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antibiotic cholecystectomy

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https://www.readbyqxmd.com/read/28375803/routine-use-of-prophylactic-antibiotics-during-laparoscopic-cholecystectomy-does-not-reduce-the-risk-of-surgical-site-infections
#1
Pinar Sarkut, Sadik Kilicturgay, Hikmet Aktas, Yilmaz Ozen, Ekrem Kaya
BACKGROUND: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallbladder stones. As infections are rare in uncomplicated LC, it is widely accepted that prophylactic antibiotics need not be administered, and guidelines do not support routine antibiotic prophylaxis during elective LC. However, routine antibiotic prophylaxis for elective LC is still popular in many clinical settings. We investigated this situation in our department. METHOD: This randomized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010...
April 4, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28273241/pancreatic-necrosis-and-gas-in-the-retroperitoneum-treatment-with-antibiotics-alone
#2
Roberto Rasslan, Fernando da Costa Ferreira Novo, Marcelo Cristiano Rocha, Alberto Bitran, Manoel de Souza Rocha, Celso de Oliveira Bernini, Samir Rasslan, Edivaldo Massazo Utiyama
OBJECTIVE: To present our experience in the management of patients with infected pancreatic necrosis without drainage. METHODS: The records of patients with pancreatic necrosis admitted to our facility from 2011 to 2015 were retrospectively reviewed. RESULTS: We identified 61 patients with pancreatic necrosis. Six patients with pancreatic necrosis and gas in the retroperitoneum were treated exclusively with clinical support without any type of drainage...
February 1, 2017: Clinics
https://www.readbyqxmd.com/read/28174034/perihepatic-pulmonary-and-renal-abscesses-due%C3%A2-to%C3%A2-spilled-gallstones
#3
Jacob Lentz, Maria A Tobar, Caleb P Canders
BACKGROUND: Spilled gallstones are common during laparoscopic cholecystectomy; however, they rarely lead to postoperative complications. Perihepatic abscesses develop in < 0.1% of patients with spilled gallstones and are typically contained within the peritoneal cavity. CASE REPORT: We present a 57-year-old man with history of cholecystectomy 2 years prior who presented with cough and flank pain and was discovered to have a perihepatic abscess invading his lung and kidney secondary to a spilled gallstone...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28144393/percutaneous-drainage-as-a-first-therapeutic-step-prior-to-surgery-in-liver-hydatid-cyst-abscess-is-it-worth-it
#4
Aylhin J Lopez-Marcano, Jose M Ramia, Vladimir Arteaga, Roberto De la Plaza, Jhonny D Gonzales, Anibal Medina
AIM: To delay surgery until the patient is in a better condition, and thus to decrease postoperative morbidity. METHODS: Using this algorithm we treated three patients aged 55, 75 and 80 years. In all three patients the clinical presentation was fever without a clear source of infection; all had nonspecific symptoms such as general malaise, dyspnea, and abdominal discomfort in the previous 15 d. They came to the emergency room at our hospital due to deterioration of their general condition...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28141548/splenic-abscess-with-bleeding-in-a-female-patient-following-coronary-artery-bypass-grafting-and-cholecystectomy-a-case-report-and-literature-review
#5
Mirosław Juszczak, Jacek Szopiński, Monika Szambelan
Splenic abscess is a potential complication of many disease entities which involve infections. Diagnostics are based on imaging studies. Treatment involves splenectomy and antibiotic therapy. In the case the abscess is limited, and particularly in young patients, percutaneous abscess drainage may be performed. This paper presents a case of a 66-year old female patient following coronary artery bypass grafting (CABG) complicated with sternum infection and cholecystectomy due to gallbladder abscess complicated with surgical site infection, who underwent long-term treatment in the ICU due to respiratory failure and persistent septic condition...
December 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28138442/intra-abdominal-abscess-and-intractable-sinus-a-rare-late-complication-after-splenectomy
#6
Badri Shrestha, James Hampton
Intra-abdominal abscess and an intractable abdominal wall sinus forty years after splenectomy is rare, which has not been described previously in the surgical literature. We report the management of a patient who had presented with an intractable sinus on his left hypochondrium forty years after having undergone splenectomy and cholecystectomy, which persisted for more than two years despite repeated surgery and courses of antibiotics and compromised quality of life significantly from pain. A sinogram and computerised tomographic scan followed by exploration and laying open of the sinus delivered multiple silk sutures used for ligation of splenic pedicle, led to complete resolution of the sinus...
January 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28121041/randomized-clinical-trial-of-extended-versus-single-dose-perioperative-antibiotic-prophylaxis-for-acute-calculous-cholecystitis
#7
RANDOMIZED CONTROLLED TRIAL
C S Loozen, K Kortram, V N N Kornmann, B van Ramshorst, B Vlaminckx, C A J Knibbe, J C Kelder, S C Donkervoort, G A P Nieuwenhuijzen, J E H Ponten, A A W van Geloven, P van Duijvendijk, W J W Bos, M G H Besselink, D J Gouma, H C van Santvoort, D Boerma
BACKGROUND: Many patients who have surgery for acute cholecystitis receive postoperative antibiotic prophylaxis, with the intent to reduce infectious complications. There is, however, no evidence that extending antibiotics beyond a single perioperative dose is advantageous. This study aimed to determine the effect of extended antibiotic prophylaxis on infectious complications in patients with mild acute cholecystitis undergoing cholecystectomy. METHODS: For this randomized controlled non-inferiority trial, adult patients with mild acute calculous cholecystitis undergoing cholecystectomy at six major teaching hospitals in the Netherlands, between April 2012 and September 2014, were assessed for eligibility...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28104282/-incidence-of-bacteria-from-cultures-of-bile-and-gallbladder-wall-of-laparoscopic-cholecystectomy-patients-in-the-university-hospital-dr-jos%C3%A3-eleuterio-gonz%C3%A3-lez
#8
Rubén Cueto-Ramos, Marco Hernández-Guedea, Edelmiro Pérez-Rodríguez, Francisco Reyna-Sepúlveda, Gerardo Muñoz-Maldonado
BACKGROUND: Through experience it has been accepted that bile in normal conditions remains sterile. Bactibilia is a common finding in individuals at high risk or with complicated cholecystolithiasis, however few data prevails about the prevalence of bactibilia in patients operated on for uncomplicated laparoscopic cholecystectomy. There is s common usage of preoperative and postoperative antibiotics in the different patients without the existence of any actual bacteriologic and epidemiologic evidence...
January 16, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28071948/current-practice-of-antibiotic-prophylaxis-during-elective-laparoscopic-cholecystectomy
#9
Caw Macano, E A Griffiths, R S Vohra
INTRODUCTION Current guidelines do not recommend antibiotic prophylaxis in elective laparoscopic cholecystectomy. Despite this, there is wide variation in antibiotic prophylaxis during cholecystectomy in population-based studies. The aim of this survey was to establish the current rationale for antibiotic prophylaxis in elective laparoscopic cholecystectomy. METHODS A short questionnaire was designed and disseminated across collaborators for a population-based study investigating outcomes following cholecystectomy and via the Association of Upper Gastrointestinal Surgeons, Researchgate and Surginet membership...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28069529/outcomes-in-older-patients-with-grade-iii-cholecystitis-and-cholecystostomy-tube-placement-a-propensity-score-analysis
#10
Francesca M Dimou, Deepak Adhikari, Hemalkumar B Mehta, Taylor S Riall
BACKGROUND: The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. STUDY DESIGN: We used Medicare data (1996 to 2010) to identify patients 66 years and older who were admitted with grade III acute cholecystitis. We evaluated adherence to the Tokyo Guidelines and compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a propensity-matched (1:3) cohort of patients with grade III cholecystitis...
April 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28050668/antibiotics-may-be-safely-discontinued-within-one-week-of-percutaneous-cholecystostomy
#11
Tyler J Loftus, Scott C Brakenridge, Camille G Dessaigne, George A Sarosi, William J Zingarelli, Frederick A Moore, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Phillip A Efron, Alicia M Mohr
BACKGROUND: For patients with acute cholecystitis managed with percutaneous cholecystostomy (PC), the optimal duration of post-procedural antibiotic therapy is unknown. Our objective was to compare short versus long courses of antibiotics with the hypothesis that patients with persistent signs of systemic inflammation 72 h following PC would receive prolonged antibiotic therapy and that antibiotic duration would not affect outcomes. METHODS: We performed a retrospective cohort analysis of 81 patients who underwent PC for acute cholecystitis at two hospitals during a 41-month period ending November 2014...
May 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27895353/bacterobilia-in-acute-cholecystitis-bile-cultures-isolates-antibiotic-sensitivities-and-antibiotic-usage-a-study-on-a-pakistani-population
#12
Yousaf Bashir Hadi, Muhammad Waqas, Hafiz Muhammad Umer, Ammar Alam, Abdul Rehman Alvi, Muhammad Rizwan Khan
Acute cholecystitis is one of the most common acute surgical conditions. Laparoscopic cholecystectomy remains the mainstay of treatment. In patients managed non-operatively, antibiotics play an important role in the treatment of cholecystitis. The current retrospective observational study was conducted at a tertiary care hospital in Karachi, and comprised medical records of patients admitted between 2008 and 2014with acute cholecystitis and in whom bile cultures were obtained. Of the 509 patients with a mean age of 51...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27858922/emphysematous-cholecystitis-in-a-young-male-without-predisposing-factors-a-case-report
#13
REVIEW
Ming-Yu Chen, Chen Lu, Yi-Fan Wang, Xiu-Jun Cai
This report describes the diagnosis and treatment for Emphysematous cholecystitis (EC) without predisposing factors, and reviews the current literature.A 49-year-old male without predisposition presented to emergency department with a two-day history of sudden onset abdominal pain, hypertension and received empirical antibiotics with Imipenem/Cilastatin 0.5 g via intravenous route every 8 hours. Computed tomography (CT)-scan revealed that air encircling gallbladder is the most important and accurate evidence for EC diagnosis...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27819646/from-laparoscopic-cholecystectomy-to-liver-transplantation-when-the-gallbladder-becomes-the-pandora-s-box
#14
Georgios C Sotiropoulos, Peter Tsaparas, Stylianos Kykalos, Nikolaos Machairas, Ernesto P Molmenti, Andreas Paul
Bile duct injuries (BDI) tend to be more complex in laparoscopic than in open cholecystectomy procedures, and frequently involve young adults with benign pathologies. The ultimate consequence may be a liver transplantation (LT), making this situation one of the most rare transplant indications. Fatal post-transplant outcome is extreme infrequently reported. Aim of this study is to report on our single-case experience and to review the literature concerning lethal outcome after LT for major BDI following cholecystectomy...
2016: Chirurgia
https://www.readbyqxmd.com/read/27770497/hospital-wide-implementation-of-an-electronic-workflow-solution-aiming-to-make-surgical-practice-improvement-easy
#15
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...
March 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27759780/antibiotic-prophylaxis-in-laparoscopic-cholecistectomy-is-it-worth-doing
#16
RANDOMIZED CONTROLLED TRIAL
Márcio Alexandre Terra Passos, Pedro Eder Portari-Filho
Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis. Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27741006/early-versus-delayed-cholecystectomy-for-acute-cholecystitis-are-the-72-hours-still-the-rule-a-randomized-trial
#17
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
https://www.readbyqxmd.com/read/27721726/acute-cholecystitis-with-significantly-elevated-levels-of-serum-carbohydrate-antigen-19-9
#18
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
https://www.readbyqxmd.com/read/27695167/percutaneous-gallbladder-aspiration-for-acute-cholecystitis
#19
REVIEW
Supannee Rassameehiran, Pakpoom Tantrachoti, Kenneth Nugent
Early cholecystectomy for patients with acute cholecystitis may not be possible in some clinical settings. Percutaneous gallbladder aspiration (PGBA) offers an alternative approach, but the benefits and risks of this procedure are unclear. We synthesized data on the outcomes of PGBA in acute cholecystitis patients using data sources from online databases, including MEDLINE and EMBASE, and bibliographies of included studies from January 2000 through December 2015. Two reviewers independently reviewed and critiqued the quality of each study...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27693543/clostridium-difficile-a-rare-cause-of-pyogenic-liver-abscess
#20
Nurver Ulger Toprak, Gulcin Balkose, Deniz Durak, Ender Dulundu, Tolga Demirbaş, Cumhur Yegen, Guner Soyletir
Extra-intestinal infections due to Clostridium difficile have been reported rarely. Herein we report a case of pyogenic liver abscess from toxigenic C. difficile in an 80-year-old non-hospitalized woman with diabetes mellitus, cerebrovascular and cardiovascular diseases. The patient was admitted to the emergency department with fever and abdominal pain. There was no history of diarrhea or use of antibiotics. Laboratory parameters revealed signs of inflammation and elevated AST and ALT levels. Abdominal ultrasound and computer tomography showed multiple focal lesions in the bilateral liver lobes and hydropic gallbladder with stones...
December 2016: Anaerobe
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