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Timing of cholecystectomy

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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
#1
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
https://www.readbyqxmd.com/read/29338146/the-effect-of-various-doses-of-infusion-solutions-on-the-endothelial-glycocalyx-layer-in-laparoscopic-cholecystectomy-patients
#2
Matija Belavić, Vlatka Sotošek Tokmadžić, Elizabeta Fišić, Antonija Brozovic Krijan, Nedjeljko Strikić, Mirjana Lončarić Katušin, Josip Žunić
BACKGROUND: The endothelial glycocalyx is located on the luminal side of blood vessels and maintains vessel integrity. This study analysed how various dosages of infusion affected the secretion of atrial natriuretic peptide (ANP) and potential glycocalyx damage in patients undergoing laparoscopic cholecystectomy. We hypothesised that the liberal administration of Ringer's solution during the operation can cause iatrogenic hypervolemia with releasing of ANP and glycocalyx damage. METHODS: The study included 90 patients with American Society of Anesthesiologists' (ASA) class I and II, in good cardiopulmonary health, who were assigned to one of three groups: Restrictive group, which received 1 ml/kg/hr intraoperatively and six hours postoperatively; Low liberal group, which received 5 ml/kg/hr of Ringer's solution intraoperatively and six hours postoperatively and High liberal group, which received 15 ml/kg/hr intraoperatively and 10 ml/kg/hr six hours postoperatively...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336751/laparoscopic-exploration-can-salvage-recurrent-common-bile-duct-stone-after-cholecystectomy
#3
Wen-Song Liu, Yan Zou, Bo Yang, Yong Jiang, Dong-Lin Sun
Conventionally, patients suffered from recurrent common bile duct (CBD) stone after cholecystectomy are suggested to be treated with endoscopic retrograde cholangiopancreaticography. This study was designed to explore the feasibility of laparoscopic common bile duct exploration (LCBDE) as a salvage procedure for recurrent CBD calculi after cholecystectomy. A retrospective review was conducted of data from 65 patients who underwent LCBDE for recurrent CBD calculi after cholecystectomy from January 2011 to July 2015...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29333074/laparoendoscopic-rendezvous-may-be-an-effective-alternative-to-a-failed-preoperative-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cholecystocholedocholithiasis
#4
Fotios Tsiopoulos, Andreas Kapsoritakis, Athanassios Psychos, Anastasios Manolakis, Konstantinos Oikonomou, George Tzovaras, Ioannis Baloyiannis, Alexandra Tsikrika, Spyros Potamianos
Background: Endoscopic retrograde cholangiopancreatography (ERCP), followed by laparoscopic cholecystectomy (LC), remains the standard way of management for patients with cholecystocholedocholithiasis. Laparoendoscopic rendezvous (LERV), a combined procedure for removing the gallbladder laparoscopically and clearing the common bile duct (CBD) endoscopically at the same time, could be an attractive alternative. The aim of this study was to compare LERV with classic ERCP in patients with cholecystocholedocholithiasis...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29332430/effect-of-creatine-phosphate-sodium-on-bispectral-index-and-recovery-quality-during-the-general-anaesthesia-emergence-period-in-elderly-patients-a-randomized-double-blind-placebo-controlled-trial
#5
Wei Wang, Wan-You Yu, Jie Lv, Lian-Hua Chen, Zhong Li
Objective To evaluate the effect of creatine phosphate sodium on bispectral index (BIS) and recovery quality during the general anaesthesia emergence period in elderly patients. Methods This randomized, double-blind, placebo-controlled study enrolled patients undergoing transabdominal cholecystectomy under general anaesthesia. Patients were randomly assigned to receive either creatine phosphate sodium (1.0 g/100 ml 0.9% saline; group P) or 100 ml 0.9% saline (group C) over 30 minutes during surgical incision...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29330979/early-versus-delayed-laparoscopic-cholecystectomy-for-acute-cholecystitis
#6
Sadaf Khalid, Zahid Iqbal, Afsar Ali Bhatti
BACKGROUND: Laparoscopic cholecystectomy is considered the gold standard for the management of acute cholecystitis but controversy surrounds the timings of the surgery. Studies are available favouring both early and delayed laparoscopic cholecystectomy. The objective of this study was to compare early versus delayed laparoscopic cholecystectomy for acute cholecystitis. METHODS: This quasi-experimental study included 180 patients irrespective of their age and sex presented at department of Surgery, Lahore General Hospital between January to December 2014 with a diagnosis of acute cholecystitis were assigned randomly to early laparoscopic cholecystectomy within 24 h of admission or to initial conservative treatment followed by delayed laparoscopic cholecystectomy, 6-12 weeks later...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29319016/analysis-of-post-operative-complication-in-single-port-laparoscopic-cholecystectomy-a-retrospective-analysis-in-817-cases-from-a-surgeon
#7
Yongmin Lee, Younghoon Roh, Minchan Kim, Younghoon Kim, Kwanwoo Kim, Sunghwa Kang, Eunjeong Jang
BACKGROUND: Single-port laparoscopic cholecystectomy (SPLC) is a new advanced technique in laparoscopic surgery which has many benefits according to previous reports. The purpose of this study was to present personal experiences with SPLC in> 800 cases performed by a surgeon to evaluate the safety and feasibility of this procedure. MATERIALS AND METHODS: A retrospective review of 817 cases of SPLC was conducted. All patients had received elective SPLC by a surgeon in our centre during March 2009-August 2015...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29313126/an-observational-study-of-the-timing-of-surgery-use-of-laparoscopy-and-outcomes-for-acute-cholecystitis-in-the-usa-and-uk
#8
A C Murray, S Markar, H Mackenzie, O Baser, T Wiggins, A Askari, G Hanna, O Faiz, E Mayer, C Bicknell, A Darzi, R P Kiran
BACKGROUND: Evidence supports early laparoscopic cholecystectomy for acute cholecystitis. Differences in treatment patterns between the USA and UK, associated outcomes and resource utilization are not well understood. METHODS: In this retrospective, observational study using national administrative data, emergency patients admitted with acute cholecystitis were identified in England (Hospital Episode Statistics 1998-2012) and USA (National Inpatient Sample 1998-2011)...
January 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29311029/recurrent-biliary-acute-pancreatitis-is-frequent-in-a-real-world-setting
#9
Serena Stigliano, Flaminia Belisario, Matteo Piciucchi, Marianna Signoretti, Gianfranco Delle Fave, Gabriele Capurso
BACKGROUND: Data about recurrent acute pancreatitis (RAP) are limited. AIMS: To evaluate the rate of RAP and associated factors. METHODS: Single-centre prospective study of consecutive patients at first episode of acute pancreatitis (AP) being followed-up. RESULTS: Of 266 consecutive AP patients, (47% biliary, 15.4% alcoholic, 14.3% idiopathic) 66 (24.8%) had RAP in a mean follow-up of 42 months; 17.9% of recurrences occurred within 30 days from discharge...
December 19, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29290380/are-postoperative-intravenous-fluids-in-patients-undergoing-elective-laparoscopic-cholecystectomy-a-necessity-a-randomized-clinical-trial
#10
Jessimara Ribeiro Henriques, Maria Isabel Toulson Davisson Correia
BACKGROUND: Intravenous (IV) fluid therapy should be individualized according to each patient's weight, disease, and comorbidities, as well as the type and duration of the operative procedure. Laparoscopic cholecystectomy represents one of the most common, short-duration operations; thus, the aim of this study was to assess the necessity of postoperative administration of IV fluids. METHOD: A randomized clinical trial with patients undergoing elective laparoscopic cholecystectomy was performed...
December 29, 2017: Surgery
https://www.readbyqxmd.com/read/29284872/effects-of-dexmedetomidine-on-intraoperative-hemodynamics-and-propofol-requirement-in-patients-undergoing-laparoscopic-cholecystectomy
#11
Avneesh Khare, Satya Prakash Sharma, Mangi Lal Deganwa, Mamta Sharma, Nitesh Gill
Background: Despite multiple benefits, laparoscopic surgery always poses anesthetic challenge due to significant alteration of hemodynamics. Various pharmacological agents have been used for the same with variable response. Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics and propofol requirement using bispectral index (BIS) in laparoscopic cholecystectomy...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29280863/corset-trunkplasty-recommended-with-abdominal-skin-laxity-and-open-cholecystectomy-scar
#12
Edwin Acevedo, Kumar S Nadhan, Marc Everett, Alexander Moya, James P Bradley
BACKGROUND: Patients undergoing abdominoplasty with previous upper abdominal wall scars are at an increased risk for postoperative complications. The corset trunkplasty is a newer technique to treat abdominal wall laxity of the entire anterolateral abdomen while incorporating any previous open cholecystectomy scar. The authors performed a comparative outcomes study to determine whether the corset procedure would decrease the incidence of postoperative complications in patients with abdominal wall laxity and an open cholecystectomy scar when compared with traditional abdominoplasty...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29280060/minimally-invasive-approach-robotic-and-laparoscopic-to-biliary-enteric-fistula-secondary-to-cholecystectomy-bile-duct-injury
#13
Adolfo Cuendis-Velázquez, Mario E Trejo-Ávila, Andrés Rodríguez-Parra, Orlando Bada-Yllán, Carlos Morales-Chávez, Luis Fernández-Álvarez, Eduardo Cárdenas-Lailson, Sujey Romero-Loera, Martin Rojano-Rodríguez, Mucio Moreno-Portillo
Spontaneous biliary-enteric fistula after laparoscopic cholecystectomy bile duct injury is an extremely rare entity. Y-en-Roux hepaticojejunostomy has been demonstrated to be an effective surgical technique to repair iatrogenic bile duct injuries. Seven consecutive patients underwent robotic-assisted (n = 5) and laparoscopic (n = 2) biliary-enteric fistula resection and bile duct repair at our hospital from January 2012 to May 2017. We reported our technique and described post-procedural outcomes. The mean age was 52...
December 26, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29277136/optimal-timing-for-laparoscopic-cholecystectomy-after-endoscopic-retrograde-cholangiopancreatography-a-systematic-review
#14
C Friis, J P Rothman, J Burcharth, J Rosenberg
BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is often used as definitive treatment for common bile duct stones. The aim of this study was to investigate the optimal time interval between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. MATERIALS AND METHODS: PubMed and Embase were searched for studies comparing different time delays between endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy...
December 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#15
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to non-modifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Though the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29245291/delayed-diagnosis-of-abdominal-pain-in-patient-with-situs-inversus-totalis-in-emergency-department-a-case-report
#16
Ying Liu, Lile Wu, Yanhong Chen, Dongze Li, Jun Jiang, Wu Zhong, Yu Cao
RATIONALE: Abdominal pain is one of the most common complaints for patients in emergency department. It's difficult to make an accurate diagnosis by emergency physician in time, especially in patients with situs inversus totalis. PATIENT CONCERNS: A patient with acute exacerbation of chronic left upper quadrant abdominal pain.DIAGNOSES:: cholangiolithiasis with situs inversus totalis. INTERVENTIONS: laparoscopic cholecystectomy and laparoscopic exploration of common bile duct...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29242652/the-effect-of-intravenous-dextrose-administration-for-prevention-of-post-operative-nausea-and-vomiting-after-laparoscopic-cholecystectomy-a-double-blind-randomised-controlled-trial
#17
Abolfazl Firouzian, Alieh Zamani Kiasari, Gholamali Godazandeh, Afshin Gholipour Baradari, Abbas Alipour, Arman Taheri, Amir Emami Zeydi, Maryam Montazemi
Background and Aims: Post-operative nausea and vomiting (PONV) is a common and distressing complication after laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the effect of intravenous (IV) dextrose administration for the prophylaxis of PONV after LC. Methods: In a double-blind, randomised controlled trial, a total of 150 female patients who were scheduled for elective LC were randomly assigned into two groups (A and B). Thirty minutes before induction of anaesthesia, patients received an infusion of 500 cc lactated Ringer's solution (Group A) and 5% dextrose in lactated Ringer's solution (Group B) and over a period of 30 min...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29241960/trends-in-common-surgical-procedures-at-children-s-and-nonchildren-s-hospitals-between-2000-and-2009
#18
Heather L Short, Samir Sarda, Curtis Travers, Jason M Hockenberry, Ian McCarthy, Mehul V Raval
PURPOSE: Though growth in children's surgical expenditures has been documented, procedure-specific differences in volume and costs at children's hospitals (CH) and non-hildren's hospitals (NCH) have not been explored. Our purpose was to compare trends in volume and costs of common pediatric surgical procedures between CH and NCH. METHODS: We performed a review of the 2000-2009 Kids' Inpatient Database identifying all cases of appendectomy for uncomplicated appendicitis (AP), tonsillectomy and adenoidectomy (TA), fundoplication (FP), humeral fracture repair (HFR), pyloromyotomy (PYL), and cholecystectomy (CHOLE)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29240006/surgical-consultation-as-social-process-implications-for-shared-decision-making
#19
Justin T Clapp, Alexander F Arriaga, Sushila Murthy, Steven E Raper, J Sanford Schwartz, Frances K Barg, Lee A Fleisher
OBJECTIVE: This qualitative study examines surgical consultation as a social process and assesses its alignment with assumptions of the shared decision-making (SDM) model. SUMMARY OF BACKGROUND DATA: SDM stresses the importance of patient preferences and rigorous discussion of therapeutic risks/benefits based on these preferences. However, empirical studies have highlighted discrepancies between SDM and realities of surgical decision making. Qualitative research can inform understanding of the decision-making process and allow for granular assessment of the nature and causes of these discrepancies...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29235252/closure-of-the-cystic-duct-orifice-in-laparoscopic-subtotal-cholecystectomy-for-severe-cholecystitis
#20
Tatsuki Matsumura, Shunichiro Komatsu, Kenichi Komaya, Keiichi Ando, Takashi Arikawa, Seiji Ishiguro, Takuya Saito, Takaaki Osawa, Shintaro Kurahashi, Tairin Uchino, Kohei Yasui, Shoko Kato, Kenta Suzuki, Yoko Kato, Tsuyoshi Sano
INTRODUCTION: Laparoscopic subtotal cholecystectomy (LSC) has been recognized as an alternative to conversion to laparotomy for severe cholecystitis. However, it may be associated with an increased risk of recurrent stones in the gallbladder remnant. The objective of this study was to evaluate the safety and feasibility of the complete removal of the gallbladder cavity in LSC for severe cholecystitis using the cystic duct orifice suturing (CDOS) technique. METHODS: In a consecutive series of 412 laparoscopic cholecystectomies that were performed from January 2015 to June 2017, 12 patients who underwent LSC with CDOS were enrolled in this retrospective study...
December 13, 2017: Asian Journal of Endoscopic Surgery
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