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Márcio Alexandre Terra Passos, Pedro Eder Portari-Filho
Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis. Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
A Marte, L Pintozzi
AIM: The closure of a cystic duct during cholecystectomy by means of radiofrequency is still controversial. We report our preliminary experimental results with the use of LigaSure on common bile duct in rats. MATERIALS AND METHODS: Thirty Wistar rats weighing 70 to 120gr were employed for this study. The animals were all anaesthetized with intraperitoneal Ketamine and then divided into three groups. The first group (10 rats, Group C) underwent only laparotomy and isolation of the common bile duct...
September 10, 2015: Minerva Pediatrica
Rubens Antonio Aissar Sallum, Eduardo Messias Hirano Padrão, Sergio Szachnowicz, Francisco C B C Seguro, Edno Tales Bianchi, Ivan Cecconello
BACKGROUND: Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. AIM: To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication...
April 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Lidia Ionescu, D Timofte, M Savin, V Fotea, R Dănilă
Impacted common bile duct (CBD) lithiasis poses therapeutical challenges and repeated attempts of removal may result in life-threatening complications. CASE REPORT. A 45 year-old female patient was admitted in emergency for right upper quadrant abdominal pain and jaundice. Clinical, lab data, abdominal ultrasound (US) and cholangio-MRI established the diagnosis of acute cholecystitis and obstructive jaundice due to distal CBD lithiasis. Endoscopic retrograde colangiopancreatography (ERCP) confirmed the presence of a distal CBD stone but extraction failed...
January 2015: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Almino Cardoso Ramos, Manoela Galvão Ramos, Manoel dos Passos Galvão-Neto, Josemberg Marins, Eduardo Lemos de Souza Bastos, Natan Zundel
BACKGROUND: In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. AIM: To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver...
2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Alessandra Surace, Silvia Marola, Rosa Benvenga, Alessandro Borello, Valentina Gentile, Alessia Ferrarese, Stefano Enrico, Valter Martino, Mario Nano, Mario Solej
Laparoscopic cholecystectomy (LC) is currently the gold standard treatment for symptomatic cholelithiasis. LC is actually condidered a medium complexity surgical operation. LC could be technically hard, especially if patient underwent previous surgical operation. These difficulties increase in outcome of previous operation in right upper quadrant (RUQ): in this case laparoscopic access is defined as an "hard access". We present two cases in which an unconventional access was performed: laparoscopic cholecistectomy is a safe and feasible procedure, although a careful assessment preoperative is indispensable...
2014: International Journal of Surgery
Girolamo Geraci, Francesco Cupido, Chiara Lo Nigro, Antonio Sciuto, Carmelo Sciumè, Giuseppe Modica
INTRODUCTION: Vocal cord injuries (VI), postoperative hoarseness (PH), dysphonia (DN), dysphagia (DG) and sore throat (ST) are common complications after general anesthesia; there is actually a lack of consensus to support the proper timing for post-operative laryngoscopy that is reliable to support the diagnosis of laryngeal or vocal fold lesions after surgery and there are no valid studies about the entity of laryngeal trauma in oro-tracheal intubation. Aim of our study is to evaluate the statistical relation between anatomic, anesthesiological and surgical variables in the case of PH, DG or impaired voice register...
July 2013: Annali Italiani di Chirurgia
A Panebianco, A Volpi, C Lozito, A Prestera, P Ialongo, N Palasciano
Aim. Gallbladder carcinoma is an uncommon cancer with a poor prognosis. In the era of laparoscopic cholecistectomy for treatment of benign diseases incidental gallbladder carcinoma has dramatically increased and now constitutes the major way patients present with gallbladder cancer and allows to detect cancer at early stages with a better prognosis. In this single-center study we report our experience with gallbladder carcinoma incidentally diagnosed during or after laparoscopic colecistectomy performed for cholelithiasis...
May 2013: Il Giornale di Chirurgia
Federico Sista, Mario Schietroma, Francesco Carlei, Emanuela Marina Cecilia, Federica Piccione, Giuseppe De Santis, Laura Lancione, Daniela Iannucci, Antonio Giuliani, Gianfranco Amicucci, Sergio Leardi
AIM: This study want to examine (a) whether neutrophils, the neutrophil-elastase, C-reactive protein and the Interleukin- 6 are modified and how, in patients after laparoscopic cholecystectomy open cholecystectomy; (b) whether these findings are indicative of an increased risk to develop infectious complications. MATERIALS OF STUDY: Circulating Interleukin-6 level, C-reactive protein and neutrophil-elastase were measured in 71 patients (35 underwent open cholecystectomy and 36 laparoscopic cholecystectomy)...
March 2013: Annali Italiani di Chirurgia
Viola Zulian, Giorgio Vasquez, Carlo V Feo
Gallstone ileus is a rare complication of cholelithiasis. It accounts for 25% of nonstrangulated small bowel obstructions in patients over the age of 65 years. The morbidity and mortality rate of gallstone ileus remains very high, partly because of misdiagnosis or delayed diagnosis. The two surgical options are: a) enterolithotomy with removal of impacted stone, cholecystectomy, and fistula repair at the same surgical operation (i.e., "one-stage" procedure) and b) enterolithotomy with stone extraction followed or not by elective biliary surgery...
January 2013: Annali Italiani di Chirurgia
Aleksandar Knežević, Violeta Knežević, Vesna Pajtić, Aleksandar Gluhović, Ivan Jovanović, Ljiljana Gvozdenović
A 68-year old patient, who had had cholecistectomy when he was 30 years old and had been hospitalized in several occasions, with clinical presentation of recidivant cholangitis was admitted to county hospital. Computed tomography was performed, where a bile duct dilatation was noted, with suspected 12 mm concrement. After that the patient was referred to the hospital in order to undergo therapeutic endoscopic retrograde cholangiopancreatography. After performing the procedure, the presence of the concrement, 12x25mm in size was confirmed...
August 2012: Medicinski Glasnik
Aderivaldo Coelho de Andrade
OBJECTIVE: To evaluate a series of cases of cicatricial stenosis of the biliary tract after cholecystectomy undergoing surgical reconstruction. METHODS: We conducted a retrospective study with 27 patients who underwent surgical reconstruction of the biliary tree for cicatricial stenosis. We analyzed the type of cholecystectomy that resulted in injury, age, gender, signs and symptoms, time of diagnosis, early or late, presence of previous surgery in an attempt to reconstruct the biliary tree, classification of stenosis and type of operation used for treatment of the injury...
April 2012: Revista do Colégio Brasileiro de Cirurgiões
D R Iusco, S Sacco, I Ismail, S Bonomi, S Virzì
Situs viscerum inversus totalis is a rare defect with a genetic predisposition, which can present difficulties in the management of abdominal pathology, especially in laparoscopic surgery (mirror-image anatomy). We report the case of a 52-year-old female with situs viscerum inversus totalis, known from pediatric age, with a medical history of colic pain in the epigastrium radiating to the right abdominal quadrant. Laparoscopic cholecistectomy was safely performed with a three trocar technique. To the best of our knowledge this is the first time that laparoscopic cholecistectomy by three trocars was performed in a patient with situs viscerum inversus...
January 2012: Il Giornale di Chirurgia
M Kiladze, Sh Giuashvili
It is presented our experience and review of literature of pathogenesis, symptomatology, diagnostics and surgical treatment of gastroesophageal reflux desease (GERD). A cohort of 104 patients (67 males and 37 females, median age - 42.5) who underwent "open" A. Chernousov modified Nissen fundoplication was evaluated for an follow-up period more than 10 years. In 23 cases with concomitant duodenal ulcer and gastric hypersecretion selective proximal vagotomy additionally was performed, 3 of them also underwent cholecistectomy and in 1 case - splenectomy because of spleen lymphoma...
October 2011: Georgian Medical News
G Conzo, F Stanzione, S Celsi, G Candela, P Venetucci, A Palazzo, C Della Pietra, L Santini, V Iaccarino
Hepatolithiasis is defined as the occurrence of stones proximal to the biliary confluence and represents a prevalent disease in South East Asia being uncommon in Western countries. Biliary sepsis, hepatic abscesses and cholangiocarcinoma are considered potential complications. The Authors describe a case of a 68 years male patient affected by a left massive intrahepatic lithiasis secondary to common duct stones and associated to acute pancreatitis. The patient refused surgery and was submitted to a conservative transhepatic percutaneous treatment...
October 2011: Il Giornale di Chirurgia
Marin Marinović, Tedi Cicvarić, Iva Juretić, Nikola Grzalja, Igor Medved, Juraj Ahel
Because of a possible delayed wound healing, critical colonization and infection of wounds present a problem for surgeons. Colonized and infected wounds are a potential source for cross-infection. Molndal technique of wound dressing has proven to be effective in prevention of infection. Also the wound heal better and faster. In our study we wanted to describe the benefits of the Molndal technique wound dressing after laparoscopic cholecistectomy compared to traditional wound dressing technique. Molndal technique consisted of wound dressing with Aquacel Ag--Hydrofiber (ConvaTec, Dublin, Ireland)...
April 2010: Collegium Antropologicum
Mariano Palermo, Mercedes Giménez Dixon, Fernando Alvarez, Adrián Ortega, Miguel Bruno, Francisco J Tarsitano
INTRODUCTION: Residual stones are those persisting in the biliary duct after a surgical intervention. They are found in approximately 2% of cases after a simple cholecistectomy and in 4% to 15% after an exploration of the common duct. MATERIAL AND METHODS: Between January 2009 and June 2008, 81 patients were treated because of residual stones. Age, sex, number of stones, days in the hospital, laboratory, complications and diagnosis were analyzed. RESULTS: Forty-eight patients were male and 33 female...
September 2010: Acta Gastroenterologica Latinoamericana
Alessandro Bini, Fabio Davoli, Nicola Cassanelli, Giampiero Dolci, Giulia Luciano, Franco Stella
AIM: We report a case of a 64-year-old man, admitted to our department following the onset a few months earlier of canalization disorders and a sensation of retrosternal tension. MATERIAL OF STUDY: Patient's history revealed blunt thoraco-abdominal trauma with multiple costal fractures 15 years earlier as a result of a road accident and a cholecystectomy at the age of 57. A barium meal revealed an intrapericardial displacement of some intestinal loops; as the patient suffered acute intestinal occlusion with severe abdominal pain associated with nausea and vomiting, we performed an emergency median xipho-umbilical laparotomy, making it possible to identify both the site of the retrosternal diaphragmatic laceration with intrapericardial colonic herniation and the true cause of the occlusion: an adhesion, caused by the previous cholecistectomy, which was strangulating a jejunal loop...
January 2010: Annali Italiani di Chirurgia
Paolo Caiazzo, Giovanni Del Vecchio, Michele Albano, Andrea Loffredo, Francesco Calbi, Antonio Comentale, Pierpaolo Di Lascio, Mauro Pastore, Pio Rocco Tramutoli
INTRODUCTION: The Authors describe our preliminary experience with the cholecistectomy with the S.I.L.S. (Single Incision Laparoscopic Surgery), with a multilumen trocar and dedicated laparoscopic instruments. MATERIALS AND METHODS: Five operations of laparoscopic cholecistectomy with S.I.L.S. technique (3 men and 2 women), of age between 26 and 52 years are reported. RESULTS: In one case was applied an additional 5 mm trocar in the right ipocondrium; in two cases a transparietal suture to suspend the gallbladder was used...
January 2010: Annali Italiani di Chirurgia
A Gardini, L Saragoni, G La Barba, D Garcea
Primary lymphoma of the gallbladder is extremely rare. We present an asymptomatic case of primary combined DLBCL--MALT lymphoma of the gallbladder in a 78-year-old man in whom definitive diagnosis was made with laparotomic cholecystectomy. Preoperative diagnosis was supported by NMR, CT and PET scans. The pathological report identified a polypoid lesion measuring 3.5 cm in diameter. A non-Hodgkin lymphoma with two different coexisting patterns was identified histologically: large diffuse B-cell lymphoma (DLBCL) associated with focal areas of extranodal marginal zone B-cell lymphoma (MALT-type) of the gallbladder...
December 2009: Pathologica
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