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best time for cholecystectomy

Narongsak Rungsakulkij, Pongsatorn Tangtawee
BACKGROUND: Situs inversus totalis is a rare autosomal disorder in which the patient's affected visceral organs are a perfect mirror image of their normal positions. Surgery in these patients is technically challenging. Minimally invasive surgery such as laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis, but it can be difficult to perform. Laparoscopic cholecystectomy in patients with situs inversus totalis may be even more technically challenging. Fluorescence cholangiography is a new innovation in the field of navigation surgery...
April 20, 2017: BMC Surgery
Luca Degrate, Davide P Bernasconi, Paola Meroni, Mattia Garancini, Daniele Macchini, Fabrizio Romano, Fabio Uggeri, Luca Gianotti
BACKGROUND: Laparoscopic cholecystectomy (LC) to treat mild biliary acute pancreatitis (MBAP) during index admission is recommended. However, the optimal surgical timing is controversial, considering that patients are actually often discharged from hospital and readmitted for elective cholecystectomy. Moreover, previous studies showed an uneven patients' stratification for pancreatitis severity. The aim of this study was to determine the outcome of patients homogenously categorised for MBAP according to the newest pancreatitis classifications, undergoing cholecystectomy with different timing...
April 19, 2017: Minerva Chirurgica
Itaru Endo, Tadahiro Takada, Tsann-Long Hwang, Kohei Akazawa, Rintaro Mori, Fumihiko Miura, Masamichi Yokoe, Takao Itoi, Harumi Gomi, Miin-Fu Chen, Yi-Yin Jan, Chen-Guo Ker, Hsiu-Po Wang, Seiki Kiriyama, Keita Wada, Hiroki Yamaue, Masaru Miyazaki, Masakazu Yamamoto
BACKGROUND: Although early laparoscopic cholecystectomy is widely performed for acute cholecystitis, the optimal timing of a cholecystectomy in clinically ill patients remains controversial. This study aims to determine the best practice for the patients presenting with acute cholecystitis focused on disease severity and co-morbidities. PATIENTS AND METHODS: An international multicentric retrospective observational study was conducted over a 2-year period. Patients were divided into four groups, Group A: primary cholecystectomy, Group B: cholecystectomy after gallbladder drainage, Group C: gallbladder drainage alone, and Group D: medical treatment alone...
April 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
Alexander V Redkin, Victor V Vdovin, Victor M Vakhtel, Pavel A Lukyanovich, Natalia A Malkina
OBJECTIVE: Reducing adverse effects in laparoscopic cholecystectomy (LCE) is important to avoid complications. After removal, the porta hepatis and gallbladder bed of liver were treated with pulse width modulated (PWM) red LED light with parameters λ = 625 ± 5 nm, full width at half maximum 17 nm, 76 Hz, duty cycle 23%, 15-30 mW/cm(2), and 0.9-1.8 J/cm(2). The changes of eight blood parameters were studied: red blood cell, hemoglobin, white blood cell, erythrocyte sedimentation rate (ESR), bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and amylase...
March 16, 2017: Photomedicine and Laser Surgery
Andru P Twinanda, Sherif Shehata, Didier Mutter, Jacques Marescaux, Michel de Mathelin, Nicolas Padoy
Surgical workflow recognition has numerous potential medical applications, such as the automatic indexing of surgical video databases and the optimization of real-time operating room scheduling, among others. As a result, surgical phase recognition has been studied in the context of several kinds of surgeries, such as cataract, neurological, and laparoscopic surgeries. In the literature, two types of features are typically used to perform this task: visual features and tool usage signals. However, the used visual features are mostly handcrafted...
January 2017: IEEE Transactions on Medical Imaging
Michel Kahaleh, Manuel Perez-Miranda, Everson L Artifon, Reem Z Sharaiha, Prashant Kedia, Irene Peñas, Carlos De la Serna, Nikhil A Kumta, Fernando Marson, Monica Gaidhane, Christine Boumitri, Viviana Parra, Carlos M Rondon Clavo, Marc Giovannini
BACKGROUND: Cholecystectomy remains the gold standard treatment of cholecystitis. Endoscopic treatment of cholecystitis includes transpapillary gallbladder drainage. Recently, endoscopic ultrasound-guided transmural drainage of the gallbladder (EUS-GBD) has been reported. This study reports the cumulative experience of an international group performing EUS-GBD. METHODS: Cases of EUS-GBD from January 2012 to November 2013 from 3 tertiary-care institutions were captured in a registry...
September 2016: Digestive and Liver Disease
Guo-Min Song, Wei Bian, Xian-Tao Zeng, Jian-Guo Zhou, Yong-Qiang Luo, Xu Tian
The laparoscopic cholecystectomy (LC) is an important approach of treating acute cholecystitis and the timing of performing this given treatment is associated with clinical outcomes. Although several meta-analyses have been done to investigate the optimal timing of implementing this treatment, the conflicting findings from these meta-analyses still confuse decision-making. And thus, we performed this systematic review to assess discordant meta-analyses and generate conclusive findings to facilitate informed decision-making in clinical context eventually...
June 2016: Medicine (Baltimore)
Yehuda Hershkovitz, Hasan Kais, Ariel Halevy, Ron Lavy
BACKGROUND: The timing of interval laparoscopic cholecystectomy continues to be a matter of debate. OBJECTIVES: To evaluate the best timing for performing this procedure after an episode of acute cholecystitis. METHODS: In this retrospective analysis, we divided 213 patients into three groups based on the time that elapsed from an episode of acute cholecystitis to surgery: Group 1: 1-6 weeks, Group II: 6-12 weeks, Group III: > 12 weeks...
January 2016: Israel Medical Association Journal: IMAJ
Silvia Enciso, Idoia Díaz-Güemes, Jesús Usón, Francisco Miguel Sánchez-Margallo
INTRODUCTION: Our objective was to assess a laparoscopic training model for general surgery residents. METHODS: Twelve general surgery residents carried out a training program, consisting of a theoretical session (one hour) and a hands-on session on simulator (7 h) and on animal model (13 h). For the first and last repetitions of simulator tasks and the Nissen fundoplication technique, time and scores from the global rating scale objective structured assessment of technical skills (OSATS) were registered...
February 2016: Cirugía Española
Purvi P Patel, Shaun C Daly, Jose M Velasco
Acute cholecystitis is one of the most common surgical diagnoses encountered by general surgeons. Despite its high incidence there remains a range of treatment of approaches. Current practices in biliary surgery vary as to timing, intraoperative utilization of biliary imaging, and management of bile duct stones despite growing evidence in the literature defining best practice. Management of patients with acute cholecystitis with early laparoscopic cholecystectomy (LC) results in better patient outcomes when compared with delayed surgical management techniques including antibiotic therapy or percutaneous cholecystostomy...
October 18, 2015: World Journal of Hepatology
Maxime Polo, Antoine Duclos, Stéphanie Polazzi, Cécile Payet, Jean Christophe Lifante, Eddy Cotte, Xavier Barth, Olivier Glehen, Guillaume Passot
BACKGROUND: The recommended treatment for acute calculous cholecystitis combines antibiotics and cholecystectomy. To reduce morbidity and mortality, guidelines recommend early cholecystectomy. However, the optimal timing for surgery on first admission remains controversial. This study aims to determine the best timing for cholecystectomy in patients presenting with acute calculous cholecystitis. STUDY DESIGN: The French national health-care database was analyzed to identify all patients undergoing cholecystectomy for acute cholecystitis during the same hospital stay between January 2010 and December 2013...
November 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Tsutomu Nomura, Yasuhiro Mamada, Yoshiharu Nakamura, Takeshi Matsutani, Nobutoshi Hagiwara, Isturo Fujita, Yoshiaki Mizuguchi, Terumichi Fujikura, Masao Miyashita, Eiji Uchida
INTRODUCTION: Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. METHODS: Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS)...
November 2015: Asian Journal of Endoscopic Surgery
Mariano Palermo, Guillermo Duza, María Laura Caviglia, Nicolás De Innocentis, Patricio Egan, Gisele Fiscella, Matías Morán, Juan Prieto, Matías Sousa, Rafael García
Gallstones are a very common disease in our area, with a prevalence of 21.9%. Among the most common complications, choledocholithiasis is associated in about 3% to 10% of cases. The treatment may be performed by minimally invasive laparoscopy, endoscopy or a combination of both. There is no current consensus on what is the best strategy for treatment. We aimed to review the evidences of highest quality available, comparing two therapeutic strategies for cholelithiasis. Choledocholithiasis is divided into that in patients who underwent a cholecystectomy and that in patients with associated cholelithiasis...
March 2015: Acta Gastroenterologica Latinoamericana
Darko Katić, Chantal Julliard, Anna-Laura Wekerle, Hannes Kenngott, Beat Peter Müller-Stich, Rüdiger Dillmann, Stefanie Speidel, Pierre Jannin, Bernard Gibaud
PURPOSE: The rise of intraoperative information threatens to outpace our abilities to process it. Context-aware systems, filtering information to automatically adapt to the current needs of the surgeon, are necessary to fully profit from computerized surgery. To attain context awareness, representation of medical knowledge is crucial. However, most existing systems do not represent knowledge in a reusable way, hindering also reuse of data. Our purpose is therefore to make our computational models of medical knowledge sharable, extensible and interoperational with established knowledge representations in the form of the LapOntoSPM ontology...
September 2015: International Journal of Computer Assisted Radiology and Surgery
Amy M Cao, Guy D Eslick, Michael R Cox
INTRODUCTION: The timing of laparoscopic cholecystectomy for acute cholecystitis remains an issue for debate amongst general surgeons. The aim of this study was to compare clinical outcomes between early and delayed cholecystectomy for acute cholecystitis. The primary outcome measures included mortality rates, complication rates, length of hospital stay and conversion rates to open procedures. MATERIALS AND METHODS: A search of electronic databases was performed for randomised controlled trials...
May 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
P Marco Fisichella, Steven R DeMeester, Eric Hungness, Silvana Perretta, Nathaniel J Soper, Alexander Rosemurgy, Alfonso Torquati, Ajit K Sachdeva, Marco G Patti
New trends have emerged regarding the best minimally invasive access approaches to perform gastrointestinal surgery. However, these newer approaches are seen critically by those who demand a more strict assessment of outcomes and safety. An international panel of expert gathered at the 2014 American College of Surgeons Meeting with the goal of providing an evidence-based understanding of the real value of these approaches in gastrointestinal surgery. The panel has compared the efficacy and safety of most established approaches to gastrointestinal diseases to those of new treatment modalities: peroral esophageal myotomy vs...
July 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Syed Nabeel Zafar, Augustine Obirieze, Babawande Adesibikan, Edward E Cornwell, Terrence M Fullum, Daniel D Tran
IMPORTANCE: There is growing evidence in support of performing early laparoscopic cholecystectomy (LC) for acute cholecystitis. However, the definition of early LC varies from 0 through 10 days depending on the research protocol. The optimum time to perform early LC is still unclear. OBJECTIVES: To determine whether outcomes after early LC for acute cholecystitis vary depending on time from presentation to surgery and to determine the optimum time to perform LC for acute cholecystitis...
February 2015: JAMA Surgery
Anne-Françoise Spinoit, Konstantinos Stravodimos, Nikolaos Nikiteas, Antonios Ploumidis, Nicolaas Lumen, Achilles Ploumidis
INTRODUCTION: Kidney tumours are often found incidentally in the work-up of abdominal pain. We are reporting, to the best of our knowledge, the first series of robot-assisted radical nephrectomy (RARN) combined with cholecystectomy (RACH) in patients with organ-confined right kidney tumour and gallbladder stones. MATERIALS AND METHODS: A solid organ-confined tumour of the right kidney, along with gallbladder stones, was demonstrated on CT in three patients following evaluation of colic-like abdominal pain...
June 2015: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
K Jamal, K Ratansingham, M Siddique, D Nehra
BACKGROUND: 70,000 cholecystectomies were performed in the United Kingdom in 2011-2012. Currently it is standard practice to submit all gallbladder specimens for routine histology to exclude malignancy. The aim of this systematic review was to establish whether a normal macroscopic appearance to the gallbladder at the time of cholecystectomy is sufficient to rule out malignancy and therefore negate the need for routine histology. METHODS: Relevant articles that were published between 1966 and January 2013 were identified through electronic databases...
2014: International Journal of Surgery
Hakan Öztürk
PURPOSE: To evaluate gastrointestinal tract complications of percutaneous nephrolithotomy (PCNL), to determine risk factors, and to develop strategies for diagnosis and treatment. MATERIAL AND METHODS: A literature review was conducted for the studies published in the English language in the databases of PubMed and Scopus between July 1985 and June 2013. The key words for digital literature search were limited to the following: "percutaneous nephrolithotomy complications, ([splenic injury, liver injury, gallbladder injury and biliary peritonitis, colonic injury] during/after [percutaneous nephrolithotomy]), complication, Clavien, Clavien-Dindo classification, management, review, PNL, PCNL...
November 2014: Journal of Endourology
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