Read by QxMD icon Read

Timing of cholecystectomy

Magdalena M Sakowska, Megan V Thomas, Saxon Connor, Ross Roberts
BACKGROUND: In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. METHODS: In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit...
October 21, 2016: ANZ Journal of Surgery
Cecilia Nilsson, Jette Led Sorensen, Lars Konge, Mikkel Westen, Morten Stadeager, Bent Ottesen, Flemming Bjerrum
BACKGROUND: Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS: A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group)...
October 21, 2016: Surgical Endoscopy
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
October 20, 2016: Updates in Surgery
A J Sutton, R S Vohra, M Hollyman, P J Marriott, A Buja, D Alderson, S Pasquali, E A Griffiths
BACKGROUND: The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs...
October 20, 2016: British Journal of Surgery
Anurag Yadava, Sunil K Rajput, Sarika Katiyar, Rajnish K Jain
BACKGROUND AND AIMS: In laparoscopic surgeries, intraperitoneal instillation of local anaesthetics and opioids is gaining popularity, for better pain relief. This study compared the quality and duration of post-operative analgesia using intraperitoneal tramadol plus bupivacaine (TB) or magnesium plus bupivacaine (MB). METHODS: In this study, 186 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups: group TB received intraperitoneal tramadol with bupivacaine and group MB received intraperitoneal magnesium sulphate (MgSO4) with bupivacaine...
October 2016: Indian Journal of Anaesthesia
Marisa de Carvalho Borges, Tharsus Dias Takeuti, Guilherme Azevedo Terra, Betânia Maria Ribeiro, Virmondes Rodrigues-Júnior, Eduardo Crema
Background: Surgical trauma triggers an important postoperative stress response characterized by significantly elevated levels of cytokines, an event that can favor the emergence of immune disorders which lead to disturbances in the patient's body defense. The magnitude of postoperative stress is related to the degree of surgical trauma. Aim: To evaluate the expression of pro-inflammatory (TNF-α, IFN-γ, IL-1β, and IL-17) and anti-inflammatory (IL-4) cytokines in patients submitted to conventional and single-port laparoscopic cholecystectomy before and 24 h after surgery...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Peter Szasz, Esther M Bonrath, Marisa Louridas, Andras B Fecso, Brett Howe, Adam Fehr, Michael Ott, Lloyd A Mack, Kenneth A Harris, Teodor P Grantcharov
OBJECTIVES: The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. BACKGROUND: Scores on performance assessments are difficult to interpret in the absence of established standards...
July 28, 2016: Annals of Surgery
George Younan, Max Schumm, Fadwa Ali, Kathleen K Christians
Introduction. Gallbladder volvulus is a rare, potentially fatal condition unless diagnosed and treated early. Choledochal cysts are rare congenital malformations of the biliary tree predisposing to different pathologies and posing the risk of degradation into cholangiocarcinoma and gallbladder cancer. Dealing with both diseases at once has not been published yet in the literature. Presentation of Case. We report a case of gallbladder volvulus in an elderly female who happened to have a concomitant type I choledochal cyst...
2016: Case Reports in Surgery
Ejas P Bava, Rashmi Ramachandran, Vimi Rewari, Chandralekha, Virinder Kumar Bansal, Anjan Trikha
BACKGROUND: Transversus abdominis plane (TAP) block has been used to provide intra- and post-operative analgesia with single incision laparoscopic (SIL) bariatric and gynecological surgery with mixed results. Its efficacy in providing analgesia for SIL cholecystectomy (SILC) via the same approach remains unexplored. AIMS: The primary objective of our study was to compare the efficacy of bilateral TAP block with local anesthetic infiltration for perioperative analgesia in patients undergoing SILC...
September 2016: Anesthesia, Essays and Researches
Annetje C P Guédon, M Paalvast, F C Meeuwsen, D M J Tax, A P van Dijke, L S G L Wauben, M van der Elst, J Dankelman, J J van den Dobbelsteen
Operating Room (OR) scheduling is crucial to allow efficient use of ORs. Currently, the predicted durations of surgical procedures are unreliable and the OR schedulers have to follow the progress of the procedures in order to update the daily planning accordingly. The OR schedulers often acquire the needed information through verbal communication with the OR staff, which causes undesired interruptions of the surgical process. The aim of this study was to develop a system that predicts in real-time the remaining procedure duration and to test this prediction system for reliability and usability in an OR...
December 2016: Journal of Medical Systems
Didier Roulin, Alend Saadi, Luca Di Mare, Nicolas Demartines, Nermin Halkic
OBJECTIVE: The aim of this study was to compare clinical outcomes of early versus delayed laparoscopic cholecystectomy (LC) in acute cholecystitis with more than 72 hours of symptoms. BACKGROUND: LC is the treatment of acute cholecystitis, with consensus recommendation that patients should be operated within 72 hours of evolution. Data however remain weak with no prospective study focusing on patients beyond 72 hours of symptoms. METHODS: Patients with acute cholecystitis and more than 72 hours of symptoms were randomly assigned to early LC (ELC) or delayed LC (DLC)...
November 2016: Annals of Surgery
Ayman Al-Jazaeri, Firas Ghomraoui, Wejdan Al-Muhanna, Ahmed Saleem, Hazem Jokhadar, Tareq Aljurf
BACKGROUND: Privatization is widely perceived as a tool to improve healthcare access; however, its impact on the access of surgical care has not been quantified. We used cholecystectomy as a model to assess the variation in access between coexisting public (PB) and private providers (PVs). METHODS: We performed cross-sectional analysis of patients who underwent cholecystectomy at two major PB and PV groups serving Riyadh, Saudi Arabia. Representative sample sizes were estimated based on 95 % confidence level and ±5 confidence interval (CI)...
October 12, 2016: World Journal of Surgery
Sheng-Hui Huang, Jing Lu, Hong-Yun Gan, Yi Li, Yong-Gang Peng, Shuan-Ke Wang
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is an adjunct therapy to provide effective postoperative analgesia in abdominal surgical procedures. Dexamethasone is a supplement agent that can improve the efficacy of local anesthesia. However, information about its additive effect is limited. This study aimed to compare the analgesic efficiency using ultrasound-guided TAP block with and without perineural dexamethasone for patients who underwent laparoscopic cholecystectomy...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Jose M de Miguel-Yanes, Manuel Mendez-Bailon, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Napoleon Perez-Farinos, Fernando Turegano, Nuria Munoz-Rivas, Ana Lopez-de-Andres
BACKGROUND: This study aimed to compare the rates of open and laparoscopic cholecystectomies and outcomes in patients with or without type 2 diabetes mellitus (T2DM) in Spain from 2003 to 2013. METHODS: We collected all cases of open and laparoscopic cholecystectomies using national hospital discharge data and evaluated the annual cholecystectomy rates stratified by T2DM status. We analyzed tendency for in-hospital mortality (IHM). We also analyzed the impact of T2DM on IHM in patients who underwent cholecystectomies...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Xming Yang, Jie Xie, Jun Liu, Tao Wang
This study aims to study the impact of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy. 40 patients scheduled for laparoscopic cholecystectomy were randomly divided into 2 groups: Dexmedetomidine group (0.5µg/kg loading within 10 min and 0.5μg•kg-1•h-1maintenance to the end of pneumoperitoneum, n=20, Group A) and control group (normal saline at the identical, n=20, Group B). The induction and maintenance of anesthesia of two groups were identical. Erythrocyte deformability index (EI) and haematocrit (Hct) were assayed before anesthesia and after the operation...
September 2016: Pakistan Journal of Pharmaceutical Sciences
Young Suk Kwon, Ji Su Jang, Na Rea Lee, Seong Su Kim, Young Ki Kim, Byeong Mun Hwang, Seong Sik Kang, Hee Jeong Son, So Young Lim
Background. Oxycodone, a semisynthetic opioid, has been widely used for acute and chronic pain. Objectives. The aim of this study was to compare the analgesic and adverse effects of oxycodone and alfentanil on postoperative pain after laparoscopic cholecystectomy. Methods. This was a prospective, randomized, double-blind study. A total of 82 patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either oxycodone or alfentanil using intravenous patient-controlled analgesia (PCA). PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass for 48 hours postoperatively...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
Kristy Kummerow Broman, Li-Ching Huang, Adil Faqih, Sharon E Phillips, Rebeccah B Baucom, Richard A Pierce, Michael D Holzman, Kenneth W Sharp, Benjamin K Poulose
BACKGROUND: Ventral hernia repair with mesh is increasingly common, but the incidence of long term complications that necessitate mesh explantation is unknown. We aimed to determine the epidemiology of mesh explantation after ventral hernia repair and to compare this with common bile duct injury, a dreaded complication of laparoscopic cholecystectomy. STUDY DESIGN: We evaluated a retrospective cohort of patients undergoing ventral hernia repair by linking the all-payers State Inpatient Databases and State Ambulatory Surgery Databases for NY, CA, and FL...
October 7, 2016: Journal of the American College of Surgeons
Vittorio Bresadola, Riccardo Pravisani, Marina Pighin, Luca Seriau, Vittorio Cherchi, Sergio Giuseppe, Andrea Risaliti
BACKGROUND: Training programs for resident surgeons represent a challenge for the mentoring activity. The aim of the present study is to investigate the impact of our training program for laparoscopic cholecystectomy on patient's safety and on the modulation of the residents' exposure to clinical scenario with different grades of complexity. MATERIAL AND METHODS: This is a retrospective study based on a clinical series of laparoscopic cholecystectomy performed in a teaching hospital...
November 2016: Annals of Medicine and Surgery
Shuji Akimoto, Masataka Banshodani, Masahiro Nishihara, Junko Nambu, Yasuo Kawaguchi, Fumio Shimamoto, Kiyohiko Dohi, Keizo Sugino, Hideki Ohdan
Serum carbohydrate antigen 19-9 (CA 19-9), a marker of malignant tumors, is generally slightly elevated in benign conditions. We report a case of acute cholecystitis with a significantly elevated level of serum CA 19-9 based on positron emission tomography (PET)-computed tomography (CT) findings. A 65-year-old woman presented with abdominal pain and fever. A CT image revealed an enlarged gallbladder without tumor shadows. The C-reactive protein (CRP) level was elevated to 7.66 mg/dl. Moreover, the serum CA 19-9 level was significantly elevated to 19,392 U/ml...
May 2016: Case Reports in Gastroenterology
Jesús A Bahena-Aponte, Guillermo Ramírez de Aguilar, Juan Carlos Torres Carrillo, Luis Espino Urbina, Jesús A Sánchez González
We present the case of a 34 years old female patient who presents with abdominal pain and elevated total and direct bilirrubins, so she underwent ERCP Reporting: a) successful sphincterotomy without complications, b) choledocholithias is endoscopically resolved, c) secondary cholangitis. She developed significant abdominal pain at 72 h, with hypovolemic shock and peritoneal irritation. She was taken to the surgery, finding a grade III liver laceration. This one was resolved with liver raffia and packing, during the same operative time cholecystectomy was performed...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"