scholarly journals Case Report: Multiple complications after laparoscopic cholecystectomy with perforation and spilled gallstones

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2322
Author(s):  
Jeanett Klubien ◽  
Dorte Winther Borgersen ◽  
Jacob Rosenberg ◽  
Hans-Christian Pommergaard
Keyword(s):  
Computed Tomography ◽  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Postoperative Complications ◽  
Acute Cholecystitis ◽  
Medical Records ◽  
Abdominal Cavity ◽  
Pleural Empyema ◽  
Common Complication ◽  
Lost Gallstone

Introduction Perforation of the gallbladder is a benign and common complication during laparoscopic cholecystectomy. However, it may result in stone spilling, which potentially can lead to serious postoperative complications. Case report A 70-year-old male underwent laparoscopic cholecystectomy for acute cholecystitis. The procedure was complicated by perforation of the gallbladder and spilling of gallstones. More than a year after the procedure, the patient developed subcutaneous abscesses containing some of the spilled stones, a computed tomography revealed a complex intraabdominal and intrathoracic fistula with communication from the abdominal cavity to pleura and ultrasonic imaging found a lost gallstone in the thorax. After two years, the patient developed pleural empyema and sepsis secondary to the condition. Presently, the patient awaits surgery for the fistula and empyema. Conclusion Proper care should be taken to avoid stone spilling during laparoscopic cholecystectomy. However, if perforation and stone spilling occur, all visible stones should be removed during the procedure and the complication should be noted in the medical records. Furthermore, the patient should be thoroughly informed. This may help accelerate diagnosis if the patient later suffers from a complication related to lost stones.

scholarly journals Retroauricular Emphysema as a Late Complication After Bonebridge Implantation: Case Report

2021 ◽  
pp. 014556132110002
Author(s):  
Soňa Šikolová ◽  
Dagmar Hošnová ◽  
Klára Perceová ◽  
Michal Bartoš ◽  
Vít Kruntorád ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Postoperative Complications ◽  
Rare Case ◽  
Late Complication ◽  
Bone Conduction ◽  
Computed Tomography Scan ◽  
Artificial Opening ◽  
Low Incidence ◽  
Tomography Scan

Bonebridge (BB) is the first active implantation system for bone conduction that is placed fully under the skin. Experience suggests that BB is characterized by low incidence of postoperative complications. This case report presents a rare case of a 16-year-old girl with incidence of emphysema occurring over the implant 1 year after operation. We performed a computed tomography scan that showed pockets of gas above the floating mass transducer so we provided the revision surgery and sealed the artificial opening with fat from the earlobe and fibrin glue. Since that time, no air has collected in the retroauricular area and the implant has been fully functional.

scholarly journals Operative and Postoperative Complications of Laparoscopic Cholecystectomy: Experience from a Tertiary Care Hospital of Bangladesh

2017 ◽  
Vol 5 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Tapash Kumar Maitra ◽  
Mahmud Ekram Ullah ◽  
Faruquzzaman ◽  
Samiran Kumar Mondol
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Invasive Technique ◽  
Favorable Result ◽  
Age Group ◽  
Open Conversion ◽  
Female Patients ◽  
Complications Of Laparoscopic Cholecystectomy

Background: The technique of laparoscopic surgery has rapidly become popular because of its several advantages over conventional open surgery. The reduction of postoperative pain provided positive human impact, and the reduction of length of hospital stay as well as the earlier return to work generated a positive socioeconomic impact. However, in spite of being a minimally invasive technique, this procedure has different peroperative and postoperative complications which cannot be disregarded.Objective: To evaluate the complications of laparoscopic cholecystectomy in symptomatic and asymptomatic cholelithiasis and other benign gall bladder diseases.Methodology: 172 patients who underwent laparoscopic cholecystectomy were included in this prospective study on the basis of non-randomized convenient sampling from a period of September 30, 2014 to September 30, 2016 in BIRDEM General Hospital, Dhaka, Bangladesh. Data of the patients regarding outcomes and complications were analyzed.Result: Results of this study suggests that 35.5% cases were male and 64.5% patients were female. In male group, most of the patients (18.0%) were in 41-50 years of age group followed by 9.9% in 51-60 years age group, whereas among the female patients these were 33.1% and 15.7% respectively. Mean±SD of age were46±1.7 and 42±1.3 years in case of male and female patients respectively.In 119 (69.2%) out of total 172 cases, laparoscopic cholecystectomy was done for chronic cholecystitis and in 18.6% (32 out of total 172) cases, it was performed for acute cholecystitis. Intra-operative bile leak(11.0%) was found to be the most frequent complications during laparoscopic cholecystectomy. The incidence rates of perforation of gall bladder, stone spillage were 9.3% and 5.2% respectively. Trocar site, vascular, and hepatic bed hemorrhages were 7.0%, 4.7% and 4.0% respectively. Open conversion was done in 17 cases (9.9%). Port site infection and post cholecystectomy syndrome developed in 5.2% and 4.7% cases respectively. The overall mortality was approximately 1.1%. Serious complications likebowel injury and bile duct injury were recorded in 0.6% and 1.2% cases respectively.The results of this study suggest that gender, age, co-morbidities, previous abdominal surgery, acute cholecystitis, obesity, thickened gall bladder wall on ultrasound, history of preoperative ERCPare probablyimportant and clinically significant relevant factors for open conversion of laparoscopic cholecystectomy.Conclusion: In our study, complications of laparoscopic cholecystectomy were similar to those of different centres in western countries. We found laparoscopic cholecystectomy as a safe and effective procedure in almost all patients with cholelithiasis. Proper preoperative work up, awareness of possible complications and adequate training on laparoscopic technique make this operation a safe procedure with favorable result and lesser complications.Bangladesh Crit Care J March 2017; 5(1): 11-16

Computed Tomography with 3d Reconstructions in Planning Two Stage Hepatectomy ALPPS for Alveococcosis of the Liver (Case Report)

2018 ◽  
pp. 81-86 ◽  
Author(s):  
А. Башков ◽  
A. Bashkov ◽  
Ю. Удалов ◽  
Yu. Udalov ◽  
Ж. Шейх ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Abdominal Cavity ◽  
Diagnostic Information ◽  
3D Reconstructions ◽  
Liver Insufficiency ◽  
The Future ◽  
Left Portal Vein

Purpose: To provide case report of alveococcosis of the liver, when ALPPS procedure was planned based on diagnostic information and 3D reconstructions of computed tomography. Material and methods: Computed tomography with bolus intravenous administration of 100 ml of contrast media Ultravist-370 was performed on multislice computed tomography Aquilion 64 Toshiba. Results: The preoperative planning is the crucial part of treatment to minimize or exclude liver insufficiency after resection. The minimal volume of remnant of the liver should be more than 25–30 % for normal parenchyma and more than 40 % in case of chronic pathologic diffuse process in the liver for example steatosis or cirrhosis. If the estimated volume of remnant is not enough to perform resection, two staged hepatectomy should be planned. According to CT data, the parenchyma of segment S2 and most of parenchyma S3, which together constitute the so-called lateral sector of the liver, were preserved. It allowed to plan an extended right-sided resection. However, the volume of the future liver remnant was 410 ml – about 30 % of the functioning part of the liver which was considered insufficient in view of the presence of prolonged biliary hypertension and a decreasing density of the parenchyma. Vascular elements of the left lateral sector – left hepatic artery, left hepatic vein and inferior vena cava were intact, however, there was a possibility of involving the wall of the left portal vein, due to its prolonged contact with the surface of the parasitic lesion. Using the segmentation tool on radiology workstation, a 3D surface model of the liver was built, where the localization of the pathologic lesion and its relationship with the main vessels were visually demonstrated. After preoperative preparation, a decision was made to perform ALPPS procedure. At the first stage intraoperative the adhesion of the parasitic lesion with the left portal vein was confirmed, which required its resection and plastic. Also in addition to the usual volume of the operation, an atypical resection of the S3 segment and Roux-en-Y choledochojejunostomy were performed. On the 7th day after the 1st stage, a control CT scan was performed, at which an increase in the volume of the remnant to 630 ml (46 % of the preserved parenchyma of the liver) was recorded. The hepatic artery, portal and hepatic veins of the future liver remainder were enhanced homogenously; drainage was traced in the area of parenchyma dissection after the second, l stage of the operation, CT was performed in 15 days to exclude liquid accumulations in the abdominal cavity and to assess the condition of the remnant due to a moderate increasing of the level of direct bilirubin up to 98 μmol/l. No pathological changes in the abdominal cavity were revealed, only free pleural effusion was observed in the pleural cavities with partial atelectasis of the lower lobes of the lungs. After conservative therapy the liver insufficiency was resolved. On the 20th day after the operation, the patient was discharged. Conclusion: In the described clinical case, computed tomography with 3D reconstructions made possible to obtain complete diagnostic information that was necessary for the surgeon to assess the resectability of the pathological process and to plan the type of surgical intervention.

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 Choice of tactics of surgical treatment of acute cholecystitis and its complications

2018 ◽  
Vol 22 (3) ◽  
pp. 442-445
Author(s):  
B.S. Zaporozhchenko ◽  
K.V. Kravets ◽  
I.E. Borodaev ◽  
D.A. Bondarets ◽  
D.A. Bondarets ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Average Duration ◽  
Abdominal Cavity ◽  
Age Groups ◽  
Total Duration ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Emergency Operations ◽  
Surgical Tactics

Acute cholecystitis ranks second in the incidence of urgent surgical diseases in hospitals in Ukraine. Despite a marked improvement in the treatment results, the lethality after emergency operations (9,4-37%) for acute cholecystitis complicated by peritonitis remains several times higher than with routine surgical interventions. Objectives — development of rational surgical tactics and evaluation of the effectiveness of treatment of acute cholecystitis and its complications in patients of different age groups, with different pathomorphological forms of acute cholecystitis. The result of treatment of 203 patients was presented: 75 (37,5%) were operated on an emergency basis, 73 (36,5%) urgently, and 52 (26%) in a deferred period. 173 (86.5%) patients were operated using laparoscopic technologies. Intraoperative cholangiography was performed in 16 (9,3%) patients during laparoscopic interventions. In 17 (8,5%) patients, “open” operations were performed. All patients underwent drainage of the abdominal cavity with one or more drains in view of the presence of peritonitis. The average duration of the preoperative period was 1.5 days, the total duration of treatment with LC was 4.5 days, and the total duration of treatment with OC was 10.8 days. So, in the early stages of the development of acute cholecystitis, laparoscopic cholecystectomy is effective. The use of lifting systems for laparoscopic cholecystectomy is advisable in elderly and senile patients, with concomitant diseases of the heart and lungs.

scholarly journals Laparoscopic cholecystectomy of acute cholecystitis

2010 ◽  
Vol 63 (5-6) ◽  
pp. 404-408 ◽  
Author(s):  
Veselin Stanisic ◽  
Milorad Bakic ◽  
Milorad Magdelinic ◽  
Hamdija Kolasinac ◽  
Igor Babic
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Operative Procedure ◽  
Course Of Disease ◽  
Quick Recovery ◽  
Preoperative Risk Factors ◽  
Severe Pathology ◽  
Duration Of Operation

Introduction. Laparoscopic cholecystectomy is a method of choice for surgical treatment of diseases of gallbladder. Although most surgeons today use laparoscopic cholecystectomy in treatment of severe acute cholecystitis, most surgeons still consider acute cholecystitis a relevant contraindication for laparoscopic cholecystectomy because of ?confused? anatomy and ?severe? pathology. Aim of the study was to analyze laparoscopic cholecystectomy outcomes in treatment of acute cholecystitis. Material and methods. A prospective analysis included 78 patients operated for acute calculose cholecystitis from Jan 2007 to Dec 2008. We analyzed clinical characteristics of the course of disease, associated diseases, duration of operation, operative and postoperative complications, reasons for conversion into open cholecystectomy. Results. The study indicated a low percentage of operative and postoperative complications, short stay in hospital, quick recovery and saving in treatment. The length of preoperative and postoperative hospitalization was 1.4?0.5 days and 2.5?1.6 days, respectively. 25 (32%) patients were operated within 72 hours from the onset of symptoms, some operative difficulties were present in 56 (71%) patients, light identification of artery and ductus cysticus in 30 (38.5%) patients, intraoperative lesion of ductus choledohus in 1 (1.3%); in 6 (7.7%) patients conversion into open cholecystectomy was done, the average duration of laparascopic cholecystectomy was 58.1?26.2 min. There were no lethal outcomes. Conclusion. Laparoscopic cholecystectomy is an efficient and reliable operative procedure in treatment of acute cholecystitis. It is much easier to select patients for laparoscopic cholecystectomy when preoperative risk factors predicting difficulties during the operation are known. An early conversion into open cholecystectomy is a rational choice of any surgeon when anatomy is not clear and in cases of advanced inflammatory process in order to decrease operative and postoperative morbidity.

scholarly journals Giant retroperitoneal liposarcoma during pregnancy: case report

2018 ◽  
Vol 7 (11) ◽  
pp. 4768
Author(s):  
Dhruba Prasad Paul ◽  
Kashish Garg
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Soft Tissue ◽  
Abdominal Cavity ◽  
Pelvic Mass ◽  
Myxoid Liposarcoma ◽  
Final Diagnosis ◽  
Retroperitoneal Tumor ◽  
Retroperitoneal Liposarcoma

24-year-old woman was presented with huge vulval mass for which she was operated, histopathological report of that mass shows angiomyoma. After few months she was discovered to have a giant retroperitoneal tumor incidentally during her routine obstetric examination at 24 weeks of gestation. Initial investigation by abdominal-pelvic computed tomography (CT) (18/08/18) revealed an a large multiseptated soft tissue attenuated minimally enhancing pelvic mass (31.8cmx13.2x 24cm) protruding in the abdominal cavity displacing the bowel loops proximally and pushing retro organs posteriorly. She underwent laparotomy with preservation of the fetus at 24 weeks of gestation. Final diagnosis was made after HPE report which shows myxoid liposarcoma. She was referred to regional cancer hospital for radiotherapy and then patient lost in follow up.

Successful Aortic Valve Replacement With Perceval Bioprosthesis for Aortic Stenosis With Membranous Ventricular Septum Aneurysm

2021 ◽  
pp. 155698452098425
Author(s):  
Shuhei Nishijima ◽  
Yoshitsugu Nakamura ◽  
Borut Gersak ◽  
Shigetaka Namiki ◽  
Tsunashi Kouzaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Postoperative Complications ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Contrast Enhancement ◽  
Valve Replacement ◽  
Bioprosthetic Valve ◽  
Ventricular Septum

Membranous ventricular septum aneurysm (MVSA) is extremely rare, especially when coexisting with aortic stenosis (AS), and reports regarding the available treatment for MVSA with AS are limited. Aortic valve replacement (AVR) can be challenging because of anatomical reasons. In this case report, a patient with MVSA and severe AS was treated with AVR with the sutureless Perceval bioprosthesis. After implantation, no paravalvular leakage was detected in echocardiography, and no other postoperative complications were observed. Postoperative electrocardiography-gated computed tomography revealed no contrast enhancement for MVSA. The MVSA was closed by the Perceval bioprosthetic valve. Thus, patients with simultaneous MVSA and AS may be effectively treated with AVR using a Perceval bioprosthesis.

scholarly journals EXPERIENCE IN PERFORMING PUNCTURE AND DRAINAGE MINI-INVASIVE INTERVENTIONS UNDER ULTRASOUND CONTROL IN THE DIAGNOSIS AND TREATMENT OF ABDOMINAL DISEASES AND POSTOPERATIVE COMPLICATIONS. Review

2020 ◽  
Vol 16 (3) ◽  
pp. 51-62
Author(s):  
M.P. Zakharash ◽  
Yu.M. Zakharash ◽  
A.I. Stelmakh ◽  
V.V. Moroz
Keyword(s):  
Acute Pancreatitis ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Acute Cholecystitis ◽  
Abdominal Cavity ◽  
Comparative Assessment ◽  
Diagnosis And Treatment ◽  
Advantages And Disadvantages ◽  
Implementation Techniques ◽  
Materials Used

The article presents a description of the main puncture and drainage interventions, indicating the method of their implementation, techniques, materials used for their implementation. The own experience of application of the specified minimally invasive interventions in the treatment of a syndrome of mechanical jaundice of benign and malignant genesis, acute cholecystitis, acute pancreatitis and its complications, hepatic abscesses, limited liquid accumulations of an abdominal cavity and retroperitoneal space is described. The advantages and disadvantages are noted, a comparative assessment is made and recommendations are given for the use of different puncture and drainage interventions depending on the type of pathology in which they are used.

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