scholarly journals Acute abdomen due to spilled gallstones: a diagnostic dilemma 10 years after laparoscopic cholecystectomy

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Mehmet Tolga Kafadar ◽  
İsmail Çetinkaya ◽  
Ulaş Aday ◽  
Ömer Başol ◽  
Hüseyin Bilge
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Abdomen ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Significant Risk ◽  
Definitive Diagnosis ◽  
Laparoscopic Technique ◽  
Gallbladder Perforation ◽  
Diagnostic Dilemma

Abstract Laparoscopic cholecystectomy (LC) carries a significant risk of gallbladder perforation and resulting scattering of bile stones into the abdominal cavity. The retrieval of the spilled stones is not always possible by laparoscopic technique. Most cases do not create long-term problems, although some cases may be complicated in future and create uncertainties regarding the correct diagnosis. Diagnosis can be difficult, and in most cases the patient may require open surgery for management of these complications. Herein, we report a case of acute abdomen due to spilled stones occurring 10 years after LC. In the first stage, definitive diagnosis could not be made with computed tomography examination. Finally, the patient was diagnosed with explorative laparotomy.

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Znacaj laparoskopije u proceni tupe abdominalne traume

2010 ◽  
Vol 57 (4) ◽  
pp. 33-38 ◽  
Author(s):  
Pavle Gregoric ◽  
Djordje Bajec ◽  
Dejan Radenkovic ◽  
Ana Sijacki ◽  
Aleksandar Karamarkovic ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Patient Positioning ◽  
Diagnostic Procedures ◽  
Definitive Diagnosis ◽  
Laparoscopic Technique ◽  
Abdominal Organs

Laparoscopic diagnostics provides fast, reliable, clear, and obvious information on extent and depth of abdominal organs injury with minimizing additional trauma to the patient. It is performed without any specific preparations and, if needed, it may be promptly converted into conventional laparotomy. Through use of optical equipment with various refraction angles and through variable patient positioning, laparoscopic technique enables visualization of whole abdominal cavity. In approximately 20% of cases of unclear findings, and after other performed diagnostic procedures, laparoscopy provides definitive diagnosis. Abdominal surgeons are familiar with this method, making interpretation of the results very fast and reliable and, what is the most important, this method avoids additional trauma caused by conventional laparotomy.

scholarly journals Acute Abdominal Disorders in Dairy Cattle: What Can Clinicians Do under Field Conditions?

Ruminants ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 46-57
Author(s):  
Rodrigo Muiño ◽  
Joaquín Hernández ◽  
Cristina Castillo
Keyword(s):  
Dairy Cattle ◽  
Acute Abdomen ◽  
Diagnostic Tests ◽  
Clinical Symptoms ◽  
Pathological Condition ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Field Conditions ◽  
Therapeutic Measure ◽  
Therapeutic Choice

Acute abdomen (AA) is the term used to define a pathological condition that affects the abdominal cavity and frequently manifests itself with acute clinical symptoms capable of compromising a cow’s life. Therefore, it should be considered as an emergency that should be evaluated as quickly as possible to adopt the appropriate therapeutic measure (medical or surgical). In an AA situation, the clinician must consider the appropriate diagnostic approach as well as the therapeutic choice. Given the emergency, the veterinarian’s experience will be decisive for the appropriate resolution. In this article, we briefly review the causes that may lead to this condition, as well as the different diagnostic tests available in field conditions to establish the correct diagnosis and treatment.

scholarly journals Lost Stones During Laparoscopic Cholecystectomy

HPB Surgery ◽  
1998 ◽  
Vol 11 (2) ◽  
pp. 105-109 ◽  
Author(s):  
J. Diez ◽  
C. Arozamena ◽  
L. Gutierrez ◽  
J. Bracco ◽  
A. Mon ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Early Diagnosis ◽  
Intestinal Obstruction ◽  
Open Surgery ◽  
Abdominal Cavity ◽  
Gallbladder Perforation ◽  
Conversion To Open Surgery ◽  
Abdominal Abscesses ◽  
Initial Surgery ◽  
Legal Consequence

Background: Gallbladder perforation, with loss of calculi in the abdomen is frequent during laparoscopic cholecystectomy. Recent publications report complications in port sites or in the abdominal cavity. A study of 3686 laparsocopic cholecystectomies performed by 6 surgeons was undertaken. In 627 patients, perforation of the gallbladder occurred and in 254 stones were spilled into the abdominal cavity. In 214 they were retrieved and in 40 left in the abdomen. Twelve patients developed complications. Percutaneous drainage was successful in 2 with serous collections. Two patients with abdominal abscesses were reoperated, stones retrieved and the abdomen drained.One patient developed an intestinal obstruction due to a stone in the ileum. One patient who had a cholecystectomy in another hospital developed a paraumbilical tumor. At reoperation a stone was retrieved. In another six patients, stones were found in port sites. Stones lost into the abdomen should be removed because of their potential morbidity, especially if they are large or if infection is present in the gallbladder at the time of initial surgery. There is no indication for routine conversion to open surgery when stone spillage occurs, although patients should be informed to avoid legal consequence, and to hasten early diagnosis of later complications.

scholarly journals Abdominal Wall Sinus: A Late Complication of Gallstone Spillage During Laparoscopic Cholecystectomy

HPB Surgery ◽  
1997 ◽  
Vol 10 (3) ◽  
pp. 163-164 ◽  
Author(s):  
Michael D. Graham ◽  
Paul G. Anderson ◽  
James Toouli
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Late Complication ◽  
Biliary Complication ◽  
Gallbladder Perforation ◽  
Sinus Formation ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Gallstone Spillage

Long term complications of laparoscopic cholecystectomy are uncommon. However, as experience with this procedure accumulates, sporadic reports of non-biliary complication have been published. We report a case of abdominal wall sinus formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy.

scholarly journals Relationship of Gallbladder Perforation and Bacteriobilia with Occurrence of Surgical Site Infections following Laparoscopic Cholecystectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nikhar Jain ◽  
Sushanto Neogi ◽  
Rajandeep Singh Bali ◽  
Niket Harsh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Significant Risk Factor ◽  
Gallbladder Perforation ◽  
E Coli ◽  
The Mean ◽  
Monomicrobial Infection ◽  
Relationship Of ◽  
Gallbladder Rupture

Aim. To assess the occurrence of SSIs in patients with spillage of gallbladder contents and bacteriobilia during laparoscopic cholecystectomy.Methods. We evaluated 113 patients who underwent laparoscopic cholecystectomy between September 2013 and April 2015. The SSIs and their relationship with gallbladder rupture and bacteriobilia were assessed.Results. The mean age of patients developing SSIs was 45.57 ± 8.89 years. 18 patients (16%) had spillage of bile from the gallbladder. Percentage of SSIs overall was 6%, while percentage of SSIs in gallbladder content spillage was 5.5%. Organism profile of the culture from surgical site showed monomicrobial infection: 58%Staphylococcus aureus, 14%Pseudomonas, and 14%E. coli. The occurrence of SSIs in patients with bacteriobilia was 16% as compared to 2% in patients without bacteriobilia.Conclusions. Gallbladder content spillage is not a significant risk factor leading to increase in SSIs. The occurrence of SSIs is significantly higher in patients with bacteriobilia.

scholarly journals Outcome of Perforated Gallbadder during Laparoscopic Cholecystectomy

2021 ◽  
Vol 17 (1) ◽  
pp. 26-30
Author(s):  
Raad Faraj Hanashe ◽  
Hasanain Talib Essa ◽  
Mohanad Abdul Wahid Abdul Razaq
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Significant Risk ◽  
Male Gender ◽  
Gallbladder Perforation ◽  
Early Complications ◽  
Hospital Data ◽  
Prospective Comparative Study ◽  
The Mean

Background: Laparoscopic cholecystectomy (LC) has become the standard treatment for symptomatic cholelithiasis. Bile duct injury and accidental gallbladder perforation with spillage of bile and stone are common complications of LC. This study was carried out to assess the early complications of gallbladder perforation during LC, and identify the risk factor of that perforation. Objectives: to evaluate the early complications which may occur after the perforation of the gallbladder during laparoscopic cholecystectomy and to determine the risk factors which are associated with the perforation of the gall bladder.  Subjects and methods: A prospective comparative study on 192 patients who underwent LC between August 2012 to January 2014 in Baghdad teaching hospital. Data were collected, Patients with and without gallbladder perforation were compared in terms of gender, age, anatomic difficulty, the experience of the surgeon, omental and other organ adhesions to the gall bladder. Results: fifty-five patients had a perforation of GB during LC, 46 patients had GB perforated during dissection of gallbladder bed from hepatic fossa. The mean operative time and duration of postoperative hospitalization were longer in the perforated group, perforation occurs more frequently in acute cholecystitis compared to chronic cholecystitis. There were significant risk factors related to gallbladder perforation which include male gender, AC, adhesion around the gallbladder, and experience of the surgeon. Conclusion: accidental gallbladder perforation leading to longer operative and hospital time which loss the advantage of LC. The male gender, AC, and experience of the surgeon had the main risk factors of the perforated gallbladder.

Association between Socioeconomic Factors and Postoperative Complications of Cholecystectomy

2021 ◽  
pp. 1-13
Author(s):  
Herman Romero Ramírez ◽  
Norma Muñoz Albán ◽  
Consuelo Albán Meneses ◽  
Alicia Escobar Torres
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Socioeconomic Factors ◽  
Control Variable ◽  
Laparoscopic Technique ◽  
Safe Operation ◽  
Conventional Surgery ◽  
Socioeconomic Characteristics ◽  
Dependent Variables ◽  
Education Levels

The article´s goal isto determine if socioeconomic factors influence the postoperative complications of cholecystectomy. For this, the observational study was defined, analytical and quantitative study was conducted in 100 patients who underwent cholecystectomy. A logistic regression model was applied in which risk factors, socioeconomic characteristics, along with a control variable, were incorporated as variables. Three models were run with alternative dependent variables that are delimited by the type of postoperative complication recorded. The results found showed that women show a higher risk of presenting complications after cholecystectomy, the same occurs in older patients. Likewise, the risk is much lower in people with higher education levels and in patients who underwent laparoscopic cholecystectomy, they only have a 5% risk of presenting complications. Postoperative complications after cholecystectomy are minimized by using the laparoscopic technique and socioeconomic factors would influence the risk of suffering postoperative complications after said surgery, which makes laparoscopic cholecystectomy a safe operation with many other benefits and advantages over traditional or conventional surgery.

scholarly journals Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lytfi Krasniqi ◽  
Mads P. Kronby ◽  
Lars P. S. Riber
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Risk ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Long Term Survival ◽  
All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

Sign in / Sign up

Export Citation Format

Share Document