scholarly journals Gallbladder perforation with liver abscess; laparoscopic cholecystectomy converted to open: a case report

2021 ◽  
Vol 9 (12) ◽  
pp. 3685
Author(s):  
Edgar Salvador Salas Ochoa ◽  
Maria Eugenia Dominguez Gutierrez ◽  
Alfredo Lopez Rocha ◽  
Edilia Naraleth Arce Sanchez ◽  
Karla Itzel Altamirano Moreno ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Liver Abscess ◽  
Rare Complication ◽  
Gallbladder Disease ◽  
Laparoscopic Approach ◽  
Abdominal Ultrasound ◽  
The United States ◽  
Gallbladder Perforation ◽  
Public Care

Gallbladder disease affects more than 20 million people in the United States. Acute cholecystitis is a clinic entity characterized by the inflammation of the vesicular wall that is usually manipulated by abdominal pain, right hypochondrial sensitivity and fever. The technique of choice for the diagnosis of cholecystitis is abdominal ultrasound; gallbladder perforation is a rare complication of acute cholecystitis (2%-11%). The presence of perivesicular abscesses is infrequent, its prevalence varies between 2.1% and 19.5%. Clinical record was reviewed of a 73 years old woman who attended a second level public care unit, with a clinical picture of acute chronic lithiasis cholecystitis, who underwent surgery consisting of open converted laparoscopic cholecystectomy with a finding of vesicular perforation with liver abscess, it was initiated with laparoscopic approach, it was not possible to identify anatomical structures, so it was decided to convert to open surgery. Cholecystectomy and abdominal lavage are usually sufficient in the treatment of gallbladder perforation.

scholarly journals Intraluminal Bowel Erosion: A Rare Complication of Retained Gallstones after Cholecystectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Alex B. Blair ◽  
Nathaniel McQuay
Keyword(s):  
United States ◽  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
The United States ◽  
Initial Operation ◽  
Mechanical Bowel Obstruction ◽  
Potential Risks ◽  
Potential Impact

Laparoscopic cholecystectomy for acute cholecystitis and cholelithiasis is one of the most common operations performed in the United States. Inadvertent perforation and spillage of gallbladder contents are not uncommon. The potential impact of subsequent retained gallstones is understated. We present the case of an intraperitoneal gallstone retained from a previous cholecystectomy eroding into the bowel and leading to intraluminal mechanical bowel obstruction requiring operative intervention. This case illustrates the potential risks of retained gallstones and reinforces the need to diligently collect any dropped stones at the time of initial operation.

scholarly journals OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY WITH &WITHOUT DRAIN

1969 ◽  
Vol 5 (1) ◽  
pp. 613-616
Author(s):  
MUHAMMAD ASLAM RAl ◽  
M FAWAD ASLAM ◽  
SARA ASLAM
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prophylactic Antibiotic ◽  
Laparoscopic Approach ◽  
Preoperative Assessment ◽  
Open Conversion ◽  
Abdominal Drain ◽  
Port Infection ◽  
Group A ◽  
Group B

BACKGROUND: Cholecystitis is common health problem and laparoscopic approach to gallstonedisease is procedure of choice. Intra abdominal drain is used to pervert post operative sub hepaticcollection. However drain insertion may increase pain discomfort and delay in discharge.OBJECTIVE: To assess the benefits and harms of drain use in laparoscopic cholecystectomyMATERIAL AND METHODS: A prospective, single centre, Study conducted on 200 patients in needof laparoscopic cholecystectomy at Rai Medical Complex Sargodha (affiliated with Rai MedicalCollege) from April, 2009 to July 2011. All patients, after preoperative assessment, were operated undergeneral anesthesia. Prophylactic antibiotic, inj. cefuroxime 1.5 gm prior to anesthesia and two furtherdoses at 8 hour interval postoperatively were given in chronic cholecystitis and therapeutic doses, forseven days in acute cholecystitis. Patients having choledocholithiasis and open conversion wereexcluded from the study four port techniques were used for laparoscopic cholecystectomy. Patients weredivided randomly in to two groups, 100 patients in each Group A, without drain and group B with drain.Data was recorded on standardized performa.RESULTS: Out of 200 patients, 18 were male and 182 were female .Age range was 20 years to 90years. 02 patients from group B, having acute cholecystitis, had epigastric port infection on 15thpostoperative day. Drainage was done with uneventful healing. One patient from group A had s/hepaticabscess 03 weeks after surgery. Ultrasonographic guided aspiration was done in OPD with goodrecovery .No mortality, no open conversion and no CBD injury. Thirty patients from group A weredischarged within 24 hours , 3 patients having drain were discharged after 72 hours and all others fromboth groups within 48 hours.04 patients from group B had severe shoulder tip pain and relieved afterremoval of drain.Postoperative pain was significantly higher in patients who had drain placed, median VAS was 5(ranging 1-10) versus 3 in non drained group .Especially removal of drain was a painful procedure.CONCLUSION: Routine use of intra abdominal drain in laparoscopic cholecystectomy is of no benefitbut causes more discomfort to patient except in empyaema gallbladder.KEY WORDS: Laparoscopic cholecystectomy, intra abdominal drain.

Laparoscopic cholecystectomy for acute cholecystitis and the consequences of gallbladder perforation, bile spillage, and “loss” of stones

2003 ◽  
Vol 164 (6) ◽  
pp. 425-431 ◽  
Author(s):  
Yaron Assaff ◽  
Ibrahim Matter ◽  
Edmond Sabo ◽  
Jorge G. Mogilner ◽  
Ernest Nash ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gallbladder Perforation ◽  
Bile Spillage

scholarly journals Laparoscopic Cholecystectomy for Acute Gallbladder Disease During Index Admission- 11 the Optimum Timing for Surgery

2013 ◽  
Vol 16 (1) ◽  
pp. 11-17
Author(s):  
Md Ibrahim Siddique ◽  
Md Atiar Rahman ◽  
Md Shahadot Hossain Sheikh ◽  
Khander Manzoor Murshed ◽  
Samia Mubin ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Index Admission ◽  
Laparoscopic Procedure ◽  
Complication Rates ◽  
Financial Benefit ◽  
Conversion To Open Cholecystectomy

Background: Laparoscopic cholecystectomy, initially considered a contraindication for the treatment of acute gallbladder disease, is now being practiced for treating acute cholecystitis worldwide. The purpose of the study is to evaluate the outcome of laparoscopic procedure in the management of acute gallbladder disease during the index admission in terms of safety and feasibility, hospital stay and the rates of complications and conversion to open cholecystectomy. Methods: Between January 2009 to December 2011, 174 patients (103 female, 71 male) with median age 43.5 years (range 27-73 years) with the diagnosis of acute gallbladder disease underwent laparoscopic cholecystectomy. Diagnosis of acute cholecystitis was made from history, physical findings and ultrasound evidence of acute inflammatory changes. Results: Median time from onset of symptoms to surgery was 70 hours. Median operative time was 76.5 minutes. Conversion rate was 1.7%. Minor post-operative complications occurred in 13.5% cases of laparoscopic procedure, which did not require further intervention. Median post-operative hospital stay was 2.5 days and total length of hospital stay was median 4.4 days. There was no mortality. Conclusion: In expert hands laparoscopic cholecystectomy for acute gallbladder disease during the index admission is safe with better clinical results, shorter hospital stay and an acceptable conversion and complication rates with additional financial benefit to the patients. DOI: http://dx.doi.org/10.3329/jss.v16i1.14442 Journal of Surgical Sciences (2012) Vol. 16 (1) : 11-17

scholarly journals A case report of ruptured amoebic liver abscess causing cardiac tamponade and requiring pericardial window

2020 ◽  
Vol 4 (5) ◽  
pp. 1-4
Author(s):  
Cliojis Francis ◽  
Swati Soni ◽  
Anunay Gupta ◽  
Sourabh Agstam
Keyword(s):  
Cardiac Tamponade ◽  
Liver Abscess ◽  
Rare Complication ◽  
Abdominal Ultrasound ◽  
Left Lobe ◽  
Amoebic Liver Abscess ◽  
Chest Drain ◽  
Pericardial Window ◽  
Extraintestinal Manifestation ◽  
Window Management

Abstract Background Amoebiasis is a prevalent infection in the tropics. Amoebic liver abscess is the most common extraintestinal manifestation. Cardiac tamponade is an uncommon complication of amoebic liver abscess that may need urgent pericardiocentesis. Case summary A 25-year-old man presented with abdominal pain and fever for 1 month. Abdominal ultrasound revealed a 4.7 × 4.7 cm abscess in the left lobe of the liver. Percutaneous pigtail drainage was performed to evacuate the abscess. After 2 days, the patient developed signs of cardiac tamponade and bilateral pleural effusion, requiring urgent pericardiocentesis and chest drain insertion. Persistent posterior collection of thick abscess in pericardium needed pericardial window for complete drainage. The patient recovered completely after pericardial window. There was no evidence of chronic constrictive pericarditis after 1 year of follow-up. Discussion A rare complication of the amoebic liver abscess was observed in this young adult who developed cardiac tamponade, requiring an urgent pericardiocentesis, and later requiring pericardial window. Management includes amoebicidal and luminicidal drugs for complete eradication of Entamoeba histolytica.

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 >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.

Spontaneous cholecystocutaneous fistula: an uncommon complication of acute cholecystitis

2020 ◽  
Vol 13 (12) ◽  
pp. e238063
Author(s):  
Philipp Kasper ◽  
Julia Kaminiorz ◽  
Christoph Schramm ◽  
Tobias Goeser
Keyword(s):  
Rare Complication ◽  
Gallstone Disease ◽  
Acalculous Cholecystitis ◽  
Abdominal Ultrasound ◽  
Gallbladder Perforation ◽  
Ct Guided ◽  
Acute Calculous Cholecystitis ◽  
Hypochondriac Region ◽  
Pericholecystic Abscess ◽  
The Right

A 78-year-old man presented to the hospital with acute right upper quadrant pain, fever and nausea. A focused abdominal ultrasound and abdominal CT scan were performed demonstrating an acute calculous cholecystitis with gallbladder perforation. Although a CT-guided cholecystostomy was performed and a pericholecystic abscess was relieved promptly, the patient developed a cholecystocutaneous fistula in the right hypochondriac region. A cholecystocutaneous fistula is an extremely rare complication that may occur in patients with acute calculous or acalculous cholecystitis, chronic gallstone disease, gallbladder carcinoma or prior hepatobiliary surgery.

scholarly journals Difficult laparoscopic cholecystectomy and preoperative predictive factors

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppe Di Buono ◽  
Giorgio Romano ◽  
Massimo Galia ◽  
Giuseppe Amato ◽  
Elisa Maienza ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Predictive Factors ◽  
Intraoperative Complications ◽  
Gallbladder Disease ◽  
Control Group ◽  
Emergency Setting ◽  
Inclusion Criteria ◽  
Radiological Findings ◽  
Increased Risk

AbstractLaparoscopic cholecystectomy (LC) is the standard technique for treatment of gallbladder disease. In case of acute cholecystitis we can identify preoperative factors associated with an increased risk of conversion and intraoperative complications. The aim of our study was to detect preoperative laboratory and radiological findings predictive of difficult LC with potential advantages for both the surgeons and patients in terms of options for management. We designed a retrospective case–control study to compare preoperative predictive factors of difficult LC in patients treated in emergency setting between January 2015 and December 2019. We included in the difficult LC group the surgeries with operative time > 2 h, need for conversion to open, significant bleeding and/or use of synthetic hemostats, vascular and/or biliary injuries and additional operative procedures. We collected 86 patients with inclusion criteria and difficult LC. In the control group, we selected 86 patients with inclusion criteria, but with no operative signs of difficult LC. The analysis of the collected data showed that there was a statistically significant association between WBC count and fibrinogen level and difficult LC. No association were seen with ALP, ALT and bilirubin values. Regarding radiological findings significant differences were noted among the two groups for irregular or absent wall, pericholecystic fluid, fat hyperdensity, thickening of wall > 4 mm and hydrops. The preoperative identification of difficult laparoscopic cholecystectomy provides an important advantage not only for the surgeon who has to perform the surgery, but also for the organization of the operating block and technical resources. In patients with clinical and laboratory parameters of acute cholecystitis, therefore, it would be advisable to carry out a preoperative abdominal CT scan with evaluation of features that can be easily assessed also by the surgeon.

scholarly journals An evaluation of early and delayed laparoscopic cholecystectomy for acute cholecystitis

2019 ◽  
Vol 6 (9) ◽  
pp. 3147
Author(s):  
M. Zaid Imbisat ◽  
S. A. A. Rizvi ◽  
Imad Ali
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
Gallbladder Perforation ◽  
Early Group ◽  
Early Laparoscopic Cholecystectomy ◽  
Total Hospital Stay ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Duration Of Surgery ◽  
Delayed Group

Background: Acute cholecystitis is one of the hepatopancreatobiliary emergencies. With more and more experience in the laparoscopic cholecystectomy studies are being carried out evaluating the effectiveness and feasibility of early laparoscopic cholecystectomy in acute cholecystitis.Methods: Fifty patients presenting with acute cholecystitis were included in this study and randomized using chit in the box method into two groups- early group and delayed group.Results: Mean duration of surgery in the early group is 42.28±5.99 mins and in the delayed group is 39.12±5.55 mins (p=0.06). Gallbladder perforation was reported in 4 patients (16%) in early group and in 2 patients (8%) in delayed group (p=0.67). Gall stone spillage was reported in 3 patients (12%) in early group and in 2 patients (8%) in delayed group (p=1.00). At 6th hr mean VAS (visual analogue scale) score in the early group was 4.0±0.41 and in the delayed group it was 3.6±0.58 (p=0.01). At 12th hr mean VAS score in the early group was 3.4±0.51 and in the delayed group it was 3.3±0.48 (p=0.39). Mean duration of postoperative stay was 2.24±0.60 days in early group and in the delayed group it was 2.08±0.57 days (p=0.34).Conclusions: It has been found that early laparoscopic cholecystectomy is safe and feasible in the setting of acute cholecystitis with added advantage of shorter total hospital stay.

scholarly journals Intraoperative and postoperative outcomes of robot-assisted cholecystectomy: a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rivfka Shenoy ◽  
Michael A. Mederos ◽  
Linda Ye ◽  
Selene S. Mak ◽  
Meron M. Begashaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laparoscopic Cholecystectomy ◽  
Narrative Analysis ◽  
Single Port ◽  
Intraoperative Complications ◽  
Gallbladder Disease ◽  
Laparoscopic Approach ◽  
Clinical Effectiveness ◽  
Robot Assisted ◽  
Conversion Rates

Abstract Background Rapid adoption of robotic-assisted general surgery procedures, particularly for cholecystectomy, continues while questions remain about its benefits and utility. The objective of this study was to compare the clinical effectiveness of robot-assisted cholecystectomy for benign gallbladder disease as compared with the laparoscopic approach. Methods A literature search was performed from January 2010 to March 2020, and a narrative analysis was performed as studies were heterogeneous. Results Of 887 articles screened, 44 met the inclusion criteria (range 20–735,537 patients). Four were randomized controlled trials, and four used propensity-matching. There were variable comparisons between operative techniques with only 19 out of 44 studies comparing techniques using the same number of ports. Operating room time was longer for the robot-assisted technique in the majority of studies (range 11–55 min for 22 studies, p < 0.05; 15 studies showed no difference; two studies showed shorter laparoscopic times), while conversion rates and intraoperative complications were not different. No differences were detected for the length of stay, surgical site infection, or readmissions. Across studies comparing single-port robot-assisted to multi-port laparoscopic cholecystectomy, there was a higher rate of incisional hernia; however, no differences were noted when comparing single-port robot-assisted to single-port laparoscopic cholecystectomy. Conclusions Clinical outcomes were similar for benign, elective gallbladder disease for robot-assisted compared with laparoscopic cholecystectomy. Overall, the rates of complications were low. More high-quality studies are needed as the robot-assisted technique expands to more complex gallbladder disease, where its utility may prove increasingly beneficial. Systematic review registration PROSPERO CRD42020156945

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