scholarly journals Multiple port sites metastasis after laparoscopic cholecystectomy: a case report

2017 ◽  
Vol 4 (12) ◽  
pp. 4096
Author(s):  
Farhanul Huda ◽  
Sudhir K. Singh ◽  
Arvind Gupta ◽  
Navin Kumar
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Radical Surgery ◽  
Histopathological Examination ◽  
Gall Stone ◽  
Stone Disease ◽  
Rare Occurrence ◽  
Port Site Metastasis ◽  
Gall Stone Disease ◽  
Incidental Gallbladder Cancer

Laparoscopic cholecystectomy is a surgical procedure of choice for gall stone disease. Incidental gallbladder cancer is found in about 0.25-3% of patients after routine cholecystectomy. Depending on the stage of tumour, additional radical surgery may be required. In recent years, several reports of port site metastasis have been published. Here, we report a case of a 55-year-old female patient who presented to us with simultaneous multiple port sites metastasis after an interval of 15 months of laparoscopic cholecystectomy for gall stone disease. We recommend the routine use of specimen bag for the retrieval of gall bladder during laparoscopic cholecystectomy and also to send the gall bladder for histopathological examination. To the best of our knowledge, metastasis to more than one port is a very rare occurrence.

scholarly journals Gall Bladder Retrieval through Umbilical versus Epigastric Port in Conventional Four Ports Laparoscopic Cholecystectomy.

2021 ◽  
Vol 28 (10) ◽  
pp. 1407-1412
Author(s):  
Gul e Lala ◽  
Sajid Malik ◽  
Mian Umar Javed ◽  
Kamran Zaib Khan ◽  
Muhammad Tauqeer Aslam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
Stone Disease ◽  
Equal Distribution ◽  
Medical College ◽  
Post Operative Pain ◽  
Gall Stone Disease ◽  
Pros And Cons

Introduction: Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gall stone disease all over the world. In laparoscopic cholecystectomy gall bladder is traditionally removed through umbilical port. In this approach surgeon has to change his position and telescope has to be changed in xiphoid port. Another approach to remove the gallbladder is through 10mm xiphoid port without changing position of telescope and surgeon. Both approaches are compared for their pros and cons regarding post-operative pain at site of removal. Study Design: Randomized control study. Setting: Department of surgery of Allama Iqbal medical college/ Jinnah hospital Lahore. Period: August 2017 to February 2018. Material & Methods: To compare mean post-operative pain in gall bladder retrieval through umbilical versus xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis. Patient were divided in two equal groups with first group had their gall bladder retrieved through umbilical port while the other underwent retrieval through xiphoid port. Standard analgesia was used in both groups and post-operative outcome was noted. Results: A total 70 patient with equal distribution in two groups were enrolled to compare post-operative pain at port site comparing umbilical versus xiphoid process. Mean post-operative pain visual analogue scale (VAS) was as lower (p<0.0001) at 1, 6, 12 & 24 hrs. In umbilical port group as compared to xiphoid port group. Conclusion: Mean post-operative pain in gall bladder retrieval umbilical port give advantage in post-operative period regarding significantly reduced pain when compared with xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis in selective cases.

scholarly journals Lost Stone During Laparoscopic Cholecystectomy: Retrieval Using a Condom

HPB Surgery ◽  
1993 ◽  
Vol 7 (1) ◽  
pp. 67-68 ◽  
Author(s):  
S. C. S. Chung ◽  
M. K. W. Li ◽  
A. K. C. Li
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gall Stone ◽  
Stone Disease ◽  
Large Stone ◽  
Gall Stone Disease ◽  
Novel Method ◽  
Laparoscopic Vision

Laparoscopic cholecystectomy is becoming increasingly popular for the treatment of gall stone disease. In this technique, the gall bladder is dissected free under laparoscopic vision and then extracted. We report an interesting complication that occurred during extraction of a gall bladder containing a large stone and a novel method of overcoming the problem.

scholarly journals Frequency of gall bladder metaplasia and its distribution in different regions of gall bladder in routine cholecystectomy specimens

2017 ◽  
Vol 6 (1) ◽  
pp. 149
Author(s):  
Renu Sharma ◽  
Bal Chander ◽  
Rashmi Kaul ◽  
Amit Rattan ◽  
Atal Sood ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Intestinal Metaplasia ◽  
Histopathological Examination ◽  
Gall Stone ◽  
Stone Disease ◽  
Premalignant Lesions ◽  
Very High Frequency ◽  
North East ◽  
The North ◽  
Gall Stone Disease

Background: In India, gall stone disease is more common in women in the north, north east and east as compared to other zones in the country. Gall bladder metaplasia has been documented as the precursor lesion of dysplasia and therefore carcinoma. Present study was conducted to ascertain the frequency and type of metaplasia along with distribution in different regions of gall bladder.Methods: All the post cholecystectomy gallbladder samples submitted for histopathology comprised the study material. Three sections were from body, fundus, and neck each. The five microns thick paraffin sections were cut with microtome and stained with Hemotoxylin and Eosin (H and E).Results: The present study was conducted on 119 cholecystectomy specimens submitted for histopathological examination. Amongst premalignant lesions, cholecystitis with metaplasia was seen in 55 (46.2%) cases. Pyloric metaplasia without intestinal metaplasia was most common metaplasia (30.2%) followed by combined metaplasia (12.60%) and only intestinal metaplasia (3.36%). Out of 55 cases, fundus showed metaplasia in 47 followed by body (44) and neck (36).Conclusions: Very high frequency of metaplasias was observed (46.2%) in routine cholecystectomy specimen with pyloric metaplasia as the predominant type and intestinal metaplasia was accompanied with pyloric metaplasia in most of the cases. Metaplasia was found to be more or less equally distributed in different regions of gall bladder.

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 Evaluation of gall bladder mucosal changes in patients undergoing laparoscopic cholecystectomy

2019 ◽  
Vol 6 (11) ◽  
pp. 4108
Author(s):  
Harpreet Singh ◽  
Roop Kishan Kaul ◽  
Naveen Kumar Singh ◽  
Aviral Gupta ◽  
Vikram Singh Yadav
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Bladder Wall ◽  
Gall Stone ◽  
Granulomatous Inflammation ◽  
Stone Disease ◽  
Research Centre ◽  
Mucosal Response ◽  
Gall Bladder Wall ◽  
Mucosal Changes

Background: Histopathological changes induced by gall stone disease or cholelithiasis are diverse including acute inflammation, chronic inflammation, glandular hyperplasia, granulomatous inflammation, cholesterosis, dysplasia and carcinoma. Hence, this study was planned to assess gallbladder mucosal changes in patients undergoing laparoscopic cholecystectomy (LC) and it’s correlation with number and types of stone.Methods: A total of 50 patients with symptomatic cholelithiasis scheduled to undergo laproscopic cholecystectomy (LC) after written and informed consent from October 2015 to October 2018 at Teerthanker Mahaveer Medical College and Research Centre, Moradabad were followed prospectively. Preoperative biochemical profile and ultrasonography of whole abdomen of all the patients was obtained. LC was done under the hands of the skilled and experienced surgeons. Morphologic profile of gallstones was recorded and analysed. Gallbladder mucosal tissues were sent to general pathology department for analysis. Histopathological typing of all the gallbladder mucosal specimens was done and was correlated with the number and type of gallstones.Results: In majority (76%) cases, cholecystitis was found. Hyperplasia was seen in 10% patients. Cholecystitis with metaplasia in 10 percent of the cases and carcinoma in 2 percent of the cases. While correlating the gallbladder mucosal response with the number and type of stones, non-significant results were obtained.Conclusions: There might be some association between gall bladder mucosal changes and gall stone. We cannot say an etiologic and effective correlation from the results of this study; possible mechanism may be gall stone erodes gall bladder wall constantly over a period of time which may constitute a risk. While correlating gallbladder mucosal response with the number and type of stones, non-significant results were obtained.

scholarly journals Laparoscopic cholecystectomy in wall echo complex gall stone disease: a study

2017 ◽  
Vol 4 (4) ◽  
pp. 1309
Author(s):  
Bhavinder K. Arora ◽  
Rachit Arora ◽  
Akshit Arora
Keyword(s):  
Gall Bladder ◽  
Bladder Wall ◽  
Gall Stone ◽  
Stone Disease ◽  
Cystic Artery ◽  
The Third ◽  
Calot’S Triangle ◽  
Conversion Rates ◽  
Gall Stone Disease ◽  
Gall Bladder Wall

Background: There are so many subtitles for difficult laproscopic cholecystectomy. Stone in the neck of gall bladder constitutes one of the entities. Wall echo complex is an ultrasound terminology used for cholelithiasis. It has three layers, first the pericholecystic fat between gallbladder and liver. Second layer consists of gall bladder wall. The third layer consists of echogenic stone itself. Wall echo complex is one of the entities which constitute difficult laproscopic cholecystectomy. Wall echo complex in the neck of the gall bladder is particularly difficult gall bladder where the conversion rates are high.Methods: The study was conducted in Department of Surgery. Standard four port cholecystectomy was done in 50 patients. Wall echo complex in all these patients was reported by ultrasonologist. Difficulties in operating wall echo complex cholelithiasis consisted of dissection of neck of gall bladder due to adhesions and a sleeve of fat covering the calot’s triangle. The difficulty of wall echo cholelithiasis was managed by opening the neck of gall bladder and evacuating the stones into a separate latex bag. By this procedure the difficult wall echo cholelithiasis was managed in all cases. Ligaclips were used for ligation of cystic duct, cystic artery and pericholecystic veins.Results: The evacuation of stones from the neck of gall bladder led to an easy cholecystectomy in 46 patients while the four patients had conversion to open cholecystectomy.Conclusions: Wall echo complex although an ultrasonologists entity but is a difficult gall bladder for laproscopic cholecystectomy. 

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