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Timing of cholecystectomy

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https://www.readbyqxmd.com/read/28326468/day-case-laparoscopic-cholecystectomy-analysis-of-the-factors-allowing-early-discharge
#1
Giovanni Domenico Tebala, Angela Belvedere, Sean Keane, Abdul Qayyum Khan, Abdelsalam Osman
Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed. Primary endpoints were: postoperative length of stay, rate of patients discharged within 24 h, and rate of those discharged on the same day...
March 21, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28325053/-iatrogenic-biliary-tract-lesions-requiring-surgical-reconstruction-presentation-and-classification-of-the-lesions-their-reconstruction-and-evaluation-of-the-results
#2
M Straka, E Holášková, L Burda, M Vávrová, P Fojtík, M Škrovina
INTRODUCTION: The incidence of biliary duct injuries requiring surgical reconstruction has stabilised between 0.30.7%. Biliary reconstruction in the hands of a trained hepatobiliary surgeon may lead to better short- and long-term outcomes in patients with this infrequent, but serious complication. METHODS: This study presents a retrospective analysis of single surgeon experience with biliary injury repair during the period of 20072016. Extramucosal hepaticojejunostomy on the excluded segment of the jejunal loop was performed without the use of any transanastomotic drain...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28316464/peritoneal-nebulization-of-ropivacaine-during-laparoscopic-cholecystectomy-dose-finding-and-pharmacokinetic-study
#3
Massimo Allegri, Martina Ornaghi, Catherine E Ferland, Dario Bugada, Yash Meghani, Serena Calcinati, Manuela De Gregori, Federica Lovisari, Krishnaprabha Radhakrishnan, Maria Cusato, Stefano Scalia Catenacci, Marta Somaini, Guido Fanelli, Pablo Ingelmo
Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28316310/three-port-two-located-on-the-pfannenstiel-line-laparoscopic-cholecystectomy-comparison-with-traditional-laparoscopic-cholecystectomy
#4
Musa Akoglu, Erdal Birol Bostanci, Muhammet Kadri Colakoglu, Erol Aksoy
Laparoscopic cholecystectomy (LC) is seen as a gateway to minimally invasive surgery. We defined a new three-port technique with different port sites and compared the postoperative results with traditional four-port LC procedure in a case-match study. Between June 2012 and May 2013, 104 consecutive patients underwent three-port LC by same experienced surgeon. In the same center, 2963 consecutive patients underwent four-port LC, and of these 2963 patients, a matched group of 104 patients was selected. Data included patient age, gender, body mass index, American Society of Anesthesiologists score, history of abdominal operations, intraoperative data about operating time and conversion to open surgery, and postoperative data about length of hospital stay and postoperative complications were recorded prospectively...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28301292/reduce-adverse-effects-of-laparoscopic-cholecystectomy-with-pulse-width-modulated-led-light-625%C3%A2-nm-76%C3%A2-hz-23-duty-cycle
#5
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
https://www.readbyqxmd.com/read/28301033/polycyclic-aromatic-hydrocarbons-produced-by-electrocautery-smoke-and-the-use-of-personal-protective-equipment-1
#6
Caroline Vieira Claudio, Renata Perfeito Ribeiro, Júlia Trevisan Martins, Maria Helena Palucci Marziale, Maria Cristina Solci, José Carlos Dalmas
Objective: analyze the concentration of polycyclic aromatic hydrocarbons in electrocautery smoke in operating rooms and the use of personal protective equipment by the intraoperative team when exposed to hydrocarbons. Method: exploratory and cross-sectional field research conducted in a surgery center. Gases were collected by a vacuum suction pump from a sample of 50 abdominal surgeries in which an electrocautery was used. A form was applied to identify the use of personal protective equipment...
March 2, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28298770/intraperitoneal-levobupivacaine-with-or-without-clonidine-for-pain-relief-after-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#7
Nishith Govil, Parag Kumar
BACKGROUND: Irrigation of local anesthetic intraperitoneally in combination with opioids and non-opioids agents has been used to provide pain relief with varying success in laparoscopic surgeries. This randomized double blind placebo controlled study is designed to study the effect of intraperitoneal instillation of levo-bupivacaine along with clonidine for pain relief after laparascopic cholecystectomy. METHODS: 75 patients were randomized to receive 20 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298759/effect-of-magnesium-sulfate-and-clonidine-in-attenuating-hemodynamic-response-to-pneumoperitoneum-in-laparoscopic-cholecystectomy
#8
Shruthi P Kamble, Yatish Bevinaguddaiah, Dinesh Chillkunda Nagaraja, Vinayak S Pujar, Tejesh C Anandaswamy
BACKGROUND: Pneumoperitoneum in laparoscopic procedures is associated with hemodynamic response, due to the release of catecholamines and vasopressin. Magnesium and clonidine have been used to attenuate such hemodynamic responses by inhibiting release of these mediators. We conducted this randomized, double-blinded study to assess which of the two attenuates hemodynamic response better. MATERIALS AND METHODS: Ninety American Society of Anesthesiologists health status Classes I and II patients posted for elective laparoscopic cholecystectomy were randomized into three groups of thirty patients each...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28284749/can-the-timing-of-laparoscopic-cholecystectomy-after-biliary-pancreatitis-change-the-conversion-rate-to-open-surgery
#9
Fikret Aksoy, Gökhan Demiral, Özgür Ekinci
BACKGROUND: Biliary pancreatitis (BP) constitutes 30-55% of all cases of acute pancreatitis. Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease. We aimed to compare and evaluate the relation between the timing of LC and the rates and reasons of conversion to open surgery (OS) after BP. METHODS: Data were collected of patients who presented for the first time with acute BP and underwent LC. The patients were divided into two groups: early cholecystectomy (Group 1), patients who underwent cholecystectomy during the first pancreatitis attack upon admission and before discharge from hospital (1-3 days); and late cholecystectomy (Group 2), patients who received medical treatment during their first pancreatitis episode and underwent surgery after 4-10 weeks...
March 9, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28281519/-abdominal-pain-syndrome-and-quality-of-life-in-patients-with-cholelithiasis-after-cholecystectomy-during-a-10-year-follow-up
#10
Yu V Makarova, N V Litvinova, M F Osipenko, N B Voloshina
AIM: To estimate the incidence of abdominal pain syndrome (APS) and to assess quality of life (QOL) in patients within 10 years after cholecystectomy (CE). SUBJECTS AND METHODS: This investigation is part of a long-term prospective follow-up study of patients after CE for cholelithiasis (CL). It enrolled 145 people: 30 (21.5%) patients with baseline asymptomatic CL and 115 (80.7%) with its clinical manifestations. The time course of changes in APS and QOL were analyzed...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28281477/impact-of-seniority-on-operative-time-and-short-term-outcome-in-laparoscopic-cholecystectomy-experience-of-an-academic-surgical-department-in-a-developing-country
#11
Amine Souadka, Mohammed Sayed Naya, Badr Serji, Hadj Omar El Malki, Raouf Mohsine, Lahsen Ifrine, Abdelkader Belkouchi, Amine Benkabbou
INTRODUCTION: Resident participation in laparoscopic cholecystectomy (LC) is one of the first steps of laparoscopic training. The impact of this training is not well-defined, especially in developing countries. However, this training is of critical importance to monitor surgical teaching programmes. OBJECTIVE: The aim of this study was to determine the impact of seniority on operative time and short-term outcome of LC. DESIGNS AND SETTINGS: We performed a retrospective study of all consecutive laparoscopic cholecystectomies for gallbladder lithiasis performed over 2 academic years in an academic Surgical Department in Morocco...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28276822/incidence-and-predictive-factors-for-positive-75-sehcat-test-improving-the-diagnosis-of-bile-acid-diarrhoea
#12
Iain Alexander Murray, Linzi Karen Murray, Kathy Louise Woolson, Hisham Sherfi, Ivor Dixon, Joanne Palmer, Tom Sulkin
AIMS: To determine the value of (75)SeHCAT retention in determining bile acid diarrhoea (BAD), treatment response and predictors of a positive result. METHODS: Retrospective casenote review of consecutive patients undergoing (75)SeHCAT from 2008 to 2014, including gender, age, history, clinical, and laboratory parameters. This included diseases associated with Type 1 BAD (ileal resection, Crohn's disease) and Type 3 BAD. Chi-squared test and logistic regression determined factors predictive of BAD...
March 5, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28272260/analgesic-efficacy-of-ultrasound-guided-subcostal-transversus-abdominis-plane-block
#13
Jianfeng Ma, Yifei Jiang, Shiyi Tang, Benfu Wang, Qingquan Lian, Zuokai Xie, Jun Li
BACKGROUND: To evaluate the analgesic efficacy on defined areas of the abdomen and back after ultrasound-guided subcostal transversus abdominis plane (TAP) block using 0.25% levobupivacaine 0.5 mL/kg. METHODS: Twenty patients undergoing elective laparoscopic cholecystectomy, between 20 and 60 years of age with operative time <1 hour, received subcostal TAP block using 0.25% levobupivacaine 0.5 mL/kg on the left side. Surgery started after 1 hour of observation...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28271266/near-infrared-fluorescence-laparoscopy-of-the-cystic-duct-and-cystic-artery-first-experience-with-two-new-preclinical-dyes-in-a-pig-model
#14
Jacqueline van den Bos, Mahdi Al-Taher, Shu Gi Hsien, Nicole D Bouvy, Laurents P S Stassen
BACKGROUND: Imaging techniques that enhance visualisation of the anatomy may help prevent bile duct injury. Near-Infrared Fluorescence Imaging is such a technique. Previous experiments with ICG have shown that illumination of the extra-hepatic bile ducts is feasible. Yet, there is room for improvement in the visualisation of the target as compared to the background. Experiments with IRDye(®) 800CW show promising results. However, this dye is too expensive for routine clinical use. The aim of this study is to test the first applicability of two newly developed preclinical dyes regarding intraoperative imaging of the cystic duct and cystic artery, compared with IRDye(®) 800CW...
March 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28270004/-the-first-use-of-iv-idarucizumab-for-dabigatran-reversal-in-hungary
#15
Lajos Driesz, Éva Barabás, Ildikó Bodócs, Zoltán Szántó, György Herr, Gábor Bencsik, László Pál, József Borbola
At present, the direct thrombin inhibitor dabigatran is the only one amongst the new direct anticoagulants which has an effective, specific reversal agent. The novel agent idarucizumab is a humanized, monoclonal antibody fragment binds to dabigatran within minutes thereby offers an opportunity to induce a safe, long-lasting reverse of the anticoagulant effects of dabigatran. The authors describe the first use of idarucizumab in Hungary (23. 05. 2016) in an old female patient with non-valvular paroxysmal atrial fibrillation of high stroke risk-score and renal dysfunction who was taking dabigatran (2 x 110 mg/day) when an acute abdomen developed requiring emergency cholecystectomy...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28262629/-results-of-cholecystectomies-2003-2010-in-a-small-hospital-in-iceland
#16
Marta Ros Berndsen, Fritz Hendrik Berndsen
AIM: Cholecystectomy is a common procedure in general surgery. The aim of this study was to retrospectivly assess the results of cholecystectomies performed in Akranes Hospital (AH), a small hospital in Iceland. MATERIAL AND METHODS: This retrospective study included all patients that underwent a cholecystectomy in AH from 1 January 2003 to 31 December 2010. Patient records were reviewed from AH, as well as from Landspitali University Hospital and Domus Medica. RESULTS: 378 operations were performed...
2017: Læknablađiđ
https://www.readbyqxmd.com/read/28261559/effects-of-combined-rocuronium-and-cisatracurium-in-laparoscopic-cholecystectomy
#17
Woo Young Park, Kwang Ho Lee, Young Bok Lee, Myeong Hoon Kim, Hyun Kyo Lim, Jong Bum Choi
BACKGROUND: Laparoscopic upper abdominal surgery can cause spontaneous respiration due to diaphragmatic stimulation and intra-abdominal CO2 inflation. Therefore, sufficient muscle relaxation is necessary for a safe surgical environment. METHODS: We investigated if the combination of rocuronium and cisatracurium can counteract the delayed onset of cisatracurium's action and delayed recovery of muscle relaxation and whether the dosage of rocuronium, which is metabolized hepatically, can be reduced...
January 2017: Journal of Lifestyle Medicine
https://www.readbyqxmd.com/read/28256257/single-incision-versus-3-port-laparoscopic-cholecystectomy-in-symptomatic-gallstones-a-prospective-randomized-study
#18
Mohammed A Omar, Alaa A Redwan, Ahmed G Mahmoud
BACKGROUND: Laparoscopic cholecystectomy is the standard treatment for symptomatic gallbladder disease. Single-incision laparoscopic surgery was developed with the aim of decreasing the invasiveness of conventional laparoscopy. The aim of this study was to compare the clinical outcome of single-incision laparoscopic cholecystectomy with 3-port laparoscopic cholecystectomy. METHODS: From February 2014 to September 2016, 187 patients with symptomatic cholecystolithiasis were randomized to a single-incision laparoscopic cholecystectomy group (89 patients) or a 3-port laparoscopic cholecystectomy group (98 patients)...
February 27, 2017: Surgery
https://www.readbyqxmd.com/read/28251270/delayed-laparoscopic-cholecystectomy-for-acute-calculous-cholecystitis-is-it-time-for-a-change
#19
Jonathan B Yuval, Ido Mizrahi, Haggi Mazeh, Daniel J Weiss, Gidon Almogy, Miklosh Bala, Eran Kuchuk, Baha Siam, Natalia Simanovsky, Ahmed Eid, Alon J Pikarsky
BACKGROUND: Our aim was to evaluate the advantages and limitations of delayed laparoscopic cholecystectomy (LC) in a tertiary center. MATERIALS AND METHODS: A retrospective analysis of all patients admitted to our institution with acute calculous cholecystitis (ACC) between January 2003 and December of 2012 was performed. Data collected included patient demographics and comorbidities, presenting symptoms, laboratory findings, imaging results, length of stay (LOS), time to surgery, and surgical complications...
March 1, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28247305/virtual-laparoscopic-training-system-based-on-vch-model
#20
Jiangzhou Tang, Lang Xu, Longjun He, Songluan Guan, Xing Ming, Qian Liu
Laparoscopy has been widely used to perform abdominal surgeries, as it is advantageous in that the patients experience lower post-surgical trauma, shorter convalescence, and less pain as compared to traditional surgery. Laparoscopic surgeries require precision; therefore, it is imperative to train surgeons to reduce the risk of operation. Laparoscopic simulators offer a highly realistic surgical environment by using virtual reality technology, and it can improve the training efficiency of laparoscopic surgery...
April 2017: Journal of Medical Systems
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