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Timing of cholecystectomy

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https://www.readbyqxmd.com/read/28916962/effects-of-cholecystectomy-on-recurrent-biliary-complications-after-endoscopic-treatment-of-common-bile-duct-stone-a-population-based-cohort-study
#1
Chi-Tung Cheng, Chun-Nan Yeh, Kun-Chun Chiang, Ta-Sen Yeh, Kuan-Fu Chen, Shao-Wei Chen
BACKGROUND: The aim of this study was to evaluate the benefits of cholecystectomy on mitigating recurrent biliary complications following endoscopic treatment of common bile duct stone. METHODS: We used the data from the Taiwan National Health Insurance Research Database to conduct a population-based cohort study. Among 925 patients who received endoscopic treatment for choledocholithiasis at the first admission from 2005 to 2012, 422 received subsequent cholecystectomy and 503 had gallbladder (GB) left in situ...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916877/bile-duct-injury-and-morbidity-following-cholecystectomy-a-need-for-improvement
#2
Meredith Barrett, Horacio J Asbun, Hung-Lung Chien, L Michael Brunt, Dana A Telem
BACKGROUND: Bile duct injury (BDI) remains the most dreaded complication following cholecystectomy with serious repercussions for the surgeon, patient and entire healthcare system. In the absence of registries, the true incidence of BDI in the United States remains unknown. We aim to identify the incidence of BDI requiring operative intervention and overall complications after cholecystectomy. METHODS: Utilizing the Truven Marketscan(®) research database, 554,806 patients who underwent cholecystectomy in calendar years 2011-2014 were identified using ICD-9 procedure and diagnosis codes...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28906420/outcomes-of-consistent-conservative-management-for-acute-cholecystitis-followed-by-delayed-cholecystectomy
#3
Shohei Komatsu, Shinobu Tsuchida, Tomoyuki Wakahara, Nozomi Ueno, Akihiro Toyokawa, Akihiko Watanabe, Atsushi Sugahara, Hidekazu Mukai
OBJECTIVE: This study's objective was to assess outcomes of a totally conservative strategy for acute cholecystitis (AC) followed by delayed elective cholecystectomy. PATIENTS AND METHODS: Consecutive patients who underwent cholecystectomy for AC were divided into the Emergent and Elective cholecystectomy groups. Patients in the elective cholecystectomy group were divided into early, medium, and late groups according to time from symptoms onset. RESULTS: The success rate for conservative management reached 97...
September 12, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28906372/efficacy-and-safety-of-laparoscopic-bile-duct-exploration-versus-endoscopic-sphincterotomy-for-concomitant-gallstones-and-common-bile-duct-stones-a-meta-analysis-of-randomized-controlled-trials
#4
Ying-Chao Gao, Jinjun Chen, Qiyu Qin, Hu Chen, Wei Wang, Jian Zhao, Fulong Miao, Xin Shi
BACKGROUND: The purpose of this study was to compare the efficacy and safety of laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct (CBD) stones exploration (LCBDE) with LC plus endoscopic sphincterotomy (EST) in the treatment of patients with gallstones and CBD stones. METHODS: The authors searched PubMed, Web of Science, and Embase to identify relevant studies. Risk ratios (RRs) were pooled to compare stone clear, retained stone, conversion to other procedures, and complications...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905807/buttressing-hepaticojejunostomy-apos-s-with-hepatic-round-ligament-flap-may-be-beneficial
#5
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
BACKGROUND: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. METHODS: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28904273/a-review-of-7-cases-of-laparoscopic-cholecystectomy-for-pediatric-cholecystolithiasis
#6
Nobutaka Matayoshi, Norihiro Sato, Takashi Okimoto, Takehide Tajima, Koichi Arase, Nagahiro Sato, Toshihisa Tamura, Kazunori Shibao, Aiichiro Higure, Keiji Hirata
Pediatric cholecystolithiasis is a relatively rare disease, but it is recently increasing in Japan. Laparoscopic cholecystectomy (LC) is a standard procedure for cholecystolithiasis not only in adults but also in children, and we are aggressively introducing single-incision laparoscopic cholecystectomy (SILC) at our hospital. We reviewed the patient characteristics, operation procedures and outcomes of 7 children (15 years old and under) with cholecystolithiasis who underwent LC in our hospital between August 1995 and December 2015...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28903845/new-maneuver-in-robotic-single-port-cholecystectomy
#7
Bahadir Ege, Merter Gulen
The need to integrate aspects of functional, psychosocial and cosmetic impairment into medical care is increasingly accepted among the physicians and the patients. For these reasons, single-port robotic surgery emerges as the most advanced approach using the technology. In this study, authors used a new robotic dissector with monopolar electrocautery feature in order to determine the device's safety and efficacy. Between January 2015 and February 2016, 10 out of 11 consecutive cholecystectomies were included in the study...
August 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28898561/haptic-simulation-of-tissue-tearing-during-surgery
#8
C Quesada, I Alfaro, D González, F Chinesta, E Cueto
We present a method for the real-time, interactive simulation of tissue tearing during laparoscopic surgery. The method is designed to work at haptic feedback rates (i.e., around 1kHz). Tissue tearing is simulated under the general framework of continuum damage mechanics. The problem is stated as a general, multidimensional parametric problem, which is solved by means of Proper Generalized Decomposition (PGD) methods. One of the main novelties is the reduction of history-dependent problems, such as damage mechanics, by resorting to an approach in which a reduced-order field of initial damage values is considered as a parameter of the formulation...
September 12, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28889240/ursodeoxycholic-acid-in-the-prevention-of-gallstone-formation-after-bariatric-surgery-an-updated-systematic-review-and-meta-analysis
#9
REVIEW
Dimitrios E Magouliotis, Vasiliki S Tasiopoulou, Alexis A Svokos, Konstantina A Svokos, Christina Chatedaki, Eleni Sioka, Dimitris Zacharoulis
We aim to review the available literature on obese patients treated with ursodeoxycholic acid (UDCA) in order to prevent gallstone formation after bariatric surgery. A systematic literature search was performed in PubMed, Cochrane library, and Scopus databases, in accordance with the PRISMA guidelines. Eight studies met the inclusion criteria incorporating 1355 patients. Random-effects meta-analysis showed a lower incidence of gallstone formation in patients taking UDCA. Subgroup analysis reported fewer cases of gallstone disease in the UDCA group in relation to different bariatric procedures, doses of administered UDCA, and time from bariatric surgery...
September 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28885898/antibiotic-prescribing-practices-for-prevention-of-surgical-site-infections-in-australia-increased-uptake-of-national-guidelines-after-surveillance-and-reporting-and-impact-on-infection-rates
#10
Ann L Bull, Leon J Worth, Tim Spelman, Michael J Richards
BACKGROUND: Antimicrobial prophylaxis is the single most effective intervention to reduce risk of surgical site infections (SSIs); however, prescribing practices should be aligned with accepted and recommended surgical antibiotic prophylaxis (SAP) regimens to be effective. As part of a comprehensive surveillance network, SAP data are collated and analyzed for compliance with recommendations. Results are reported to hospitals for quality improvement purposes. In this study, statewide results were analyzed to ascertain changes over time and whether improved compliance was associated with a reduction in risk for SSI...
September 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28883294/potential-risk-factors-for-postoperative-complications-and-deaths-after-laparoscopic-cholecystectomy-in-the-elderly
#11
Manabu Sato, Koujin Endo, Akihiko Harada, Shinichi Yabuuchi
Laparoscopic cholecystectomy (LC) is performed for gallbladder stones and cholecystitis in a large number of elderly patients. However, the safety of LC in the elderly is questioned. The aim of this study was to investigate predictive factors for the incidence of postoperative complications and deaths after LC in patients aged 80 years and older. Data from 85 elderly patients who underwent LC between January 2005 and December 2015 were prospectively collected in a database at our hospital. The following factors were compared for the occurrence of postoperative complications and deaths:age, gender, Body Mass Index, laboratory date, severity grade of cholecystitis, comorbidity of choledocholithiasis, conversion to open cholecystectomy, early or delayed LC, amount of time from onset to LC, operative duration, blood loss, and the following scoring systems for predicting risk of surgery:ECOG-PS, ASA, SIRS, CONUT, POSSUM, SAS, E-PASS...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28882683/structured-operative-autonomy-an-institutional-approach-to-enhancing-surgical-resident-education-without-impacting-patient-outcomes
#12
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Dustin R Long, Haytham Ma Kaafarani, Emil Petrusa, John T Mullen, Keith D Lillemoe, Roy Phitayakorn
BACKGROUND: Though barriers to granting surgical residents autonomy in the operating room are well described, few have proposed practical strategies to overcome them. Our department adopted a multidisciplinary approach to develop a rotation that aimed to grant chief residents structured operative autonomy. In this study, we assess the feasibility of implementation, impact on patient safety and educational benefit to residents following the program's pilot year. STUDY DESIGN: During a one-month rotation, chief residents began cases alone using their own operative block time...
September 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28876676/factors-contributing-to-elective-theatre-cancellations-in-the-department-of-surgery-at-chbah
#13
M Mulira, M D Smith, J Moorman
BACKGROUND: Elective theatre cancellations is a common experience the world over that impacts on theatre efficiency with undesirable consequences on the health care system, the patients and their families. It increases costs of running theatres, is a financial burden and emotional strain on patients and their families. METHOD: A retrospective study where 300 cancellations in the Department of Surgery were randomly selected and analysed from the Morbidity and Mortality meetings held at Chris Hani Baragwanath Academic Hospital from November 2015...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875690/use-of-fully-covered-self-expanding-metal-stents-for-benign-biliary-etiologies-a-large-multi-center-experience
#14
Abdul Haseeb, Ali Siddiqui, Linda J Taylor, Alyssa Mills, Thomas E Kowalski, David E Loren, Jessica Dahmus, Silpa Yalamanchili, Christopher Cao, Andrew Canakis, Tayebah Mumtaz, Meet Parikh, Douglas G Adler
INTRODUCTION: Fully-covered self-expandable metal stents (FCSEMS) have been used in benign biliary diseases although reported data is limited. These devices are most commonly used to treat biliary leaks, strictures, or both. The aim of this study was to evaluate effectiveness of FCSEMS in treating benign biliary disease and recognize the associated complications. METHODS: We performed a multi-center longitudinal retrospective cohort study of patients with benign biliary disease needing FCSEMS between 2011 and 2016...
September 5, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28875529/single-incision-robotic-cholecystectomy-is-associated-with-a-high-rate-of-trocar-site-infection
#15
Chetana Lim, Georges Bou Nassif, Eylon Lahat, Mohamad Hayek, Michael Osseis, Concepcion Gomez Gavara, Toufic Moussalem, Daniel Azoulay, Chady Salloum
BACKGROUND: Single-incision robotic cholecystectomy has been developed to decrease post-operative pain and improve cosmetic results. METHODS: Thirty-seven patients underwent single-site robotic cholecystectomy between 2014 and 2015. Postoperative outcomes and costs were compared to reported outcomes for laparoscopic cholecystectomy using the configuration of suprapubic trocars. RESULTS: The median age was comparable between the two groups (46 years in the robotic group vs...
September 6, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28874623/factors-affecting-the-conversion-to-open-surgery-during-laparoscopic-cholecystectomy-in-patients-with-cholelithiasis-undergoing-ercp-due-to-choledocholithiasis
#16
Hamza Cinar, Gökhan S Ozbalci, Ismail A Tarim, Kagan Karabulut, Tugrul Kesicioglu, Ayfer K Polat, Kenan Erzurumlu, Murat Derebey
BACKGROUND: The rate of conversion to open surgery is high in laparoscopic cholecystectomy (LC) after Endoscopic Retrograde Cholangiopancreotocography (ERCP). The present study aimed to evaluate the risk factors associated with the conversion to open cholecystectomy and minimize the rate of conversion to open surgery. METHODS: A total of 157 patients admitted to the Ondokuz Mayıs University Medical Faculty Hospital due to cholelithiasis and choledocholithiasis between January 2002 and December 2012, and they receiving laparoscopic cholecystectomy were included in the study...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28874618/cholecystectomy-in-emilia-romagna-region-italy-a-retrospective-cohort-study-based-on-a-large-administrative-database
#17
Fausto Catena, Rita Maria Melotti, Daniel Louis, Daniela Fortuna, Luca Ansaloni, Federico Coccolini, Salomone Di Saverio, Massimo Sartelli, Antonio Tarasconi, Gianluca Baiocchi, Nazario Portolani, Josephine Napoli, Belinda De Simone, Rodolfo Catena, Rossana De Palma
BACKGROUND: The aim of this study was to ascertain the variability and to identify a trend for the outcome of cholecystectomy surgery when used to treat cholelithiasis and acute cholecystitis. METHODS: This was a large retrospective cohort study following patients up to 11 years post surgery, based on administrative data collected from 2002 to 2012 in the Emilia-Romagna Region (Northern Italy) and comparing the effectiveness and efficiency of surgical activity (laparoscopic (LC) and open cholecystectomy (OC))...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28872096/clinical-reappraisal-of-vasculobiliary-anatomy-relevant-to-laparoscopic-cholecystectomy
#18
Kuldip Singh, Ranbir Singh, Manjot Kaur
BACKGROUND: Laparoscopic cholecystectomy (LC) has many advantages as compared to open cholecystectomy. However, vasculobiliary injuries still continue to be a matter of concern despite advances in laparoscopic techniques. Misidentification and misperception of vasculobiliary structures is considered to be a pivotal factor leading to injuries. Although many studies since time immemorial have stressed on the importance of anatomy, an insight into laparoscopic anatomy is what essentially constitutes the need of the hour...
October 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28871872/comparative-study-of-2d-and-3d-optical-imaging-systems-laparoendoscopic-single-site-surgery-in-an-ex-vivo-model
#19
Jaime Vilaça, José Pedro Pinto, Sandra Fernandes, Patrício Costa, Jorge Correia Pinto, Pedro Leão
BACKGROUND: Usually laparoscopy is performed by means of a 2-dimensional (2D) image system and multiport approach. To overcome the lack of depth perception, new 3-dimensional (3D) systems are arising with the added advantage of providing stereoscopic vision. To further reduce surgery-related trauma, there are new minimally invasive surgical techniques being developed, such as LESS (laparoendoscopic single-site) surgery. The aim of this study was to compare 2D and 3D laparoscopic systems in LESS surgical procedures...
September 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28869389/the-use-of-imaging-in-acute-pancreatitis-in-united-kingdom-hospitals-findings-from-a-national-quality-of-care-study
#20
Simon John McPherson, Derek A O'Reilly, Martin T Sinclair, Neil Smith
OBJECTIVE: To assess use of imaging in patients admitted to UK hospitals with acute pancreatitis (AP). METHODS: 4,479 patients had a diagnosis AP in the first 6 months of 2014. The National Confidential Enquiry into Patient Outcome and Death Patients (NCEPOD) selected patients with more severe AP for case review. Clinicians completed 712 questionnaires and case reviewers assessed 418 cases. The use of imaging in patients with AP is reported. RESULTS: The common causes of AP were gallstones (46...
September 4, 2017: British Journal of Radiology
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