scholarly journals Endoscopic cystic duct stent as primary treatment for intrahepatic gallbladder perforation with abscess formation

2017 ◽  
Vol 99 (4) ◽  
pp. e128-e130 ◽  
Author(s):  
P Williams ◽  
R French ◽  
B Paranandi ◽  
C Wilson ◽  
R Charnley
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Open Cholecystectomy ◽  
Primary Treatment ◽  
Abscess Formation ◽  
Gallbladder Perforation ◽  
Biliary Disease ◽  
Invasive Treatment ◽  
Endoscopic Retrograde ◽  
Uncommon Presentation

Intrahepatic gallbladder perforation with abscess formation is an uncommon presentation of biliary disease. There is no consensus on how to treat this condition, with strategies varying from percutaneous drainage to open cholecystectomy and washout. We present a case of a novel, minimally invasive treatment, using endoscopic retrograde cholangiopancreatography to place a transcystic drain as a bridge to laparoscopic cholecystectomy.

scholarly journals Complications of laparoscopic cholecystectomy: an analysis of 1,695 laparoscopic operations

2017 ◽  
Vol 4 (9) ◽  
pp. 3049
Author(s):  
Dasharadha Jatothu ◽  
Rajkumar Sade ◽  
Kirthana Sade ◽  
. Taruni ◽  
Nagababu Pyadala
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Treatment Options ◽  
Gallstone Disease ◽  
Minimally Invasive Treatment ◽  
Medical Sciences ◽  
Invasive Treatment ◽  
Gold Standard Method ◽  
Operative Complication

Background: Laparoscopic cholecystectomy (LCs) is the gold standard method to treat gallstone disease. But there are some complications which occur frequently as compared to open cholecystectomy.Methods: The prospective study was conducted in the Department of Surgery, Kamineni Institute of Medical Sciences, Telengana during the period of 2 years; March 2015 to February 2017. A total of 1,695 laparoscopic cholecystectomy cases were included in this study. Several treatment options such as, conservative treatment, minimally invasive treatment and open surgery was performed based on the severity of the disease.Results: Majority of patients were female (83.9%) and most common age group affected was above 40 years. Intra-operative and post-operative complication occurred in 4.5% and 1.9% patients respectively. Majority complications were treated by conservative treatment and minimally invasive treatment. So, in conclusion, we can use conservative and minimally invasive treatment to manage the complications from laparoscopic cholecystectomy.Conclusions: Conservative treatment options and minimally invasive treatment was more efficient to overcome the post-operative complication of laparoscopic cholecystectomy.

Concurrent Biliary Disease Increases the Risk for Conversion and Bile Duct Injury in Laparoscopic Cholecystectomy: A Retrospective Analysis at a County Teaching Hospital

2017 ◽  
Vol 83 (10) ◽  
pp. 1024-1028 ◽  
Author(s):  
Lara H. Spence ◽  
Samuel Schwartz ◽  
Amy H. Kaji ◽  
David Plurad ◽  
Dennis Kim
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Biliary Tract ◽  
Bile Duct Injury ◽  
Odds Ratio ◽  
Open Cholecystectomy ◽  
Biliary Tract Disease ◽  
Endoscopic Retrograde ◽  
Conversion To Open Cholecystectomy ◽  
Tract Disease

Biliary tract disease remains a common indication for operative intervention. The incidence of concurrent biliary tract disease (>2 biliary tract disease processes) is unknown and the impact of more than one biliary tract diagnosis on outcomes remains to be defined. The objective of this study was to determine the effect of concurrent biliary tract disease on conversion rate and outcomes after laparoscopic cholecystectomy. A 5-year retrospective analysis of all patients who underwent a laparoscopic cholecystectomy was performed comparing those with a single biliary diagnosis to patients with concurrent biliary tract disease. Variables analyzed were conversion to open cholecystectomy, incidence of bile duct injury, use of endoscopic retrograde cholangiopancreatography and/or intraoperative cholangiogram, length of surgery, and duration of hospitalization. The incidence of concurrent biliary tract disease was 9 per cent and a conversion to open cholecystectomy was performed in 16 per cent of patients. After adjusting for confounding factors, concurrent biliary tract disease was predictive of conversion (odds ratio 1.6, 95% confidence interval 1.1–2.3, P = 0.03) and bile duct injury (odds ratio 2.5, 95% confidence interval 0.8–5, P = 0.01). Concurrent biliary tract disease patients were more likely to undergo intraoperative cholangiogram or endoscopic retrograde cholangiopancreatography, as well as longer operation and length of stay.

DOES EARLY LAPAROSCOPIC CHOLECYSTECTOMY AFTER ERCP OFFERS SIGNIFICANT BENEFIT IN SURGICAL OUTCOME? A COMPARATIVE STUDY BETWEEN EARLY AND LATE GROUPS

2021 ◽  
pp. 59-61
Author(s):  
Anshul Mathur ◽  
Ketan Patel ◽  
Jitendra Kumar Mangtani ◽  
K.K. Dangayach
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Endoscopic Retrograde ◽  
Endoscopic Retrograde Cholangiopancreaticography ◽  
Early Laparoscopic Cholecystectomy ◽  
Conversion Rates ◽  
Group A ◽  
Group B

Introduction:- Endoscopic retrograde cholangiopancreaticography (ERCP) prior to Laparoscopic Cholecystectomy(LC) is most commonly practiced strategy worldwide for management of co-existing cholelithiasis with choledocholithiasis. The time interval between Endoscopic Retrograde Cholangiopancreaticography (ERCP) and Laparoscopic cholecystectomy (LC) is questionable and varies from 1 day to 6 weeks in different studies. Aims and objectives:- To compare two groups of patients managed with laparoscopic cholecystectomy (after ERCP), EARLY(24 to 72 hours), and LATE(> 6weeks) in terms of mean operative time in minutes, intraoperative difculties, conversion rates to open cholecystectomy, conversion rates to open cholecystectomy, drain insertion required or not, postoperative complications, and duration of hospital stay. Materials and methods:- A prospective randomized comparative study was conducted on 70 patients who presented with concomitant cholelithiasis with choledocholithiasis over a period of January 2019 to June 2020 at the Department of General Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur. After ERCP and stone retrieval patients were randomised into 2 groups using sealed envelope method. Group A underwent early laparoscopic cholecystectomy (24 to 72hours) and Group B underwent late laparoscopic cholecystectomy (after 6 weeks). Data collected, statistical analysis done, results and observations concluded. Result:- We found that mean operative time, intraoperative difculties, post operative complications and mean hospital stay in days were signicantly higher in Group B as compared to Group A. Though the conversion rates to open procedure and requirement of drain insertion were comparatively higher in Group B but were found to be statistically non signicant. Conclusion:- We hereby conclude that early laparoscopic cholecystectomy (24 to 72 hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP) is better as compared to late laparoscopic cholecystectomy (>6 weeks) after ERCP in patients of cholelithiasis with coexisting choledocholithiasis. So, we recommend performing early Laparoscopic Cholecystectomy (24-72hours) after Endoscopic Retrograde Cholangiopancreaticography (ERCP)

scholarly journals Optimal timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography

2017 ◽  
Vol 4 (10) ◽  
pp. 3504 ◽  
Author(s):  
Rasmiranjan Sahoo ◽  
Debasish Samal ◽  
A. Pradhan ◽  
Rima Sultana ◽  
Nabakishore Nayak ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Secondary Outcome ◽  
Optimal Timing ◽  
Endoscopic Retrograde ◽  
Early Laparoscopic Cholecystectomy ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Nowadays in patients with cholelithiasis with choledocholithiasis, the ideal treatment is endoscopic retrograde cholangiopancreatographic (ERCP) removal of duct stone and laparoscopic cholecystectomy. But when to do and whether we can do it simultaneously or one after another and what interval should be there, that is always controversial. The purpose was an optimal gap for cholecystectomy after ERCP.Methods: We have done a comparison study in 60 patients within a duration of 2 year who had already done ERCP. Group 1, those patients who had laparoscopic cholecystectomy within 72 hours compared with group 2 who had laparoscopic cholecystectomy after an interval of 6 week. Primary outcome was the conversion rate from lap to open cholecystectomy. Secondary outcome was duration of operation, intra-operative difficulties, postoperative morbidity and hospital stay.Results: Of 60 consecutive patients 30 were in group I and 30 were in group II. There is no difference in demographics, laboratory or ultrasonographic findings. The hospital stays in group I is significantly shorter than group II and conversion rate; operative time is higher in group II. No statistically significant difference in post-operative morbidity between both groups.Conclusions: Early laparoscopic cholecystectomy within 72 hr is better than interval (6 week) cholecystectomy after ERCP with shorter hospital stay and less intraoperative difficulties.

scholarly journals Gall stone abscess, a delayed complication following laparoscopic cholecystectomy

2019 ◽  
Vol 6 (9) ◽  
pp. 3397
Author(s):  
Amaresh Aruni ◽  
Hemanth Kumar ◽  
Harjeet Singh ◽  
Satish Subbiah Nagaraj
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Early Diagnosis ◽  
Minimally Invasive ◽  
Male Patient ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Diagnosis And Treatment ◽  
Symptomatic Cholelithiasis ◽  
Delayed Complication

In the current era of minimally invasive surgeries, laparoscopic cholecystectomy being the popular surgery for the symptomatic cholelithiasis and complications pertaining to these minimally invasive surgeries, here we report a complication related to gall stone spillage after 4 months of surgery in 80-year male patient presenting as abdomen lump. The risk of stone spillage and complications related to it are more than open cholecystectomy. Careful dissection, extraction and complete retrieval of all the spilled stones can avoid these complications and hence complication related to stone spillage can be potentially avoided, and intra-operative documentation of the gall stone spillage can help to think for early diagnosis and treatment of the complications.

scholarly journals The standardisation of minimally invasive methods approaches in treatment of post-laparoscopic cholecystectomy bile leakage

2018 ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Early Postoperative Period ◽  
Endoscopic Retrograde ◽  
Septic Complications ◽  
Endoscopic Techniques ◽  
Results Of Treatment ◽  
Ultrasound Guided Puncture

The paper analyses the results of surgical treatment of 10243 patients with cholelithiasis who underwent laparoscopic cholecystectomy. In the early postoperative period 60 patients (0.59%) had bile leakage. Developed surgical technique based on ultrasound data and endoscopic retrograde cholangiopancreatography can improve the results of treatment and avoid septic complications and lethal outcomes. Conservative treatment, minimally invasive endoscopic techniques, ultrasound guided puncture methods and relaparoscopy were effective in 52 patients (86,7%). Postoperative bile leakage is currently one of the most frequent complications of LCE, routine drainage of the subhepatic space facilitates early diagnosis of postoperative complications. When choleo-excretion is more than 200 ml per day, endoscopic retrograde cholangiography is necessary to diagnose damage to the main bile ducts, while confirming the injury of the hepaticocholedochus, a reconstructive surgery with laparotomy is indicated. Drainage bile bleeding, accompanied by symptoms of biliary peritonitis or a significant accumulation of bile in the abdominal cavity in the absence of an injury to the hepaticocholedochus, requires a relaparoscopy for diagnostic and therapeutic purposes. Standardization of the complex application of relaparoscopy, transduodenal endoscopic interventions and puncture techniques can significantly reduce the number of laparotomic operations to correct the complications that have arisen.

scholarly journals Evaluation of difficulties in laparoscopic cholecystectomy

2017 ◽  
Vol 70 (9-10) ◽  
pp. 271-276
Author(s):  
Katarina Sarcev ◽  
Dimitrije Damjanov ◽  
Dijana Kosijer ◽  
Dragomir Damjanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Conversion To Open Surgery ◽  
Preoperative Prediction ◽  
Conversion To Open Cholecystectomy ◽  
Group B

Introduction. For decades, laparoscopic cholecystectomy has been the gold standard in surgical treatment of patients with cholelithiasis all over the world. The main advantage of this approach is that it is a minimally invasive procedure for patients. Although this method is a routine in our country, there are certain cases where the presumed outcome of minimally invasive procedure is not achieved, and the surgery is converted to open surgery, or a subsequent laparoscopic surgery is performed, in order to deal with the complications. The aim of this study was to establish if it was possible to create a model for preoperative prediction of difficult laparoscopic cholecystectomies. Material and Methods. Two groups of patients were analyzed. Group A included patients with cholelithiasis who were studied in order to determine parameters associated with difficult laparoscopic cholecystectomies. Out of 16 analyzed parameters, 8 showed significant correlation with difficult laparoscopic cholecystectomies. Based on these parameters, a prediction model was established, consisting of five groups: I - easy (score 1), II - laparoscopic cholecystectomy with mild difficulties (score 2), III - laparoscopic cholecystectomy with major difficulties (score 3), IV - difficult (score 4), V - conversion to open surgery is expected (score 5). This model was preoperatively applied in patients with cholelithiasis included in group B. Results. The overall predictability of the model was 82%. The greatest prediction accuracy was achieved in groups II and III (98.3% and 100%, respectively). Conversion to open cholecystectomy was predicted in 76% of patients. Conclusion. Based on certain preoperative parameters it is possible to establish a model to predict a difficult laparoscopic cholecystectomy.

scholarly journals Gallbladder perforation with concomitant liver abscess: a case report with a review of treatment options

2020 ◽  
Vol 7 (4) ◽  
pp. 1283
Author(s):  
Alejandro Quiroga Garza ◽  
Milton Alberto Muñoz Leija ◽  
Juan Manuel Valdivia Balderas ◽  
Santos Guzmán López ◽  
Rodrigo E. Elizondo Omaña
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Treatment Options ◽  
Hepatic Abscess ◽  
Definitive Treatment ◽  
Gallbladder Perforation ◽  
Type Ii ◽  
Endoscopic Retrograde ◽  
Laparoscopic Drainage

Gallbladder perforation (GBP) management is still controversial in regards to time (early vs. interval), first procedure (surgical vs. drainage) and technique (laparoscopic vs. open). This is the case report of an adult patient with GBP Niemeier type II, complicated with a concomitant hepatic abscess. The patient was treated medically and with laparoscopic drainage of abscess and pyocholecistolithiasis. She was scheduled shortly after for endoscopic retrograde cholangiopancreatography, and posteriorly for definitive treatment with laparoscopic cholecystectomy 1 month later. Satisfactory postsurgical outcome, with uneventful 1-month follow-up.

scholarly journals Retroperitoneal Abscess Formation as a Result of Spilled Gallstones during Laparoscopic Cholecystectomy: An Unusual Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Grigoris Chatzimavroudis ◽  
Stefanos Atmatzidis ◽  
Basilis Papaziogas ◽  
Ioannis Galanis ◽  
Ioannis Koutelidakis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Symptoms ◽  
Gallstone Disease ◽  
Abscess Formation ◽  
Gallbladder Perforation ◽  
Retroperitoneal Abscess ◽  
Ct Guided ◽  
Good General Condition ◽  
Gallstone Spillage ◽  
Unusual Case Report

One of the complications of laparoscopic cholecystectomy for gallstone disease that seems to exceed that of the traditional open method is the gallbladder perforation and gallstone spillage. Its incidence can occur in up to 40% of patients, and in most cases its course is uneventful. However in few cases an abdominal abscess can develop, which may lead to significant morbidity. Rarely an abscess formation due to spilled and lost gallstones may occur in the retroperitoneal space. We herein report the case of a female patient who presented with clinical symptoms of sepsis six months following laparoscopic cholecystectomy. Imaging investigations revealed the presence of a retroperitoneal abscess due to retained gallstones. Due to patient’s decision to refuse abscess’s surgical drainage, she underwent CT-guided drainage. The 24-month followup of the patient has been uneventful, and the patient remains in good general condition.

scholarly journals Minimally Invasive Treatment for Cholelithiasis

2021 ◽  
Author(s):  
Hirotaka Okamoto
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive Surgery ◽  
Bile Duct ◽  
Minimally Invasive ◽  
Endoscopic Sphincterotomy ◽  
Gallstone Disease ◽  
Common Bile Duct Exploration ◽  
Biliary Reconstruction ◽  
Invasive Treatment

Gallstone disease, cholecysto- and choledocho-lithiasis, is one of the most common digestive diseases. Most patients with symptomatic cholecystolithiasis are recommended to undergo cholecystectomy to alleviate their symptoms like abdominal pain and jaundice. Approximately 10–20% of patients who undergo cholecystectomy for gallstones have choledocholithiasis. Nowadays, endoscopic and/or laparoscopic approaches are widely accepted as the treatment for patients with gallstone. Patients with cholecystolithiasis are usually treated by laparoscopic cholecystectomy, whereas patients with choledocholithiasis are done by endoscopic sphincterotomy (EST) or laparoscopic common bile duct exploration (LCBDE). Additionally, some cases are treated by biliary reconstruction such as biliary enteric anastomosis. In this chapter, currently available laparoscopic approaches as a minimally invasive surgery are introduced and discussed on the basis of pathogenesis of the gallstone.

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