Prophylactic Antibiotics for Elective Laparoscopic Cholecystectomy

2018 ◽  
Vol 84 (4) ◽  
pp. 576-580 ◽  
Author(s):  
J. Patrick Smith ◽  
Navdeep S. Samra ◽  
David H. Ballard ◽  
Jonathan B. Moss ◽  
Forrest D. Griffen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Site Infections ◽  
Prophylactic Antibiotics ◽  
Practice Change ◽  
Control Group ◽  
Study Group ◽  
Institutional Practice ◽  
Before And After ◽  
Elective Laparoscopic Cholecystectomy ◽  
Elective Cholecystectomy

Surgical site infections with elective laparoscopic cholecystectomy are less frequent and less severe, leading some to suggest that prophylactic antibiotics (PA) are no longer indicated. We compared the incidence of surgical site infections before and after an institutional practice change of withholding PA for elective laparoscopic cholecystectomy. Between May 7, 2013, and March 11, 2015, no PA were given to patients selected for elective cholecystectomy by two surgeons at a single center. The only patients excluded were those who received antibiotics before surgery for any reason. All others, including those at high risk for infection, were included. The incidence and severity of infections were compared with historical controls treated with prophylaxis by the same two surgeons from November 6, 2011, to January 13, 2013. There were 268 patients in the study group and 119 patients in the control group. Infection occurred in 3.0 per cent in the study group compared with 0.9 per cent in the controls ( P = 0.29). All infections were mild except one. Based on these data, the routine use of PA for elective laparoscopic cholecystectomy is not supported.

scholarly journals A prospective study: role of prophylactic antibiotics versus no antibiotics in elective laparoscopic cholecystectomy

2020 ◽  
Vol 7 (5) ◽  
pp. 1580
Author(s):  
Renu Verma ◽  
Sushil Kumar Mittal ◽  
Navdeep Kumar Singla
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Biochemical Parameter ◽  
Significant Degree ◽  
Prophylactic Antibiotics ◽  
Chi Square ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy

Background: Elective gallbladder surgery is the most common abdominal surgical procedure. Antibiotic prophylaxis is a common conduct in open cholecystectomy, but there is ambiguity about the use of prophylactic antibiotics in laparoscopic cholecystectomy. Some surgeons suggest that the elimination of prophylactic antibiotics in patients undergoing elective laparoscopic cholecystectomy increase the incidence of postoperative infective complications but not to a statistically significant degree. The aim of this study was to evaluate the role of prophylactic antibiotics in laparoscopic cholecystectomy.Methods: A total of 100 patients were included and they were randomized in 2 groups of 50 each. Group A was given prophylactic intravenously (IV) antibiotic within 1 hour before surgery and group B was not given any antibiotics. Results were compared and data analyzed statistically using chi-square and t test. Complications in both the groups were compared.Results: Rate of surgical site infections were 6% (n=3) and 4% (n=2) in group A and B respectively; and the difference between them was not found statistically significant. All infections which occurred in present study were superficial surgical site infection. There was no evidence of deep-seated infections and none of the patients developed distant infection. There was no derangement in any of the biochemical parameter in this study.Conclusions: We were not able to demonstrate any significant benefit from addition of prophylactic antibiotics in elective laparoscopic cholecystectomy. 

The effects of breathing exercises on respiratory functions, functional capacity and quality of life in vehicle spray painters

2021 ◽  
Vol 28 (12) ◽  
pp. 1-8
Author(s):  
Burak Yilmaz ◽  
Cagtay Maden ◽  
Begümhan Turhan
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Control Group ◽  
Study Group ◽  
Breathing Exercises ◽  
Sf 36 ◽  
Significant Difference ◽  
Before And After ◽  
Respiratory Exercises

Background/aims Workers engaged in vehicle spray painting are at a risk of developing respiratory problems because of the solvents in the spray paints. Changes in respiratory functions and functional capacities caused by spray painting can be improved with respiratory exercises. The aim of this study was to examine the effects of respiratory exercises on the respiratory functions, functional capacity and quality of life in vehicle spray painters. Methods A total of 70 volunteers with similar characteristics participated in the study. The groups were divided into two groups randomly (35 study group, 35 control group). Respiratory functions (value of forced expiratory volume percentage in 1 second [FEV1]), forced vital capacity percentage [FVC], FEV1/FVC percentage, peak expiratory flow percentage [PEF (%)] and maximum voluntary ventilation percentage [MVV (%)]), functional capacity (6-Minute Walk Test) and quality of life (Short Form Health Survey [SF-36]) were evaluated. The study group undertook supervised breathing exercises 3 days a week for 6 weeks. The same exercises were given to the control group as a home programme. Home programmes were followed up by telephone calls. Evaluations were performed again after 6 weeks. Results In the study group, FEV1 (%) increased more than in the control group (P<0.05). The increase in PEF (%) was similar in both groups (P>0.05). In the study group, FEV1/FVC (%) and MVV (%) were significantly different before and after the intervention (P<0.05), but there was no difference in the control group (P>0.05). There was a greater increase in the study group than in the control group (P<0.05). 6-Minute Walk Test distance (m) before and after the intervention in both groups were similar (P>0.05). Before and after the intervention, a significant difference was found in the vitality and the social function domains of the SF-36 in the study group. In the comparisons of groups, a significant difference was found in the study group in the role-emotional, social function and bodily pain domains of the SF-36 after the intervention (P<0.05). Conclusions Breathing exercises can be recommended for vehicle spray painters to avoid an increase in respiratory resistance and to improve their quality of life.

scholarly journals Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Case Control Study ◽  
Gallbladder Disease ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Standard Laparoscopic Cholecystectomy ◽  
Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

scholarly journals Acalculous gallbladder disease: the outcomes of treatment by laparoscopic cholecystectomy

2011 ◽  
Vol 93 (3) ◽  
pp. 209-212 ◽  
Author(s):  
M Ahmed ◽  
R Diggory
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Daily Living ◽  
Preoperative Diagnosis ◽  
Gallbladder Disease ◽  
Symptom Control ◽  
Study Group ◽  
Moderate Pain ◽  
State Of Health ◽  
Before And After ◽  
Results Of Surgery

INTRODUCTION The treatment of symptomatic patients with the presence of gallstones is well established, with laparoscopic cholecystectomy being the treatment of choice for symptomatic cholelithiasis. The results of surgery in symptomatic patients without gallstones are highly variable. These patients are often referred to as having acalculous gallbladder disease and represent between 5% and 30% of laparoscopic cholecystectomies performed annually. We retrospectively reviewed the outcomes of patients who underwent laparoscopic cholecystectomy for acalculous gallbladder disease in our institution. PATIENTS AND METHODS We retrospectively analysed the period from February 2005 to January 2006 where 20 laparoscopic cholecystectomies had been performed specifically for a preoperative diagnosis of acalculous gallbladder disease. The histology of all laparoscopic cholecystectomies performed during this year was analysed and it was found that a further 46 patients had histological specimens that demonstrated the absence of gallstones in the presence of an intact gallbladder specimen. These patients were therefore included in the study group for acalculous gallbladder disease. All patients were sent a questionnaire comparing their state of health before and after surgery. RESULTS After laparoscopic cholecystectomy, 66% of patients were completely pain free. The remainder, however, experienced infrequent, moderate pain with occasional pain on eating. Following surgery, all patients were able to conduct their activities of daily living without any limitation. CONCLUSIONS We therefore conclude that laparoscopic surgery for patients with acalculous gallbladder disease is effective in symptom control and allowing patients to return to their normal lifestyle.

scholarly journals Effect of Semi-Recumbent Position on Blood Oxygen Saturation in Postanesthetic Patients After Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 82-85
Author(s):  
Xiaoling Chen ◽  
Yuelan Qin ◽  
Fanghua Gong
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Lung Function ◽  
Oxygen Saturation ◽  
Intervention Group ◽  
Control Group ◽  
Blood Oxygen ◽  
Recumbent Position ◽  
Blood Oxygen Saturation ◽  
Bed Elevation ◽  
Before And After

BackgroundUndergoing general anesthesia and pneumoperitoneum could affect the lung function and comprise oxygenation in laparoscopic cholecystectomy patients. Position of patients after surgery may affect lung function of these patients.AimTo observe the effect of semi-recumbent position on blood oxygen saturation (SpO2) in postanesthetic patients after laparoscopic cholecystectomy.MethodsA number of 225 patients who admitted to postanesthetic care unit after laparoscopic cholecystectomy from September 2016 to May 2017 were randomly assigned into the intervention group and the control group. The intervention group adopted a semi-recumbent position with head bed elevation by 10 to 20°, while the control received a supine position without lying on a pillow. Both groups received routine postanesthesia care. Data on SpO2 before and after extubation were collected. Independent t-test was used for data analysis.ResultsThere was no vomiting and cough reactions before and after extubation in both groups. Intervention group reported a significantly higher level of SpO2 at 1 minute and 30 minutes after extubation, compared to the control group (both ps < 0.05).ConclusionSemi-recumbent position with the head bed elevation could significantly increase the SpO2 level of postanesthetic patients, thus ensuring the safety of patients when removing the endotracheal tube.

scholarly journals The Effect of Pilates Training on the Balance of Elderly

2019 ◽  
Vol 1 (16) ◽  
Author(s):  
Kristina Zaičenkovienė ◽  
Renata Rakovaitė
Keyword(s):  
Dynamic Balance ◽  
Step Test ◽  
Control Group ◽  
Static Balance ◽  
Study Group ◽  
Timed Up And Go ◽  
Physically Active ◽  
Before And After ◽  
Four Square ◽  
And Control

Research background. Falling is one of the most important problems in the elderly’s mobility disorder, which is most often affected by the loss of balance. It is known that Pilates exercises could help to increase the deep muscle strength, improve posture and proprioception, which affects the improvement of the balance. Objective – to evaluate the effects of Pilates exercises on the elderly’s static and dynamic balance. Methodology. The study population consisted of 20 volunteers, men and women, who were divided into Pilates exercises (n = 10, age 65.1 ± 2.6) and control (n = 10, age 68.6 ± 4.9) groups. The study group participated in Pilates classes 2 times per week for six weeks (session duration 60 minutes). The control group did not participate in any physical activity, but they were physically active as usually in their daily life. The main outcome measures were assessed before and after the intervention. The static balance was assessed by measuring posturographic parameters using the force platform, dynamic balance was measured with the Timed up and Go Test (TUG) and the Four Square Step Test (FSST). Results. The results showed signifcant improvement in static balance of the experimental group after the Pilates exercises during standing tests when the feet were apart, eyes opened and closed and when the feet together with eyes opened, and when the foot was in front of the other foot. The results of the control group did not differ during both tests. The results of both groups did not differ in the static balance tests before and after the study, but after the Pilates exercises, the results of the Pilates group signifcantly differed from the control group test results when the feet were in shoulder line with open eyes. The results of the dynamic balance after Pilates exercises signifcantly improved in both tests in the study group. Before the study, there were not statistically signifcant differences in the dynamic balance results between the groups. Conclusions. Six-week Pilates exercises had a positive effect on the elderly’s static and dynamic balance.Keywords: Pilates training, static balance, dynamic balance.

Role of Ultrasound Screening for Gallbladder Disease in Pretransplant Patients

2008 ◽  
Vol 74 (9) ◽  
pp. 832-833
Author(s):  
Madhavi Meka ◽  
Santosh Potdar ◽  
Peter Benotti ◽  
J. Edward Hartle ◽  
Christopher Senkowski
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallbladder Disease ◽  
Graft Loss ◽  
Day Surgery ◽  
Control Group ◽  
Study Group ◽  
Gallstone Pancreatitis ◽  
Safe Procedure ◽  
Ultrasound Screening ◽  
Clinical Value

There is no uniform data regarding prophylactic cholecystectomy in patients undergoing renal transplantation with gallbladder disease. Data analyses suggest that posttransplant patients on cyclosporine have a higher incidence of gallbladder calcifications compared with nonimmunosuppressed patients. Laparoscopic cholecystectomy is a relatively safe procedure in modern-day surgery. Taking these facts into consideration, we attempted to compare risks and complications associated with gallbladder disease and eventual cholecystectomy in pretransplant versus post-transplant patients. Between June 1999 and December 2005, 210 renal transplants were performed at our institution. One hundred four patients who had transplants before April 2003 were not screened for gallbladder disease and nine of these patients developed gallbladder disease. These patients form our control group. One hundred six patients who had transplants after April 2003 had pretransplant screening for gallbladder disease and 11 patients were identified with gallbladder disease. These patients form our study group. Nine patients who developed gallbladder disease after renal transplant underwent laparoscopic cholecystectomy with three resulting morbidities (33%), two graft losses (22%), and one mortality (11%). There was one mortality (11%) in this group. One patient in the study group died of acute gallstone pancreatitis. Of the 11 patients who were found to have gallbladder disease on screening, nine patients underwent laparoscopic cholecystectomy with one morbidity and no mortality or graft loss. Given the relative rarity of the critical events in this study (morbidity, mortality, and graft loss), the definitive statistical value of prescreening for gallbladder disease cannot be established. However, our results are suggestive of clinical value and thus we tentatively recommend ultrasound screening for gallbladder disease for all pretransplant patients and laparoscopic cholecystectomy for those identified to have gallbladder disease.

scholarly journals Analysis of Surface Roughness and 3D Scanning Topography of Zirconia Implants Before and After Photofunctionalisation by 3D Optical Profilometry- An Invitro Study

2021 ◽  
Author(s):  
Arunjaikumar Ravindran ◽  
Suma Karthigeyan ◽  
Ramesh Bhat ◽  
Madhulika Naidu ◽  
Senthilnathan Natarajan ◽  
...  
Keyword(s):  
Surface Roughness ◽  
Roughness Parameter ◽  
In Vitro Study ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Optical Profilometry ◽  
Before And After ◽  
Zirconia Implants

Introduction: Zirconia is considered as an alternative material for the fabrication of implants. Surface roughness of the implant plays a fundamental role in the initial bone formation. The rationale of using 3D optical profilometry in this study was to evaluate the surface roughness of the zirconia implants before and after Ultraviolet (UV) photofunctionalisation. Also, Moreso 3D optical instruments have a better resolution than the mechanical ones like Atomic Force Microscopy (AFM). Aim: To analyse the surface roughness and topography of zirconia implants after photofunctionalisation using optical profilometry. Materials and Methods: This is an in-vitro study conducted over a period of six months from March 2020 to August 2020. Ten commercially machined Zirconia implants, five each in study and control group, were micro analysed at three different regions (abutment, thread and crest) by optical profilometry. Study group was surface treated by UV radiation for 48 hours. Quantitative morphometric analysis was done between two groups and p-value less than 0.05 was considered statistically significant. The statistical test applied in this study was independent t-test. Results: Scanning micrographs of the study group revealed highest density of summits contributing to increased surface area in the study group. Quantitative analysis of surface roughness showed statistically significant higher mean roughness parameter for photofunctionalised implants in abutment, crest and thread region (p<0.05). Conclusion: Photofunctionalisation is a potentially synergistic technique in producing textured zirconia implants.

scholarly journals The ımportance of art therapy ın the qualıty of lıfe ın hemodıalysıs patıents

2020 ◽  
pp. 27-33
Author(s):  
Ergün Parmaksız ◽  
Hüseyin Demirbilek
Keyword(s):  
Quality Of Life ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Study Group ◽  
State Trait Anxiety Inventory ◽  
Important Place ◽  
Before And After ◽  
Avoidance Measures ◽  
The Mean

Dialysis causes many psycho-social problems in patients with chronic renal failure and decreases their quality of life by increasing their anxiety. We aimed to determine the influence of artistic activities on quality of life and reducing or eliminating dialysis anxiety.Methods. Among 180 hemodialysis patients, 8 patients were randomly selected as a study group and 8 patients as a control group. We performed our theater rehearsals in 16 sessions, two hours per week. State-Trait Anxiety Inventory (STAI), STAII and  Social Anxiety Scales (SAS) were employed in both groups before and after the play. Results. The means of the eighth-month SAS fear and avoidance measures of the study group were found to be significantly lower than the control group and significantly lower than the baseline. The mean difference of the initial eighth-month SAS fear and avoidance in the study group was statistically significantly higher than the control group.Initial and eighth month SAS fear and avoidance difference averages of the study group were found statistically significantly higher than the control group.Conclusions. We determined that the therapies to be done with art have an important place in relieving or reducing anxiety in hemodialysis patients. In addition, it was the opinion that our patients would make positive contributions to their quality of life. However, further studies are needed to demonstrate whether theater rehearsals reduce anxiety in hemodialysis patients.

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