The impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis: A retrospective study

2019 ◽  
Vol 13 (3) ◽  
pp. 351-358
Author(s):  
Shigeo Ninomiya ◽  
Shota Amano ◽  
Tadashi Ogawa ◽  
Yoshitake Ueda ◽  
Norio Shiraishi ◽  
...  
2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Asarbakhsh ◽  
N Lazarus ◽  
P Lykoudis

Abstract Background The definitive management of acute cholecystitis is laparoscopic cholecystectomy on the same admission if the patient is fit. As the Covid-19 pandemic emerged, evidence suggested adverse outcomes for asymptomatic Covid positive patients undergoing surgery, including increased mortality risk. Risks to theatre staff were also highlighted. This prompted changes in acute cholecystitis management guidelines. Method The audit aim was to assess the impact of guideline change on clinical outcomes and readmission rate for acute cholecystitis. The revised Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) guidelines were the gold standard. All inpatient admissions for acute cholecystitis during the 4-week peak of the pandemic (17/04/2020 – 14/05/2020) were included. Result 24 patients were admitted with acute cholecystitis. 10 patients (41.7%) were managed with antibiotics alone, 4 patients (16.6%) underwent cholecystostomy. 12 patients (50%) were discharged within 3 days. Lack of clinical progress/ongoing symptoms was the indication for laparoscopic cholecystectomy in 5 cases (20.8%). 5 conservatively managed patients (20.8%) were readmitted with ongoing cholecystitis or pancreatitis. Conclusions 19 patients (80%) were managed non-surgically in accordance with AUGIS guidelines. However conservative management was not always appropriate. We recommend that laparoscopic cholecystectomy should remain a management option for acute cholecystitis during the ongoing Covid-19 pandemic.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seijiro Sato ◽  
Masaya Nakamura ◽  
Yuki Shimizu ◽  
Tatsuya Goto ◽  
Terumoto Koike ◽  
...  

2020 ◽  
Vol 27 (8) ◽  
pp. 451-460
Author(s):  
Yoshito Tomimaru ◽  
Nariaki Fukuchi ◽  
Shigekazu Yokoyama ◽  
Takuji Mori ◽  
Masahiro Tanemura ◽  
...  

2018 ◽  
Vol 12 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Yuki Yokota ◽  
Yoshito Tomimaru ◽  
Kozo Noguchi ◽  
Takehiro Noda ◽  
Hisanori Hatano ◽  
...  

1996 ◽  
Vol 10 (7) ◽  
pp. 746-750 ◽  
Author(s):  
H. S. Ho ◽  
K. A. Mathiesen ◽  
B. M. Wolfe

1999 ◽  
Vol 178 (4) ◽  
pp. 303-307 ◽  
Author(s):  
Samuel Eldar ◽  
Arie Eitan ◽  
Amitai Bickel ◽  
Edmond Sabo ◽  
Ayala Cohen ◽  
...  

2021 ◽  
pp. 219256822110497
Author(s):  
Ken Ninomiya ◽  
Kunimasa Okuyama ◽  
Ryoma Aoyama ◽  
Satoshi Nori ◽  
Junichi Yamane ◽  
...  

Study Design A retrospective study. Objectives This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P < .01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P < .01, 35.1 vs 52.3; P = .047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups ( < .01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.


2019 ◽  
Vol 6 (11) ◽  
pp. 3897
Author(s):  
Deepu Thiyagarajan ◽  
Prince Deva Ruban

Background: Early laparoscopic cholecystectomy (LC) is a life-saving procedure in the management of acute cholecystitis as it helps in prevention of late complications like development of adhesions, haemorrhage and sepsis. The study aims at comparing the outcomes of early versus late laparoscopic cholecystectomy in the management of acute cholecystitis.Methods: A retrospective study was done by analyzing the past 5 years medical records of 250 patients admitted to the emergency department with diagnosis of acute cholecystitis established according to the Tokyo criteria. The relevant clinio-social demographic data of the patients, clinical and radiological parameters, intra-operative and post-operative findings and follow-up data were compared between early and late LC group of patients.Results: The study included 125 middle aged patients who underwent early LC (within 24 hours) and 125 patients who underwent late LC (after 24 4hours). The complication rate, conversion to open cholecystectomy and duration of surgery showed no significant differences between early and late laparoscopic cholecystectomy except for an increased duration of stay among the late LC group.Conclusions: Early LC is an efficient procedure for acute cholecystitis but it has risks of complications which can be minimized by careful selection of patients after clear clinical and radiological evaluation. 


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