scholarly journals Comparative Study Of Open Cholecystectomy In Acute And Chronic Cholelithiasis In Rural Centre Of India.

2021 ◽  
pp. 36
Author(s):  
Keyword(s):  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Total Hospital ◽  
Acute Case ◽  
Operative Morbidity ◽  
Gall Stones ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Day By Day

The incidence of cholecystitis with cholelithiasis is increasing day by day either acute or chronic cases. Gall stones are the most common cause of acute cholecystitis in 90-95% of the cases. The management of acute cholecystitis is still laparoscopic cholecystectomy in urban area of India but in rural area open cholecystectomy is still preferred method of surgery for acute as well as chronic gall stone. Our study was conducted on 100 patients divided into two groups of 50 of each to compare the results of open cholecystectomy between acute and chronic cases. The overall post-operative morbidity was more in acute cases. But there was significant difference in the total hospital stay and total cost of the therapy in both the groups. drain output was also high in first three days in acute case so, acute case cholecystectomy was found to be more expensive overall and higher length stay and more co morbidities than chronic cases.

scholarly journals A comparative study of interval cholecystectomy and early cholecystectomy in acute cholecystitis

2020 ◽  
Vol 7 (5) ◽  
pp. 1419
Author(s):  
Gursimranjit Singh ◽  
Rana Ranjit Singh ◽  
Darpan Bansal
Keyword(s):  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Early Surgery ◽  
Total Hospital ◽  
Total Cost ◽  
Early Cholecystectomy ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Delayed Group ◽  
Day By Day

Background: In the whole world including India, the incidence of acute cholecystitis is increasing day by day. Gall stones are the most common cause of acute cholecystitis in 90-95% of the cases. The management of acute cholecystitis was conservative earlier but now there are studies recommending early surgery as the treatment of choice.Methods: Our study was conducted on 60 patients divided into two groups of 30 each to compare the results of early surgery with the delayed surgery.Results: The overall post-operative complication rate was same in both the groups but there was significant difference in the total hospital stay and total cost of the therapy in both the groups. The average total hospital stay in early group was 6.50±4.44 days and in delayed group was 10.80±5.55 days without including the number of days in non-operating admission.Conclusions: So, early cholecystectomy was found to be more economical with less total hospital stay and less total cost of the therapy than interval cholecystectomy in acute cholecystitis. 

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 An evaluation of early and delayed laparoscopic cholecystectomy for acute cholecystitis

2019 ◽  
Vol 6 (9) ◽  
pp. 3147
Author(s):  
M. Zaid Imbisat ◽  
S. A. A. Rizvi ◽  
Imad Ali
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gall Stone ◽  
Gallbladder Perforation ◽  
Early Group ◽  
Early Laparoscopic Cholecystectomy ◽  
Total Hospital Stay ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Duration Of Surgery ◽  
Delayed Group

Background: Acute cholecystitis is one of the hepatopancreatobiliary emergencies. With more and more experience in the laparoscopic cholecystectomy studies are being carried out evaluating the effectiveness and feasibility of early laparoscopic cholecystectomy in acute cholecystitis.Methods: Fifty patients presenting with acute cholecystitis were included in this study and randomized using chit in the box method into two groups- early group and delayed group.Results: Mean duration of surgery in the early group is 42.28±5.99 mins and in the delayed group is 39.12±5.55 mins (p=0.06). Gallbladder perforation was reported in 4 patients (16%) in early group and in 2 patients (8%) in delayed group (p=0.67). Gall stone spillage was reported in 3 patients (12%) in early group and in 2 patients (8%) in delayed group (p=1.00). At 6th hr mean VAS (visual analogue scale) score in the early group was 4.0±0.41 and in the delayed group it was 3.6±0.58 (p=0.01). At 12th hr mean VAS score in the early group was 3.4±0.51 and in the delayed group it was 3.3±0.48 (p=0.39). Mean duration of postoperative stay was 2.24±0.60 days in early group and in the delayed group it was 2.08±0.57 days (p=0.34).Conclusions: It has been found that early laparoscopic cholecystectomy is safe and feasible in the setting of acute cholecystitis with added advantage of shorter total hospital stay.

scholarly journals Is hypothyroidism a risk for gall stone disease? a study to assess the association

2017 ◽  
Vol 4 (8) ◽  
pp. 2665
Author(s):  
Yawar Zahoor Watali ◽  
Rahul Jain ◽  
Rajandeep Singh Bali ◽  
Ankul Mittal
Keyword(s):  
Gall Stone ◽  
Stone Disease ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Endocrine Disorders ◽  
Gall Stones ◽  
Significant Difference ◽  
Gall Stone Disease ◽  
Thyroid Profile

Background: Gall stones are one of the most common problems affecting the digestive tract requiring hospitalization. The disease frequently occurs in young, otherwise healthy people with a prevalence of 11-36 % on autopsy report. Thyroid diseases are, arguably, among the commonest endocrine disorders worldwide. In the present study, we have tried to determine an association between gall stone disease, and previously diagnosed and undiagnosed hypothyroidism in patients presenting to our hospital for treatment. The aim of this study was to determine association between gallstones and hypothyroidism and to study the prevalence of previously undiagnosed hypothyroidism in all patients of gallstones.Methods: The study was a hospital based cross sectional, observational study conducted on 200 patients with upper abdominal pain attending the Surgery OPD and Emergency over a period of 1 years. Patients were divided into 2 groups: Case group (100 patients) with gall stones on ultrasound and Control group (100 patients) without gall stones on ultrasound. Thyroid profile along with other biochemical investigations was done and both the groups were compared for the parameters.Results: Both groups were comparable for age and sex of the patients. On considering the thyroid profile of the patients in both the groups we observed that 14% of patients were hypothyroid in case group and 8% of the patients in control group. On comparing the two groups, there was no statistically significant difference in the prevalence of hypothyroidism (p value 0.175) between the two groups. There was a significant difference when serum cholesterol and bilirubin levels were compared between the two groups. 7 patients out of 100 cholelithiasis had Choledocolithiasis too, these patients had significantly raised cholesterol and deranged liver function tests.Conclusions: No significant relation between gallstones and hypothyroidism was found in this study (p value=0.175) and need further evaluation. Among the hypothyroid patients the incidence of gall stones was highest among 51-60 years of age so we recommend that TSH level should be measured for every patient with gallstone disease in this age range.

scholarly journals CT-derived sarcopenia should not preclude surgical stabilization of traumatic rib fractures

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Derrick A. Doolittle ◽  
Matthew C. Hernandez ◽  
Francis I. Baffour ◽  
Michael R. Moynagh ◽  
Naoki Takahashi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Stay ◽  
Frailty Index ◽  
Rib Fractures ◽  
Total Hospital ◽  
Skeletal Muscle Index ◽  
Icu Stay ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Considerable Morbidity

Abstract Background Rib fractures are associated with considerable morbidity and mortality. Surgical stabilization of rib fractures (SSRF) can be performed to mitigate complications. Sarcopenia is in general known to be associated with poor clinical outcomes. We investigated if sarcopenia impacted number of days of mechanical ventilation, intensive care unit (ICU) stay, and total hospital stay in patients who underwent SSRF. Methods A retrospective single institutional review was performed including patients who underwent SSRF (2009–2017). Skeletal muscle index (SMI) was semiautomatically calculated at the L3 spinal level on computed tomography (CT) images and normalized by patient height. Sarcopenia was defined as SMI < 55 cm2/m2 in males and < 39 cm2/m2 in females. Demographics, operative details, and postoperative outcomes were reviewed. Univariate and multivariate analyses were performed. Results Of 238 patients, 88 (36.9%) had sarcopenia. There was no significant difference in number of days of mechanical ventilation (2.8 ± 4.9 versus 3.1 ± 4.3, p = 0.304), ICU stay (5.9 ± 6.5 versus 4.9 ± 5.7 days, p = 0.146), or total hospital stay (13.3 ± 7.2 versus 12.9 ± 8.2 days, p = 0.183) between sarcopenic and nonsarcopenic patients. Sarcopenic patients demonstrated increased modified frailty index scores (1.5 ± 1.1 versus 0.9 ± 0.9, p < 0.001) compared to nonsarcopenic patients. Conclusions For patients who underwent SSRF for rib fractures, sarcopenia did not increase the number of days of mechanical ventilation, ICU stay, or total hospital stay. Sarcopenia should not preclude the utilization of SSRF in these patients.

scholarly journals ACUTE CHOLECYSTITIS

2009 ◽  
Vol 16 (04) ◽  
pp. 489-491
Author(s):  
MUHAMMAD FAISAL BILAL LODH ◽  
SUMERA KANWAL ◽  
MUHAMMAD AKRAM
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Operative Time ◽  
Early Group ◽  
Total Hospital ◽  
Effective Technique ◽  
Early Laparoscopic Cholecystectomy ◽  
Total Hospital Stay ◽  
Symptomatic Gallstones ◽  
Late Group

Laparoscopic cholecystectomy has been accepted as the treatment of choice for symptomatic gallstones. Its efficacy and timingin cases of acute cholecystitis is still under debate. This study was undertaken to evaluate our experience with early cholecystectomy as a safe,effective treatment of acute cholecystitis. M a t e r i a l s a n d m e t h o d s : Record of all the patients who had undergone laparoscopic cholecystectomy for the diagnosis of acute cholecystitis was reviewed. Patients were divided into two groups on the bases of onset of symptoms to surgical intervention: less than 72 hours in the early group (n = 15) and more than 72 hours in the late group (n = 25). Results: Conversion to openprocedure was insignificantly less (3 out of 15 in early group and 8 out Of 25 in late group) (20% versus 32%) in the early treated patients (pvalue0.411). Furthermore, the operative time (75 versus 95 minutes) postoperative hospitalization (2 versus 4 days) and total hospital stay (4versus 6 days) were significantly reduced in patients undergoing early laparoscopic cholecystectomy. C o n c l u s i o n : Laparoscopiccholecystectomy is a safe, effective technique for acute cholecystitis in experienced hands with lower conversion rate, shorter operative timeand reduced hospitalization.

scholarly journals The ideal timing of cholecystectomy for mild gallstone pancreatitis

2019 ◽  
Vol 7 (1) ◽  
pp. 253
Author(s):  
Satishkumar R. ◽  
Anukethan J.
Keyword(s):  
Hospital Stay ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Gallstone Pancreatitis ◽  
Readmission Rates ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Conversion To Open Cholecystectomy ◽  
The Ideal

Background: Gallstone disease is one of the most common problems affecting the digestive tract with a prevalence of 11% to 36% and is the most common cause of gall stone pancreatitis. The cholecystectomy is necessary to prevent recurrent pancreatitis in gallstone pancreatitis, but the ideal timing for cholecystectomy is controversial.Methods: This was a prospective randomized study with 59 patients conducted in the department of general surgery, KIMS, Bangalore from 2014 to 2019. All patient with mild gallstone pancreatitis, the following variables, duration and cost of hospital stay, readmission rates, intraoperative time, intra and postoperative complications and conversion to open cholecystectomy were studied.Results: A total of 59 patients in the age group of 21 to 71 years with mild gallstone pancreatitis were included in the study. Mean age of presentation was 57years. Out of 59 patients 28 underwent same admission cholecystectomy and 31 underwent interval cholecystectomy. There was a significant difference noted in terms of  mean duration of hospital stay (9.28 versus 17.20 days), mean cost of hospital stay (19340 versus 28240rs) and readmission rate (0% versus 19.35%), but in terms of mean intraoperative time (85 min versus 92 min) and conversion rate (0% versus 6.4%) there was no statistically significant difference between two group.Conclusions: Same admission cholecystectomy for mild gallstone pancreatitis can significantly reduce cost and duration of hospital stay and readmission rates. With regard to intraoperative time, conversion to open, intraoperative and postoperative complication there is no statistically significant difference seen. Hence same admission cholecystectomy is safe, feasible and recommended.

scholarly journals Giant gall stone: a rare finding performed with open cholecystectomy

2019 ◽  
Vol 6 (2) ◽  
pp. 630
Author(s):  
Vikrant Sharma ◽  
Vishal Kaundal ◽  
Ankur Sharma ◽  
Gopal Singh ◽  
Payal Shah ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Wide Spectrum ◽  
Open Cholecystectomy ◽  
Gall Stone ◽  
Abdominal Sonography ◽  
Open Procedure ◽  
Calot’S Triangle ◽  
Large Size ◽  
Gall Stones ◽  
Better Than

Very few cases of a giant gall stone (>50mm) are reported worldwide. Author reported a case of a gall stone measuring 80x44x41mm in a 64 years old female who underwent open cholecystectomy at our institution. Gall stones measuring more than 30mm are associated with a higher risk of developing gall bladder carcinoma and any patient who is harbouring a large calculus requires cholecystectomy. Large gall stones when detected on abdominal sonography throw a reasonable surgical challenge as on usual basis, laparoscopic cholecystectomy is an ideal approach for intervention in cholelithiasis. Giant gall stones are also associated with a wide spectrum of diseases including Bouveret syndrome, colonic ileus etc. Once a surgery is planned for a giant gall stone, open procedure is better than laparoscopic cholecystectomy as the latter is difficult to perform owing to the large size of calculus and associated adhesions in the region of Calot’s triangle. It further saves the patient from unnecessary conversion to open procedure that may occur subsequently in due course of surgery that involves a giant calculus. 

scholarly journals Proton Pump Inhibitors Were Associated With Reduced Pseudocysts in Acute Pancreatitis: A Multicenter Cohort Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Shengyu Zhang ◽  
Ziying Han ◽  
Yuelun Zhang ◽  
Xiaomao Gao ◽  
Shicheng Zheng ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Hospital Stay ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Control Group ◽  
Total Hospital ◽  
Total Hospital Stay ◽  
Study Results ◽  
Significant Difference

Background: Acute pancreatitis (AP) is a systemic inflammatory disorder with a wide spectrum of clinical symptoms that can range from mild to severe. Previous preclinical study results suggest that proton pump inhibitors (PPIs) can inhibit exocrine pancreatic secretion and exert anti-inflammatory properties, which might in turn improve the outcome of AP.Aim: We conducted this multicenter, retrospective cohort study to investigate the potential effects of PPIs on the mortality, and total duration of hospital stay and local complication occurrence of patients with AP.Methods: A total of 858 patients with AP were included. All patients presented to the hospital within 48 h of symptom onset and were divided into the following two groups: patients who were treated with PPIs (n = 684) and those not treated with PPIs (n = 174). We used propensity score matching (PSM) analysis to reduce confounding bias before comparing the outcomes between the two groups.Results: Before PSM analysis, there were significant differences in a number of parameters between the two groups, including age, sex, hematocrit, blood urea nitrogen, peritonitis signs, Ranson’s score, and Acute Physiology Chronic Health Evaluation II score and organ failure occurrence. Before PSM, the PPIs group had a higher rate of mortality than the control group [RR = 1.065; 95% confidence ratio (CI) 1.045–1.086; p = 0.001]. After PSM, there was no significant difference in mortality (RR = 1.009; 95% CI, 0.999–1.019; p = 0.554) or total hospital stay (p = 0.856), although the PPIs group had a lower occurrence of pancreatic pseudocyst (RR = 0.416; 95% CI 0.221–0.780; p = 0.005).Conclusion: This study showed that PPIs therapy was not associated with reduced mortality or total hospital stay, but was associated with a reduction in the occurrence of pseudocysts in patients with acute pancreatitis.

scholarly journals Comparison of Clinical Safety and Outcomes of Early versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Min-Wei Zhou ◽  
Xiao-Dong Gu ◽  
Jian-Bin Xiang ◽  
Zong-You Chen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Confidence Interval ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Meta Analysis ◽  
Total Hospital ◽  
Clinical Safety ◽  
Early Laparoscopic Cholecystectomy ◽  
Total Hospital Stay ◽  
Delayed Laparoscopic Cholecystectomy

Objective.To compare the clinical safety and outcomes of early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy for acute cholecystitis.Methods.Pertinent studies were selected from the Medline, EMBASE, and Cochrane library databases, references from published articles, and reviews. Seven randomized controlled trials (early laparoscopic cholecystectomy versus delayed laparoscopic cholecystectomy) were selected. Conventional meta-analysis according to Cochrane Collaboration was used for the pooling of the results.Results.Seven trials with 1106 patients were included. There was no significant difference between the two groups in terms of bile duct injury (Peto odds ratio 0.49 (95% confidence interval 0.05 to 4.72);P=0.54) or conversion to open cholecystectomy (risk ratio 0.91 (95% confidence interval 0.69 to 1.20);P=0.50). The total hospital stay was shorter by 4 days for early laparoscopic cholecystectomy (mean difference −4.12 (95% confidence interval −5.22 to −3.03) days;P<0.00001).Conclusion.Early laparoscopic cholecystectomy during acute cholecystitis is safe and shortens the total hospital stay.

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