scholarly journals Evaluation of patients undergoing cholecystectomy with special reference to post-cholecystectomy syndrome

2018 ◽  
Vol 5 (6) ◽  
pp. 2313
Author(s):  
P. S. Khatana ◽  
Jitendra Kumar ◽  
Deepak Kumar Sharma
Keyword(s):  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
New Delhi ◽  
Biliary Disease ◽  
Medical College ◽  
Number Of Patients ◽  
Gall Stone Disease ◽  
The Mean ◽  
Age Range

Background: Significant percentage of patients remain symptomatic even after the cholecystectomy surgery for gall stone disease. Traditionally, this has been termed Post-Cholecystectomy syndrome which may consist of same symptoms for which cholecystectomy was performed or it may be a new set of symptoms that have developed after cholecystectomy. Aim of this study to find out incidence as well as pre-operative, intra-operative and post-operative determinants for the post- cholecystectomy syndrome.Methods: This is the prospective study, done in the Department of Surgery, Dr BSA Medical College and Hospital, New Delhi. Total 102 number of patients were included in this study, out of which 51 patients underwent open and another 51 patients underwent laparoscopic cholecystectomy.Results: The mean age of the patients was 40.29±10.69 years with an age range of 19 to 80 years. Incidence rate of post cholecystectomy symptoms were16.66% (n=17).  Incidence of post-cholecystectomy syndrome in patients who underwent laparoscopic cholecystectomy were 15.69% (n=8) while in the open cholecystectomy group it was 17.64% (n=9). Out of seventeen symptomatic patients, eight (47.05%) were having the biliary disease while nine patients (52.95%) were having non-biliary cause.Conclusions: As authors studied present symptomatic group of patients thoroughly, it has become clear that the post-cholecystectomy symptoms are multiple and diverse arising from various causes; which in reality has no relation with the removal of gall bladder. Hence the appellation ‘post-cholecystectomy syndrome is inappropriate and instead we have used the term ‘Post-Cholecystectomy Symptoms’ for these patients.

scholarly journals Prediction of difficulties during laparoscopic cholecystectomy by preoperative clinical examination and ultrasonography

2017 ◽  
Vol 4 (4) ◽  
pp. 1335 ◽  
Author(s):  
Arun Kumar ◽  
Kunwar Vishal Singh ◽  
Jugendra Pal Singh Shakya ◽  
Sangita Sahu ◽  
Soniya Dhiman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Examination ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
Medical College ◽  
Preoperative Ultrasonography ◽  
Gall Stone Disease ◽  
Symptomatic Gall Stone

Background: Cholelithiasis (gall stone disease) is a well-known disease worldwide. Ultrasonography is the most common screening test for cholecystitis and cholelithiasis. Laparoscopic Cholecystectomy is considered the treatment of choice for symptomatic gall stone disease. It is important to know the different clinical, radiological parameter and specific predictor that give some prediction of difficult LC. The aim of this study was to predict the difficulty of LC and the possibility of conversion to OC before surgery using the clinical and ultrasonographic criteria in our set up.Methods: The present study was carried out in the Department of surgery, Sarojini Naidu Medical College Agra, from November 2014 to October 2016.  A total of 210 patients were enrolled for the laparoscopic cholecystectomy. All patients who were included in the study were undergone detailed history and clinical examination. A number of clinical and ultrasonographical parameters were noted.Results: Amongst the 210 patients admitted for laparoscopic cholecystectomy, 21 (10%) were male and 189 (90%) female, with age ranging from 12–60 years.  The conversion rate in our study was 4.5% (9 of 210). In our study significant pre-operative factors which increased the conversion rate to open cholecystectomy includes male gender, obesity, abdominal scar of previous surgery, contracted and thickened gall bladder and patients having stone impacted at the neck of gall bladder.Conclusions: From this study, we conclude that preoperative ultrasonography is a good predictor of difficult laparoscopic cholecystectomy in the majority of cases and should be used as a screening procedure.

scholarly journals Prevalence of Sub-Clinical Hypothyroidism in Diagnosed Cases of Gallstone Disease

2021 ◽  
pp. 207-212
Author(s):  
C. Kamalakkhannan
Keyword(s):  
Gallstone Disease ◽  
Gall Stone ◽  
Clinical History ◽  
Gallstone Formation ◽  
Stone Disease ◽  
Thyroid Function Tests ◽  
Age Group ◽  
Medical College ◽  
Gall Stone Disease ◽  
A Prospective Study

Thyroid issues have long been debated as a possible cause of gall stone disease. The link between hypothyroidism and gallstone disease could be explained in a variety of ways. The main objective of this study is to determine the prevalence of hypothyroidism in gallstone patients and to rule out hypothyroidism as a probable cause of gallstone formation. A prospective study was conducted in surgical wards of Department of surgery sree balaji medical college from 2016 to 2017. All patients were evaluated using a comprehensive clinical history and examination, as well as suitable investigations such as abdominal USG, thyroid function tests, and lipid profiles. Out of 22 patients 19 patients (86.4%) had normal TSH, 2 patients (9.1%) had increased TSH, 1 patient (4.5%) had decreased TSH. Raised TSH was more in the AGE Group of 61- 75 years, which is comparable to other studies. Out of 22 patients, (100%) had normal T3 levels. 19 patients (86.4%) had normal T4 levels and Ultrasound examination of neck, 2 patients (9.1%) had decreased T4 level and 1 patient (4.5%) had increased T4 levels and 3 patients (13.6%) had abnormal Ultrasound Neck findings. Hence In this Study Cholelithiasis is most commonly seen in Females of age group of 41-60 years and prevalence of raised TSH level in cholelithiasis patient was 9% and most were found in the age group of 61-80 years.

scholarly journals Evaluation of relationship of body mass index with severity of cholecystitis

2019 ◽  
Vol 6 (3) ◽  
pp. 868 ◽  
Author(s):  
Varun V. Chauhan ◽  
Bhushan A. Shah ◽  
Shivaratna J. Mahadik ◽  
Rohan P. Videkar
Keyword(s):  
Risk Factor ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
Established Risk Factor ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy ◽  
Gall Stone Disease ◽  
Total Body ◽  
A Prospective Study

Background: Obesity is an established risk factor for gall stone disease. Male sex has also been recently cited as a risk factor for severe symptomatic cholelithiasis. As a possible cause of several difference in regards to the severity of cholecystitis, many physiological differences between the two sexes can be examined. Many studies have been done on the risk factors for developing the gall bladder disease explaining its polygenic nature It is postulated that the total body fat, the main value of which is significantly higher for females than males, may contribute to this sex difference. Only a couple of studies are available on BMI and its effect on severity of cholecystitis hence depicting the need for this study in our setup.Methods: This is a prospective study carried out on 70 patients for cholecystitis whose weight and height measurements had been recorded on admission. Patients were placed in either group-Obese (BMI e” 25kg/m2) or Non-Obese (BMI <25kg/m2). The association between BMI and severity of cholecystitis was investigated.Results: 18% of the laparoscopic cholecystectomy surgeries required conversion to open cholecystectomy due to reasons like severe adhesions to an adjacent organ, etc. Pain in abdomen (100%) was the commonest complaint and was present in all the patients followed by dyspepsia (44%).69% of patients were having complaints for more than 72 hours. No significant difference observed among mean BMI of different grades of severity (p=0.963).Conclusions: There is negative correlation between BMI and grade of severity of cholecystitis and BMI is not a predictor for the conversion from laparoscopic to open cholecystectomy.

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 Diagnosis of Helicobacter pylori in cholelithiasis and cholecystitis: by histology and serological association

2019 ◽  
Vol 6 (11) ◽  
pp. 3986
Author(s):  
Srinivasan Doraiswamy ◽  
Dharmendra Kumar ◽  
P. N. Sreeramulu ◽  
Suresh .
Keyword(s):  
Helicobacter Pylori ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Stone Disease ◽  
Marked Rise ◽  
Female Ratio ◽  
Gall Stone Disease ◽  
Calculus Disease ◽  
Set Up ◽  
Calculous Cholecystitis

Background: Biliary calculus disease is one of the most common disorders affecting the gastrointestinal tract. It is an important cause of morbidity. There has been marked rise in the incidence of gall stone disease in the west. In India, it is more common in northern states than in South India. Incidence of gallstones increases with age with a male to female ratio of 1:4. About 50% of these patients are asymptomatic.Methods: An analytical prospective study on patients diagnosed with cholecystitis and/or cholelithiasis was conducted in R. L. Jalappa Hospital Tamaka, Kolar. 58 patients were included in the study between June 2018 and May 2019. Data was collected and analysed using SPSS 22 version software. Categorical data was represented in the form of frequencies and proportions.Results: The age incidence was found to be highest between 31 to 40 years. The incidence of cholelithiasis was more in females. All patients presented with pain abdomen. Calculous cholecystitis was the most common mode of presentation. Open cholecystectomy was commonly done for cholelithiasis in our set up. Chronic calculous cholecystitis is the commonest histopathology.Conclusions: According to our findings evidence of recent and chronic infection Helicobacter pylori as shown by demonstration of IgM and IgG class of antibodies respectively to the organism was found in most of patients and histological evidence of the patients with cholecystitis and cholelithiasis. Thus, the frequency of helicobacter infection seems to be low in the patient population studied.

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 Association between Thyroid Function and Gall Stone Disease

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 36-40
Author(s):  
Md Nahid Reza ◽  
M Fardil Hossain Faisal ◽  
Tahmina Noor ◽  
Riaz Mahmud ◽  
Monsur Miah ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Thyroid Function ◽  
Gall Stone ◽  
Density Lipoprotein ◽  
Thyroid Stimulating Hormone ◽  
Stone Disease ◽  
University Hospital ◽  
Control Group ◽  
Gall Stone Disease ◽  
The Mean

Background: There was a long term perception that gall stone disease may have a hidden association to alteration of thyroid function. Objective: To find out the association between thyroid function status in gall stone disease. Materials and Methods: This case control study was conducted in department of Surgery, Bangabandhu Sheikh Mujib Medical University Hospital from July 2017 to June 2018. This study recruited 152 gall stone patients diagnosed with Ultrasonography (USG). The control group underwent USG to exclude any asymptomatic cholelithiasis. Fasting blood samples were taken from all participants for measurements of Fasting Blood Sugar (FBS), serum free thyroxine (FT4), serum thyroid stimulating hormone (TSH), total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Results: The mean serum TSH levels among cases (3.56±4.6) was higher than controls (2.46±1.68) (p<0.05). Subclinical hypothyroidism was noted in 11.8% of cases and all were found female and 3.8% of controls, whereas hypothyroidism was detected in 3 (3.8%) controls and 22 (14.5%) cases. The mean total cholesterol levels in cases was much higher than in controls, and was significant (p<0.05). Conclusion: Hypothyroidism has a significant role on development of gall stone disease with increasing age especially in female. KYAMC Journal.2021;12(1): 36-40

The Prevalence and Association between Subclinical Hypothyroidism and Gall Stone Disease: Study in Shaheed Suhrawardy Medical College Hospital

2020 ◽  
Vol 11 (2) ◽  
pp. 130-133
Author(s):  
Nadim Ahmed ◽  
ABM Muksudul Alam ◽  
Shoaeb Imtiaz Alam ◽  
Sami Ahmad ◽  
Rafiqul Karim Khan ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Stone Formation ◽  
Gall Stone ◽  
Thyroid Function Test ◽  
Stone Disease ◽  
College Hospital ◽  
Cross Sectional ◽  
Gall Stones ◽  
Number Of Patients ◽  
Gall Stone Disease

Background: Gall stones are the most common biliary pathology. Subclinical hypothyroidism is not an uncommon problem in the population with thyroid disease, several explanations for a possible relation between hypothyroidism and lipid metabolism with gall stone formation proved that prevalence of gall stones is increased in patients with hypothyroidism. Objective: To find the prevalence and correlation between the subclinical hypothyroidism and gall stone disease. Methods: This is a cross-sectional study was done in the Unit-II of department of Surgery of Shaheed Suhrawardy Medical Hospital between July 2018 to June 2019, where 80 patients presented with gall stones. All the patients were assessed and prepared for cholecystectomy by detailed history, clinical examination, thyroid function test, abdominal ultrasound and others investigation needed for general anaesthesia. Results: Among 80 patients, 78.57% were in 40–59 year age group, 56 (70%) of them were female and 24 (30%) were male. Of the total number of patients, 14 of them (17.5%) had subclinical hypothyroidism and 66 (82.5%) were euthyroid. Most of patients in the subclinical hypothyroid group were showing female gender predominance with 78.57%. While the prevalence among males were found 21.43%. Dyslipidemia was present among 81.25% patients (p=0.03) having subclinical hypothyroidism and gall stones. Besides single stone was common (57.14%) among this hypothyroid group and all stones of this group were >1 cm. Conclusion: There is a gender speciûc relationship between subclinical hypothyroidism and gall stone disease. As this study sharing statistically significant in the prevalence of the subclinical hypothyroidism among females in age groupe³40 years, dyslipidemia and single gall stone. This subset of patients should be assessed for thyroid dysfunction. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 130-133

scholarly journals An evaluation of open versus laparoscopic cholecystectomy in tertiary centre

2019 ◽  
Vol 6 (8) ◽  
pp. 2797
Author(s):  
Kanwar Singh Goel ◽  
Sapna Goel ◽  
Sham L. Singla ◽  
Pawan Tiwari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Stone ◽  
Age Groups ◽  
Stone Disease ◽  
Average Hospital ◽  
Medical College ◽  
Tertiary Centre ◽  
Gall Stone Disease ◽  
Open Versus ◽  
Surgery Department

Background: Cholecystectomy is a method of treatment for acute or chronic cholecystitis with cholelithiasis or any other diseases of gall bladder. The diagnosis of gall stone disease depends on an accurate history, physical examination, supporting lab investigations and a proper ultrasound of abdomen. After the advent of lap cholecystectomy there is revolution in minimally invasive surgery. Because of better technological innovations, the lap cholecystectomy has become gold standard presently.Methods: This prospective observational study was performed in Surgery Department in SGT Medical College, Budhera, Gurugram, over a period of 2 years from January 2017 to January 2019. Patients were taken from both sexes and all age groups from different units of surgery. A total of 100 patients were taken for study who underwent cholecystectomy.Results: Mean age of patients in our study was 38.64 years. Most patients were females. Procedure adopted was open in 18% patients and lap cholecystectomy in 74% patients. Conversion from laparoscopic to open was done in 8% patients. In 8% patients there were operative complications. Average hospital stay was much less for lap cholecystectomy.Conclusions: After the advent of laparoscopic cholecystectomy, most of the surgeons are performing more and more of laparoscopic cholecystectomy. Here incision is small, pain is less, and hospitalization is shorter. Even in acute cholecystitis, in experienced hand, lap cholecystectomy can be performed safely. The author’s inclination is totally in favour of lap cholecystectomy, except the cases where lap cholecystectomy is contraindicated. 

scholarly journals Laparoscopic cholecystectomy for gall stone disease. A single center experience.

2020 ◽  
Vol 27 (09) ◽  
pp. 1983-1988
Author(s):  
Shehzad Ahmad Qamar ◽  
Munawar Jamil ◽  
Kokab Salim
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Demographic Data ◽  
Gall Stone ◽  
Major Complication ◽  
Stone Disease ◽  
Safe Procedure ◽  
Trocar Site ◽  
Single Center Experience ◽  
Gall Stone Disease

Objectives: Laparoscopic cholecystectomy has turned into the gold standard for patients with symptomatic cholelithiasis. But still this procedure is not complication free. Many a time’s laparoscopic cholecystectomy needs to be converted to open cholecystectomy. Study Design: Observational study. Setting: Civil Hospital Bahawalpur. Period: 3 years from July 2015 to June 2018. Material & Methods: Carried out to review the frequency of complications encountered in laparoscopic cholecystectomy by assessing 400 cases of laparoscopic cholecystectomies. Performa was intended to incorporate important demographic data, history of illness, examination and investigations. Results: The major complication of our procedure was bleeding. Bleeding from the trocar site happened in 11 cases (2.75%), vascular damage in the callots triangle in 2 (0.5%) and from liver bed in 19 (4.75%) cases, followed by biliary leak that happened in 20 (5%) cases. Spilled gallstones were seen in 8(2%), Port site infection in 24 (6%) cases. Common bile channel stricture was accounted for in 5 patients, 14 (3.5%) out of 400 patients were converted to open surgery. Mortality was low for our situation I.e. 1 patient. Conclusion: Laparoscopic cholecystectomy is becoming a safe procedure in terms of complications.

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