scholarly journals Laparoscopic Cholecystectomy After Endoscopic Trans-papillary Gallbladder Stenting for Acute Cholecystitis

2020 ◽  
Author(s):  
Fumihiro Kawano ◽  
Ryuji Yoshioka ◽  
Yu Gyoda ◽  
Hirofumi Ichida ◽  
Tomoya Mizuno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Postoperative Hospital Stay ◽  
Urgent Surgery ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Median Blood Loss

Abstract Background: Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD.Methods: Intraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared.Results: Eighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209 minutes (range, 107–357) and median 161 minutes (range, 130–273), respectively, P = 0.10], median blood loss [ETGBS 2 (range, 2–180 ml) and PTGBD 24 (range, 2–100 ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range, 4–24 days) and ETGBS 8 (range 4–16 days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients.Conclusion: ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD.

scholarly journals Laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting for acute cholecystitis: a pilot study of surgical feasibility

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fumihiro Kawano ◽  
Ryuji Yoshioka ◽  
Yu Gyoda ◽  
Hirofumi Ichida ◽  
Tomoya Mizuno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Cholecystectomy ◽  
Pilot Study ◽  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Postoperative Hospital Stay ◽  
Urgent Surgery ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Median Blood Loss

Abstract Background Percutaneous transhepatic gallbladder drainage (PTGBD) is indicated for patients with acute cholecystitis (AC) who are not indicated for urgent surgery, but external tubes reduce quality of life (QOL) while waiting for elective surgery. The objective of the present study was to investigate the feasibility of laparoscopic cholecystectomy after endoscopic trans-papillary gallbladder stenting (ETGBS) comparing with after PTGBD. Methods Intraoperative and postoperative outcomes of patients with ETGBS and PTGBD were retrospectively compared. Results Eighteen ETGBS and ten PTGBD patients were compared. Differences in the duration of ETGBS and PTGBD [median 209 min (range 107–357) and median 161 min (range 130–273), respectively, P = 0.10], median blood loss [ETGBS 2 (range 2–180 ml) and PTGBD 24 (range 2–100 ml), P = 0.89], switch to laparotomy (ETGBS 11% and PTGBD 20%, P = 0.52), and median postoperative hospital stay [ETGBS 8 (range 4–24 days) and ETGBS 8 (range 4–16 days), P = 0.99]. Thickening of the cystic duct that occurred in 60% of the ETGBS patients and none of the PTGBD patients (P = 0.005) interfered with closure of the duct by clipping. No obstruction occurred in ETGBS patients. Conclusion ETGBS did not make laparoscopic cholecystectomy less feasible than after PTGBD. This is a pilot study, and further investigations are needed to validate the results of the present study.

scholarly journals Comparison of emergency cholecystectomy and delayed cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with acute cholecystitis: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Shao-Zhuo Huang ◽  
Hao-Qi Chen ◽  
Wei-Xin Liao ◽  
Wen-Ying Zhou ◽  
Jie-Huan Chen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Acute Cholecystitis ◽  
Conversion Rate ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Gallbladder Drainage ◽  
Percutaneous Transhepatic Gallbladder Drainage

Abstract Laparoscopic cholecystectomy and percutaneous transhepatic gallbladder drainage (PTGBD) are common treatments for patients with acute cholecystitis. However, the safety and efficacy of emergency laparoscopic cholecystectomy (ELC) and delayed laparoscopic cholecystectomy (DLC) after PTGBD in patients with acute cholecystitis remain unclear. The PubMed, EMBASE, and Cochrane Library databases were searched through October 2019. The quality of the included nonrandomized studies was assessed using the Methodological Index for Nonrandomized Studies (MINORS). The meta-analysis was performed using STATA version 14.2. A random-effects model was used to calculate the outcomes. A total of fifteen studies involving 1780 patients with acute cholecystitis were included in the meta-analysis. DLC after PTGBD was associated with a shorter operative time (SMD − 0.51; 95% CI − 0.89 to − 0.13; P = 0.008), a lower conversion rate (RR 0.43; 95% CI 0.26 to 0.69; P = 0.001), less intraoperative blood loss (SMD − 0.59; 95% CI − 0.96 to − 0.22; P = 0.002) and longer time of total hospital stay compared to ELC (SMD 0.91; 95% CI 0.57–1.24; P < 0.001). There was no difference in the postoperative complications (RR 0.68; 95% CI 0.48–0.97; P = 0.035), biliary leakage (RR 0.65; 95% CI 0.34–1.22; P = 0.175) or mortality (RR 1.04; 95% CI 0.39–2.80; P = 0.933). Compared to ELC, DLC after PTGBD had the advantages of a shorter operative time, a lower conversion rate and less intraoperative blood loss.

scholarly journals Comparative Analysis of Knee Joint Fusion with Long Locking Nail and Ilizarov Apparatus in Patients with Deep Infection after Arthroplasty

2020 ◽  
Vol 26 (3) ◽  
pp. 109-118
Author(s):  
L. N. Solomin ◽  
E. A. Shchepkina ◽  
K. L. Korchagin ◽  
F. K. Sabirov
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Blood Loss ◽  
Knee Joint ◽  
Internal Fixation ◽  
Inpatient Treatment ◽  
Deep Infection ◽  
Knee Arthrodesis ◽  
Locking Nail

Relevance. Deep infection after knee arthroplasty requires radical surgical treatment of the infection site, removal of endoprosthesis components, and an antimicrobial spacer placement. If revision knee arthroplasty is impossible, the «gold standard» for this kind of patients is knee joint arthrodesis. The purpose of the study was the comparative analysis of knee joint fusion by external and internal fixation. Materials and Methods. The analysis of 60 cases of knee arthrodesis was carried out. The patients were divided into two groups with 30 patients in each. In the first group, knee arthrodesis was performed with long locking nail, in the second group — with external ring fixation. We compared the groups by intraoperative and drainage blood loss, the inpatient treatment duration, the terms of fusion and complications registered. The patients quality of life was evaluated using the SF-36 questionnaire before surgery, for the periods of 3, 6, and 12 months after the surgery. Results. The comparison of two methods of knee arthrodesis showed that blood loss in the internal fixation compared with external one, was 2.03 times more, the duration of inpatient treatment was 1.4 times less, and the total number of complications was 4.4 times less. However, the complications that affected the treatment outcome in long nail group were 1.5 times more. The differences in the average time of ankylosis formation were not statistically significant (p<0.05). The functional results of the treatment in 3 months after surgery in the group with internal fixation were much better. In 6 months after surgery the quality of life had no significant differences. In 12 months follow-up the indices in both groups were the same. Conclusion. The results of our study suggests us to think, knee joint arthrodesis by long fusion nail should be prefereble. If the nail insertion is technically impossible, and there is the high risk of deep infection recurrence, the external osteosynthesis should be used.

Risk of Gastrointestinal Complications in Post Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (11) ◽  
pp. 3054-3055
Author(s):  
Ali Akbar Shah ◽  
Maaz-ul- Hassan ◽  
Syed Muhammad Shah ◽  
Muhammad Aqil Razzaq ◽  
Muhammad Hanif ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Laparoscopic Cholecystectomy ◽  
Body Mass ◽  
Gastrointestinal Symptoms ◽  
Significant Risk ◽  
Gastrointestinal Complication ◽  
Quadrant Pain ◽  
Gastrointestinal Complications

Background: Post-cholecystectomy is related with a significant risk of developing gastrointestinal symptoms which affect the quality of life of patients. Objective: To assess the gastrointestinal complications risks in post-cholecystectomy patients (laparoscopic). Study Design: Retrospective study Place and Duration of Study: Department of Surgery, Services Hospital, Lahore from 1st April 2020 to 31st March 2021. Methodology: One hundred and fifty patients were enrolled. All patients under went laparoscopy for their acute or chronic cholelithiasis treatment. Patients demographic, body mass index, clinical assessment was documented. Patients were followed up for a period of six months and their gastrointestinal complains were recorded. Results: There were 86 females and 64 males with a mean age 49.8±6.3 years and mean body mass index were 24.8±3.6 kg/m2. Diarrhoea and fat intolerance were main complains within 56% and 57.3% patients within three months respectively. Flatulence, fat intolerance and right upper quadrant pain was also main complains of patients. Conclusion: Risk of diarrhoea, right upper quadrant pain, flatulence, and fat intolerance are noticeable as gastrointestinal complication in laparoscopic post-cholecystectomy patients. Keywords: Post-cholecystectomy, Gastrointestinal complications, Diarrhoea

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