scholarly journals Laparoscopic cholecystectomy in situs ambiguous with gallbladder stones with biliary pancreatitis: Report of a case

2021 ◽  
Vol 25 (1) ◽  
pp. S412-S412
Author(s):  
Yejong PARK ◽  
Dae Wook HWANG ◽  
Jae Hoon LEE ◽  
Ki Byung SONG ◽  
Woohyung LEE ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Biliary Pancreatitis ◽  
Gallbladder Stones ◽  
Situs Ambiguous

scholarly journals Comparison of Two Management Strategies, "Endoscopy First" and "Laparoscopic Cholecystectomy First", for Patients with Gallbladder Stones and Intermediate Risk for Choledocholithiasis: Study Protocol for a Diagnostic Randomized Trial

2020 ◽  
Author(s):  
Ausra Aleknaite ◽  
Gintaras Simutis ◽  
Juozas Stanaitis ◽  
Tomas Jucaitis ◽  
Mantas Drungilas ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasound ◽  
Management Strategies ◽  
Endoscopic Retrograde Cholangiography ◽  
Intraoperative Cholangiography ◽  
Intermediate Risk ◽  
Endoscopic Retrograde ◽  
On Demand ◽  
Gallbladder Stones

Abstract Background: The optimal approach for patients with gallbladder stones and intermediate risk for choledocholithiasis still remains undetermined. Use of diagnostic endoscopic retrograde cholangiopancreatography should be minimized as it carries considerable risk of post-procedural complications. This study compares two different management strategies: intraoperative cholangiography and endoscopic ultrasound before laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis and intermediate risk for choledocholithiasis. Methods: It is a diagnostic randomized active-controlled single-centre clinical trial enrolling adult patients undergoing laparoscopic cholecystectomy due to symptomatic gallbladder stones with intermediate risk for choledocholithiasis. The risk for choledocholithiasis is calculated using an original prognostic score – Vilnius University Hospital Index. A total of 106 participants will be included and randomized into two groups. Evaluation of bile ducts using endoscopic ultrasound and endoscopic retrograde cholangiography on demand will be performed before laparoscopic cholecystectomy for one arm (“Endoscopy first”). Intraoperative cholangiography during laparoscopic cholecystectomy and postoperative endoscopic retrograde cholangiopancreatography on demand will be administered in another arm (“Cholecystectomy first”). Postoperative follow-up is 6 months. The primary endpoint is the length of hospital stay. Secondary endpoints will include accuracy of the different management strategies, adverse events of interventions, duct clearance and technical success of interventions (intraoperative cholangiography, endoscopic ultrasound, endoscopic retrograde cholangiography), costs of treatment. Discussion: This trial is planned determine which strategy is better approach for a patient with intermediate common bile duct stones risk and to define a simple to calculate and safe algorithm on managing choledocholithiasis. Trial registration: The trial is registered at ClinicalTrials.gov, identification number NCT03658863.

Laparoscopic cholecystectomy in situs ambiguous

2014 ◽  
Vol 4 (3) ◽  
pp. 180
Author(s):  
Anoop Varma ◽  
Abhinav Mahajan ◽  
Mohinder Singh ◽  
GunjeetS Sandhu ◽  
Navkiran Kaur
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Situs Ambiguous

Early versus Delayed Single-Stage Laparoscopic Eradication for Both Gallstones and Common Bile Duct Stones in Mild Acute Biliary Pancreatitis

2005 ◽  
Vol 71 (8) ◽  
pp. 682-686 ◽  
Author(s):  
John Griniatsos ◽  
Evangelos Karvounis ◽  
Alberto Isla
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Single Stage ◽  
Definitive Treatment ◽  
Morbidity Rate ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Laparoscopic Management ◽  
Significant Difference

Several studies addressed that preoperative endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct (CBD) clearance, followed by interval laparoscopic cholecystectomy (two-stage approach), constitutes the most common practice in cases of uncomplicated mild acute biliary pancreatitis. Between June 1998 and December 2002, 44 patients (35 females and 9 males with a median age of 62 years) suffering from uncomplicated mild acute biliary pancreatitis were treated in our unit. All patients were electively submitted to surgery after subsidence of the acute symptoms, and for definitive treatment we favored the single-stage laparoscopic management, avoiding preoperative ERCP. All patients underwent laparoscopic cholecystectomy plus fluoroscopic intraoperative cholangiogram (IOC). If filling defect(s) were detected in the IOC, a finding suggestive of concomitant choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) was added in the same sitting. Twenty patients were operated upon within 2 weeks since the attack of the acute symptoms and constitute the early group (n = 20), whereas 24 patients underwent an operation later on and constitute the delay group (n = 24). We retrospectively compare the safety, effectiveness, and outcome after the single-stage laparoscopic management between the two groups of patients. Laparoscopic cholecystectomy alone constituted the definitive treatment in 38 patients, while an additional LCBDE was performed in the remaining 6 patients (14%), and all operations were achieved laparoscopically. There was no statistically significant difference between the groups in terms of operative time, incidence of concomitant choledocholithiasis, morbidity rate, and postoperative hospital stay. During the follow-up, none of the patients experienced recurrent pancreatitis. In uncomplicated mild acute biliary pancreatitis cases, a single-stage definitive laparoscopic management, avoiding preoperative ERCP, can be safely performed during the same admission, after the improvement of symptoms and local inflammation. Postoperative ERCP should be selectively used in patients in whom the single-stage method failed to resolve the problem.

scholarly journals Timing of Cholecystectomy in Mild Acute Biliary Pancreatitis.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Orhan Alimoğlu ◽  
Nuray Colapkulu ◽  
Tunç Eren
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Surgical Outcomes ◽  
Gold Standard ◽  
Definitive Treatment ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Timing Of Cholecystectomy ◽  
Safe Approach ◽  
First Admission

Acute biliary pancreatitis (ABP) is one of the most common gastrointestinal events that requires acute admission to the hospital with considerable risks of mortality & morbidity. Laparoscopic cholecystectomy has become the gold standard for the treatment of ABP. Our aim was to determine the safety of cholecystectomy during the first admission by performing a review of the current literature. Waiting for 6 - 8 weeks to perform cholecystectomy may result with an increased incidence of recurrent ABP attacks, which may increase morbidity and the length of the hospital stay. On the contrary, cholecystectomy during the index admission for mild ABP appears to be a preferable and safe approach with better surgical outcomes providing a definitive treatment.

scholarly journals Index Admission Laparoscopic Cholecystectomy, Our Experience after the Inception of Acute Care Surgery Programme

2020 ◽  
Author(s):  
Muhammad Aakif ◽  
Zeeshan Razzaq ◽  
James Byrne ◽  
Hamid Mustafa ◽  
Mudassar Majeed ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Length Of Hospital Stay ◽  
Index Admission ◽  
Acute Care Surgery ◽  
Biliary Colic ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Symptomatic Disease ◽  
Care Surgery

Abstract Background: Gallstones are very common and frequently present as acute cholecystitis in up to 20 % of patients with symptomatic disease, with wide variation in severity. Laparoscopic Cholecystectomy (LC) has become the gold standard for treatment of symptomatic disease. Although multiple studies have confirmed its safety, LC at index admission is still not widely practiced in Ireland. We present our experience of a cohort of patients who underwent index admission laparoscopic cholecystectomy at Cork University Hospital since the start of the acute care surgery program in May 2017.Aim: To determine the feasibility and safety of laparoscopic cholecystectomy at index admission.Methods: All adult patients who presented to an acute surgical assessment unit (ASAU) with symptomatic gall stone disease and underwent early laparoscopic cholecystectomy at index admission were included. The duration of this prospective cohort study was 27 months (May 2017 to July 2019). Patient demographics, indication for surgery, post-operative complications and conversion rates were recorded. In addition, timing of imaging, imaging findings and length of hospital stay were also noted.Results: A total of 233 patients underwent laparoscopic Cholecystectomy at index admission for various indications. Median age was 50 years with range between 16 - 88. Male to female ratio was 1: 1.78. 142 (61%) patients had acute cholecystitis, while the other indications were CBD obstruction (15.5%), biliary colic (11%) and acute biliary pancreatitis (10.5%). 93 (40%) patients had pre-op MRCP while 41 (17.6%) underwent pre-op ERCP. All except 3 patients undergoing ERCP had pre-procedure MRCP. 2 patients had intra-operative cholangiograms. Overall morbidity was 4.7%. In terms of complications, 3 (1.3%) patients had bile leak and only 1 (0.85%) had re-operation. There was 1 common bile duct injury and only 1 conversion to open surgery. There was no mortality in this case series. The average length of hospital stay was 5.6 days. (Range 2 to 14 days).Conclusions: Index admission laparoscopic cholecystectomy for acute cholecystitis, choledocholithiasis, biliary colic and acute biliary pancreatitis, has been a safe and feasible treatment option in our hospital. A safe practice can be ensured by adherence to this care pathway and a multidisciplinary, consultant-led service. Index cholecystectomy service can be provided safely to reduce disease-related morbidity and multiple re-admissions in patients awaiting interval surgery.

scholarly journals Early same-admission laparoscopic cholecystectomy for acute mild biliary pancreatitis: a retrospective study

2019 ◽  
Author(s):  
yunxiao lyu ◽  
Yunxiao Cheng ◽  
Bin Wang
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Optimal Time ◽  
Control Group ◽  
Biliary Pancreatitis ◽  
Group I ◽  
Estimated Blood Loss ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery ◽  
Group Ii

Abstract Background As the standard procedure for the surgical treatment for gallbladder stones, we investigated the controversy surrounding the optimal time for laparoscopic cholecystectomy (LC) for acute mild biliary pancreatitis.Methods This retrospective study included medical records of all patients who were admitted with a diagnosis of acute mild biliary pancreatitis at Dongyang People’s Hospital from July 2011 to June 2018. Main outcomes included perioperative characteristics, length of hospital stay, complications, morbidity, and mortality.Results A total of 119 patients were divided into an early LC group (Group I; 52 patients) and a control group (Group II; 67 patients). The mean age was 60.5 years (range, 30–79 years). Conversion to open cholecystectomy (COC) was performed in 17 patients (6 patients in Group I and 11 patients in Group II, P=0.62). There were no significant differences in terms of estimated blood loss and duration of surgery (P=0.08 and P=0.64, respectively). Bile duct injury (BDI) occurred in one patient from each group. The overall hospital stays in Group I were significantly less than in Group II (10.86±3.21 vs 13.29±4.51, P=0.001). Compared with postoperative bile leakage (P=0.72) and postoperative morbidity (P=0.97) and mortality, there were no significant differences between the groups.Conclusions Early LC during the same admission is safe for acute mild biliary pancreatitis and has the advantage of shortening overall hospital stay. There was no significant increase in COC, BDI, and complications.

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