scholarly journals Fundus first laparoscopic cholecystectomy in patients with gall stone disease and the Fitz-Hugh-Curtis syndrome

2020 ◽  
Vol 8 (6) ◽  
pp. 2062
Author(s):  
Alexander F. Ale ◽  
Mercy W. Isichei ◽  
Danaan J. Shilong ◽  
Solomon D. Peter ◽  
Andrew H. Shitta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Gall Stone ◽  
Operating Time ◽  
Stone Disease ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery ◽  
Gall Stone Disease ◽  
The Mean ◽  
Fitz Hugh Curtis Syndrome

Background: To present this experience using the fundus-first technique during laparoscopic cholecystectomy for the management of symptomatic gall stone disease with an intra-operative finding of Fitz-Hugh-Curtis syndrome.Methods: This is a prospective review of patients who had the fundus-first dissection during laparoscopic cholecystectomy. The study was carried out at the Jos University Teaching Hospital (JUTH), and FOMAS hospital, both of which are tertiary hospitals located in Jos. Patients were recruited from January 2017 - January 2019. All patients undergoing laparoscopic cholecystectomy who had an intraoperative diagnosis of Fitz-Hugh-Curtis syndrome, and who had the fundus-first dissection, were included in the study. Patients who had fundus-first dissection for indications other than Fitz-Hugh-Curtis syndrome, were excluded from the study. Demographic and clinical information of patients included age, sex, duration of surgery, complications, and duration of hospital stay. Descriptive statistics were applied.Results: A total of 76 patients had elective laparoscopic cholecystectomies over the study period. Of that number, 17 (22.4%) patients had an intra- operative diagnosis of Fitz-Hugh-Curtis syndrome, and had the fundus-first dissection. The mean patient age was 46.3 years (SD = 11.7 years). All patients were female. The mean operating time was 70 minutes (SD = 23 minutes). The duration of hospital stay was 24 hours. There was one conversion due to uncontrollable intraoperative bleeding.Conclusions: This study revealed that the fundus-first dissection is suitable for removing the gall bladder during laparoscopic cholecystectomy in patients with gall stone disease, and an intraoperative finding of Fitz-Hugh-Curtis syndrome.

scholarly journals Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India

2018 ◽  
Vol 5 (2) ◽  
pp. 426
Author(s):  
Peeyush Kumar ◽  
Anil K. S. Rana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Return To Work ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Gall Stone ◽  
North India ◽  
Duration Of Hospital Stay ◽  
Conversion Rates ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Improvement of Laparoscopic Cholecystectomy (LC) technique in terms of reduction in size and number of ports is being tried to improve patient satisfaction and outcome. Present study was conducted to evaluate and compare the safety outcome and advantages of three-port and four-port LC. Methods: This prospective study included 90 patients presenting with symptomatic gall stone disease or gall bladder polyp more than 1cm at base. Patients with jaundice and choledocholithiasis were excluded. Patients were divided into two groups: A and B, who underwent three-port and four-port LC respectively. Outcomes of the two groups were assessed and compared in terms of duration of surgery, intra-operative and post-operative variables including rate and nature of complications, conversion rates, post-operative pain, duration of hospital stay, return to work and cosmetic outcome.Results: Statistically significant difference was found between the two groups in terms of Visual Analogue Score for pain at 6 and 24 hours, analgesic requirement, duration of hospital stay and return to work; all being less in the three- port LC group. Cosmetic outcome as perceived by patients was also better in the three-port group. Results of other variables were comparable in the two groups. Conclusions: Three-port procedure is safe and appears to be more cost effective than four-port LC. If LC is performed by an experienced surgeon, it can be started with three ports, if required, a fourth port can be inserted. 

scholarly journals Comparative study between 3-ports and 4-ports laparoscopic cholecystectomy for the cases of gall stone disease

2016 ◽  
Vol 18 (3) ◽  
pp. 15
Author(s):  
KK Tamrakar ◽  
P Khwaunju ◽  
K Sah
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Stone ◽  
Operating Time ◽  
Wound Infection Rate ◽  
Stone Disease ◽  
Chi Square ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Chi Square Test ◽  
Operative Findings

Laparoscopic cholecystectomy is currently accepted approach for the management of patients with cholelithiasis. The standard method for removal of gall bladder in laparoscopic cholecystectomy is by using four ports. Although other techniques such as by using 3 ports or only single port are being practiced, their safety and efficacy has not been established. This study was done to assess the efficacy and safety of the use of only three ports for laparoscopic cholecystectomy.Methods: Between August 2013 and February 2014, 78 patients with the diagnosis of cholelithiasis were operated. Patients were randomized into 3-ports group and 4-ports group using random number. Operative time taken for the procedure and operative findings were noted. Postoperative pain and complications were noted in both groups. The two groups were compared using student-T test and chi square test. Results: There was no significant difference in the operating time taken for the 3-ports laparoscopic cholecystectomy and 4-ports laparoscopic cholecystectomy. However operating time was significantly higher when the cases that had dense adhesions present were compared with those who did not have. Conversion from 3-ports technique to 4-ports technique was determined mainly by the degree of adhesions and to some degree by the BMI of the patient. Postoperative wound infection rate was similar among the two groups. There was no incidence of biliary injury in both the groups.Conclusion: 3-ports laparoscopic cholecystectomy is safe and efficient approach for the selected patients who seek for lesser invasive method of laparoscopic cholecystectomy.

scholarly journals Comparative study between 3-ports and 4-ports laparoscopic cholecystectomy for the cases of gall stone disease

2017 ◽  
Vol 7 (1) ◽  
pp. 1-6
Author(s):  
Kishor Kumar Tamrakar ◽  
Pragyan Khwaunju ◽  
Keshar Bahadur Sah
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Stone ◽  
Operating Time ◽  
Wound Infection Rate ◽  
Stone Disease ◽  
Chi Square ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Invasive Method ◽  
Operative Findings

Background: Laparoscopic cholecystectomy is currently accepted approach for the management of patients with cholelithiasis. The standard method for removal of gall bladder in laparoscopic cholecystectomy is by using four ports. Although other techniques such as by using 3 ports or only single port are being practiced, their safety and efficacy has not been established. This study was done to assess the efficacy and safety of the use of only three ports for laparoscopic cholecystectomy.Methods: Between August 2013 and February 2014, 78 patients with the diagnosis of cholelithiasis were operated. Patients were randomized into 3-ports group and 4-ports group using random number. Operative time taken for the procedure and operative findings were noted. Postoperative pain and complications were noted in both groups. The two groups were compared using student-T test and chi square test.Results: There was no significant difference in the operating time taken for the 3-ports laparoscopic cholecystectomy and 4-ports laparoscopic cholecystectomy. However operating time was significantly higher when the cases that had dense adhesions present were compared with those who did not have. Conversion from 3-ports technique to 4-ports technique was determined mainly by the degree of adhesions and to some degree by the BMI of the patient. Postoperative wound infection rate was similar among the two groups. There was no incidence of biliary injury in both the groups.Conclusion: 3-ports laparoscopic cholecystectomy is safe and efficient approach for the selected patients who seek for lesser invasive method of laparoscopic cholecystectomy.

Early experience of laparoscopic cholecystectomy in acutely inflamed gallbladder

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Ali Abdul Hussein Handoz ◽  
Ahmed Kh Alsagban
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
The Elderly ◽  
Stone Disease ◽  
Definitive Treatment ◽  
Adjacent Structures ◽  
Common Causes ◽  
Gall Stone Disease ◽  
Male To Female

Gallstones are now among the most important disease in the era of surgery. Definitive treatment of gall stone disease remains cholecystectomy. One of the common causes of emergency surgical referral is acute cholecystitis of which 50-70% cases are seen in the elderly patients.50 patients were treated with laparoscopic cholecystectomy from October 2013 to October 2015. The patient’s age was from 20 to 65 years old with a mean age of 34 ±3 years old. The patients received in the emergency unit and their attack not more than 72 hrs of acute gall stone inflammation were included in this study.From the 50 patients,15 were males (34%) and females were 35 (74%) so the ratio of 1:2of male to female. Problems and complications that facing in this study at time of laparoscopy were mainly adhesions to the adjacent structures like stomach, colon, and omentum. Adhesion into CBD also considered.Early intervention for acute cholecystitis of calculus type by laparoscopy now regarding safe and gold standard approach that should be kept in mind when dealing with such cases.

scholarly journals Prospective randomised trial of standard pressure versus low pressure laparoscopic cholecystectomy in a tertiary care hospital from Kolkata: Our experience

2018 ◽  
Vol 9 (4) ◽  
pp. 17-22
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Gall Stone ◽  
Low Pressure ◽  
Stone Disease ◽  
Care Hospital ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Standard Pressure ◽  
Symptomatic Gall Stone

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22

scholarly journals A study on laparoscopic cholecystectomy, indications, complications and conversion to open in a tertiary care hospital

2019 ◽  
Vol 6 (11) ◽  
pp. 3942
Author(s):  
N. Chandramouli
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Tertiary Care ◽  
Gall Stone ◽  
Stone Disease ◽  
Care Hospital ◽  
Open Conversion ◽  
Calot’S Triangle ◽  
Institutional Ethics ◽  
Gall Stone Disease ◽  
A Prospective Study

Background: Disease of gall bladder, especially the stones, is one of the most common health problems leading to surgical intervention. Laparoscopic cholecystectomy is the gold standard operation for gall stone disease with a good safety profile. The aim of the study was to discuss the indications, complications encountered and open conversion rate of laparoscopic cholecystectomy in a tertiary care hospital.Methods: It was a prospective study, conducted at Sri Adichunchanagiri Hospital and Research Center, B.G. Nagara, Karnataka after the approval from institutional ethics committee (IEC). This study included 30 patients who presented to the ER or OPD with pain abdomen, from October 2018 to March 2019, and diagnosed to have gall stone disease with or without inflammation. All the patients were worked up as per standard institutional protocol. Patients clinical characteristics, ultrasonogram (USG) findings, surgical management and complications were recorded.Results: Mean age was 41.1±6.06. The indications for cholecystectomy in gall stone disease at our institute during the aforementioned timeline were symptomatic gall stones (60%) and calculus cholecystitis (40%). All underwent laparoscopy and 2 patients were converted to open surgery intra-operatively in view of difficulty in dissection of Calot’s triangle. 3 patients had post-operative complications and treated conservatively.Conclusions: Laparoscopic cholecystectomy is a standardised, efficacious procedure for the treatment of gall stone disease whether symptomatic or infected. Complications are minimal but a thorough knowledge of open procedure is also essential in case of intra-operative conversion.

scholarly journals Study on outcome of laparoscopic donor nephrectomy

2017 ◽  
Vol 4 (8) ◽  
pp. 2811
Author(s):  
Subha Kanesh S. K. ◽  
Govindarajan P.
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operating Time ◽  
Donor Nephrectomy ◽  
Laparoscopic Donor Nephrectomy ◽  
Analgesic Requirement ◽  
Ischemic Time ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
The Mean

Background: Laparoscopic donor nephrectomy is being performed in increasing numbers since 1995. Now laparoscopic donor nephrectomy has been accepted as good alternate to open procedure as seen in various other abdominal surgeries. This was the basis of the present study. So, the present study was designed to analyse and compare the outcome of Laparoscopic donor nephrectomy and Open donor nephrectomies.Methods: The prospective and observational study was conducted at Stanley Medical College in Department of Urology in 61 Patients aged between 25-50 years who underwent left donor nephrectomy The Mean operating time, warm ischemic time, blood loss, analgesic requirement and duration of hospital stay were recorded and analysed statistically.Results: Out of 61 donor nephrectomies, 16 kidneys harvested by laparoscopic method with only 2 (12%) conversion to open due bleeding. Mean operating time was 179.9±47.6 minutes. Present study showed mean blood loss of (163±93 ml). Analgesic requirement of the LDN (mean 1.25 days) was significantly lower when compared to open group (mean 3.75 days). The present study shows duration of hospital stay was lower in LDN (mean 5.1days).Conclusions: Laparoscopic donor nephrectomy is an effective, safe and rewarding though it is time consuming and technically challenging. The analgesic requirement, duration of hospital stay and the blood loss were less with the laparoscopic surgery. Results of graft functioning of kidneys in both procedures were equivalent. So laparoscopic donor nephrectomy can be made as the procedure of choice in future.

scholarly journals Anatomy of Rouviere’s Sulcus and Its Association with Complication of Laparoscopic Cholecystectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abhijeet Kumar ◽  
Rupesh Shah ◽  
Narendra Pandit ◽  
Suresh Prasad Sah ◽  
Rakesh Kumar Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Prospective Observational Study ◽  
Operative Time ◽  
Gall Stone ◽  
Anatomical Landmark ◽  
External Edge ◽  
Duration Of Hospital Stay ◽  
The World ◽  
Release Group ◽  
The Mean

Background and Objective(s). Rouviere’s sulcus (RS) is an important anatomical landmark. The aim of this study was to find the distribution of anatomical characteristics of RS seen during laparoscopic cholecystectomy in the population of our part of the world and its association with complications. Methods. This is a prospective observational study involving patients of age ≥16 years who underwent laparoscopic cholecystectomy for uncomplicated gall stone at BPKIHS between May and July 2019. Result. 230 cases were analyzed, and RS was present in 90.4%. Open sulcus type was the commonest (54%), followed by scar type (22.9%), closed sulcus type (12.5%), and slit type (10.6%), respectively. In 59.1% of cases, it was oblique to the anterior, inferior, and external edge of the liver, while in the remaining cases, it was transverse. The mean ± SD values for operative time and duration of hospital stay in the RS visible and the RS not visible groups were 29.16 ± 8.736 and 42.9 ± 23.646 minutes, and 1.26 ± 0.440 and 1.90 ± 0.910 days, respectively (p value ≤0.001). One minor complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 minor complications occurred in the RS not visible group. Only one major complication occurred in the RS not visible group. Conclusion. Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy.

RETROSPECTIVE STUDY ON OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN THE ELDERLY AT JSS HOSPITAL, MYSURU

2021 ◽  
pp. 34-35
Author(s):  
Sudhir S. ◽  
Deepak Naik P ◽  
Deepak R. Sridhar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Open Cholecystectomy ◽  
The Elderly ◽  
Age Group ◽  
Elderly Age ◽  
Duration Of Hospital Stay ◽  
Wide Range ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

(a) Laparoscopic cholecystectomy is a widely performed surgery in India and across the world for a wide range of indications. It is one of the most commonly performed surgeries, and hence a study based on outcomes of Laparoscopic cholecystectomy in the elderly would go a long way in determining the safety and success of Laparoscopic cholecystectomy in the elderly, and could help in timing surgery more effectively to avoid complications and difculties. (b) Materials and methods: Out of 250 patients who underwent Laparoscopic Cholecystectomy at JSS Hospital in the period starting January 2019 onwards who were selected by randomization, 65 patients t the criteria (age > 60 years) while 185 patients were aged <60. Data regarding comorbidities, duration of surgery, duration of hospital stay, conversion to open cholecystectomy was compiled and studied. (c) Results: A signicant number of the patients in the elderly age group had associated comorbidities. Duration of surgery was prolonged by a mean duration of 9.5 minutes in the elderly. Duration of hospital stay was increased by a mean of 2.2 days in the elderly. Incidence of conversion to open cholecystectomy was also higher in the elderly. (d) Conclusions: Laparoscopic cholecystectomy is a relatively safe and easy surgery with few complications. However, one may experience difculties while operating on the elderly, viz. Adhesions, contracted gall bladder with hepatic adhesions etc., Which may result in longer duration of surgery and higher rates of conversion to open cholecystectomy.

scholarly journals Can Laparoscopic Cholecystectomy be a Feasible Standard in a Rural set up too? - An Experience of 348 cases from a Peripheral set up of Western Nepal

2017 ◽  
Vol 13 (2) ◽  
pp. 130-133
Author(s):  
A.L. Shrestha ◽  
P. Shrestha ◽  
D. Brown
Keyword(s):  
Socioeconomic Status ◽  
Laparoscopic Cholecystectomy ◽  
Rural Population ◽  
Gall Stone ◽  
Stone Disease ◽  
Uneventful Recovery ◽  
Conversion To Open Cholecystectomy ◽  
Gall Stone Disease ◽  
Set Up ◽  
The Impact

Background Gall stone disease is a common reason for admissions in both acute and elective situations and bears significant morbidity in the rural population of western Nepal. The earlier conventional open method of treatment for the same seems to have been largely seeded by the laparoscopic approach owing to its numerous benefits.Objective To study the clinical profile of patients with symptomatic gall stones with respect to demography and to assess the feasibility of using Laparoscopic cholecystectomy as the next standard in this set up too as guided by the outcome in terms of complications, conversion rates and potential impact it bears on the health and socioeconomic status in this group.Method A retrospective analysis of all the patients undergoing an attempted laparoscopic cholecystectomy from 1st Jestha 2068 to 30th Jestha 2070 was done. Relevant medical records were reviewed to study demography, various indications for operations, intra operative events including conversions and complications.Result Of 348 patients 293(84.19%) were females and 55(15.80%) were males. The mean age was 38.46 years (range 15-76 years). Most of the patients belonged to the Palpa district of Lumbini zone and many were from other surrounding areas. Gall stone disease was commonest in people of Brahmin ethnicity. The operating time was <2 hours for most and most had an uneventful recovery with a mean hospital stay of 3.8 days. The rate of conversion to open cholecystectomy was 6.9% (24 out of 348 patients). Post operative complications were noted in 5 patients (1.42%). Of these 1 sustained a major bile duct injury (0.28%) requiring immediate conversion and repair, 3 had post operative bilioma and 1 had diffuse bleeding from the gall bladder fossa all requiring re explorations. There was no mortality in this study.Conclusion Laparoscopic cholecystectomy is a safe, reliable and a promising option even in the rural peripheral set up. Due to its well known advantages and superiority over the open conventional method and considering the impact that it holds on the overall outcome, morbidity, health and socioeconomic status of the rural population, it can be recommended as an acceptable feasible standard in rural peripheral set up.

Sign in / Sign up

Export Citation Format

Share Document