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Gangrenous cholecystitis

Stefan Jansen, Maciej Stodolski, Hubert Zirngibl, Daniel Gödde, Peter C Ambe
Background: Acute perforated cholecystitis (APC) is probably the most severe benign gallbladder pathology with high rates of morbidity and mortality. The cause of APC has not been fully understood. We postulated that APC is a complication of advanced gallbladder inflammation. The aim of this study was to investigate the extent of gallbladder inflammation in patients with APC. Methods: Patients with intraoperative and histopathologic diagnosis of APC were compared with cases with acute cholecystitis without perforation with respect to the extent of inflammation on histopathology as well as surgical outcomes...
2018: World Journal of Emergency Surgery: WJES
Mattia Portinari, Michele Scagliarini, Giorgia Valpiani, Simona Bianconcini, Dario Andreotti, Rocco Stano, Paolo Carcoforo, Savino Occhionorelli
BACKGROUND: Some authors have proposed different predictive factors of severe acute cholecystitis, but generally, the results of risk analyses are expressed as odds ratios, which makes it difficult to apply in the clinical practice of the acute care surgeon. The severe form of acute cholecystitis should include both gangrenous and phlegmonous cholecystitis, due to their severe clinical course, and cholecystectomy should not be delayed. The aim of this study was to create a nomogram to obtain a graphical tool to compute the probability of having a severe acute cholecystitis...
February 20, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Andrew P Loehrer, David C Chang, John W Scott, Matthew M Hutter, Virendra I Patel, Jeffrey E Lee, Benjamin D Sommers
Importance: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and decreased likelihood of receiving optimal surgical care. The Patient Protection and Affordable Care Act's (ACA) Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions remains unknown. Objective: To evaluate the association of the ACA's Medicaid expansion with access to timely and recommended care for common and serious surgical conditions...
January 24, 2018: JAMA Surgery
Antonio Gangemi, Richard Danilkowicz, Francesco Bianco, Mario Masrur, Pier Cristoforo Giulianotti
Background and Objectives: Open conversion (OC) occurs in 5 to 10% of laparoscopic cholecystectomies (LCs) and results in suboptimal outcomes. Herein, we report our experience with OC in cholecystectomy performed with the minimally invasive (MIS) approach. Methods: Data from 960 minimally invasive cholecystectomies performed in the University of Illinois at Chicago (UIC) Division of General, Minimally Invasive, and Robotic Surgery were retrospectively compiled. Patient demographics and outcomes were analyzed for the major indicators that may predispose to OC...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Leon Kunišek, Miodrag Gudelj, Marko Zelić, Dorian Kršul, Juraj Kunišek
We report a case of a 75-year-old female with acute torsion of the gallbladder with gangrene and cholelithiasis. On admission, the patient underwent physical examination, laboratory blood analysis, abdominal ultrasound and plain abdominal x-ray. Due to the signs of acute abdomen and poor general condition of the patient, urgent surgical procedure was indicated. Intraoperatively, the gallbladder was found to be greatly enlarged, gangrenous and greatly distended with 360° clockwise torsion around its mesentery...
December 2016: Acta Clinica Croatica
Víctor Soria Aledo, Lorena Galindo Iñíguez, Diego Flores Funes, Milagros Carrasco Prats, Jose Luis Aguayo Albasini
BACKGROUND AND OBJECTIVES: There is currently no consensus with regard to the use of cholecystectomy or percutaneous cholecystostomy as the therapy of choice for acute acalculous cholecystitis. The goal of this study was to review the scientific evidence on the management of these patients according to clinical and radiographic findings. METHODS: A systematic review of the literature from 2000 to 2016 was performed. The databases of PubMed, Índice Médico Español, Cochrane Library and Embase were searched according to the following inclusion criteria: publication language (English or Spanish), adult patients, acalculous etiology and appropriate study design...
October 2017: Revista Española de Enfermedades Digestivas
Hichem Cheikhrouhou, Karim Jmal, Amine Kharrat, Meriem Keskes, Abdelhamid Karoui
Postoperative acalculous gangrenous cholecystitis is a serious and severe complication, especially in patients hospitalized in the Department of Reanimation. It occurs most often during vascular surgery or major digestive surgery, a polytrauma, in a context septic or in a context of shock. We report the case of a 74 year man who underwent surgery for femoral neck fracture. On the sixth postoperative day, he developed acute cholecystitis. Radiological examinations confirmed acalculous cholecystitis. After emergency cholecystectomy, anatomo-pathologic study confirmed the diagnosis of acalculous gangrenous cholecystitis...
2017: Pan African Medical Journal
Rebekah Kirkwood, Lauren Damon, Jennifer Wang, Esther Hong, Kimberly Kirkwood
BACKGROUND: Gangrenous cholecystitis is associated with a higher conversion rate of conversion from laparoscopic to open than acute non-gangrenous cholecystitis. New strategies and techniques are needed to decrease conversion rates and improve outcomes. METHODS: In this article, we provide a richly detailed, illustrated description of a modified fundus-first technique that we have developed over the last 15 years and now use routinely with rare conversions. We also compared outcomes of laparoscopic (LC) and open (OC) approaches for pathologically confirmed gangrenous cholecystitis in 146 patients during 1995-2005, the first 10 years during which these two approaches were performed contemporaneously at our institution on comparable patients...
December 2017: Surgical Endoscopy
Suat Can Ulukent, İnanc Samil Sarici, Nuri Alper Sahbaz, Yigit Mehmet Ozgun, Ozlem Akca, Kamuran Sanlı
Raoultella planticola is an aquatic and soil organism that does not notoriously cause invasive infections in humans. Infections in the literature are limited only in case reports. We present a very rare case of R. planticola cholecystitis. A 71-year-old female patient with abdominal pain was diagnosed with acute cholecystitis. Patient received intravenous antibiotic treatment, but the treatment failed and the patient underwent an open cholecystectomy. The final pathological result was gangrenous cholecystitis complicated with R...
2017: Case Reports in Infectious Diseases
A Ashfaq, K Ahmadieh, A A Shah, A B Chapital, K L Harold, D J Johnson
INTRODUCTION: Surgery for the difficult gallbladder (DGB) is associated with increased risk compared to more routine laparoscopic cholecystectomies (LC). Laparoscopic "damage control" methods including cholecystostomy, fundus-down approach and subtotal cholecystectomy (SC) have been proposed to avoid conversion to open. We hypothesized that a Total LC (TLC) for DBG can be completed safely with an acceptably low conversion rate. MATERIAL AND METHODS: All patients that underwent LC from January 2005-June 2015 were retrospectively reviewed...
December 2016: American Journal of Surgery
P Tammaro, N Richard, B Andre, A Andremont, H Mammeri
So far, Streptococcus devriesei, which belongs to the mutans streptococci group, has been incriminated in the formation of caries in Equidae. We report the first human infection due to this species in a 54-year-old man with gangrenous cholecystitis. The patient was treated successfully by cholecystectomy and ceftriaxone.
January 2017: New Microbes and New Infections
Ionuţ Simion Coman, Elena-Violeta Radu, Vasile Șandru, Ionuţ Cristinel Bârsan, Cristinel Dumitru Badiu, Gabriel Constantinescu, Valentin Titus Grigorean
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum...
November 2016: Chirurgia
J Ma, S C Lü, J T Kou, X L Li, J Q Zhu, H M Dong, Q He
Objective: To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage. Methods: The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed...
December 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Pedro Abadía-Barnó, Magdalena Coll-Sastre, Carmen Picón-Serrano, Alfonso Sanjuanbenito-Dehesa, Jacobo Cabañas-Montero
BACKGROUND: The gallbladder volvulus is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is an extremely rare surgical disease and definitive diagnosis is usually made during surgery. CASE REPORT: A 78 year old woman presented with upper right quadrant abdominal pain, with no comorbidities and no other accompanying symptoms. Analysis revealed haemodynamic instability and leukocytosis. Computed tomography of abdomen showed an acute cholecystitis...
December 9, 2016: Cirugia y Cirujanos
Deepa Magge, Jennifer Steve, Stephanie Novak, Adam Slivka, Mellissa Hogg, Amer Zureikat, Herbert J Zeh
Laparoscopic cholecystectomy is the standard of care for cholelithiasis as well as cholecystitis. However, in the setting of Mirizzi syndrome or gangrenous cholecystitis where the critical view cannot be ascertained, subtotal cholecystectomy may be necessary. Using the robot-assisted approach, difficult cholecystectomies can be performed upfront without need for partial cholecystectomy. Even in the setting of Mirizzi syndrome where severe scarring and fibrosis are evident, definitive cholecystectomy and takedown of the cholechystocholedochal fistula can be performed in a safe and feasible fashion following successful endoscopic common bile duct stent placement...
March 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Petra Maria Terho, Ari Kalevi Leppäniemi, Panu Juhani Mentula
BACKGROUND: The purpose of the study was to identify risk factors for conversion of laparoscopic cholecystectomy and risk factors for postoperative complications in acute calculous cholecystitis. The most common complications arising from cholecystectomy were also to be identified. METHODS: A total of 499 consecutive patients, who had undergone emergent cholecystectomy with diagnosis of cholecystitis in Meilahti Hospital in 2013-2014, were identified from the hospital database...
2016: World Journal of Emergency Surgery: WJES
Binit Sureka
No abstract text is available yet for this article.
February 2017: AJR. American Journal of Roentgenology
George Younan, Max Schumm, Fadwa Ali, Kathleen K Christians
Introduction. Gallbladder volvulus is a rare, potentially fatal condition unless diagnosed and treated early. Choledochal cysts are rare congenital malformations of the biliary tree predisposing to different pathologies and posing the risk of degradation into cholangiocarcinoma and gallbladder cancer. Dealing with both diseases at once has not been published yet in the literature. Presentation of Case. We report a case of gallbladder volvulus in an elderly female who happened to have a concomitant type I choledochal cyst...
2016: Case Reports in Surgery
Hiromitsu Maehira, Aya Itoh, Masayasu Kawasaki, Masao Ogawa, Atsuo Imagawa, Naoto Mizumura, Satoshi Okumura, Masao Kameyama
OBJECTIVE: To determine if the increase in transient focal enhancement of the liver adjacent to the gallbladder seen on dynamic computed tomography (CT) is greater in gangrenous cholecystitis than in nongangrenous cholecystitis by determining the CT attenuation value. METHODS: We retrospectively reviewed the medical records of 57 patients who underwent emergency cholecystectomy for acute cholecystitis and preoperative dynamic CT scans between March 2011 and April 2016...
December 2016: American Journal of Emergency Medicine
Wei-Chou Chang, Yuxin Sun, En-Haw Wu, So Yeon Kim, Z Jane Wang, Guo-Shu Huang, Benjamin M Yeh
OBJECTIVE: The objective of our study was to evaluate the diagnostic accuracy of CT in differentiating gangrenous cholecystitis from uncomplicated cholecystitis and healthy gallbladders. MATERIALS AND METHODS: We performed a retrospective review of 308 patients with histologically proven gangrenous cholecystitis who underwent preoperative CT 1 month before gallbladder removal over a 4-year period. Two readers who were blinded to the histologic diagnosis independently recorded CT features of and overall likelihood of gangrenous cholecystitis on a 5-point scale (1, definitely absent; 5, definitely present)...
August 2016: AJR. American Journal of Roentgenology
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