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Timing of laparoscopic cholecystectomy

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https://www.readbyqxmd.com/read/28635403/psychomotor-skills-assessment-by-motion-analysis-in-minimally-invasive-surgery-on-an-animal-organ
#1
Erlend Fagertun Hofstad, Cecilie Våpenstad, Lars Eirik Bø, Thomas Langø, Esther Kuhry, Ronald Mårvik
BACKGROUND: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. MATERIAL AND METHODS: Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model...
February 8, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28629763/delayed-referral-to-specialist-centre-increases-morbidity-in-patients-with-bile-duct-injury-bdi-after-laparoscopic-cholecystectomy-lc
#2
S Martinez-Lopez, V Upasani, S Pandanaboyana, M Attia, G Toogood, P Lodge, E Hidalgo
BACKGROUND: There is still a debate regarding the optimal management of bile duct injury following cholecystectomy. Our aim was to ascertain if delayed referral influenced clinical outcomes for patients with BDI treated in our institution. MATERIALS AND METHODS: We interrogated a prospectively maintained database, including all patients with BDI (Bismuth and Strasberg classifications) post LC managed in our unit from 2000-2014. Referrals were arbitrarily defined as early (<96 hours from the injury) and delayed (>96 hours)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28625451/is-perioperative-administration-of-5-dextrose-effective-in-reducing-the-incidence-of-ponv-in-laparoscopic-cholecystectomy-a-randomized-control-trial
#3
Ankita Mishra, Ravinder Kumar Pandey, Ankur Sharma, Vanlalnghaka Darlong, Jyotsna Punj, Devalina Goswami, Renu Sinha, Vimi Rewari, Chandralekha Chandralekha, Virinder Kumar Bansal
STUDY OBJECTIVE: To compare the incidence of postoperative nausea and vomiting (PONV) during perioperative administration of 5% dextrose and normal saline in laparoscopic cholecystectomy. DESIGN: Prospective, randomized, double-blind trial. SETTING: Operating rooms in a tertiary care hospital of Northern India. PATIENTS: One hundred patients with American Society of Anesthesiologists status I to II undergoing laparoscopic cholecystectomy were enrolled in this study...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623596/impact-of-residency-training-level-on-the-surgical-quality-following-general-surgery-procedures
#4
Dominik Loiero, Maja Slankamenac, Pierre-Alain Clavien, Ksenija Slankamenac
OBJECTIVE: To investigate the safety of surgical performance by residents of different training level performing common general surgical procedures. METHODS: Data were consecutively collected from all patients undergoing general surgical procedures such as laparoscopic cholecystectomy, laparoscopic appendectomy, inguinal, femoral and umbilical hernia repair from 2005 to 2011 at the Department of Surgery of the University Hospital of Zurich, Switzerland. The operating surgeons were grouped into junior residents, senior residents and consultants...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28621510/laparoscopic-cholecystectomy-for-acute-cholecystitis-an-analysis-of-early-versus-delayed-cholecystectomy-and-predictive-factors-for-conversion
#5
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/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#6
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
June 15, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28619262/the-parkland-grading-scale-for-cholecystitis
#7
Tarik D Madni, David E Leshikar, Christian T Minshall, Paul A Nakonezny, Canon C Cornelius, Jonathan B Imran, Audra T Clark, Brian H Williams, Alexander L Eastman, Joseph P Minei, Herb A Phelan, Michael W Cripps
BACKGROUND: Gallbladders (GBs) with severe inflammation have longer operative times and an increased risk for complications. We propose a grading system using intraoperative images to better stratify GB inflammation. METHODS: After reviewing the intraoperative images of GBs obtained during several hundred laparoscopic cholecystectomies, we developed a five-tiered grading system based on anatomy and inflammatory changes. Fifty intraoperative photographs were taken prior to dissection and then distributed to 11 surgeons who rated each GB's severity per the grading system...
June 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28617680/pulse-photoplethysmographic-amplitude-and-heart-rate-variability-during-laparoscopic-cholecystectomy-a-prospective-observational-study
#8
Riccardo Colombo, Ferdinando Raimondi, Alberto Corona, Andrea Marchi, Beatrice Borghi, Simone Pellegrin, Paola Bergomi, Tommaso Fossali, Stefano Guzzetti, Alberto Porta
BACKGROUND: Surgical stress affects the autonomic nervous system by increasing sympathetic outflow. One method of monitoring sympathetic activity is pulse photoplethysmographic analysis. From this two indices can be derived - autonomic nervous system state (ANSS) and ANSS index (ANSSi). It has recently been claimed that these indices can be used to measure sympathetic activity in anaesthetised patients, but their validity has not yet been demonstrated. OBJECTIVE: To measure changes in pulse photoplethysmographic indices and determine any agreement with autonomic nervous system modulation of the cardiovascular system in healthy study participants during surgery under general anaesthesia...
June 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28614174/minimally-invasive-cholecystolithotomy-to-treat-cholecystolithiasis-in-children-a-single-center-experience-with-23-cases
#9
Xiaokun Lin, Jingli Cai, Jisheng Wang, Congde Chen, Guorong He, Yijiang Han
OBJECTIVE: Minimally invasive cholecystolithotomy is recently popularized treatment that may offer advantages over laparoscopic cholecystectomy, especially in China. However, there are few reports concerning the use of this technique in the pediatric population. This report describes our initial experience with minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy to treat cholecystolithiasis in children. MATERIALS AND METHODS: A retrospective review of 23 pediatric patients with cholecystolithiasis who underwent minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy from January 2009 to December 2015 was performed...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28607283/natural-orifice-transluminal-endoscopic-surgery-hybrid-cholecystectomy-the-dhillon-technique
#10
Kanwarjit Singh Dhillon, Divya Awasthi, Arshbir Singh Dhillon
INTRODUCTION: This study presents a novel technique to perform cholecystectomy and assess its outcome and feasibility. PATIENTS AND METHODS: This study presents the novel Dhillon technique and experience of hybrid natural orifice transluminal endoscopic surgery (NOTES) technique, that is, laparoscopic-assisted transvaginal cholecystectomy. We have evaluated the outcomes in terms of cosmesis, post-operative recovery and analgesic requirement. The study included 257 patients who underwent hybrid NOTES cholecystectomy at single tertiary hospital...
July 2017: Journal of Minimal Access Surgery
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/28601335/-take-home-box-trainers-are-an-effective-alternative-to-virtual-reality-simulators
#13
Marina Yiasemidou, Jonathan de Siqueira, James Tomlinson, Daniel Glassman, Simon Stock, Michael Gough
BACKGROUND: Practice on virtual reality simulators (VRSs) has been shown to improve surgical performance. However, VRSs are expensive and usually housed in surgical skills centers that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers (BT) are inexpensive and can be used anywhere at anytime. This study assesses "take-home" BTs as an alternative to VRS. METHODS: After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT), 25 surgical trainees were randomized to two groups...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601325/adoption-of-robotics-in-a-general-surgery-residency-program-at-what-cost
#14
J Hunter Mehaffey, Alex D Michaels, Matthew G Mullen, Kenan W Yount, Max O Meneveau, Philip W Smith, Charles M Friel, Bruce D Schirmer
BACKGROUND: Robotic technology is increasingly being utilized by general surgeons. However, the impact of introducing robotics to surgical residency has not been examined. This study aims to assess the financial costs and training impact of introducing robotics at an academic general surgery residency program. METHODS: All patients who underwent laparoscopic or robotic cholecystectomy, ventral hernia repair (VHR), and inguinal hernia repair (IHR) at our institution from 2011-2015 were identified...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601317/iatrogenic-injuries-of-the-extrahepatic-biliary-system
#15
Ghodratollah Maddah, Mohammad Taghi Rajabi Mashhadi, Mehdi Parvizi Mashhadi, Mehdi Jabbari Nooghabi, Masoumeh Hassanpour, Abbas Abdollahi
BACKGROUND: Iatrogenic traumatic extrahepatic biliary tract injuries though rarely occur; they can lead to exceedingly morbid complications. The aim of this study was to evaluate the management strategies and outcomes of patients presented with iatrogenic bile duct injuries. METHODS: This is a retrospective study. Over 19 y, 124 patients were managed for iatrogenic biliary injuries at our institution. The data related to the etiology of biliary tract injury, symptoms of injury, laboratory and radiologic studies, injury-to-diagnosis time, type of biliary tract injury, injury management, hospitalization time, and postoperative complications were reviewed...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28598447/single-stage-management-of-concomitant-cholelithiasis-and-choledocholithiasis
#16
M R Joshi, S Rupakheti, T P Bohara, D R Singh
INTRODUCTION: Concomitant cholelithiasis and choledocholithiasis are commonly managed in two stage procedure, endoscopic management of common bile duct stone followed by laparoscopic cholecystectomy in different time and setting. We perform these two procedures in same sitting in operating room set up. We evaluated the procedure in terms of outcome, feasibility and complications. METHODS: Prospective cross-sectional study carried out since April 2013 to August 2016 in all patients who had undergone single stage endoscopic and laparoscopic management of concomitant cholelithiasis and choledocholithiasis...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28594628/three-dimensional-versus-two-dimensional-laparoscopic-cholecystectomy-a-systematic-review
#17
Iman Komaei, Giuseppe Navarra, Giuseppe Currò
BACKGROUND AND AIMS: In the last decades, the three-dimensional (3D) imaging systems have been introduced in an attempt to improve depth perception and image quality during laparoscopic cholecystectomy interventions. The goal of our systematic review was to provide enough convincing evidences on superiority and benefits of 3D over two-dimensional (2D) imaging systems, from both surgeon's and patient's point of view, justifying the cost-effectiveness of newly developed 3D systems. METHODS: Two authors separately performed a full literature search aiming to find randomized controlled trials evaluating the advantages and disadvantages of 3D versus 2D laparoscopic cholecystectomy procedures...
June 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28593692/it-s-worth-the-wait-optimizing-questioning-methods-for-effective-intraoperative-teaching
#18
Meredith Barrett, Christopher P Magas, Larry D Gruppen, Priya H Dedhia, Gurjit Sandhu
BACKGROUND: The use of questioning to engage learners is critical to furthering resident education intraoperatively. Previous studies have demonstrated that higher level questioning and optimal wait times (>3 s) result in learner responses reflective of higher cognition and retention. Given the importance of intraoperative learning, we investigated question delivery in the operating room. METHODS: A total of 12 laparoscopic cholecystectomies were observed and recorded...
June 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28593410/xanthogranulomatous-cholecystitis-is-an-initial-laparoscopic-approach-feasible
#19
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
#20
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
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