scholarly journals Incidence of double cystic artery: a clinical study

2020 ◽  
Vol 7 (9) ◽  
pp. 2837
Author(s):  
Tamer Akay ◽  
Metin Leblebici
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Study ◽  
Cystic Artery ◽  
Indication For Operation ◽  
Biliary Injury ◽  
Intraoperative Bleeding ◽  
Duration Of Hospital Stay ◽  
Retrospective Clinical Study ◽  
The Mean ◽  
Bladder Polyp

Background: A successful laparoscopic cholecystectomy is associated with the knowledge about anatomic structures and the congenital anomaly of the biliary tract. The aim of this study was to become familiar with vascular variations in laparoscopic cholecystectomy.Methods: This was a retrospective clinical study. The files of patients who underwent laparoscopic cholecystectomy due to benign gallbladder diseases were analyzed. The characteristics and complications of the patients with double cystic artery were recorded and examined.Results: A total of 360 patients, 76 males and 284 females were included in the study. The mean age was 51.2 (25-81). When the files of the patients were examined, it was found that double cystic arteries were detected during the operation in two male (2.63%) and nine female patients (3.16%). Gall bladder polyp was found as an indication for operation in one of 11 patients, while multiple gallbladder stones were found as an indication for operation in the other patients. The laparoscopic cholecystectomy was converted to conventional cholecystectomy in two from 11 patients (18.1%) with double cystic arteries due to bleeding. The mean duration of hospital stay in the patients with double cystic artery is 5.2 (3-11) days, and (2.7 days) longer compared to the patients without a double cystic artery.Conclusions: Cystic artery variations and other variations can coexist. Awareness of cystic artery variations can reduce the possibility of uncontrolled intraoperative bleeding, extrahepatic biliary injury, and switching to conventional 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 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.

scholarly journals Retrospective clinical study of tracheostomy among intubated patients of respiratory intensive care unit

2020 ◽  
Vol 6 (12) ◽  
pp. 2253
Author(s):  
Sudhakar Rao M. S. ◽  
Bipinkumar .
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Study ◽  
Clinical Outcome ◽  
Upper Airway ◽  
Inclusion Criteria ◽  
Prolonged Intubation ◽  
Retrospective Clinical Study ◽  
Respiratory Intensive Care Unit ◽  
The Mean

<p><strong>Background:</strong> Tracheostomy is a common surgical procedure performed in upper airway obstruction to establish alternate airway, to ease the access for secretion removal and protect lower airways and to wean in critically ill, ventilator-dependent patients. This retrospective clinical study emphasises on the indications and clinical outcome of tracheostomy procedure among intubated patients of varied clinical diagnosis in respiratory intensive care unit (RICU).</p><p><strong>Methods:</strong> This is a retrospective clinical study of intubated patients of RICU who underwent tracheostomy between Jan 2014 to Dec 2019.The case sheets of patients who fulfilled the inclusion criteria of this study and whose records were available in medical records department (MRD) of our institute for the study period were analysed for the indications for tracheostomy, timing of tracheostomy and its clinical outcome among them.</p><p><strong>Results:</strong> A total of 33 patients were included in this study and their case sheets were analysed. Most common indication for the tracheostomy was found to be prolonged intubation secondary to the chemical poisoning. The mean days of intubation before the tracheostomy was 7 days. The mean days of stay in RICU after tracheostomy among survived and dead patients was 21 and 7 days respectively which was highly significant (p=0.00).</p><p><strong>Conclusion:</strong> This retrospective study concludes that conditional survival after the tracheostomy among the previously intubated patients is found to be more after three weeks whereas the mortality is likely to be in the first week of post tracheostomy period. Hence the number of days of stay after the tracheostomy among these patients, there need not be a linear decrease in survival and should not be the reason for being despondent.</p>

scholarly journals Total clipless cholecystectomy by means of harmonic sealing

2015 ◽  
Vol 28 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Almino Cardoso RAMOS ◽  
Manoela Galvão RAMOS ◽  
Manoel dos Passos GALVÃO-NETO ◽  
Josemberg MARINS ◽  
Eduardo Lemos de Souza BASTOS ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Operative Time ◽  
Case Series ◽  
Cystic Artery ◽  
Morbidity Rate ◽  
Pressure Test ◽  
The Mean ◽  
Prospective Case Series ◽  
Laparoscopic Cholecistectomy

BACKGROUND: In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. AIM: To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver. METHODS: Was evaluate a series of 125 patients who underwent laparoscopic cholecystectomy where the sealing and division of cystic artery and duct was carried out only by harmonic shears. The intact extracted gallbladder was submitted to a reverse pressure test for assessment of the technique safety by means of CO2 insuflation. RESULTS: The most common indication for surgery was gallstones. The mean operative time was 26 min and all gallbladders were dissected intact from the liver bed. There was no mortality and the overall morbidity rate was 0.8% with no hemorrhage or leaks. The reverse pressure test showed that all specimens support at least 36-mmHg of pressure without leaking. CONCLUSION: The harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time.

scholarly journals Laparoscopic Cholecystectomy: Complication and Conversion Rate

2012 ◽  
Vol 8 (4) ◽  
pp. 367-369 ◽  
Author(s):  
B R Malla ◽  
R K M Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Learning Curve ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Complete Information ◽  
Laparoscopic Technique ◽  
Biliary Injury ◽  
Cholecystectomy Complication ◽  
The Mean

Background Laparoscopic cholecystectomy has become standard method for treating gallstone. However, different centres have reported different complications and conversion rate. The objective of this study was to evaluate complications and conversion of laparoscopic cholecystectomy into open cholecystectomy in Dhulikhel Hospital, Kathmandu University, Nepal. Methods Files of all patients who had laparoscopic cholecystectomy from January 2005 to December 2009 were reviewed. Out of 119 laparoscopic cholecystectomy cases, 102 were included in the study as complete information was lacking in the rest. Results Out of 102 cases, 80 were female. Symptomatic cholelithiasis were 76.47%. The mean hospital stay was 2.48 days. Postoperative complications occured in 5.88% patients. Conversion rate to open cholecystectomy was 3.92%. Conclusions Laparoscopic cholecystectomy is a reliable and safe surgery. With growing experience in laparoscopic technique, it is possible to bring complications and conversion rate to minimum. However, there will be no significant improvements once learning curve is reached. Rather, the nature of biliary injury may become more severe.http://dx.doi.org/10.3126/kumj.v8i4.6232 Kathmandu Univ Med J 2010;8(4):367-9

scholarly journals Crown-to-implant ratio of short locking-taper implants placed in posterior areas of the maxilla: a retrospective study 2 years after loading

2017 ◽  
pp. 89-94
Author(s):  
Lombardo Giorgio ◽  
Pighi Jacopo ◽  
Corrocher Giovanni ◽  
Simancas Pallares Miguel Angel ◽  
Marincola Mauro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Study ◽  
Bone Loss ◽  
Ratio Analysis ◽  
Marginal Bone Loss ◽  
Cumulative Survival ◽  
Retrospective Clinical Study ◽  
The Mean ◽  
Short Implant

Introduction: The purpose was to study any relationship between crown-to-implant ratio and peri-implant bone loss of short, plateau-design, locking taper implants in posterior maxillary areas. Methods: This retrospective clinical study was conducted between May 2013 and September 2013. The sample was composed of patients who had received at least one short implant(5-to-8-mm-long) between January 2009 and December 2011. The outcome variables were implant failure and peri-implant bone loss in relation to crown-to-implant ratio. Analysis of variance (ANOVA) was used to check out correlations between crown-to-implant ratio and peri-implant bone loss. Results: Thirty-six subject who received 79 locking-taper implants were followed for an average of 24 months. Four implants failed, giving a cumulative survival rate (CSR) of 94.9%. The mean crown-to-implant ratio was 2.01. The peri-implant bone loss between prosthetic loading and last recall was 0.21 mm. No statistically significant relationship was observed between increasing crown-implant ratios and marginal bone loss (P = .93). Conclusion: The crown-to-implant ratio, although high, was not associated to increased bone loss. However further studies with longer follow-up are needed to confirm our data.

scholarly journals Control of cystic artery during laparoscopic cholecystectomy: clips versus ultrasonic energy devices which is better?

2017 ◽  
Vol 4 (12) ◽  
pp. 3844
Author(s):  
Mahidhar Reddy Venkatapuram ◽  
Sreeram Sateesh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Bleeding ◽  
Cystic Artery ◽  
Ultrasonic Energy ◽  
Energy Device ◽  
Intraoperative Bleeding ◽  
Energy Devices ◽  
Group A ◽  
Energy Application ◽  
Group B

Background: This study was undertaken to know whether clip usage or ultrasonic energy application, obtains better haemostasis of cystic artery during laparoscopic cholecystectomy.Methods: About 80 patients undergoing laparoscopic cholecystectomy were selected on a prospective basis and divided into two equal groups- A and B. a comparative study was done between the two group. Clips were used to control cystic artery in group A patients and ultrasonic energy device was used for the same in group B.Results: In group A, 2 patients had clip slippage intraoperatively which was dealt by reapplication of clips.in group B,1 patient had intraoperative bleeding from cystic artery few minutes after application of ultrasonic energy which was dealt by bipolar cauterization. In both the groups no, postoperative bleeding was encountered.Conclusions: During laparoscopic cholecystectomy, clip usage and ultrasonic energy application are equally competent in achieving haemostasis of cystic artery.

Sign in / Sign up

Export Citation Format

Share Document