Incidental carcinoma gall bladder during laparoscopic cholecystectomy for symptomatic gall stone disease

2008 ◽  
Vol 23 (9) ◽  
pp. 2041-2046 ◽  
Author(s):  
Om Tantia ◽  
Mayank Jain ◽  
Shashi Khanna ◽  
Bimalendu Sen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gall Stone ◽  
Stone Disease ◽  
Carcinoma Gall Bladder ◽  
Gall Stone Disease ◽  
Symptomatic Gall Stone

scholarly journals Prospective randomised trial of standard pressure versus low pressure laparoscopic cholecystectomy in a tertiary care hospital from Kolkata: Our experience

2018 ◽  
Vol 9 (4) ◽  
pp. 17-22
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Gall Stone ◽  
Low Pressure ◽  
Stone Disease ◽  
Care Hospital ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Standard Pressure ◽  
Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22

scholarly journals Multiple port sites metastasis after laparoscopic cholecystectomy: a case report

2017 ◽  
Vol 4 (12) ◽  
pp. 4096
Author(s):  
Farhanul Huda ◽  
Sudhir K. Singh ◽  
Arvind Gupta ◽  
Navin Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Radical Surgery ◽  
Histopathological Examination ◽  
Gall Stone ◽  
Stone Disease ◽  
Rare Occurrence ◽  
Port Site Metastasis ◽  
Gall Stone Disease ◽  
Incidental Gallbladder Cancer

Laparoscopic cholecystectomy is a surgical procedure of choice for gall stone disease. Incidental gallbladder cancer is found in about 0.25-3% of patients after routine cholecystectomy. Depending on the stage of tumour, additional radical surgery may be required. In recent years, several reports of port site metastasis have been published. Here, we report a case of a 55-year-old female patient who presented to us with simultaneous multiple port sites metastasis after an interval of 15 months of laparoscopic cholecystectomy for gall stone disease. We recommend the routine use of specimen bag for the retrieval of gall bladder during laparoscopic cholecystectomy and also to send the gall bladder for histopathological examination. To the best of our knowledge, metastasis to more than one port is a very rare occurrence.

scholarly journals Gall Bladder Retrieval through Umbilical versus Epigastric Port in Conventional Four Ports Laparoscopic Cholecystectomy.

2021 ◽  
Vol 28 (10) ◽  
pp. 1407-1412
Author(s):  
Gul e Lala ◽  
Sajid Malik ◽  
Mian Umar Javed ◽  
Kamran Zaib Khan ◽  
Muhammad Tauqeer Aslam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
Stone Disease ◽  
Equal Distribution ◽  
Medical College ◽  
Post Operative Pain ◽  
Gall Stone Disease ◽  
Pros And Cons

Introduction: Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gall stone disease all over the world. In laparoscopic cholecystectomy gall bladder is traditionally removed through umbilical port. In this approach surgeon has to change his position and telescope has to be changed in xiphoid port. Another approach to remove the gallbladder is through 10mm xiphoid port without changing position of telescope and surgeon. Both approaches are compared for their pros and cons regarding post-operative pain at site of removal. Study Design: Randomized control study. Setting: Department of surgery of Allama Iqbal medical college/ Jinnah hospital Lahore. Period: August 2017 to February 2018. Material & Methods: To compare mean post-operative pain in gall bladder retrieval through umbilical versus xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis. Patient were divided in two equal groups with first group had their gall bladder retrieved through umbilical port while the other underwent retrieval through xiphoid port. Standard analgesia was used in both groups and post-operative outcome was noted. Results: A total 70 patient with equal distribution in two groups were enrolled to compare post-operative pain at port site comparing umbilical versus xiphoid process. Mean post-operative pain visual analogue scale (VAS) was as lower (p<0.0001) at 1, 6, 12 & 24 hrs. In umbilical port group as compared to xiphoid port group. Conclusion: Mean post-operative pain in gall bladder retrieval umbilical port give advantage in post-operative period regarding significantly reduced pain when compared with xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis in selective cases.

scholarly journals Prediction of difficulties during laparoscopic cholecystectomy by preoperative clinical examination and ultrasonography

2017 ◽  
Vol 4 (4) ◽  
pp. 1335 ◽  
Author(s):  
Arun Kumar ◽  
Kunwar Vishal Singh ◽  
Jugendra Pal Singh Shakya ◽  
Sangita Sahu ◽  
Soniya Dhiman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Examination ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
Medical College ◽  
Preoperative Ultrasonography ◽  
Gall Stone Disease ◽  
Symptomatic Gall Stone

Background: Cholelithiasis (gall stone disease) is a well-known disease worldwide. Ultrasonography is the most common screening test for cholecystitis and cholelithiasis. Laparoscopic Cholecystectomy is considered the treatment of choice for symptomatic gall stone disease. It is important to know the different clinical, radiological parameter and specific predictor that give some prediction of difficult LC. The aim of this study was to predict the difficulty of LC and the possibility of conversion to OC before surgery using the clinical and ultrasonographic criteria in our set up.Methods: The present study was carried out in the Department of surgery, Sarojini Naidu Medical College Agra, from November 2014 to October 2016.  A total of 210 patients were enrolled for the laparoscopic cholecystectomy. All patients who were included in the study were undergone detailed history and clinical examination. A number of clinical and ultrasonographical parameters were noted.Results: Amongst the 210 patients admitted for laparoscopic cholecystectomy, 21 (10%) were male and 189 (90%) female, with age ranging from 12–60 years.  The conversion rate in our study was 4.5% (9 of 210). In our study significant pre-operative factors which increased the conversion rate to open cholecystectomy includes male gender, obesity, abdominal scar of previous surgery, contracted and thickened gall bladder and patients having stone impacted at the neck of gall bladder.Conclusions: From this study, we conclude that preoperative ultrasonography is a good predictor of difficult laparoscopic cholecystectomy in the majority of cases and should be used as a screening procedure.

scholarly journals Study of persistent post laparoscopic cholecystectomy symptoms: a 6 month long follow up of 62 patients

2018 ◽  
Vol 5 (10) ◽  
pp. 3368
Author(s):  
Sagar Soitkar ◽  
Divish Saxena ◽  
Nitin Wasnik ◽  
Murtaza Akhtar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Gall Stone ◽  
Stone Disease ◽  
Complete Relief ◽  
Care Hospital ◽  
Psychiatric Illnesses ◽  
Gall Stone Disease ◽  
Symptomatic Gall Stone

Background: Majority of patient undergoing laparoscopic cholecystectomy for symptomatic gall stone disease is either cured or show improvement in their pre-operative symptoms. However, in few patients these preoperative symptoms may still persist and may continue to bother them even after surgery. The aim of this study is to evaluate and manage these patients with persistent post cholecystectomy symptoms.Methods: 62 patients of diagnosed symptomatic cholelithiasis had undergone laparoscopic cholecystectomy at a tertiary care hospital. They were evaluated with a questionnaire both before and; 3 months and 6 months after surgery. The symptoms present pre-operatively and the symptoms that persisted after laparoscopic cholecystectomy or emergence of any new symptoms were taken into consideration.Results: Out of 62 operated patients, 38 patients (61.3%) were relieved of their symptoms after cholecystectomy on follow up after 3 months whereas 24 patients (38.7%) had persistence of their symptoms. However, at 6 months follow up 16 out of these 24 patients showed improvement of their symptoms. Pain in right hypochondrium and non-specific dyspepsia were the commonest symptoms that were persistent. Thus, in this study 54 (87.1%) patients had complete relief after laparoscopic cholecystectomy and were satisfied with the treatment and in 08 (12.90%) patients the symptoms were not relieved.Conclusions: All the patients undergoing laparoscopic cholecystectomy should be evaluated in detail regarding their symptoms, psychiatric illnesses and be investigated thoroughly so as not to miss any other organic cause for their symptoms and should be counseled regarding persistence of their symptoms even after laparoscopic cholecystectomy.

scholarly journals Lost Stone During Laparoscopic Cholecystectomy: Retrieval Using a Condom

HPB Surgery ◽  
1993 ◽  
Vol 7 (1) ◽  
pp. 67-68 ◽  
Author(s):  
S. C. S. Chung ◽  
M. K. W. Li ◽  
A. K. C. Li
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gall Stone ◽  
Stone Disease ◽  
Large Stone ◽  
Gall Stone Disease ◽  
Novel Method ◽  
Laparoscopic Vision

Laparoscopic cholecystectomy is becoming increasingly popular for the treatment of gall stone disease. In this technique, the gall bladder is dissected free under laparoscopic vision and then extracted. We report an interesting complication that occurred during extraction of a gall bladder containing a large stone and a novel method of overcoming the problem.

scholarly journals Diagnostic value of upper gastrointestinal endoscopy prior to elective laparoscopic cholecystectomy for symptomatic cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 105
Author(s):  
Indira Khedkar ◽  
Dinesh Prasad ◽  
Achal Datta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Stone ◽  
Gastrointestinal Symptoms ◽  
Stone Disease ◽  
P Value ◽  
Upper Gastrointestinal Endoscopy ◽  
Complete Relief ◽  
Gastrointestinal Lesions ◽  
Gall Stone Disease ◽  
Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy is gold standard surgery for symptomatic gall stone disease which is the commonest disease needs surgical management. Present study was conducted to contribute UGI endoscopy as routine preoperative investigation and the importance of UGI endoscopy to evaluate the association between gastrointestinal symptoms with gallstones and reduce the prevalence of post cholecystectomy pain.Methods: Patients with Ultrasonography suggestive of single or multiple gall stones were included and investigated as per proforma. Upper GI Scopy was done 1 to 2 days prior to laparoscopic cholecystectomy as per inclusion and exclusion criteria. All patients above 18years, with ultrasonographically proven diagnosis of cholelithiasis and with symptoms (typical and atypical) were included.Results: In present study, author have evaluated the different OGD pathologies the most common site of pathology was stomach (72.5%) that was gastritis. Followed by oesophagitis (55%), and Hiatus hernia (16.5) The most common duodenal pathology was duodenitis (6.25%). In present study, 71 patients had pain in epigastrium at presentation which gradually subsided with no complains of pain in 3 months. Statistically significant reduction in pain was appraised at the end of first week itself (p-value <0.0001).Conclusions: Certain symptoms associated with gallstones are not alleviated by cholecystectomy itself and requires further exploration, therefore, patients presenting with symptomatic gall stone disease should undergo routine OGD prior to cholecystectomy as many gastrointestinal lesions may coexist which prevents the complete relief of the symptoms after cholecystectomy.

Early experience of laparoscopic cholecystectomy in acutely inflamed gallbladder

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Ali Abdul Hussein Handoz ◽  
Ahmed Kh Alsagban
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
The Elderly ◽  
Stone Disease ◽  
Definitive Treatment ◽  
Adjacent Structures ◽  
Common Causes ◽  
Gall Stone Disease ◽  
Male To Female

Gallstones are now among the most important disease in the era of surgery. Definitive treatment of gall stone disease remains cholecystectomy. One of the common causes of emergency surgical referral is acute cholecystitis of which 50-70% cases are seen in the elderly patients.50 patients were treated with laparoscopic cholecystectomy from October 2013 to October 2015. The patient’s age was from 20 to 65 years old with a mean age of 34 ±3 years old. The patients received in the emergency unit and their attack not more than 72 hrs of acute gall stone inflammation were included in this study.From the 50 patients,15 were males (34%) and females were 35 (74%) so the ratio of 1:2of male to female. Problems and complications that facing in this study at time of laparoscopy were mainly adhesions to the adjacent structures like stomach, colon, and omentum. Adhesion into CBD also considered.Early intervention for acute cholecystitis of calculus type by laparoscopy now regarding safe and gold standard approach that should be kept in mind when dealing with such cases.

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