scholarly journals Early same-admission laparoscopic cholecystectomy for acute mild biliary pancreatitis: a retrospective study

2019 ◽  
Author(s):  
yunxiao lyu ◽  
Yunxiao Cheng ◽  
Bin Wang
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Optimal Time ◽  
Control Group ◽  
Biliary Pancreatitis ◽  
Group I ◽  
Estimated Blood Loss ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery ◽  
Group Ii

Abstract Background As the standard procedure for the surgical treatment for gallbladder stones, we investigated the controversy surrounding the optimal time for laparoscopic cholecystectomy (LC) for acute mild biliary pancreatitis.Methods This retrospective study included medical records of all patients who were admitted with a diagnosis of acute mild biliary pancreatitis at Dongyang People’s Hospital from July 2011 to June 2018. Main outcomes included perioperative characteristics, length of hospital stay, complications, morbidity, and mortality.Results A total of 119 patients were divided into an early LC group (Group I; 52 patients) and a control group (Group II; 67 patients). The mean age was 60.5 years (range, 30–79 years). Conversion to open cholecystectomy (COC) was performed in 17 patients (6 patients in Group I and 11 patients in Group II, P=0.62). There were no significant differences in terms of estimated blood loss and duration of surgery (P=0.08 and P=0.64, respectively). Bile duct injury (BDI) occurred in one patient from each group. The overall hospital stays in Group I were significantly less than in Group II (10.86±3.21 vs 13.29±4.51, P=0.001). Compared with postoperative bile leakage (P=0.72) and postoperative morbidity (P=0.97) and mortality, there were no significant differences between the groups.Conclusions Early LC during the same admission is safe for acute mild biliary pancreatitis and has the advantage of shortening overall hospital stay. There was no significant increase in COC, BDI, and complications.

scholarly journals Early same-admission laparoscopic cholecystectomy for acute mild biliary pancreatitis: a retrospective study

2019 ◽  
Author(s):  
yunxiao lyu ◽  
Yunxiao Cheng ◽  
Bin Wang
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Optimal Time ◽  
Control Group ◽  
Biliary Pancreatitis ◽  
Group I ◽  
Estimated Blood Loss ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery ◽  
Group Ii

Abstract Background As the standard procedure for the surgical treatment for gallbladder stones, we investigated the controversy surrounding the optimal time for laparoscopic cholecystectomy (LC) for acute mild biliary pancreatitis.Methods This retrospective study included medical records of all patients who were admitted with a diagnosis of acute mild biliary pancreatitis at Dongyang People’s Hospital from July 2011 to June 2018. Main outcomes included perioperative characteristics, length of hospital stay, complications, morbidity, and mortality.Results A total of 119 patients were divided into an early LC group (Group I; 52 patients) and a control group (Group II; 67 patients). The mean age was 60.5 years (range, 30–79 years). Conversion to open cholecystectomy (COC) was performed in 17 patients (6 patients in Group I and 11 patients in Group II, P=0.62). There were no significant differences in terms of estimated blood loss and duration of surgery (P=0.08 and P=0.64, respectively). Bile duct injury (BDI) occurred in one patient from each group. The overall hospital stays in Group I were significantly less than in Group II (10.86±3.21 vs 13.29±4.51, P=0.001). Compared with postoperative bile leakage (P=0.72) and postoperative morbidity (P=0.97) and mortality, there were no significant differences between the groups.Conclusions Early LC during the same admission is safe for acute mild biliary pancreatitis and has the advantage of shortening overall hospital stay. There was no significant increase in COC, BDI, and complications.

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 Laparoscopic cholecystectomy in hepatitis C liver cirrhosis patients: “to drain or not to drain: impact on postoperative pain”

2019 ◽  
Vol 6 (8) ◽  
pp. 2708
Author(s):  
Ahmed Mohamed Abdelaziz Hassan ◽  
Magdy M. A. Elsebae ◽  
Mohamed Abbas ◽  
Hussien Ezzat ◽  
Mohamed Z. Ali ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Laparoscopic Cholecystectomy ◽  
Hepatitis C ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Nausea And Vomiting ◽  
Analgesic Requirement ◽  
Group I ◽  
Duration Of Surgery ◽  
Drain Group

Background: When cirrhotic patients with symptomatic gallstones require laparoscopic cholecystectomy (LC), the drainage tube is supposed to prevent postoperative abdominal radiating to the right shoulder, nausea and vomiting due to pneumoperitoneum using carbon dioxide gas. Aim of this work is to evaluate the effect of placing of drains on the incidence of postoperative pain, nausea and vomiting in those patients.Methods: sixty-four patients with uncomplicated chronic calcular cholecystitis and liver cirrhosis were recruited for the study during the period from February 2017 to February 2019. They electively operated upon at the department of general surgery of Theodor Bilharz Research Institute (TBRI) using laparoscopic technique. Patients were subdivided into two equal groups Group-I (n=32); suction drains were placed in the sub-hepatic region (Morison’s pouch) and Group-II (n=32), no drains were placed. Duration of surgery, postoperative shoulder tip pain and vomiting and analgesics requirement were evaluated and recorded.Results: Operative time's difference was not statistically significant between the two groups. Drain group had a significant lower shoulder tip pain and analgesic requirement at post-operative 6 and 12 hours but that was higher After 12 hours, than group without drain. The overall incidence of nausea/vomiting was significantly higher statistically in group without drain than in drain group. Patients in drain group had a significantly longer hospital stay as compared to group without drain that was statistically significant.Conclusions: Although the incidence of pain and nausea/vomiting are less in early  post-operative period after LC  with abdominal drain in hepatitis C liver cirrhosis patients; its routine use is not justified because post-operative pain and analgesic requirement  after 12 hours is higher and hospital stay is longer. 

scholarly journals Role of scoring system in prediction of difficult laparoscopic cholecystectomy

2017 ◽  
Vol 5 (1) ◽  
pp. 257
Author(s):  
Delie Rhezhii ◽  
Vikas Goyal ◽  
Nitin Nagpal ◽  
Shobhit Kumar Nemma ◽  
Monica Gupta
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Scoring System ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
Scoring Systems ◽  
Gall Stones ◽  
Group I ◽  
Conversion To Open Cholecystectomy ◽  
Group Ii

Background: One of the most common reasons for admission to hospital is cholecystectomy and it has a mortality rate of 0.45% to 6%. Many risk factors have been found to be associated laparoscopic cholecystectomy that make it difficult like advance age, male gender, fever, obesity, previous abdominal surgeries, thick gall bladder lining, distention of bladder, presence of gall stones. There have been different scoring systems in literature that determine the risk of conversion to open cholecystectomy. The aim of present study is to determine the role of scoring system in predicting difficult laparoscopic surgery.Methods: The present prospective study was conducted for a period of 1 year in the Department of Surgery at Guru Gobind Singh Medical College, Faridkot, Punjab. The study included all the patients with symptomatic gall stones reporting to the OPD of the hospital. Patients were categorized into two groups after the surgery. Group I included patients who underwent successfully laparoscopic cholecystectomy and group II included those who were converted into an open case. In this study all the entities were provided with a score. Patients with score less than 4 were grouped as difficult. At the end of the study all the data were analyzed to see how scoring system can predict which patients will have easy or difficult laparoscopic cholecystectomy based on postoperative scoring. All the data was recorded in a tabulated form and analyzed using SPSS software.Results: The present prospective analytical study involved 112 subjects; out of these 94 were males and 18 females. The mean age of subjects was 48.2±3.7 years. There were 98 patients in Group I and 8 patients in group II who had didn’t show presence of peri cholecystic fluid. There was 1 patient in Group I and 5 patients in group II who had peri cholecystic fluid on ultrasound. There were 104 subjects with gall was thickness less than 4 mm. There were 95 patients in Group I and 9 patients in group II who had who had who had bladder wall thickness of less than 4 mm.Conclusions: The scoring tool evaluated in our study is useful in evaluating the risk of conversion of laparoscopic cholecystectomy into open cholecystectomy.

scholarly journals Harmonic scalpel versus titanium clips and l-hook in the ligation of cystic duct and artery and gall bladder dissection in laparoscopic cholecystectomy

2017 ◽  
Vol 5 (12) ◽  
pp. 5145
Author(s):  
Anand Vijayvargiya ◽  
S. K. Jain ◽  
Varsha Soni
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Hospital Stay ◽  
Cystic Duct ◽  
Harmonic Scalpel ◽  
P Value ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: Laparoscopic cholecystectomy is a gold standard for gall bladder stone surgery. The Aim and objective of study was to compare the total duration of surgery, intraoperative complication like bile leak from cystic duct stump, spillage of bile from gallbladder and post op pain and abdomen distension and jaundice.Methods: Study was carried out in dept. of gen Surgery, Govt medical college Kota in yr. 2015-16 in a total of 50 patients with cholelithiasis with cholecystitis. Patient were equally divided randomly into two groups (a) Harmonic scalpel group and (b) Titanium Clip and L hook group. All patients with medical comorbidities, Concomitant CBD calculi, cirrhosis and portal HT were excluded from study. Intraoperatively adhesions, bile spillage from GB and cystic duct stump noted Postoperatively complain like pain abdomen, Jaundice, and fever were noted. Duration of hospital stay was observed. All results were statistically analyzed using Chi square and ANOVA test.Results: Both groups were comparable on the basis of age and sex distribution, as no statistically difference was noted (P value 0.867 and 0.999 respectively). Intraoperative findings were adhesions 5 in clip group and 7 in harmonic group. Spillage from gall bladder was 2 in Clip group and 3 in harmonic group. Mean duration of surgery was 65.20 min in clip group and 63.68 in harmonic group with no statistically significant difference in both the group (P Value 0.727). Average duration of hospital stay was similar in both the groups with a mean of 2.6 days. Postoperative complication was fever, abdomen pain and distension were 3,1,1 were respectively in the clip group and 3,2,2 respectively in harmonic group with the P value of 0.999 which was statistically insignificant. No CBD injury was noted in any case. Conversion to open cholecystectomy was not done in any case. On 1week and 1 month follow up 2 cases in clip group and 1 in HS group had collection in gall bladder fossa and none at I month.Conclusions: Harmonic scalpel offers an effective, alternative and safe method to cystic duct division and Gallbladder dissection from liver bed.

Impact of Proning in COVID-19 Patients Admitted in Allama Iqbal Memorial Teaching Hospital Sialkot

2021 ◽  
Vol 15 (6) ◽  
pp. 1256-1258
Author(s):  
H. T. Hussain ◽  
A. W. Khan ◽  
Z. U. Mustafa ◽  
M. A. Qamar ◽  
M. A. U. Din
Keyword(s):  
Respiratory Failure ◽  
Hospital Stay ◽  
Prone Position ◽  
Teaching Hospital ◽  
Control Group ◽  
Common Symptom ◽  
Group I ◽  
Chest X Ray ◽  
Group Ii ◽  
Bilateral Lung

Aim: To determine the effects of prone position in patients with COVID-19. Study design: Retrospective/observational study Place and duration of study: Department of Medicine Allama Iqbal Memorial Teaching Hospital, Sialkot and its related ICU from 1st November 2020 to 30th April 2021 Methodology: Fifty patients of respiratory failure admitted to ICU were included in this study. Patient’s details demographics age, sex and body mass index were recorded after taking informed written consent. Patients were aged between 25-80years.Patients were divided in to two groups I and II. Group I had 25 COVID-19 patients underwent prone position and group II with 25 patients taken as control. Chest x-ray of both groups was taken. Patients of group I were kept in prone position while group II received invasive ventilation and follow up was taken in duration of 15-days. Results: There were majority of males, 40 (80%) and rest females 10 (20%). Mean age of the patients in prone positioning group was 50.3±18.22 years with mean BMI 26.14±7.13 kg/m2 and in control group it was 51.5±18.22 years with mean BMI 26.41±7.13 kg/m2.Thirty (60%) patients had moderate and 20 (40%) had severe covid-19 disease. Mean duration of prone position was 5.14±6.31 hours. Most of the patients 42 (84%) had bilateral lung involvement, interstitial infiltrates 55 (90%). Fever, cough and dyspnea were the most common symptom found in both groups. Mean PF ratio was increases in prone group as compared to controlled group. Mean hospital stay in group I was 6.9±18.8 days and in group II mean hospital stay was 9.7±13.2 days. Conclusion: The use of prone position among patients of COVID-19 was effective and safe method to reduce intubation, mortality and hospital stay. There was no any complication were found after this treatment. Keywords: Prone Position, Covid-19, Respiratory Failure, Mortality

scholarly journals A comparative study between laparoscopic and open cholecystectomy in cases of cholecystitis with cholelithiasis: one year experience in tertiary care center

2017 ◽  
Vol 4 (3) ◽  
pp. 903 ◽  
Author(s):  
Ashutosh Shukla ◽  
Sharad Seth ◽  
Alok Ranjan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Open Cholecystectomy ◽  
Care Center ◽  
Tertiary Care ◽  
Gall Stone ◽  
Treatment Strategies ◽  
Group I ◽  
Duration Of Surgery ◽  
Group Ii

Background: Gall stones are a major cause of morbidity all over the world. Until the end of 1980’s, open cholecystectomy was the gold standard for treatment of stones in the gall bladder. Laparoscopy has revolutionized surgery causing a re-evaluation of treatment strategies including cholecystectomy, however, it is not completely devoid of pitfalls. This study was undertaken to determine whether laparoscopic cholecystectomy can be recommended over open cholecystectomy as the procedure of choice for the treatment of cholecystitis with cholelithiasis.Methods: This study included a total of 100 patients in the age group 20-70 years diagnosed as calculous cholecystitis on ultrasonography and admitted to the surgical wards of Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India between November 2014 to October 2015. They were divided into two groups. Group I (n = 50) who underwent laparoscopic cholecystectomy and Group II (n = 50) who underwent open cholecystectomy.Results: A comparison of the two groups showed that the duration of surgery was significantly more in Group I (mean 52.32 minutes) as compared to Group II (mean 37.66 minutes) (p <0.001). There was <100 ml blood loss in the majority of Group I cases (94%), however, in Group II, majority had blood loss ≥100 ml (96%) (p <0.001). Mean duration of post-operative pain was 14.68 hours in group I and 27.92 hours in group II (p <0.001). Time taken to restoration of oral feeds, was less in group I (mean 11.68 hours) as compared to group II (mean 17.24 hours). Post-operative hospital stay was a mean of 1.18±0.52 days in Group I and a mean of 4.78±1.42 days in Group II (p<0.001). The time taken for resumption of normal activity was two days and three days (p <0.001) in group I and II respectively. In Group I, average cost of treatment was rupees 10870, but in Group II it was significantly more at rupees 12152 (p = 0.007).Conclusions: Laparoscopic cholecystectomy as a surgical procedure can be recommended over open cholecystectomy in carefully selected patients of gall stone disease.

scholarly journals Laparoscopy versus laparotomy in the treatment of benign ovarian cyst

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Sohail Khurshid Lodhi ◽  
Tabinda Rana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ovarian Cyst ◽  
Preoperative Evaluation ◽  
Normal Activity ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Laparoscopic Fenestration ◽  
Group Ii

Objective: To compare laparoscopy with laparotomy in the treatment of benign ovarian cyst in women under 40 years of age. Design: Experimental. Place and duration of study: The study was conducted over a period of one and half year from June 2003 to Nov 2004 in Obstetrics & Gynaecology Department, Unit-III, Lady Willingdon Hospital, Lahore. Subjects & Methods: The sixty consecutive patients of benign ovarian cysts who required surgical treatment underwent either Laparoscopy(group I). or laparotomy (group II). The laparoscopic fenestration, aspiration and cystectomies were performed in group I (30 patients). However, ovarian cystectomies, salpingo-oophorectomy and oophorectomy were performed by laparotomy in group II (30 patients). Results: The comparison was done with respect to duration of surgery intra-operative blood loss, time of mobilization, duration of hospital stay and amount of analgesia used, time to return to normal activity. The amount of analgesics used, time of mobilization, duration of hosp ital stay and time to return to normal activity was less (P<0.05) in Laparoscopy as compared to Laparotomy. There was statistically no significant difference in the duration of surgery, blood loss and post operative morbidity (P>0.05). Conclusion: With appropriate preoperative evaluation, laparoscopic surgery is safe and effective in treating benign ovarian cyst in women under 40 years of age where the risk of malignancy is low. It is associated with early mobilization, less use of analgesia, shorter hospital stay.

scholarly journals Managing bilateral inguinal hernia laparoscopically: is it gold standard?

2016 ◽  
Vol 4 (1) ◽  
pp. 296
Author(s):  
Kalpesh H. Patel ◽  
Jayesh B. Gohel ◽  
Bhumika J. Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Bilateral Inguinal Hernia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background:Even after many studies done in recent years, no consensus has been achieved on the surgical technique of inguinal hernia repair. It was believed that in bilateral inguinal hernia cases laparoscopic surgery is very much advantageous as it can be done through same incisions as unilateral laparoscopic inguinal hernia repair (no additional incision required), whereas in open surgery for bilateral case separate groin incision for each side required. Aim of this study is to evaluate and compare results of bilateral inguinal hernia patients operated by laparoscopic (transabdominal preperitoneal) or open (lichenstein) repair.Methods: A prospective comparative study was conducted in a tertiary care teaching hospital over the period of two years. 60 patients with bilateral inguinal hernia were taken up and randomly divided into two groups. Group I (study group) includes patients operated by bilateral laparoscopic hernia repair (TAPP) and Group II (control group) includes patients operated by open hernia repair (lichenstein tension free hernioplasty). All patients were followed up for 18 months post-operatively. All patients of both groups were monitored for operative time, conversion rate, length hospital stay, post-operative complications and recurrence, time to return to work.Results:Statistically there was significant difference between both groups in terms of length of hospital stay and time to return to work. Group I patients where TAPP surgery performed, 22 patients (73.33%) were discharged within 36 hours of surgery, whereas in Group II patients - control group where open surgery performed, only 4 patients (13.33%) discharged within 36 hours. All 30 patients (100%) in group I had joined their routine work within 10 days of surgery; whereas in Group II patients only 4 cases (13.33%) joined duties on or before 10 days and most of the patients 26 (86.67%) had taken more than 10 days to resume their duties. But there was no significant difference between operative time, complication rates and recurrence rates. All cases in group I were completed laparoscopically (no conversion to open repair).Conclusions:Simultaneous bilateral inguinal hernia repair laparoscopically does not increase the risk for the patient and has an equal morbidity compared with unilateral repair, length of hospital stay, and return to normal work and over all recovery after laparoscopic repair is faster than after open bilateral simultaneous repair. Laparoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

Hawthorn Herb Increases the Risk of Bleeding after Cardiac Surgery: An Evidence-Based Approach

2016 ◽  
Vol 19 (4) ◽  
pp. 175 ◽  
Author(s):  
Abeer M Rababa’h ◽  
Salah E. Altarabsheh ◽  
Osama Haddad ◽  
Salil V. Deo ◽  
Yagthan Obeidat ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Hospital Stay ◽  
Chest Tube ◽  
Control Group ◽  
Group I ◽  
Hawthorn Extract ◽  
Group Ii ◽  
The Impact

<strong>Objectives:</strong> Hawthorn extract consumption is becoming more widespread among the Jordanian population with cardiovascular disorders. We conducted this prospective observational longitudinal study to determine the impact of hawthorn extract on bleeding risk in patients who undergo cardiac surgery. <br /><strong>Methods:</strong> A prospective observational study was performed on 116 patients who underwent cardiac surgery in the period between June 2014 and May 2015. Patients were divided into two groups: Group I (patients recently consumed hawthorn extract) and Group II (patients never consumed hawthorn extract). Endpoint measures included the rates of reopening to control bleeding, early mortality, duration of intensive care unit stay, total in-hospital stay period, and duration and amount of chest tube drainage. <br /><strong>Results:</strong> Hawthorn patients had a significantly higher rate of postoperative bleeding necessitating take back to the operating room compared to the control group (10% versus 1%; <br />P = .03) respectively. The overall mortality rate for group I and II was 4% and 0% respectively; P = .17. Chest tubes were kept in for longer times in group I compared to group II <br />(54 ± 14.6 versus 49 ± 14.7 hours respectively; P = .01). Group I stayed longer in the intensive care unit compared to group II (24 versus 22 hours respectively; P = .01). The total in-hospital stay period was comparable between the two groups. <br /><strong>Conclusion:</strong> Hawthorn extract consumption does increase the potential for bleeding and the amount of chest tube output after cardiac surgery.

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