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laparoscopic cholecystectomy and complications

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
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
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
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
Justin Gerard, Minh B Luu, Jennifer Poirier, Daniel J Deziel
INTRODUCTION: The revised Tokyo Guidelines include criteria for determining the severity of acute cholecystitis with treatment algorithms based on severity. The aim of this study was to investigate the relationship of the revised Tokyo Guidelines severity grade to clinical outcomes of cholecystectomy for acute cholecystitis. METHODS: We identified 66 patients with acute cholecystitis from a prior study of difficult cholecystectomy cases. We examined the relationship between severity grade and multiple variables related to perioperative and postoperative outcomes...
March 9, 2018: Surgical Endoscopy
César Muñoz Castro, Sergio Pacheco Santibañez, Tomás Contreras Rivas, Nicolás Jarufe Cassis
INTRODUCTION: Gallbladder cancer (GBC) is a rare tumor in developed countries. Chile has one of the highest incidences worldwide. For patients affected by resectable T1b or more advanced GBC, radical cholecystectomy (RC) is considered the standard therapy. Our aim is to describe the surgical technique and clinical-pathological results of patients undergoing totally laparoscopic radical resection of GBC. METHODS: Patients undergo laparoscopic radical resection for primary and incidental GBC, between the years 2009 and 2016 in two centers from Chile...
March 8, 2018: World Journal of Surgery
Daniel Gilsdorf, Jake Henrichsen, Katie Liljestrand, Allison Staheli, Griffin Olsen, Prem Narayanan, Mark Ott, David S Morris, Raymond Price
BACKGROUND: The ideal management of common bile duct (CBD) stones remains controversial, whether with single-stage management using laparoscopic CBD exploration (LCBDE) during laparoscopic cholecystectomy, or with two-stage management using preoperative or postoperative endoscopic retrograde cholangiopancreatography (ERCP). We wished to elucidate the practice patterns within our health system, which includes both large urban referral centers and small rural critical access hospitals. STUDY DESIGN: Retrospective data analysis from our 22-hospital, not-for-profit, integrated healthcare system...
March 5, 2018: Journal of the American College of Surgeons
Tiancheng Zhao, Zhen Shen, Shihou Sheng
BACKGROUND: Pain control after laparoscopic cholecystectomy (LC) has become an important topic. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of nefopam for pain management after LC. METHODS: PubMed, Medline, Embase, ScienceDirect, and the Cochrane Library were searched up to November 2017 for comparative articles involving nefopam and placebo for reducing postoperative pain after LC. Primary outcomes were postoperative pain scores and opioid consumption...
March 2018: Medicine (Baltimore)
Martín de Santibañes, Juan Glinka, Pablo Pelegrini, Fernando A Alvarez, Cristina Elizondo, Diego Giunta, Laura Barcan, Lionel Simoncini, Nora Cáceres Dominguez, Victoria Ardiles, Oscar Mazza, Rodrigo Sanchez Claria, Eduardo de Santibañes, Juan Pekolj
BACKGROUND: Acute calculous cholecystitis (ACC) is the most common complication of cholelithiasis. Laparoscopic cholecystectomy (LC) is the gold standard treatment in mild and moderate forms. Currently there is consensus for the use of antibiotics in the preoperative phase of ACC. However, the need for antibiotic therapy after surgery remains undefined with a low level of scientific evidence. METHODS: The CHART (Cholecystectomy Antibiotic Randomised Trial) study is a single-center, prospective, double blind, and randomized trial...
March 2, 2018: Surgery
Reed I Ayabe, Aaron B Parrish, Christine E Dauphine, Danielle M Hari, Junko J Ozao-Choy
BACKGROUND: It has become increasingly important to expose surgical residents to robotic surgery as its applications continue to expand. Single-site robotic cholecystectomy (SSRC) is an excellent introductory case to robotics. Resident involvement in SSRC is known to be feasible. Here, we sought to determine whether it is safe to introduce SSRC to junior residents. MATERIALS AND METHODS: A total of 98 SSRC cases were performed by general surgery residents between August 2015 and August 2016...
April 2018: Journal of Surgical Research
Giuliano La Barba, Andrea Gardini, Elena Cavargini, Alessandro Casadei, Paolo Morgagni, Francesca Bazzocchi, Fabrizio D'Acapito, Davide Cavaliere, Roberta Curti, Domenico Tringali, Alessandro Cucchetti, Giorgio Ercolani
BACKGROUND AND AIM: Although the ideal management of cholecysto-choledocholitiasis is controversial, the two-stage approach, namely the common bile duct (CBD) clearance through endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy, remains the standard way of management. However, whenever feasible, the one-stage approach, using the so-called "laparoendoscopic rendezvous" (LERV) technique, offers some advantages, mainly reducing the hospital stay and the risk of post-ERCP pancreatitis...
February 27, 2018: Surgical Endoscopy
Ahmed K Abdel Aal, David P Jones, Jessica Caraway, Amr S Moustafa, Sherif M Moawad, Edgar S Underwood
A case of a 79-year-old man, status post laparoscopic cholecystectomy with a drainage catheter placed at the gallbladder fossa is presented. The case was complicated postoperatively by abdominal pain and bilious discharge from the drainage catheter. Endoscopic retrograde cholangio-pancreatography demonstrated leakage through the cystic duct stump into the gallbladder fossa. Placement of a covered metal stent endoscopically failed to seal the leak. We performed percutaneous embolization of the cystic duct stump using a combination of coils and gelatin sponge through the drainage catheter in the gallbladder fossa...
December 2017: Radiology Case Reports
Shigeru Fujisaki, Motoi Takashina, Yukari Woo, Ryouichi Tomita, Kenichi Sakurai, Tadatoshi Takayama
We present here a case of transduodenal ampullectomy for an ampullary neoplasm coexisting with gastric and colon cancer. The patient was a 72-year-old man who was referred to our hospital with a positive fecal blood test. Colonoscopy revealed advanced cancer in the descending colon. As part of the preoperative examination, for the colonic cancer, upper gastrointestinal endoscopy was performed. Endoscopy showed a 2 cm elevated lesion(0'-II a type)with subserosalinfil tration on the small curvature side of the upper part of the stomach, and a 2 cm elevated lesion on the papilla of Vater...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bao Z Yao, Liang Li, Ming Jiang, Jie Wang, Jun Zhang
RATIONALE: Gallstone disease is commonly worldwide and safely treated by laparoscopic cholecystectomy. Chylous ascites is a rare but serious complication of many abdominal operations. PATIENT CONCERNS: We present a rare case of refractory chyle leakage post-LC for acute cholecystitis that is successfully treated in a 40-year-old man, and review current literature on the prevalence, diagnosis, and management of this complication. DIAGNOSES: Refractory chyle leakage post-LC, a rare but serious complication after laparoscopic cholecystectomy...
January 2018: Medicine (Baltimore)
Shanay Niusha, Farshid Salehi, Mohammad Behgam Shadmehr
Obstructive tracheal pseudomembrane is a rare complication of endotracheal intubation, which could cause fatal airway obstruction following extubation. Hereby, we reported a patient who had only undergone a short course of intubation for a laparoscopic cholecystectomy and developed progressive respiratory distress after extubation.
November 1, 2017: Archives of Iranian Medicine
Mirko Mihalj, Dajana Vladić, Zoran Karlović, Željka Zadro, Višnja Majerić Kogler
Many papers have been published investigating the effects of intraoperative mechanical ventilation on the incidence of intra- and postoperative respiratory complications. The potential advantages of protective pressure over volume-controlled ventilation mode during laparoscopic surgery have yet to be proven. This study included 60 patients aged between 18 and 70 with ASA score 1-3, body mass index (BMI) ≤35 kg/m2, and without prior history of chronic respiratory diseases, who were scheduled for laparoscopic cholecystectomy under general anesthesia...
September 2017: Acta Clinica Croatica
Luke Nugent, Palanichamy Chandran
Dropped gallstones, in addition to inadvertent damage to the biliary tree, is a complication seen in laparoscopic cholecystectomy (LC) far more frequently than the open procedure. It can result in symptomatic abscess formation, and given its relative rarity, can present a diagnostic challenge. We present the case of a lady whose dropped gallstone resulted in a peritoneo-cutaneous fistula, over 20 years on from her LC.
February 2018: Journal of Surgical Case Reports
V I Greyasov, V M Chuguevsky, N I Sivokon, M A Agapov, R S Abubakarov
AIM: To analyze the effect of gallbladder's morpho-functional changes as a risk factor for injury of extrahepatic bile ducts during cholecystectomy. MATERIAL AND METHODS: Laparoscopic cholecystectomy was performed in 20 564 patients. There were 147 64 (71.8%) patients with chronic gallbladder inflammation and 5800 (28.2%) - with acute process. It was performed a retrospective analysis of the incidence and causes of intraoperative trauma of extrahepatic bile ducts and bile outflow...
2018: Khirurgiia
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