Impact of Conversion to Open Surgery on Early Postoperative Morbidity After Laparoscopic Resection for Rectal Adenocarcinoma: A Retrospective Study

2016 ◽  
Vol 26 (9) ◽  
pp. 697-701 ◽  
Author(s):  
Anass Mohammed Majbar ◽  
Mourad Abid ◽  
Mouna Alaoui ◽  
Farid Sabbah ◽  
Mohamed Raiss ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Open Surgery ◽  
Postoperative Morbidity ◽  
Laparoscopic Resection ◽  
Rectal Adenocarcinoma ◽  
Conversion To Open Surgery

scholarly journals Acute Care Surgeon: Use of the Endo GIA Stapler for Cystic Duct Ligation in Emergent Cholecystectomy

2017 ◽  
Vol 6 (1) ◽  
pp. 44-48
Author(s):  
Vicente Gracias ◽  
Paul Truche ◽  
David Blitzer ◽  
Erin Scott ◽  
Joseph Hanna
Keyword(s):  
Logistic Regression ◽  
Laparoscopic Cholecystectomy ◽  
Acute Care ◽  
Cystic Duct ◽  
Open Surgery ◽  
Postoperative Morbidity ◽  
Biliary Duct ◽  
Conversion To Open Surgery ◽  
Duct Ligation ◽  
Ed Visits

ABSTRACT Introduction Endo GIA stapler use is a method to ligate cystic ducts during laparoscopic cholecystectomy in the elective and emergent setting. Its use has not been widely described in the acute care surgery (ACS) setting. Our study aims to determine factors predicting Endo GIA use by acute care surgeons and evaluate when applied its safety and efficacy in emergent cholecystectomy. Additionally, we investigate the use of Endo GIA stapler with respect to conversion to open surgery, reduction in postoperative morbidity, and impact on length of stay in an ACS setting. Materials and methods A retrospective chart review was conducted for laparoscopic cholecystectomy performed by ACS in a public university training hospital over 1 year. Variables associated with Endo GIA stapler use were identified through multivariate logistic regression and subsequently, assessed after optimizing the model to control for confounding effects. Results Of the 118 laparoscopic cholecystectomies performed, the Endo GIA Stapler was used for cystic duct ligation in 20 cases. Surgeons’ dictated reason for stapler use included dilated cystic duct (45%), short cystic duct remnant (15%), inadequate room for clip ligation and division (10%), and nonspecific (45%). Patient demographic variables for Endo GIA stapled and clipped groups were not significantly different. Logistic regression revealed a significantly higher likelihood of Endo GIA stapler use in patients with comorbid biliary duct disease, preoperative endoscopic retrograde cholangiopancreatography (ERCP), and a trend towards significance in patients with previous emergency department (ED) visits. There was no significant difference in conversion to open surgery, postoperative morbidity, and postoperative length of stay. Conclusion Comorbid biliary duct disease, previous ED visits, and preoperative ERCP are predictive of patients requiring use of the Endo GIA stapler for cystic duct ligation during emergent cholecystectomy. The use of Endo GIA stapler by Acute Care Surgeons is safe and effective. How to cite this article Truche P, Blitzer D, Scott E, Hanna J, Gracias V, Peck G. Acute Care Surgeon: Use of the Endo GIA Stapler for Cystic Duct Ligation in Emergent Cholecystectomy. Panam J Trauma Crit Care Emerg Surg 2017;6(1):44-48.

scholarly journals THE CONVERSION TO OPEN SURGERY IN LAPAROSCOPIC CHOLECYSTECTOMY

2018 ◽  
Vol 1 (2) ◽  
pp. 57-61
Author(s):  
I. Slavu ◽  
V. Braga ◽  
L. Alecu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Gold Standard ◽  
Preoperative Diagnosis ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Safe Method ◽  
Conversion To Open Surgery ◽  
Conversion To Open Cholecystectomy

After more than 20 years from the beginning of laparoscopic surgery, laparoscopic cholecystectomy still holds a conversion rate of 5.1 % in the specialty literature. We have conducted a retrospective study based on the experience of the clinical unit of General Surgery within “Prof. Dr. A. Ionescu” Emergency Clinical Hospital, between 1997 and 2013. A number of 2,309 laparoscopic cholecystectomies were performed. The average age of the group was 47.3 years. Conversion was performed to a number of 58 patients (2.51%), out of which 74.13% women (no. = 43) and 26% men (no. 15). The average age of the patients to whom the conversion was performed was 57. Conversion to open cholecystectomy was more frequent in patients over 60 (no. 38). The main preoperative diagnosis in converted patients was acute lithiasic cholecystitis. Laparoscopic cholecystectomy is a safe method with optimal results, being considered the “gold standard” in the treatment of bladder lithiasis. Conversion to open surgery is an expression of the surgeon’s experience and wisdom.

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

AN ACCOUNT OF 15 YEARS EXPERIENCE OF LAPAROSCOPIC COMMON BILE DUCT EXPLORATION IN CHOLEDOCHOLITHIASIS FOLLOWED BY PRIMARY REPAIR AND ITS COMPARISON WITH OPEN CHOLEDOCHOLITHOTOMY IN DISHARI HEALTH POINT PRIVATE LIMITED, MALDA

2021 ◽  
pp. 15-16
Author(s):  
Arkaprovo Roy ◽  
Manabesh Pramanik
Keyword(s):  
Retrospective Study ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Open Surgery ◽  
Primary Repair ◽  
Common Bile Duct Exploration ◽  
Laparoscopic Bile Duct Exploration

A retrospective study of 4628 patients who underwent laparoscopic cholecystectomies with choledocholithotomy with primary repair of common bile duct , with a mean follow-up of 23.2 months is carried outto evaluate the safety and feasibility of laparoscopic choledocholithotomy via choledochotomy for the treatment of choledocholithiasis in Dishari Health Point Private Limited, a multispeciality hospital in Malda from January 2004 to January 2019. We had to convert to open surgery in 27 patients and could complete the operation laparoscopically in rest 4621 patients. We also did open surgery in 30 patients apart from this. We analyse the results and it was found that Laparoscopic bile duct exploration via choledochotomy followed by primary duct closure is feasible and safe for the treatment of choledocholithiasis.

Emergency Cholecystectomy for Patients on Antiplatelet Therapy

2017 ◽  
Vol 83 (5) ◽  
pp. 486-490 ◽  
Author(s):  
Keiichi Akahoshi ◽  
Takanori Ochiai ◽  
Ayumi Takaoka ◽  
Takuya Kitamura ◽  
Daisuke Ban ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Acute Cholecystitis ◽  
Antiplatelet Therapy ◽  
Open Surgery ◽  
Massive Hemorrhage ◽  
Intraoperative Blood Loss ◽  
Local Inflammation ◽  
Conversion To Open Surgery ◽  
Difficult Decision ◽  
Emergency Cholecystectomy

The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACTis still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014. Treatment outcomes among 13 patients who underwent cholecystectomy without discontinuing APT (the cAPT group), 11 patients who discontinued APT and ACT (the D group), and 89 patients who did not receive preoperative APT and/or ACT (the No APT group) were compared. There were no significant differences in intraoperative blood loss, conversion to open surgery, and bleeding-related complications. However, the incidence of intraoperative blood transfusion was higher in the cAPT group (P = 0.04). They presented with severe local inflammation; thus, it was difficult to stop bleeding from the gallbladder bed. Hemostatic tools for liver surgery were used to control bleeding. Emergency cholecystectomy was tolerable for patients with acute cholecystitis while continuing APT. However, in case of severe local inflammation, there is a greater risk for massive hemorrhage.

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