Gangrenous cholecystitis: Analysis of risk factors and experience with laparoscopic cholecystectomy

Background: Gallstone disease is among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is now the preferred approach to its treatment. When performing laparoscopic cholecystectomy, the surgeon should have the low threshold for open conversion in case of difculty. The aim of the study was Pre-operative prediction of difcult laparoscopic cholecystectomy using clinical, ultrasonographic and intraoperative parameters. Methods:This study was done on 200 patients presenting with symptomatic cholelithiasis who underwent laparoscopic cholecystectomy. A prospective analysis of parameters including the patient demographics, laboratory values, radiologic data and intraoperative parameters was performed. Results: The factors which were considered a difculty parameter were males, age>60years, preoperative ERCP, rised amylase, sonographic features of contracted or distended gallbladder and pericholecystic collection. Intraoperative parameters were adhesions around gallbladder, contracted or distended gallbladder inamed gallbladder. Conclusions: The above mentioned factors must be adequately studied and the surgeon and the patient should be prepared for difcult laparoscopic cholecystectomy.

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Infected Renal Cyst as a Complication of Dropped Gallstones during Laparoscopic Cholecystectomy

Case Reports in Gastrointestinal Medicine ◽

10.1155/2018/2478245 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Chelsea Kennedy-Snodgrass ◽

Vivian Keenan ◽

Douglas S. Katz

Keyword(s):

Risk Factors ◽

Laparoscopic Cholecystectomy ◽

Ct Scan ◽

Renal Cyst ◽

Early Recognition ◽

Common Complication ◽

Abdominal Ct ◽

Abdominal Ct Scan ◽

Substantial Morbidity

Dropped gallstones are a relatively common complication, occurring in 3% to 32% of laparoscopic cholecystectomies performed, depending on various intraoperative risk factors. However, complications arising from dropped gallstones are relatively rare, occurring in fewer than 1% of such patients, and can include abscesses and inflammatory masses confined to the subhepatic space, presenting days to years later. We report a patient who developed an infected renal cyst as a result of dropped gallstones, which created a fistula from the duodenum to a previously simple right renal cyst, which was initially identified on an abdominal CT scan. Dropped gallstones can result in substantial morbidity in a minority of patients following cholecystectomy performed for cholecystitis, and a high clinical as well as radiological index of suspicion may be required for accurate early recognition and treatment.

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Analysis of Risk Factors for Postoperative Complication of Repair of Bile Duct Injury After Laparoscopic Cholecystectomy

Digestive Diseases and Sciences ◽

10.1007/s10620-014-3255-7 ◽

2014 ◽

Vol 59 (12) ◽

pp. 3085-3091 ◽

Cited By ~ 14

Author(s):

Qiang Huang ◽

Han Hui Yao ◽

Feng Shao ◽

Chen Wang ◽

Yuan Guo Hu ◽

...

Keyword(s):

Risk Factors ◽

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Postoperative Complication ◽

Bile Duct Injury

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Does the male gender govern conversion of laparoscopic cholecystectomy?

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i1.27071 ◽

2019 ◽

Vol 6 (1) ◽

pp. 14-20

Author(s):

Kishor Manandhar ◽

Sujita Manandhar

Keyword(s):

Risk Factors ◽

Abdominal Pain ◽

Laparoscopic Cholecystectomy ◽

Operating Time ◽

Male Gender ◽

Female Group ◽

Emergency Visit ◽

Significant Difference ◽

Conversion To Open Cholecystectomy ◽

Upper Abdominal

Introductions: Laparoscopic cholecystectomy (LC) occasionally demands conversion to open cholecystectomy (OC) because of multiple risk factors. This study was conducted to find out whether male gender is a stand-alone risk factors for conversion of LC to OC. Methods: This was a comparative analysis of conversion of LC to OC in patients operated for symptomatic cholelithiasis during June 2017 to May 2018 at Bir hospital, National Academy of Medical Sciences, Kathmandu, Nepal. The patients were divided into two groups: male (group 1) and female (group 2). Study variables included gender, America Society of Anesthesiologist class, history of upper abdominal pain within six weeks prior to surgery, upper abdominal surgery, emergency department visit due to upper abdominal pain, adhesion of gallbladder to adjacent structure and body mass index. Binominal logistic regression analysis of risk factors for conversion was conducted. Odds ratio (95% CI) was calculated. The p value ≤ 0.05 was considered statistically significant. Results: Among 151 patients (male 39, female 112), 7 (4.6%, male 3 and female 4) had conversion from LC to OC. Male gender itself as an isolated risk factor had no significant association to conversion (p=0.303). There was no significant difference found for age, operating time and hospital stay. Previous emergency visit (p=0.020) and adhesion (p<0.030) were associated with conversion. Conclusions: Male gender had no significant association for conversion of LC to open. Previous emergency visit due to upper abdominal pain and adhesion of gallbladder were associated risk factors for conversion.

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Early Laparoscopic Cholecystectomy Is the Appropriate Management for Acute Gangrenous Cholecystitis

The American Surgeon ◽

10.1177/000313481107700412 ◽

2011 ◽

Vol 77 (4) ◽

pp. 401-406 ◽

Cited By ~ 5

Author(s):

Sae Byeol Choi ◽

Hyung Joon Han ◽

Chung Yun Kim ◽

Wan Bae Kim ◽

Tae-Jin Song ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Hospital Stay ◽

Operative Time ◽

Early Operation ◽

Duration Of Symptoms ◽

Early Laparoscopic Cholecystectomy ◽

Gangrenous Cholecystitis ◽

Total Hospital Stay ◽

Urgent Operation ◽

Operation Group

Treatment of severe acute cholecystitis by laparoscopic cholecystectomy remains controversial because of technical difficulties and high rates of complications. We determined whether early laparoscopic cholecystectomy is appropriate for acute gangrenous cholecystitis. The medical records of 116 patients with acute gangrenous cholecystitis admitted to the Korea University Guro Hospital between January 2005 and December 2009 were reviewed. The early operation group, those patients who had cholecystectomies within 4 days of the diagnosis, was compared with the delayed operation group, who had cholecystectomies 4 days after the diagnosis. Of the 116 patients, 57 were in the early operation group and 59 were in the delayed operation group. There were no statistical differences between the groups with respect to gender, age, body mass index, operative methods, major complications, duration of symptoms, mean operative time (98 vs 107 minutes), or postoperative hospital stay. However, the total hospital stay was significantly longer in the delayed operation group. More patients underwent preoperative percutaneous cholecystostomy in the delayed operation group (3.5 vs 15.3%). Early laparoscopic cholecystectomy for acute gangrenous cholecystitis is safe and feasible. There is no advantage to postponing an urgent operation in patients with acute gangrenous cholecystitis.

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