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Shinji Miyajima, Go Yamakawa, Masaya Ohana
Edwardsiella tarda is an unusual human pathogen. Gastroenteritis is the most frequently reported manifestation of E.tarda infection and extraintestinal infection including cholangitis has rarely been reported. The overall mortality rate for E.tarda bacteremia is, however, reported to be up to 50% (Janda and Abbott, 1993). We describe a 80-year-old diabetic woman with cholangitis and E.tarda bacteremia with a biliary obstruction associated with a large juxtapapillary duodenal diverticulum (Lemmel syndrome) in the setting of past partial hepatectomy and cholecystectomy...
2018: IDCases
Daniel R Slack, Shaunda Grisby, Uzoamaka Kimberly Dike, Harjeet Kohli
Background and Objectives: Many risk factors have been identified in minimally invasive cholecystectomies that lead to higher complications and conversion rates. No study that we encountered looked at nonvisualization of the gallbladder (GB) during surgery as a risk factor. We hypothesized that nonvisualization was associated with an increased risk of complications and could be an early intraoperative identifier of a higher risk procedure. Recognizing this could allow surgeons to be aware of potential risks and to be more likely to convert to open for the safety of the patient...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
F Fuertes-Guirò, M Girabent-Farrés
BACKGROUND: We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). METHODS: We identified studies comparing use of both techniques during the period 2008-2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences...
January 2018: Il Giornale di Chirurgia
Yoichi Matsui, Sohei Satoi, Satoshi Hirooka, Hisashi Kosaka, Takayuki Kawaura, Tomoki Kitawaki
INTRODUCTION: Many researchers have addressed overdosage and inappropriate use of antibiotics. Many meta-analyses have investigated antibiotic prophylaxis for low-risk laparoscopic cholecystectomy with the aim of reducing unnecessary antibiotic use. Most of these meta-analyses have concluded that prophylactic antibiotics are not required for low-risk laparoscopic cholecystectomies. This study aimed to assess the validity of this conclusion by systematically reviewing these meta-analyses...
March 16, 2018: BMJ Open
Rachael F Grace, Paola Bianchi, Eduard J van Beers, Stefan W Eber, Bertil Glader, Hassan M Yaish, Jenny M Despotovic, Jennifer A Rothman, Mukta Sharma, Melissa M McNaull, Elisa Fermo, Kimberly Lezon-Geyda, D Holmes Morton, Ellis J Neufeld, Satheesh Chonat, Nina Kollmar, Christine M Knoll, Kevin Kuo, Janet L Kwiatkowski, Dagmar Pospíŝilová, Yves D Pastore, Alexis A Thompson, Peter E Newburger, Yaddanapudi Ravindranath, Winfred C Wang, Marcin W Wlodarski, Heng Wang, Susanne Holzhauer, Vicky R Breakey, Joachim Kunz, Sujit Sheth, Melissa J Rose, Heather A Bradeen, Nolan Neu, Dongjing Guo, Hasan Al-Sayegh, Wendy B London, Patrick G Gallagher, Alberto Zanella, Wilma Barcellini
An international, multicenter registry was established to collect retrospective and prospective clinical data on patients with pyruvate kinase (PK) deficiency, the most common glycolytic defect causing congenital non-spherocytic hemolytic anemia. Medical history and laboratory and radiologic data were retrospectively collected at enrollment in 254 patients with molecularly confirmed PK deficiency. Perinatal complications were common, including anemia requiring transfusions, hyperbilirubinemia, hydrops, and prematurity...
March 16, 2018: Blood
Nishant Patel, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Jordan C Castle, Narasimham Dasika, Wael E Saad, Ravi N Srinivasa
OBJECTIVE: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. MATERIALS AND METHODS: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula...
March 16, 2018: AJR. American Journal of Roentgenology
Lingfu Zhang, Chunsheng Hou, Zhi Xu, Lixin Wang, Xiaofeng Ling, Dianrong Xiu
Objective: Although laparoscopic treatment of gallbladder cancer (GBC) has been explored in the last decade, long-term results are still rare. This study evaluates long-term results of intended laparoscopic treatment for suspected GBC confined to the gallbladder wall, based on our experience over 10 years. Methods: Between August 2006 and December 2015, 164 patients with suspected GBC confined to the wall were enrolled in the protocol for laparoscopic surgery. The process for GBC treatment was analyzed to evaluate the feasibility of computed tomography (CT) and/or magnetic resonance imaging (MRI) combined with frozen-section examination in identifying GBC confined to the wall...
February 2018: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Tatenda C Nzenza, Yahya Al-Habbal, Glen R Guerra, S Manolas, Tuck Yong, Trevor McQuillan
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) has become well established as a modality for the management of common bile duct stones (CBDS), especially in the setting of associated cholangitis. Our study aims to determine the rate of long term morbidity of recurrent CBDS post ES. METHODS: A retrospective analysis of patients who underwent ERCP and ES (ERCP+ES) was undertaken on a prospectively maintained database from 1998 to 2012 at the Northern Hospital, Melbourne...
March 15, 2018: BMC Gastroenterology
Benjamin R Poh, Paul A Cashin, Daniel G Croagh
INTRODUCTION: Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery. METHODS: A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group. Primary outcomes were morbidity and mortality rate...
March 14, 2018: World Journal of Surgery
Ferdinando F Calabria, Mario Leporace, Antonio Bagnato
A 72-year-old woman was examined by F-FDG PET/CT, showing pathologic tracer uptake in the gallbladder. PET/CT also depicted condition of situs inversus totalis, with dextrocardia, liver on the left side and spleen on the right side of the body. These findings were essential to plan and develop laparoscopic cholecystectomy, which diagnosed cholangiocarcinoma. The recognition of anatomical variants and abnormalities by means of hybrid PET/CT imaging is essential in order to plan the best therapeutic approach.
March 13, 2018: Clinical Nuclear Medicine
Dezső Kelemen, Zoltán Lőcsei, Róbert Papp, Sándor Ferencz, András Vereczkei
CASE PRESENTATION: After neoadjuvant oncological therapy the surgical treatment of distal pancreatic tumour - infiltrating the celiac axis and the stomach - was reported. During the operation resection of the trunc, distal pancreatectomy, splenectomy, total gastrectomy, resection of the left adrenal gland and cholecystectomy were carried out. The patient's clinical course was uneventful, only transient alteration of liver functions was detected. Histological work-up revealed R1 resection, so adjuvant oncological therapy was decided...
March 2018: Magyar Sebészet
Ashwin Rammohan, Sripriya Srinivas, Yahya Al Azri, Mettu Srinivas Reddy, Mohamed Rela
Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Hongyan Yu, Esther Ern-Hwei Chan, Pravin Lingam, Jingwen Lee, Winston Wei Liang Woon, Jee Keem Low, Vishal G Shelat
Backgrounds/Aims: Previous studies have evaluated quality of life (QoL) in patients who underwent laparoscopic cholecystectomy (LC) for cholelithiasis. The purpose of this study was to evaluate QoL after index admission LC in patients diagnosed with acute cholecystitis (AC) using the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. Methods: Patients ≥21 years admitted to Tan Tock Seng Hospital, Singapore for AC and who underwent index admission LC between February 2015 and January 2016 were evaluated using the GIQLI questionnaire preoperatively and 30 days postoperatively...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Bader Hamza Shirah, Hamza Asaad Shirah, Syed Husham Zafar, Khalid B Albeladi
Backgrounds/Aims: Postcholecystectomy syndrome represents a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. It is rare and under-reported in Saudi Arabia. It can be attributed to many complications such as bile duct injury, biliary leak, retained common bile duct stones, recurrent bile duct stones, and bile duct strictures. In this study, we aimed to analyze the causes and evaluate the approach to postcholecystectomy syndrome in our local Saudi Arabian community because of the vast number of cases encountered in our hospital for gallbladder clinical conditions and its related complications...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Ashish Singh, Abhimanyu Kapoor, Rajneesh Kumar Singh, Anand Prakash, Anu Behari, Ashok Kumar, Vinay Kumar Kapoor, Rajan Saxena
Backgrounds/Aims: A residual gallbladder (RGB) following a partial/subtotal cholecystectomy may cause symptoms that require its removal. We present our large study regarding the problem of a RGB over a 15 year period. Methods: This study involved a retrospective analysis of patients managed for symptomatic RGB from January 2000 to December 2015. Results: A RGB was observed in 93 patients, who had a median age of 45 (25-70) years, and were comprised of 69 (74...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Gabriel O Ologun, Rachel Lovely, Mohammad Sultany, Mustafa Aman
Gallstone spillage is a common intraoperative event during laparoscopic cholecystectomy (LC). Patients present months to years with nonspecific symptoms after the original procedure. The complications of retained peritoneal gallstones are infrequent. Having a high index of suspicion is the key to early diagnosis. Every effort should be made to remove spilled gallstones at the index operation to prevent future complications, however, conversion from laparoscopy to laparotomy for retrieval of spilt gallstone is not recommended...
January 6, 2018: Curēus
Kor Woi Tiang, Hang Fai So, Yang Hwang, Manjunath Siddaiah-Subramanya
Laparoscopic cholecystectomy (LC) is preferred in the treatment of symptomatic cholecystolithiasis. Gallstone spillage is not uncommon, and there have been reports of associated complications. We report a case of a free intraperitoneal gallstone, left inadvertently during LC, which developed an inflammatory phlegmon with abscess containing gallstone, causing extraluminal compression on the distal ileum, resulting in small bowel obstruction. This complication in particular is almost unheard of. The patient underwent laparoscopic drainage of abscess and retrieval of gallstone, which relieved the obstruction...
2018: Case Reports in Surgery
B Joseph Elmunzer, Derek J Feussner, K Mark Payne, Satish N Nadig, Ricardo Yamada
No abstract text is available yet for this article.
March 2018: American Journal of Gastroenterology
Long Pan, Mingyu Chen, Lin Ji, Longbo Zheng, Peijian Yan, Jing Fang, Bin Zhang, Xiujun Cai
OBJECTIVE: The aim of this study was to compare the efficacy and safety of the laparoscopic common bile duct exploration (LCBDE) and laparoscopic cholecystectomy (LC) with preoperative endoscopic sphincterotomy (pre-EST) and LC for concomitant gallstones and common bile duct (CBD) stones. BACKGROUND: It remains controversial whether LCBDE+LC is better than pre-EST+LC for gallstones and CBD stones. METHODS: A specific search of online databases was performed from January 2006 to October 2017...
March 12, 2018: Annals of Surgery
Felicia Turowski, Ulrich Hügle, Arno Dormann, Matthias Bechtler, Ralf Jakobs, Uwe Gottschalk, Ellen Nötzel, Dirk Hartmann, Albrecht Lorenz, Frank Kolligs, Wilfried Veltzke-Schlieker, Andreas Adler, Olaf Becker, Bertram Wiedenmann, Nataly Bürgel, Hanno Tröger, Michael Schumann, Severin Daum, Britta Siegmund, Christian Bojarski
BACKGROUND AND AIMS: The aim of the study was to evaluate the usefulness and diagnostic and therapeutic outcome of the single-operator cholangiopancreatoscopy (SOC) with SpyGlassDS™. METHODS: In a retrospective multicenter study between November 2015 and January 2017, SpyGlassDS™ procedures were analyzed in participating centers. Indications, accuracy of SOC-guided biopsies, management of large bile duct stones, and complications were analyzed. Follow-up was 4 months...
March 12, 2018: Surgical Endoscopy
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