Timing of elective laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreaticography with sphincterotomy: a prospective observational study of 308 patients

2010 ◽  
Vol 395 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Erdal Birol Bostanci ◽  
Metin Ercan ◽  
Ilter Ozer ◽  
Zafer Teke ◽  
Erkan Parlak ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Elective Laparoscopic Cholecystectomy

DOES EARLY LAPAROSCOPIC CHOLECYSTECTOMY AFTER ERCP OFFERS SIGNIFICANT BENEFIT IN SURGICAL OUTCOME? A COMPARATIVE STUDY BETWEEN EARLY AND LATE GROUPS

2021 ◽  
pp. 59-61
Author(s):  
Anshul Mathur ◽  
Ketan Patel ◽  
Jitendra Kumar Mangtani ◽  
K.K. Dangayach
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Early Laparoscopic Cholecystectomy ◽  
Conversion Rates ◽  
Group A ◽  
Group B

Introduction:- Endoscopic retrograde cholangiopancreaticography (ERCP) prior to Laparoscopic Cholecystectomy(LC) is most commonly practiced strategy worldwide for management of co-existing cholelithiasis with choledocholithiasis. The time interval between Endoscopic Retrograde Cholangiopancreaticography (ERCP) and Laparoscopic cholecystectomy (LC) is questionable and varies from 1 day to 6 weeks in different studies. Aims and objectives:- To compare two groups of patients managed with laparoscopic cholecystectomy (after ERCP), EARLY(24 to 72 hours), and LATE(> 6weeks) in terms of mean operative time in minutes, intraoperative difculties, conversion rates to open cholecystectomy, conversion rates to open cholecystectomy, drain insertion required or not, postoperative complications, and duration of hospital stay. Materials and methods:- A prospective randomized comparative study was conducted on 70 patients who presented with concomitant cholelithiasis with choledocholithiasis over a period of January 2019 to June 2020 at the Department of General Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. After ERCP and stone retrieval patients were randomised into 2 groups using sealed envelope method. Group A underwent early laparoscopic cholecystectomy (24 to 72hours) and Group B underwent late laparoscopic cholecystectomy (after 6 weeks). Data collected, statistical analysis done, results and observations concluded. Result:- We found that mean operative time, intraoperative difculties, post operative complications and mean hospital stay in days were signicantly higher in Group B as compared to Group A. Though the conversion rates to open procedure and requirement of drain insertion were comparatively higher in Group B but were found to be statistically non signicant. Conclusion:- We hereby conclude that early laparoscopic cholecystectomy (24 to 72 hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP) is better as compared to late laparoscopic cholecystectomy (>6 weeks) after ERCP in patients of cholelithiasis with coexisting choledocholithiasis. So, we recommend performing early Laparoscopic Cholecystectomy (24-72hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP)

Volatile organic compounds in bile can distinguish pancreatic cancer from chronic pancreatitis: a prospective observational study

Endoscopy ◽  
2020 ◽  
Author(s):  
Udayakumar Navaneethan ◽  
Chad Spencer ◽  
Xiang Zhu ◽  
John J. Vargo ◽  
David Grove ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Volatile Organic Compounds ◽  
Observational Study ◽  
Organic Compounds ◽  
Prospective Observational Study ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Endoscopic Retrograde ◽  
Volatile Organic

Abstract Background Early and accurate diagnosis of pancreatic cancer is important. Our aim was to identify potential volatile organic compounds (VOCs) in the bile that can help distinguish pancreatic cancer from chronic pancreatitis. Methods In this prospective observational study, bile was aspirated from patients undergoing endoscopic retrograde cholangiopancreatography for chronic pancreatitis and pancreatic cancer, and the gaseous headspace was analyzed using mass spectrometry. Results The study included a discovery cohort of 57 patients (46 pancreatic cancer, 11 chronic pancreatitis) and a validation cohort of 31 patients (19 and 12, respectively). Using logistic regression analysis, the model [0.158 × age + 9.747 × log (ammonia) – 3.994 × log (acetonitrile) + 5.044 × log (trimethylamine) – 30.23] successfully identified patients with pancreatic cancer with a sensitivity of 93.5 % and specificity of 100 % (likelihood ratio 40.9, area under the curve 0.98, 95 % confidence interval 0.95 – 1.00). The diagnostic accuracy of this model was confirmed in the second independent validation cohort. Conclusion The measurement of VOCs in bile helped to accurately distinguish pancreatic cancer from chronic pancreatitis.

scholarly journals A prospective observational study: combined irrigation of bupivacaine at the gallbladder fossa with infiltration at port site for postoperative pain relief after laparoscopic cholecystectomy

2020 ◽  
Vol 7 (10) ◽  
pp. 3340
Author(s):  
Palak Paliwal ◽  
Tanweerul Huda ◽  
Krishnanand Anand ◽  
Manish Shivani ◽  
Navneet Mishra
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Gallbladder Disease ◽  
Oral Intake ◽  
Multimodal Approach ◽  
Considerable Decrease ◽  
Analgesic Use ◽  
Gallbladder Fossa

Background: Laparoscopic cholecystectomy is a well-established procedure for gallbladder disease. Pain in laparoscopic cholecystectomy is associated with multiple factors: somatic, visceral, and phrenic nerve irritation. Effective analgesic support should, therefore, be a multimodal approach following laparoscopic surgery for better patient compliance.Methods: A prospective, randomized observational study was undertaken at a tertiary research center for a period of two years (2018-2020). 160 patients undergoing laparoscopic cholecystectomy were chosen and randomized using a computer program into 2 groups. No infiltration was given in the control population. The study group was irrigated with a 0.5% bupivacaine solution (20cc in 30 ml normal saline).Results: The bupivacaine group required fewer analgesics in comparison to the control faction, with less pain at 6 hrs. The timing of oral intake and ambulation were comparable in both factions.Conclusions: Combined bupivacaine use led to a considerable decrease in postoperative pain thereby leading to decreased analgesic use.   

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