Laparoscopic cholecystectomy under spinal anesthesia with nitrous oxide pneumoperitoneum: A feasibility study

2003 ◽  
Vol 17 (9) ◽  
pp. 1426-1428 ◽  
Author(s):  
M. A. Hamad ◽  
O. A. Ibrahim El-Khattary
2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
G Armstrong ◽  
G Toogood ◽  
DG Jayne ◽  
AM Smith

Abstract Introduction This study explored near-infrared fluorescent cholangiography (NIRFC) with Indocyanine Green (ICG) during laparoscopic cholecystectomy (LC) surgery in a tertiary referral hepatobiliary unit. ICG binds to albumin and is excreted in bile. NIRFC utilises the fluorescent and excretory properties of ICG to provide dynamic extrahepatic bile duct mapping during LC. Method Non-randomised single centre feasibility study. Twenty-two participants were sequentially allocated to four dosing subgroups prior to NIRFC assisted LC. Each received a single intravenous dose of ICG prior to LC with the Stryker Novadaq NIR laparoscope. The biliary anatomy was assessed with NIRFC at three time-points, detection was compared to radiological cholangiogram where available and surgeon satisfaction was assessed. Result Eight participants received 2.5mg ICG 20-40min before surgery, four 0.25mg/kg 20-40min, five 90min – 180min and five 12 – 36 hour pre-operatively. Average age 50 years (S.D±15), BMI 27.5m2 (S.D±3.6), 6/22 were acute LC procedures. The prolonged dosing interval produced increased extrahepatic biliary structure identification (p = 0.016), reduced noise to signal ratio and was consistently preferred by the operating surgeon. NIRFC was inferior to radiological cholangiogram (n = 10) (p = 0.014) for bile duct mapping. We observed iatrogenic bile spillage saturating the field and obscuring structure differentiation and peri-hilar inflammation impeding fluorescent detection in acute LC. Conclusion The dosing regimen 0.25mg/kg ICG 12 to 36 hours prior to surgery provides optimum NIRFC structure visualisation. Fluorescent tissue penetrance is limited in acute peri-hilar inflammation. More research in to the efficiency of NIRFC in emergency LC is required. Take-home message An intravenous dose of 0.25mg/kg of Indocyanine Green 12 to 36 hours before surgery is the optimum dosing regimen for increased extra-hepatic bile duct structures with near infrared fluorescent cholangiography. The role of NIRFC in acute laparoscopic cholecystectomy surgery remains ill-defined.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Prita Daliya ◽  
Jody Carvell ◽  
Judith Rozentals ◽  
Maria Ubhi ◽  
Dileep Lobo ◽  
...  

Abstract Introduction The majority of institutions no longer offer routine post-operative follow-up after elective laparoscopic cholecystectomy. National guidelines however recommend the use of post-operative hotlines or planned telephone follow-up for day-case procedures. At a time when NHS resources are limited, a digital solution may provide a safe alternative to telephone or physical follow-up. Our aim was to identify if digital follow-up with aboutmyop.org; a digital data-sharing platform, was equivalent to telephone follow-up. Method Study participants were invited to use aboutmyop.org before and after surgery. Patients were given free choice on whether they opted to use post-operative digital follow-up or routine post-operative care (no follow-up or telephone follow-up). In addition to follow-up compliance, the outcomes measured included 30-day post-operative complications, readmission, and re-operation. Results Of 597 laparoscopic cholecystectomy patients who were offered follow-up, 16.4% opted for digital follow-up, and 33.3% phone follow-up. Over 5 times as many patients who opted for telephone follow-up missed their appointment when compared to those who chose digital follow-up (5.6% vs. 30.9%, p < 0.001). Digital follow-up had a high sensitivity (68.2%-100%) and specificity (100%) for identifying complications at 30-days post-operatively and was completed significantly earlier than phone follow-up (median 6 days vs. 13.5 days, p = 0.001) with high patient acceptability. Conclusion This feasibility study demonstrates that digital follow-up utilising the aboutmyop.org platform is an acceptable alternative modality to telephone follow-up in elective laparoscopic cholecystectomy patients. Future work should aim to compare matched cohorts of patients undergoing digital follow-up, telephone follow-up, and no follow-up as a randomised controlled trial.


1993 ◽  
Vol 37 (7) ◽  
pp. 683-686 ◽  
Author(s):  
A. G. JENSEN ◽  
H. PREVEDOROS ◽  
E. KULLMAN ◽  
B. ANDERBERG ◽  
C. LENNMARKEN

2018 ◽  
Vol 25 ◽  
pp. 55-58
Author(s):  
SMA Taher ◽  
Jamil Raihan ◽  
M Abu Zahid ◽  
AK Azad ◽  
MI Alam ◽  
...  

Laparascopic Cholecystectomy under regional anesthesia alone has been reported only with severe chronic obstructive airway disease1,2. In a randomised trial, epidural with general anesthesia have been found to be more effective in lessening postoperative pain compare with general anesthesia alone3. Regional anesthesia has been successfully used for laparascopic cholecystectomy in patient. Hamad and Ibrahim El-Khatter4 used spinal anesthesia for laparoscopic for the first time. We performing Laparascopic Cholecystectomy with carbondioxide pneumoperitoneum under spinal anesthesia alone of healthy patients with symptomatic gall stone disease5. We design a control randomized trial to compare spinal anesthesthesia with the Gold standard general anesthesia for elective Laparascopic Cholecystectomy in healty patients.TAJ 2012; 25: 55-58


2019 ◽  
Vol 13 (2) ◽  
pp. 243 ◽  
Author(s):  
AymanAnis Metry ◽  
GeorgeM Nakhla ◽  
WahbaZ Wahba ◽  
RamiM Wahba ◽  
IbrahimH Kamel

2014 ◽  
Vol 8 (1) ◽  
pp. 21 ◽  
Author(s):  
AhmedAbdelaal Ahmed Mahmoud ◽  
HazemAbdelwahab Hussein ◽  
AhmedMostafa Kamal ◽  
HeshamAhmed Nafady ◽  
Karim Girgis

Author(s):  
Federico Roesch-Dietlen ◽  
Alfonso Gerardo Pérez-Morales ◽  
Jaime Anastasio Gómez-Delgado ◽  
Julio Roberto Ballinas-Bustamante ◽  
Silvia Martínez-Fernández ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document