Zhe Jin, Yu Fu, Yahui Liu
The rate of acute cholecystitis in patients with severe underlying diseases is currently increasing. Several studies have reported percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) as a safe and reliable therapeutic option in such patients. This study aimed to elucidate the optimal time interval between PTGBD and LC. In total, 65 patients with acute complicated cholecystitis from our hospital were divided into two groups, short-term LC (sLC) and postponed LC (pLC) group according to whether the procedure was performed within 5 days of gallbladder drainage or after 5 days, respectively...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29428014/comparison-of-risk-adjusted-outcomes-in-medicare-open-versus-laparoscopic-cholecystectomy
#5
Donald E Fry, Michael Pine, Susan M Nedza, Agnes M Reband, Chun-Jung Huang, Gregory Pine
More than 90 per cent of cholecystectomies are performed laparoscopically and this has resulted in concern that surgeons will not have sufficient experience to perform open procedures when clinical circumstances require it. We reviewed the open cholecystectomies (OCs) of Medicare patients from 2010 to 2012 in hospitals with 20 or more cases, created risk-adjusted models for adverse outcomes which were evaluated for 90-days after discharge, and compared the hospital-level outcomes with laparoscopic cholecystectomy performed in the same hospitals for the same period of time...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29417182/simultaneous-common-bile-duct-clearance-and-laparoscopic-cholecystectomy-experience-of%C3%A2-a-one-stage-approach
#6
Shahin Mohseni, John Ivarsson, Rebecka Ahl, Sinan Dogan, Sten Saar, Arvo Reinsoo, Teesi Sepp, Karl-Gunnar Isand, Edvard Garder, Ilmar Kaur, Heiti Ruus, Peep Talving
INTRODUCTION: The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons. METHODS: Retrospective analysis of all consecutive patients subjected to LC + IO-ERCP during their index admission between 4/2014 and 9/2016...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29412236/assessment-of-a-new-kind-of-surgical-simulator-the-physical-surgical-simulator
#7
José Arnaldo Shiomi da Cruz, André Filipe Miranda, Lucas Evangelista da Costa, Rafael Ulysses de Azevedo, Sabrina Thalita Dos Reis, Miguel Srougi, Carlo Camargo Passerotti
PURPOSE: To evaluate whether the use of the physical surgical simulator may benefit the development of laparoscopic skills. METHODS: Ten medical students were divided into two groups: the first one performed ten weekly training sessions with a physical surgical simulator - ETX A2 LAP and, afterwards, one laparoscopic cholecystectomy in a porcine model, while the second group performed only a laparoscopic cholecystectomy. Both groups were compared regarding bleeding, total surgical time, time to perform each surgical step and qualitative parameters, based on a previously validated tool...
January 2018: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29396277/simulation-based-testing-of-pager-interruptions-during-laparoscopic-cholecystectomy
#8
Joseph A Sujka, Karen Safcsak, Indermeet S Bhullar, William S Havron
OBJECTIVE: To determine if pager interruptions affect operative time, safety, or complications and management of pager issues during a simulated laparoscopic cholecystectomy. DESIGN: Twelve surgery resident volunteers were tested on a Simbionix Lap Mentor II simulator. Each resident performed 6 randomized simulated laparoscopic cholecystectomies; 3 with pager interruptions (INT) and 3 without pager interruptions (NO-INT). The pager interruptions were sent in the form of standardized patient vignettes and timed to distract the resident during dissection of the critical view of safety and clipping of the cystic duct...
January 30, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29393818/comparison-of-intraperitoneal-nebulization-of-ropivacaine-with-ropivacaine-fentanyl-combination-for-pain-control-following-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#9
Nidhi Bhatia, Swati Mehta, Vikas Saini, Babita Ghai, Lileshwar Kaman
PURPOSE: Intraperitoneal local anesthetic nebulization is a new and novel technique for providing pain relief following laparoscopic cholecystectomy. We compared the analgesic efficacy of intraperitoneal ropivacaine-fentanyl nebulization with ropivacaine nebulization alone for providing pain relief following laparoscopic cholecystectomy Materials and Methods: This prospective, randomized, double-blind, placebo-controlled trial included 75 American Society of Anesthesiologists I/II patients, 18-60 years old, scheduled to undergo laparoscopic cholecystectomy under general anesthesia...
February 2, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29393173/comparison-of-single-incision-laparoscopic-cholecystectomy-versus-needlescopic-cholecystectomy-a-single-institutional-randomized-clinical-trial
#10
Akira Umemura, Takayuki Suto, Seika Nakamura, Hisataka Fujiwara, Fumitaka Endo, Hiroyuki Nitta, Takeshi Takahara, Akira Sasaki
BACKGROUND: Both single-incision laparoscopic cholecystectomy (SILC) and needlescopic cholecystectomy (NSC) are superior to conventional laparoscopic cholecystectomy in terms of cosmetic outcome and incisional pain. We conducted a prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures. METHODS: In this trial, 105 patients were enrolled (52 in the SILC group; 53 in the NSC group)...
January 24, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29391101/comparative-analysis-of-laparoscopic-and-open-approaches-in-emergency-abdominal-surgery
#11
Anaar Siletz, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29373141/-the-influence-of-the-menstrual-cycle-on-acute-and-persistent-pain-after-laparoscopic-cholecystectomy
#12
Sinem Sari, Betul Kozanhan, Ayse Ilksen Egilmez, Aykut Soyder, Osman Nuri Aydin, Fabrizio Galimberti, Daniel Sessler, Alparslan Turan
BACKGROUND AND OBJECTIVES: Fluctuations of female sex hormones during menstrual cycle influence pain perception. Endogenous pain inhibition is impaired in follicular phase of menstrual cycle. We tested the primary hypothesis that the women having surgery during their follicular phase have more acute pain and require higher opioids than those in the luteal phase, and secondarily we tested that women who have surgery during their follicular phase have more incisional pain at 3 month postoperatively...
January 16, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29372265/percutaneous-cholecystostomy-for-severe-tokyo-2013-stage-iii-acute-cholecystitis
#13
F Polistina, C Mazzucco, D Coco, M Frego
PURPOSES: To evaluate the impact of percutaneous cholecystostomy (PC) on severe acute cholecystitis (AC). METHODS: According to the ICD-9 classification, we retrospectively retrieved medical records of patients discharged with a diagnosis of AC from January 2007 to December 2016 at our hospital. Patients were then stratified according to the Tokyo 2013 (TG 13) AC severity criteria. Grade III AC was diagnosed according to the TG 13 criteria. Indications for PC were failure of optimal medical treatment within 48 h, worsening of clinical condition within early medical treatment, patients unfit for upfront surgery and patient's preference...
January 25, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29368279/the-clinical-utility-of-pre-operative-neutrophil-to-lymphocyte-ratio-as-a-predictor-of-outcomes-in-patients-undergoing-elective-laparoscopic-cholecystectomy
#14
Brian M Moloney, Ronan M Waldron, Niamh O' Halloran, Michael E Kelly, Eddie Myers, Joseph T Garvin, Michael J Kerin, Chris G Collins
BACKGROUND: In recent years, there has been an increasing trend towards day-case surgery for patients undergoing laparoscopic cholecystectomy (LC). We investigated the predictive value that pre-operative neutrophil-to-lymphocyte ratio (PNLR) had on surgical outcomes. METHODS: A review of all patients who underwent LC during a 6-year period in a single institution was performed and PNLR recorded. A PNLR cutoff value of 3 was utilised. We compared operation time, length of stay (LOS), and conversion to open between those with PNLR less and greater than 3...
January 24, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29365029/association-of-the-affordable-care-act-medicaid-expansion-with-access-to-and-quality-of-care-for-surgical-conditions
#15
Andrew P Loehrer, David C Chang, John W Scott, Matthew M Hutter, Virendra I Patel, Jeffrey E Lee, Benjamin D Sommers
Importance: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and decreased likelihood of receiving optimal surgical care. The Patient Protection and Affordable Care Act's (ACA) Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions remains unknown. Objective: To evaluate the association of the ACA's Medicaid expansion with access to timely and recommended care for common and serious surgical conditions...
January 24, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29362652/single-center-experience-in-laparoscopic-treatment-of-gallbladder-perforation
#16
Nuri Alper Sahbaz, Kivanc Derya Peker, Hamit Ahmet Kabuli, Alpen Yahya Gumusoglu, Halil Alis
Introduction: Gallbladder perforation (GBP) is a rare disease with potential mortality. Previous series have reported an incidence of approximately 2-11% and it still continues to be a significant problem for surgeons. Aim: To present our clinical experience with gallbladder perforation. Material and methods: The records of 2754 patients who received surgical treatment for cholelithiasis between 2010 and 2016 were reviewed retrospectively...
December 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29353903/evaluation-of-endotracheal-tube-cuff-pressure-in-laparoscopic-cholecystectomy-and-postoperative-sore-throat
#17
Gajal Lakhe, Surendra Mohan Sharma
BACKGROUND: The use of nitrous oxide and carboperitoneum in laparoscopic cholecystectomy lead to increase in endotracheal tube cuff pressure. It may impair tracheal mucosal perfusion with subsequent tracheal damage. The purpose of this study was to evaluate cuff pressure and incidence of post-operative sore throat in patients undergoing laparoscopic cholecystectomy. METHODS: In this prospective observational study, 128 patients aged 18-65 years of American Society of Anesthesiologist physical status I and II undergoing laparoscopic cholecystectomy were enrolled and allocated alternately into two groups, Study Group (Maintenance of anesthesia with sevoflurane 1-2%, oxygen/nitrous oxide mixture; 40/60), Control Group (Maintenance of anesthesia with sevoflurane 1-2%, oxygen/air mixture; 40/60) were analysed and comapared...
January 1, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29350371/fundus-first-technique-and-partial-cholecystectomy-for-difficult-laparoscopic-cholecystectomies
#18
İsmail Cem Sormaz, Yiğit Soytaş, Ali Fuat Kaan Gök, İlker Özgür, Levent Avtan
BACKGROUND: This study aims to evaluate the impact of conversion from retrograde dissection to fundus-first technique (FF) or laparoscopic partial cholecystectomy (LPC) on complication rates, operation time, and duration of hospitalization. METHODS: The medical records of 210 consecutive patients who underwent laparoscopic cholecystectomy between January 2010 and December 2014 were retrospectively evaluated. All laparoscopic cholecystectomies were initiated with retrograde dissection (RD)...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29350363/is-nighttime-laparoscopic-general-surgery-under-general-anesthesia-safe
#19
Ahmet Kemalettin Koltka, Mehmet İlhan, Achmet Ali, Ali Fuat Kaan Gök, Nükhet Sivrikoz, Teoman Hakan Yanar, Mustafa Kayıhan Günay, Cemalettin Ertekin
BACKGROUND: Fatigue and sleep deprivation can affect rational decision-making and motor skills, which can decrease medical performance and quality of patient care. The aim of the present study was to investigate the association between times of the day when laparoscopic general surgery under general anesthesia was performed and their adverse outcomes. METHODS: All laparoscopic cholecystectomies and appendectomies performed at the emergency surgery department of a tertiary university hospital from 01...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29340809/randomized-controlled-study-of-intraincisional-infiltration-versus-intraperitoneal-instillation-of-standardized-dose-of-ropivacaine-0-2-in-post-laparoscopic-cholecystectomy-pain-do-we-really-need-high-doses-of-local-anesthetics-time-to-rethink
#20
Singh Mathuria Kaushal-Deep, Afzal Anees, Shehtaj Khan, Mohammad Amanullah Khan, Mehershree Lodhi
BACKGROUND: Earlier studies done to compare the efficacy of use of local anesthetics at intraperitoneal location versus intraincisional use had utilized equal amount of drugs at the two locations, usually 10-20 ml. Using this large amount of drug in the small space of intraincisional location as compared to similar amount of drug in large intraperitoneal space created an inadvertent bias in favor of patients receiving the drug intraincisionally so these patients naturally experienced less pain...
January 16, 2018: Surgical Endoscopy
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