GALLBLADDER CARCINOMA;

Objective: Chronic Cholecystitis is one of the commonest diseases presenting in surgical department and is subjected to cholecystectomy each time. A suspicious gall bladder on ultrasound initiates further investigations to rule out carcinoma of gall bladder yet some times a benign looking gall bladder on ultrasound turns out to be carcinoma of gall bladder on histopathology. Design: Descriptive study. Place & Duration of study: District Head Quarters Hospital, Sargodha, from September 2007 to March 2009. Patients & Methods: 200 patients who underwent both open and Laparoscopic cholecystectomy for cholelithiasis were subjected to this study. All relevant data was documented on a standardized data form. Patients were between the ages of 28-74. Patients already diagnosed as Gallbladder Carcinoma, empyema gall bladder, mucocele and gall bladder polyp were excluded from the study. Gall bladders removed after each surgery ware sent to laboratory for histopathological evaluation. Results: A total of 200 cases were studied (161 females, 39 males; M: F ratio 1:4). The mean age was 45 years (range 28-74 years). The most common presenting complaint was pain right hypochondrium with nausea and vomiting (85%).The average operating time was 50 minutes in case of open cholecystectomy and 1 hour in laparoscopic cholecystectomy. Complications included biliary leak in 2 patients (1%), Wound Infection in 3 patients (1.5%) and death in one case (0.5%). The overall rate of complications was 3%. There were a total of 5 patients of laparoscopic cholecystectomy who required extension of the incision, for Carcinoma Gallbladder. Conclusions: Carcinoma of gall bladder is a very aggressive malignancy and usually presents at a very advance stage as its symptoms mostly are marked by symptoms of cholecystitis. Detection of gall bladder carcinoma is very difficult in early stages on ultrasound. Any findings in ultrasound suggesting malignancy should be confirmed on further investigations like CT scan .Carcinoma of Gall bladder is not very common in cases of cholecystectomy for chronic Cholecystitis but once found should be dealt with extreme precision following established operating protocols.

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Laparoscopic Cholecystectomy: An Initial Clinical Experience at Faridpur District

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v2i2.24875 ◽

2015 ◽

Vol 2 (2) ◽

pp. 30-33

Author(s):

PK Saha ◽

Ratna Rani Roy ◽

Nukul Sarkar ◽

Jahangir Alam

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bile Duct ◽

Gall Bladder ◽

Open Cholecystectomy ◽

Operating Time ◽

Symptomatic Treatment ◽

Safe Procedure ◽

Bladder Stones ◽

Average Operating ◽

Gall Bladder Stones

Background: Laparoscopic cholecystectomy quickly emerged as an alternative to open cholecystectomy. However its safety, efficacy, and morbidity have yet to be fully evaluated.Objective: The purpose of the present study was to determine the efficacy and safety of laparoscopic cholecystectomy Procedure in the removal of gall bladder stones at Faridpur district-one of the remote district of Bangladesh.Methodology: A prospective, nonrandomized, open label Consecutive study was carried out at Faridpur district using laparoscopic cholecystectomy (LC) procedure for the symptomatic treatment of Gall bladder stones. For this purpose a total number of 145 patients having conclusively diagnosed as gall bladder stones were enrolled. LC procedure was performed by North American technique-a well established and standard procedure described earlier for the purpose. The key variables studied were average operating room time, condition of the gall bladder, the presence or absence of stones, the character of stones, post-operative complicates and duration of hospital stay.Result: The study revealed that among 145 patients 83.4% were female with an average age of 40.3 years. The average operating time required was 130 minutes. Gall bladder was thickened but was free from adhesion in 96.5% cases and stones' only 3.45% patients needed open method due to fibrosis and adhesion of the gall bladder with omentum and gut. The duration of hospital or clinic stay following LC was 3.5 days. Evidence of infection like fever, pain etc. was seen only in 2.75% cases. Bleeding was present in 2.06% cases. This was corrected after blood transfusion. No injury to the common bile duct or any of the bile duct or any of the blood vessels was observed. Similarly no evidence of malignancy was seen in any of the gall bladder removed.Conclusion: The present study concludes that laparoscopic cholecystectomy is a safe, minimal invasive, cost-effective and safe procedure for the symptomatic treatment of gall bladder stones.Journal of Current and Advance Medical Research, 2015;2(2):30-33

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Bangla Technique of Laparoscopic Cholecystectomy: a Novel, Safe and Cost-effective modification of American and French Techniques (Preprint)

10.2196/preprints.25136 ◽

2020 ◽

Author(s):

Md Jafrul Hannan ◽

Mosammat Kohinoor Parveen ◽

Alak Kumar Nandy

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gallbladder Disease ◽

Operating Time ◽

Cost Effective ◽

Infection Prevention And Control ◽

French School ◽

Average Operating ◽

Average Operating Time ◽

Theater Time ◽

And Control

BACKGROUND Laparoscopic cholecystectomy (LC) can be performed by following either of the two approaches proposed by the American and the French school. The two approaches have comparable operative times, but use different arrangements for the patient’s and operators’ positions, and sites for port insertions. OBJECTIVE The aim of the present paper is to describe an alternative to the American and the French approaches, referred to as the Bangla technique, which uses a standard four port approach but requires the presence of only one assistant along with the surgeon. It is hoped that the Bangla technique will improve surgery outcomes for gallbladder disease patients and encourage healthcare professionals in resource-poor settings to adopt minimally invasive/laparoscopic approaches to surgical problems. METHODS The sample consisted of a total of 280 gallbladder disease retrospective observational cases (of which 21 were children between 6 and 16 of age) who were treated with the Bangla technique at the South Point Hospital Chittagong, Bangladesh, between January 2018 and February 2020. RESULTS Surgery data showed that using the Bangla technique, the average operating time and average operation theater time were36.25 and 45.9 minutes, respectively. Of the patients, 86% left the hospital on the same day of operation, while the remaining left the following day. In 91.7% of the cases, there were no complications, while content leakage and bleeding occurred in 6.7% and 1.4% cases, respectively. CONCLUSIONS The proposed LC technique will benefit infection prevention and control by reducing the number of personnel in the operation theatre (one assistant and the surgeon) and, as such, reducing surgery-related expenses, which can be further decreased by using only one monitor. More so, the Bangla technique can be combined with the cystic artery sparing technique to reduce the risk of injury to the common bile duct and bleeding.

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Bangla Technique of Laparoscopic Cholecystectomy: a Novel, Safe and Cost-effective modification of American and French Techniques

10.1101/2020.10.08.20209056 ◽

2020 ◽

Author(s):

Md Jafrul Hannan ◽

Mosammat Kohinoor Parveen ◽

Alak Kumar Nandy

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gallbladder Disease ◽

Operating Time ◽

Cost Effective ◽

Infection Prevention And Control ◽

French School ◽

Average Operating ◽

Average Operating Time ◽

Theater Time ◽

And Control

Abstract and KeywordsBackgroundLaparoscopic cholecystectomy (LC) can be performed by following either of the two approaches proposed by the American and the French school. The two approaches have comparable operative times, but use different arrangements for the patient’s and operators’ positions, and sites for port insertions.The aim of the present paper is to describe an alternative to the American and the French approaches, referred to as the Bangla technique, which uses a standard four port approach but requires the presence of only one assistant along with the surgeon. It is hoped that the Bangla technique will improve surgery outcomes for gallbladder disease patients and encourage healthcare professionals in resource-poor settings to adopt minimally invasive/laparoscopic approaches to surgical problems.MethodsThe sample consisted of a total of 280 gallbladder disease retrospective observational cases (of which 21 were children between 6 and 16 of age) who were treated with the Bangla technique at the South Point Hospital Chittagong, Bangladesh, between January 2018 and February 2020.ResultsSurgery data showed that using the Bangla technique, the average operating time and average operation theater time were36.25 and 45.9 minutes, respectively. Of the patients, 86% left the hospital on the same day of operation, while the remaining left the following day. In 91.7% of the cases, there were no complications, while content leakage and bleeding occurred in 6.7% and 1.4% cases, respectively.ConclusionThe proposed LC technique will benefit infection prevention and control by reducing the number of personnel in the operation theatre (one assistant and the surgeon) and, as such, reducing surgery-related expenses, which can be further decreased by using only one monitor. More so, the Bangla technique can be combined with the cystic artery sparing technique to reduce the risk of injury to the common bile duct and bleeding.Mini AbstractLaparoscopic cholecystectomy can be performed following the American or the French approach. The present paper proposes an alternative to the American and the French approaches referred to as the Bangla technique, which uses a standard four port approach but requires the presence of only one assistant along with the surgeon.

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Abdominal wall nodule in a cholecystectomy scar : A rare marker of occult carcinoma gallbladder

Polish Journal of Surgery ◽

10.5604/01.3001.0012.8557 ◽

2019 ◽

Vol 91 (2) ◽

pp. 16-19

Author(s):

Ashish Gupta ◽

Amit Gupta ◽

Sweety Gupta ◽

Udit Chauhan ◽

Ashok Singh

Keyword(s):

Laparoscopic Cholecystectomy ◽

Neuroendocrine Tumor ◽

Abdominal Wall ◽

Gallbladder Carcinoma ◽

Histopathological Examination ◽

Open Cholecystectomy ◽

Single Patient ◽

Hospital Database ◽

Carcinoma Gallbladder ◽

The Mean

: gallbladder carcinoma (GBC) is a rare pathology. We reviewed our hospital database for prognosticating the patients with post cholecystectomy abdominal wall nodule.On reviewing the database we could find 7 patients who were diagnosed with GBC after a simple cholecystectomy. 3 of these patients were diagnosed after evaluation of scar site nodule.2 patients were females and one patient was male. The mean age of the patient was 55 years. 2 patients underwent laparoscopic cholecystectomy and one patient underwent open cholecystectomy. The average time of detection of malignancy was 10.6 months. The gallbladder was not subjected to histopathological examination in all three patients. The patients had unresectable disease on restaging workup. Two patients had adenocarcinoma while single patient had neuroendocrine tumor. abdominal wall nodule is a rare marker of occult carcinoma gallbladder. Subjecting every gallbladder specimen for histopathology should help in improving the survival in these patients.

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Minilaparotomy Cholecystectomy: A Forgotten Art in Laparoscopic Cholecystectomy Era (Our Experience from a Peripheral Hospital in North India)

Journal of Archives in Military Medicine ◽

10.5812/jamm.116265 ◽

2022 ◽

Vol In Press (In Press) ◽

Author(s):

Bharath N Kumar ◽

Rahul Pandey

Keyword(s):

Laparoscopic Cholecystectomy ◽

Hospital Stay ◽

Perioperative Complications ◽

Open Cholecystectomy ◽

Operating Time ◽

North India ◽

Incision Size ◽

Peripheral Hospital ◽

Conversion To Open Cholecystectomy ◽

Average Operating Time

Background: This study aimed to report the experience of performing minilaparotomy cholecystectomy in a peripheral hospital by a single surgeon. Methods: Data collected from 50 consecutive patients undergoing minilaparotomy cholecystectomy by a single surgeon over 18 months at a peripheral hospital were reviewed and studied. The recorded data encompassed demographics, operating time, incision size, conversion rate to open cholecystectomy, perioperative complications, and hospital stay duration. Results: Fifty consecutive patients, who underwent minilaparotomy cholecystectomy for symptomatic cholelithiasis, were studied, among whom 48 patients were females. The participants’ mean age was 45 years. The length of the surgical incision was 4.5 - 6 cm, and only three patients required conversion to open cholecystectomy. The average operating time was 60 minutes; and the average postoperative hospital stay was 2.14 days. Conclusions: Minilaparotomy cholecystectomy is comparable with laparoscopic cholecystectomy in terms of postoperative morbidity, and it is ideal for peripheral hospitals lacking laparoscopic facilities.

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SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY IN HUE CENTRAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.2.4 ◽

2012 ◽

pp. 25-30

Author(s):

Xuan Dong Pham ◽

Nhu Hiep Pham ◽

Huu Thien Ho ◽

Anh Vu Pham ◽

Hai Thanh Nguyen ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Single Port ◽

Operating Time ◽

Chronic Cholecystitis ◽

Central Hospital ◽

Gallbladder Polyp ◽

Gallbladder Polyps ◽

Hospital Patients ◽

Wound Pain ◽

Initial Results

Purpose: Evaluating the initial results in applying single port laparoscopic cholecystectomy at Hue Central Hospital. Patients and methods: 29 gallbladder polyps, gallstones with symptoms of acute or chronic cholecystitis and surgeried by single port laparoscopic cholecystectomy at Hue Central Hospital from March 2011 to December 2011. Results: Male/female was 0.45/1. Age: 49.24 ± 16.43 (21-81), 40 to 60 years 54.6%. Cholecystitis: 75.9%, 17.3% gallbladder polyp, gallbladder adenomyomatosis 3.4%. Added 1 trocart because difficult dissection surgery 10.2%, bleeding 6.8% difficult to handle, added 2 trocart 3.4%. Bleeding intraoperative 10.3%. Operating time: 76.2 ± 33.5 minutes, hospital stay: 4 - 6 days 51.7%. Wound pain after 2 weeks of hospital discharge 6.9%, with no wound seromas and no wound infection. Conclusions: Single port laparoscopic cholecystestomy is safe, has fewer complications, can be done with experienced surgeons laparoscopic surgery. Keywords: Single port laparoscopic cholecystectomy, gallbladder ston Key words: Single port laparoscopic cholecystectomy, gallbladder stone

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Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

Scandinavian Journal of Surgery ◽

10.1177/145749690709600304 ◽

2007 ◽

Vol 96 (3) ◽

pp. 206-208 ◽

Cited By ~ 8

Author(s):

J. Harju ◽

M. Pääkkönen ◽

M. Eskelinen

Keyword(s):

Randomised Trial ◽

Operating Time ◽

Day Surgery ◽

Prospective Randomised Trial ◽

Wound Pain ◽

Average Operating ◽

Average Operating Time ◽

Study Support ◽

The Mean

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure. Patients and Methods: Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27–68), the mean body mass index 29 kg/m2 (range 19–41). Gallstones were confirmed with ultrasound and the pre-operative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter. Results: The average operating time was 51 minutes (range 30–105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14–30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients. Conclusions: The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.

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EVALUATION OF CLINICO-RADIOLOGICAL FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

10.36106/ijar/2009947 ◽

2021 ◽

pp. 63-66

Author(s):

Wasif Mohammad Ali ◽

Nazia Nanen ◽

Atia Zaka Ur Rab ◽

Syed Amjad Ali Rizvi ◽

Mehtab Ahmad

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Open Cholecystectomy ◽

Previous History ◽

Safe Procedure ◽

Chi Square ◽

Preoperative Prediction ◽

Conversion To Open Cholecystectomy ◽

Chi Square Test ◽

A Prospective Study

Introduction: Laparoscopic cholecystectomy has become procedure of choice for treatment of symptomatic gallstone [1] disease . Even though it is a safe procedure occasionally it can be difcult and requires conversion to open cholecystectomy for various problems faced during surgery. Preoperative prediction of difcult laparoscopic cholecystectomy and likelihood of conversion to open cholecystectomy will avoid such complications and overall cost of treatment. Aim: To evaluate the clinico-radiological factors predicting difcult laparoscopic cholecystectomy Methods: This was a prospective study conducted from October 2018 to November 2020. Total of 101 patients meeting inclusion criteria undergoing laparoscopic cholecystectomy were included in the study. Various clinical, radiological and biochemical parameters and intraoperative difculties during surgery were recorded. The statistical analysis was done using chi-square test and ANOVA test. Results: The parameters such as sex, age, duration of disease, co-morbid disease, previous history of cholecystitis, palpable gall bladder, BMI, TLC, thickness of gall bladder, largest stone size and impacted stone are found statistically signicant in predicting difcult laparoscopic cholecystectomy and conversion to open cholecystectomy preoperatively. Conclusion: Difcult laparoscopic cholecystectomy may be predicted preoperatively even with a good clinical judgement whereas both clinical and radiological parameters provide a better preoperative prediction of difcult cholecystectomy so that the surgeon can prepared in advance for the complications.

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Video assisted resections. Increasing access to minimally invasive liver surgery?

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912015005009 ◽

2015 ◽

Vol 42 (5) ◽

pp. 318-324 ◽

Cited By ~ 2

Author(s):

Fabricio Ferreira Coelho ◽

Marcos Vinícius Perini ◽

Jaime Arthur Pirola Kruger ◽

Renato Micelli Lupinacci ◽

Fábio Ferrari Makdissi ◽

...

Keyword(s):

Operating Time ◽

Perioperative Outcomes ◽

Liver Lesions ◽

Minimally Invasive Liver Surgery ◽

Video Assisted ◽

Average Operating ◽

Average Operating Time ◽

Average Size ◽

Anesthesia Time ◽

Prospective Database

Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.

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Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i1.1761 ◽

1970 ◽

Vol 7 (1) ◽

pp. 26-30 ◽

Cited By ~ 5

Author(s):

R Gabriel ◽

S Kumar ◽

A Shrestha

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Predictive Factors ◽

Open Cholecystectomy ◽

Abdominal Cavity ◽

Bladder Wall ◽

Patient Factors ◽

College Hospital ◽

Biliary Pain ◽

Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30

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