scholarly journals Optimal timing for laparoscopic cholecystectomy in the treatment of gallbladder calculi incarceration

2021 ◽  
Vol 19 ◽  
pp. 205873922110519
Author(s):  
Jian-Heng Bao ◽  
Yu-Jie Wang ◽  
Hai-Tao Shang ◽  
Cheng-Fei Hao ◽  
Jun-Jian Liu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Operation Time ◽  
Optimal Timing ◽  
Duration Of Symptoms ◽  
Popular Method ◽  
Duration Of Hospitalization ◽  
Independent Risk Factors ◽  
The Relationship

Objective Laparoscopic cholecystectomy (LC) has become a popular method in the treatment of gallbladder calculi incarceration (GCI). This study aimed to investigate the effect of early and delayed LC on patients with GCI to determine the optimal timing for LC. Methods The clinical data of 639 patients with GCI who had received LC were analyzed retrospectively. According to the duration of symptoms before admission and that from admission to LC, the patients were divided into different groups. The relationship between conversion and postoperative complications was compared among the different groups. Results Seventy-two patients (11.27%) underwent conversion to laparotomy, and 65 patients (10.17%) had postoperative complications. Patients in the LC > 15 d group were older ( p < 0.001), had a longer operation time ( p < 0.001), had a longer duration of hospitalization ( p < 0.001), had a higher proportion of conversion ( p < 0.001), and had a higher incidence of postoperative complications ( p < 0.001). Type 2 diabetes mellitus (T2DM) (RR = 1.701; 95% CI: 1.410–2.047; p < 0.001) and duration from admission to LC (RR = 7.072; 95% CI: 3.044–16.431; p < 0.001) were independent risk factors for conversion. Older age, T2DM, CRP, duration of symptoms before admission >3  m, and duration from admission to LC > 15 d were independent predictors of postoperative complications. Conclusion For patients younger than 65 years without contraindications, early operation should be performed within 3 d after admission to reduce the operation time, hospitalization time, conversion, and postoperative complications.

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 850
Author(s):  
Rie Osako ◽  
Yuhei Matsuda ◽  
Chieko Itohara ◽  
Yuka Sukegawa-Takahashi ◽  
Shintaro Sukegawa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Postoperative Complications ◽  
Operation Time ◽  
Bacterial Count ◽  
Cardiovascular Complications ◽  
Pericardial Fluid ◽  
Bacterial Counts ◽  
Lung Torsion ◽  
Propensity Score Adjustment ◽  
The Relationship

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00–1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients.

scholarly journals Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Prospective, Randomized Study

2014 ◽  
Vol 99 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Alper Bilal Özkardeş ◽  
Mehmet Tokaç ◽  
Ersin Gürkan Dumlu ◽  
Birkan Bozkurt ◽  
Ahmet Burak Çiftçi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Operation Time ◽  
Early Laparoscopic Cholecystectomy ◽  
Laparoscopic Cholecystectomy Group ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy

Abstract We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6–8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 ± 1.40 versus 7.8 ± 1.65 days; P = 0.04) and total costs were higher (2500.97 ± 755.265 versus 3713.47 ± 517.331 Turkish Lira; P = 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P = 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.

scholarly journals Application of near-infrared fluorescent cholangiography using indocyanine green in laparoscopic cholecystectomy

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097922
Author(s):  
Chusi Wang ◽  
Wenguang Peng ◽  
Jiarui Yang ◽  
Yuxuan Li ◽  
Jiawei Yang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Near Infrared ◽  
Hepatic Duct ◽  
Operation Time ◽  
Common Hepatic Duct ◽  
Intraoperative Blood Loss ◽  
Real Time Identification

Objective Near-infrared fluorescence cholangiography (NIRF-C) can help to identify the bile duct during laparoscopic cholecystectomy. This retrospective study was performed to investigate the effect of NIRF-C in laparoscopic cholecystectomy. Methods Consecutive patients who underwent NIRF-C-assisted laparoscopic cholecystectomy (n = 34) or conventional laparoscopic cholecystectomy (n = 36) were enrolled in this study. Identification of biliary structures, the operation time, intraoperative blood loss, and postoperative complications were analyzed. Results Laparoscopic cholecystectomy was completed in all patients without conversion to laparotomy. The median operation time and intraoperative blood loss were not significantly different between the two groups. No intraoperative injuries or postoperative complications occurred in either group. In the NIRF-C group, the visualization rate of the cystic duct, common bile duct, and common hepatic duct prior to dissection was 91%, 79%, and 53%, respectively. The success rate of cholangiography was 100% in the NIRF-C group. NIRF-C was more effective for visualizing biliary structures in patients with a BMI of <25 than >25 kg/m2. Conclusions NIRF-C is a safe and effective technique that enables real-time identification of the biliary anatomy during laparoscopic cholecystectomy. NIRF-C helps to improve the efficiency of dissection.

Early Versus Delayed Laparoscopic Cholecystectomy in Cases of Acute Calcular Cholecystitis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Mohammed Bahaa El-Din ◽  
Hany Rafik Halim ◽  
Mohammed Abd El-Sattar Abd El-Hamid ◽  
Mohammed Safwat Abd El-Razek
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Randomized Study ◽  
Operation Time ◽  
The United States ◽  
Optimal Timing ◽  
University Hospitals ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Abstract Background Acute cholecystitis (AC) is one of the important causes of abdominal pain on presentation to the emergency department. Early diagnosis and treatment of AC has a positive effect on morbidity and mortality. Laparoscopic cholecystectomy (LC) is an important approach for treating acute cholecystitis nowadays. Issued data indicated that approximately 917,000 and &gt;50,000 LCs were annually performed to treat acute cholecystitis in the United States and England, respectively. Although LCs have been extensively performed to manage acute cholecystitis, the optimal timing of LC for this given condition is inconclusive. Aim of the work The aim of this study is to prospectively compare between early and delayed laparoscopic cholecystectomy as a management of acute calcular cholecystitis along with their operative and post-operative outcomes. Patients and methods From December 2019 to December 2020 in Ain Shams University Hospitals, a prospective randomized study was conducted over 20 patients of acute cholecystitis: 10 of them underwent laparoscopic cholecystectomy from 3 day to 7 day of symptoms of acute cholecystitis, and the other 15 after 6- 8 weeks. Operation time, intraoperative and postoperative surgical complications and duration of hospital stay were assessed and compared in the 2 groups. Results Although the operation time was longer in the group with early laparoscopic cholecystectomy, but the overall complications along with the total hospital stay were less in this group of patients. Conclusion Early timing of laparoscopic cholecystectomy in relation to the onset of gall bladder inflammation may reduce the conversion rate and the total complication rate. So, early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.

scholarly journals Diabetes mellitus in patients using psychotropic medications: How does it work?

2021 ◽  
Vol 75 ◽  
pp. 398-405
Author(s):  
Marcin Kosmalski ◽  
Monika Różycka-Kosmalska ◽  
Joanna Sikora ◽  
Tadeusz Pietras
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Psychotropic Medications ◽  
Point Of View ◽  
Chronic Hyperglycemia ◽  
Therapeutic Procedures ◽  
Independent Risk Factors ◽  
Practice Questions ◽  
The Relationship

Diabetes mellitus (DM) is not a single disease, but a group of diseases that are characterized by chronic hyperglycemia and risk of damage to tissues and organs. The mechanisms of its development are different and due mainly to disorders of insulin secretion or its effects. For this reason, 4 types of DM have been distinguished. One of them is a specific type of DM, determined, inter alia, by the use of certain psychotropic medications. Chronic hyperglycemia often occurs in association with some of these drugs, but in many cases it is categorized erroneously as type 2 (T2DM) or 1 (T1DM). The relationship between DM and psychiatric disorders is bi-directional, involving two mutually independent risk factors for the development of the disease. However, not all patients with a mental illness develop carbohydrate metabolism disorders, which is due to a varied diabetogenic potential and mechanisms of action of psychotropic medications. In clinical practice, questions concerning the frequency of this type of DM, risk factors of its development and hyperglycemic mechanism of psychotropic medications arise. Therefore, the aim of this article is to attempt to answer these questions. From a practical point of view, obtaining such information should allow for the development of appropriate diagnostic and therapeutic procedures.

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.

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