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laparoscopy for asymptomatic gallstones

Azadeh Jabbari Nooghabi, Masoumeh Hassanpour, Ali Jangjoo
BACKGROUND: Laparoscopic cholecystectomy (LC) has become a popular and widespread procedure for the treatment of gallstone disease. There is still an increasing concern about specific complications of LC due to gallbladder perforation and spillage of bile and stones. Although unretrieved intraperitoneal gallstones rarely become symptomatic, their infective complications may cause serious morbidities even after a long interval from LC. METHODS: We performed a review of the literature on the diagnosis, prevention, consequences, and management of lost gallstones...
June 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Chiara Lo Nigro, Girolamo Geraci, Antonio Sciuto, Francesco Li Volsi, Carmelo Sciume, Giuseppe Modica
BACKGROUND: Laparoscopic cholecystectomy (LC) for gallstone disease is the most common surgical procedures performed in Western countries and bile leaks remain a significant cause of morbidity (0.2-2%). The bile ducts of Luschka (DL)are small ducts which originate from the right hepatic lobe, course along the gallbladder bed, and usually drain in the extrahepatic bile ducts. Injuries to these ducts are the second most frequent cause of bile leaks after cholecystectomy. Aim of our study is build a literature review starting from our experience...
July 2012: Annali Italiani di Chirurgia
Marco Aurelio Santo, Carlos Eduardo Domene, Daniel Riccioppo, Lian Barreira, Flavio Roberto Takeda, Henrique Walter Pinotti
CONTEXT: About 9% of the Brazilian population has gallstones and the incidence increases significantly with aging. The choledocholithiasis is found around 15% of these patients, and a third to half of these cases presented as asymptomatic. Once the lithiasis in the common bile duct is characterized through intraoperative cholangiography, the laparoscopic surgical exploration can be done through the transcystic way or directly through choledochotomy. OBJECTIVE: To evaluate the results and outcomes of the laparoscopic treatment of common bile duct lithiasis...
January 2012: Arquivos de Gastroenterologia
Avinash Supe
India has a large burden of individuals harboring asymptomatic gallstones. Based on Markov model decision and cost analysis, selective and concomitant cholecystectomy is recommended for special indications like hemolytic disorders and stones in endemic areas. Expectant management should be adopted in all others. The evolution of laparoscopy should not alter the indications of cholecystectomy. Since more than 90% patients with asymptomatic gallstones remain clinically "silent", routine laparoscopic cholecystectomy is not indicated for the vast majority of subjects with asymptomatic cholelithiasis...
July 2011: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Umut Barbaros, Aziz Sümer, Fatih Tunca, Osman Gözkün, Tuğrul Demirel, Orhan Bilge, Valentina Randazzo, Ahmet Dinççağ, Ridvan Seven, Selçuk Mercan, Demir Budak
BACKGROUND: Most of the laparoscopic surgeons have been attempting to reduce incisional morbidity and improve cosmetic outcomes by using fewer and smaller ports. Single-incision laparoscopic surgery (SILS) is a new laparoscopic procedure. Herein we would like to present our experiences. PATIENTS AND METHODS: Between January 2009 and October 2009, data of the 32 patients who were operated through SILS are evaluated prospectively. There were 22 females and 10 males with a mean age of 45...
October 2010: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Ashish Singhal, Rajesh Kanagala, Harlan I Wright, Vivek Kohli
Bile duct hamartomas (von Meyenburg complex) are the rare benign neoplasm of the liver due to dysembryogenesis; constituted historically, cystic dilatations of the bile duct encompassed by fibrous stroma. Usually, they are asymptomatic and are not detected on routine radiological examinations including ultrasound or CT scan. Magnetic resonance cholangiography has been suggested as the best investigation for their imaging diagnosis. Their presence can cause diagnostics confusion and complicate the patient's management...
October 2010: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ioannis Triantafyllidis, Leonidas Papapavlou, Nikolaos Nikoloudis, Athanasios Economou, Efstathios Andreadis, Maria Chrissidou, Konstantinos Georgakis, Thomas Chrissidis
INTRODUCTION: Ectopic liver tissue is a rare entity, reported to occur in several intra-, retro- and extra- peritoneal sites, including the gallbladder. It is usually detected incidentally, during laparoscopy, laparotomy, or autopsy. Several possible mechanisms may explain the development of liver ectopia. Although ectopic liver tissue is usually asymptomatic, it behaves like orthotopic liver, developing the same pathologic conditions. CASE PRESENTATION: We describe the case of a 54-year-old woman who was found to have a nodule attached to the gallbladder wall without any connection with the main liver, during an elective laparoscopic cholecystectomy for gallstone disease...
2009: Cases Journal
Suzanne M Yoder, Steven Rothenberg, Kuojen Tsao, Mark L Wulkan, Todd A Ponsky, Shawn D St Peter, Daniel J Ostlie, Timothy D Kane
BACKGROUND: Pancreatic pseudocysts are problematic sequelae of pancreatitis or pancreatic trauma causing persistent abdominal pain, nausea, and gastric outlet obstruction. Due to the low volume of disease in children, there is scant information in the literature on the operative management of pseudocysts with minimally invasive techniques. We conducted a multi-institutional review to illustrate several technical variations utilized in achieving laparoscopic cystgastrostomy in the pediatric population...
April 2009: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Montiel Jiménez Fuertes, Rafael López Andújar, Máxim Lloret Larrea, Angel Moya Herráiz, José Mir Pallardó
Anomalies of the liver are infrequent. Agenesis of the right hepatic lobe is an uncommon, usually asymptomatic, entity that is diagnosed through new imaging techniques or during surgery. We present the case of a 51-year-old woman with right hepatic lobe agenesis who underwent technically difficult cholecystectomy for symptomatic gallstones. We discuss the diagnosis and technical difficulties that can be encountered during cholecystectomy when there is right hepatic lobe agenesis.
October 2007: Cirugía Española
S Chan, J Currie, A I Malik, A A Mahomed
BACKGROUND: Laparoscopic cholecystectomy is the treatment of choice in symptomatic paediatric cholelithiasis. However, controversy exists about its role in asymptomatic cholelithiasis and biliary dyskinesia. We have reviewed the experiences of two UK paediatric centres with laparoscopic cholecystectomy over an 8.5 year period and critically evaluated the indications and outcomes of surgery. METHODS: Patients who underwent laparoscopic cholecystectomy by a single surgeon at the Royal Aberdeen and Royal Alexandra Hospitals between May 1996 to August 2003 and September 2003 to December 2005, respectively, were studied...
May 2008: Surgical Endoscopy
A H W Schiphorst, M G H Besselink, N G Venneman, P M N Y H Go
Three patients, men in the ages of 58, 66 and 56 years, respectively, had experienced 'warning colics' a considerable time before gallstone complications or severe recurrent colic. Ultrasonographically proven gallstones had not led to cholecystectomy. The 58-year-old man died of sepsis due to infected pancreatic necrosis; the other men underwent laparoscopic cholecystectomy, after which they recovered fully. Approximately 10-5% of the adult Dutch population have gallstones, but only 10% will develop symptoms...
November 4, 2006: Nederlands Tijdschrift Voor Geneeskunde
Salman Y Guraya
Recently, dramatic advances in research have elucidated the prognosis of gallstone disease and have permitted a more selective choice of persons for treatment based on symptom status and projected prognosis. Ultrasound- detected-incidental gallstones are infrequently clinically significant, but this finding has prompted the surgeons to have a liberal attitude towards the operative indications for cholelithiasis particularly after the advent of laparoscopy. At the same time, the management of gallstones in the diabetics still remains controversial...
November 2005: Saudi Medical Journal
M Sianesi, E Capocasale, G Ferreri, M P Mazzoni, R Dalla Valle, N Busi
INTRODUCTION: We reviewed our clinical experience to assess the role of cholecystectomy transplant candidates pre- and posttransplantation. METHODS: Between April 1986 and December 2003, 57 (6.8%) candidates among 839 kidney transplants were found during routine pretransplant screening to show gallstones. RESULTS: Thirty nine (68.4%) symptomatic patients underwent cholecystectomy before transplantation. Among 18 (31.6%) asymptomatic patients monitored after transplantation, the 7 (39%) who developed biliary tract symptoms underwent laparoscopy or minilaparocholecystectomy without postoperative morbidity, mortality, or graft loss...
June 2005: Transplantation Proceedings
Antonio Iannelli, Enrico Facchiano, Pascal Fabiani, Eric Sejor, Jean-Louis Bernard, Eric Niezar, Jean Gugenheim
Congenital agenesis of the right liver (ARL) is a rare condition that is generally asymptomatic. Congenital anomalies of the liver are generally diagnosed with current cross-sectional imaging modalities such as ultrasound, computed tomography, and magnetic resonance imaging (MRI) before surgery. However, discovery of a congenital anomaly of the liver only at time of surgery remains a possibility. Herein reported is the case of a 68-year-old woman undergoing laparoscopic cholecystectomy for symptomatic gallbladder stones as diagnosed on preoperative ultrasounds...
April 2005: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
A Kessaf Aslar, Tamer Ertan, Hakan Oguz, Erdal Gocmen, Mahmut Koc
Although the indications for laparoscopic cholecystectomy are generally the same as those for open cholecystectomy, there has been a suspicion that indications for cholecystectomy have broadened and the spectrum of patients undergoing this procedure has changed. This study was designed to determine whether surgeons and patients have lowered the threshold for proceeding to cholecystectomy with use of laparoscopic cholecystectomy. Discharge data were collected for all patients who underwent an elective operation in general surgery clinics in Ankara Numune Teaching and Research Hospital between 1990 to 2001...
October 2003: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Alexander Klaus, Ronald A Hinder, James Swain, Sami R Achem
Cholelithiasis and gastroesophageal reflux are both very common diseases that may occur simultaneously. Management of asymptomatic gallstones is still controversial. Because severe complications due to gallstones may occur incidental cholecystectomy during nonrelated abdominal surgery may be offered to patients with coexisting gallbladder disease. The aim of this study was to assess the clinical outcome of patients after laparoscopic fundoplication and incidental cholecystectomy for cholelithiasis compared with the outcome of patients after fundoplication alone...
July 2002: American Surgeon
V Bresadola, S Intini, G Terrosu, U Baccarani, M G Marcellino, M Sistu, F Scanavacca, F Bresadola
BACKGROUND: The role of laparoscopic intraoperative cholangiography (IC) in the diagnosis of asymptomatic choledocholithiasis is still controversial. The aim of this study was to evaluate the diagnostic-therapeutic impact and the educational implications of this method for residents specializing in general surgery. METHODS: We reviewed the records of 835 patients who underwent laparoscopic cholecystectomy for cholecystolithiasis without choledocholithiasis. IC was routinely performed by both expert surgeons and residents in general surgery...
August 2001: Surgical Endoscopy
N Gotohda, S Itano, S Horiki, A Endo, A Nakao, N Terada, N Tanaka
We report a rare adult case of gallbladder agenesis with no other biliary tract abnormality. The patient was a 29-year-old man with pain in the right upper-quadrant of the abdomen, and vomiting. The gallbladder was not visualized by ultrasonography, computed tomography, or endoscopic retrograde cholangiography. The common bile duct was slightly dilated. No other abnormalities, including anomalous choledochopancreatic duct junction, were found. Based on these imaging findings and the patient's right hypochondrial pain, there was a high index of suspicion of chronic cholecystitis caused by incarcerated gallstones in the neck of the gallbladder...
2000: Journal of Hepato-biliary-pancreatic Surgery
L Sarli, N Pietra, A Franzé, G Colla, R Costi, S Gobbi, M Trivelli
BACKGROUND: No procedure has yet been identified as the standard for the detection and management of choledocholithiasis in patients undergoing laparoscopic cholecystectomy. METHODS: A prospective study involved 1305 patients undergoing elective laparoscopic cholecystectomy. Intravenous cholangiography was performed on all patients except those with jaundice or cholangitis, acute pancreatitis, or allergy to contrast material. Patients underwent endoscopic retrograde cholangiography (ERC) and endoscopic sphincterotomy when there was a strong suspicion of choledocholithiasis, positive or inconclusive findings on intravenous cholangiography or allergy to contrast material with signs of possible choledocholithiasis...
August 1999: Gastrointestinal Endoscopy
W S Melvin, D J Meier, E A Elkhammas, G L Bumgardner, E A Davies, M L Henry, R Pelletier, R M Ferguson
BACKGROUND: The appropriate management of gallstones in patients undergoing renal transplantation is controversial. Screening for gallstones and subsequent prophylactic cholecystectomy has been recommended by some authors for kidney transplant candidates. Our program does not practice routine pretransplant screening for gallstones, and we reviewed our data to determine the outcome of our management approach. METHODS: We reviewed the records of the 1,364 currently followed patients who have undergone kidney transplant at our institution since 1985 in order to evaluate the morbidity and mortality of biliary disease in the post-transplant period...
April 1998: American Journal of Surgery
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