scholarly journals Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature

2021 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Anup Shrestha ◽  
Shachee Bhattarai ◽  
Shreya Shrestha ◽  
Manoj Chand ◽  
Abhishek Bhattarai
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Open Cholecystectomy ◽  
Review Of Literature ◽  
Post Operative Period ◽  
Laparoscopic Equipment ◽  
Biliary Pathology

Gallstones disease are the most common biliary pathology. Its prevalence in Nepal is found to be 4.87%. Giant/large gallstones have a higher risk of complications and presents technical difficulties during laparoscopic cholecystectomy. Open cholecystectomy is preferred in most of the cases with giant gallstones. With the availability of experience laparoscopic surgeon and modern laparoscopic equipment, laparoscopic cholecystectomy is also feasible in large/giant gallstones. We report 2 cases, one large gallstone in 51 years old female and one giant gallstone in 39 years old female each of which were successfully managed laparoscopically with uneventful post-operative period.

scholarly journals Laparoscopic Cholecystectomy for Large/Giant Gallstones: Case Report and Brief Review of Literature.

2021 ◽  
Author(s):  
Anup Shrestha ◽  
Shachee Bhattarai ◽  
Shreya Shrestha ◽  
Manoj Chand ◽  
Abhishek Bhattarai
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Open Cholecystectomy ◽  
Umbilical Incision ◽  
Post Operative Period ◽  
Laparoscopic Equipment ◽  
Asymptomatic Patients ◽  
History Of ◽  
Normal Gallbladder ◽  
Colicky Pain

Abstract Background Gallstones disease (GSD) is the most common biliary pathology. GSD is one of the common surgical problems in which lead people admit to the hospital in Nepal. Its prevalence is found to be 4.87%. The size of a gallstone is important, as giant/large gallstones have a higher risk of complications and present technical difficulties during laparoscopic cholecystectomy (LC). Open cholecystectomy is preferred in most cases with giant gallstones. With the availability of experienced laparoscopic surgeons and modern laparoscopic equipment LC is also feasible in large/giant gallstones. In this case report, we report 2 cases of one large and one giant gallstone each which were successfully done laparoscopically.Case Presentation Case 1 A 51 years old female presented with 5 months history of intermittent right upper quadrant colicky pain related to fatty food with no significant past medical and surgical history.Ultrasound abdomen showed normal gallbladder with multiple gallstones, largest measuring approximately 4cms. She was planned for elective LC. The gallbladder was removed out after extension of the infra-umbilical incision. On the cut section, we found multiple gallstones with one large gallstone measuring 4*3.3*3 cm and weighted 23.2 gm. Her post-operative period was uneventful. Case 2 A 39 years old female, known case of hypertension under calcium channel blocker(CCB) and angiotensin receptor blocker(ARBs) presented with 5 months history of intermittent right upper quadrant colicky pain related to fatty foods with non-significant surgical history. Ultrasound abdomen showed a normal gallbladder with a single large gallstone (approximately 4.7 cm). Elective LC was performed and the gallbladder was removed out after extension of infraumbilical incision. On the cut section, we found a single giant gallstone measuring 5* 3*2.8 cm and weighted 24.7 gm. Her post-operative period was uneventful.Conclusion Large/giant gallstones are associated with a high risk of complications and cholecystectomy is warranted in symptomatic and asymptomatic patients. Even for large/giant gallstones, LC appears to be the treatment of choice over open cholecystectomy and should be performed by an experienced laparoscopic surgeon, taking into consideration the possibility of conversion to open in case of inability to expose the anatomy and any intraoperative technical difficulties.

Unfused Liver Segments: a Case Report of an Unknown Phenotype of the Conradi-Hünermann-Happle Syndrome

2016 ◽  
Vol 25 (4) ◽  
pp. 547-549 ◽  
Author(s):  
Fabian Bartsch ◽  
Maximilian Ackermann ◽  
Hauke Lang ◽  
Stefan Heinrich
Keyword(s):  
Magnetic Resonance Imaging ◽  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Magnetic Resonance ◽  
Binding Protein ◽  
Genetic Disorder ◽  
Open Cholecystectomy ◽  
Chondrodysplasia Punctata ◽  
Resonance Imaging ◽  
Anatomical Variant

Background: Since its description in 1957, Couinaud`s classification of the segmental organization of the liver has remained valid. However, recent investigations by 3-dimensional computed tomography suggest a significant variability of the vascular anatomy and segment volume. Here, we report a surprise finding during the laparoscopic cholecystectomy of a patient with Conradi-Hünermann-Happle syndrome, in whom the liver segments were not fused. Case report: Laparoscopic cholecystectomy was performed because of recurrent biliary pancreatitis in a 47 year-old male patient, who had been diagnosed with Conradi-Hünermann-Happle syndrome. Upon direct view, the liver parenchyma appeared normal, but liver segments were separated and connected by fibrous bridges containing vascular structures, only. Since the hilar anatomy was unclear, an open cholecystectomy was performed without technical difficulties and the postoperative course was uneventful. Postoperatively, magnetic resonance imaging was performed, which revealed a trifurcation of the portal vein and a right bile duct draining into the left main duct. Intersegmental signal alterations corresponded to the fibrous bands seen during laparoscopy. Conclusions: The intraoperative findings of this case confirm the segmental organization of hepatic anatomy proposed by Couinaud. The first description of such an unusual anatomical variant in an extremely rare genetic disorder strongly suggests an association with the genetic background of the syndrome. The established abnormalities of cholesterol biosynthesis in patients with Conradi-Hünermann-Happle syndrome may well explain the observed liver anomaly, which is a novel phenotype of this syndrome. Based on this case, we suggest a potential involvement of the mutation in the emopamil-binding protein gene in liver development and regeneration. Abbreviations: CDPX2: X-linked dominant chondrodysplasia punctata; EPB: emopamil-binding protein; MRCP: magnetic resonance cholangiopancreatography; MRI: magnetic resonance imaging; RCDP: rhizomelic chondrodysplasia punctuata.

scholarly journals Multiple Recalcitrant Draining Sinuses Caused by Mycobacterium mageritense Following Laparoscopic Cholecystectomy: a Case Report and Brief Review of Literature

2020 ◽  
Vol 73 (3) ◽  
pp. 256-258
Author(s):  
Lipika Singhal ◽  
Alisha Bhagat ◽  
Menal Gupta ◽  
Neelam Gulati ◽  
Ashwani Kumar Dalal ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Review Of Literature

scholarly journals Successful combined transpapillary and transmural management of a large biloma and bile duct injury: A case report and review of literature

2015 ◽  
Vol 6 (03) ◽  
pp. 119-122 ◽  
Author(s):  
Hemanta Kumar Nayak ◽  
Vivek Anand Saraswat ◽  
Samir Mohindra ◽  
Atul Sharma ◽  
Uday C. Ghoshal
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Biliary Obstruction ◽  
Biliary Stricture ◽  
Open Cholecystectomy ◽  
Endoscopic Management ◽  
Review Of Literature ◽  
Biliary Stenting ◽  
The One

AbstractHere, we report a patient with bile duct injury (BDI) following open cholecystectomy, who developed a very large biloma, causing duodenal and biliary obstruction, and also had a biliary stricture at the site of BDI. We successfully managed the patient by endoscopic biloma-gastrostomy with biliary stenting that resulted in resolution of the biloma and aggressive endoscopic management of the biliary stricture with stent bundles till resolution. Pertaining this case to be the one with largest biloma in the literature (approximately 6.5 L), which developed following open cholecystectomy that resulted in biliary stricture following injury to BD. We successfully managed the patient by endoscopic biloma-gastric stenting and an aggressive endoscopic management of biliary stricture.

Conversion of Laparoscopic to Open Cholecystectomy in the Current Era of Laparoscopic Surgery

2012 ◽  
Vol 78 (12) ◽  
pp. 1392-1395 ◽  
Author(s):  
Viet H. Le ◽  
Dane E. Smith ◽  
Brent L. Johnson
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Medical Center ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Published Data ◽  
Hospital System ◽  
Laparoscopic Equipment ◽  
Number Of Patients ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy is the gold standard treatment for benign gallbladder pathologies. In certain circumstances, the procedure must be converted to open to safely complete the operation. This study aims to evaluate the reasons for conversion of this operation in the current era of laparoscopic surgery. A retrospective review of medical records was undertaken to identify all laparoscopic converted to open cholecystectomy performed at a single center over a 2-year period. Reasons for conversion, surgeon's preoperative indications, and specimen pathologic results were documented. A review of published data from the previous two decades was also conducted for comparison of contemporary versus historical reasons for intraoperative conversion. Between May 2008 and April 2010, 3371 laparoscopic cholecystectomies were performed at Greenville Hospital System University Medical Center. Eighty-six patients (2.6%) required conversion to open cholecystectomy during the study period. A diagnosis of acute cholecystitis (58.8%) was more common among converted cases. Inflammation (35%), adhesions (28%), and anatomic difficulty (22%) were the three most common intraoperative findings leading to conversion. In the years since laparoscopic cholecystectomy was introduced, there has been a noted improvement in the quality of laparoscopic equipment affording a near wholesale shift toward the laparoscopic approach in the surgical management of this condition. However, inflammation, adhesions, and anatomic difficulty continue to challenge the use and safety of this approach in a small number of patients. The willingness and ability of surgeons to convert to open cholecystectomy continues to be important to the safety of this operation.

scholarly journals Outpatient Laparoscopic Cholecystectomy

HPB Surgery ◽  
1994 ◽  
Vol 7 (4) ◽  
pp. 261-264 ◽  
Author(s):  
R. Smith ◽  
D. Kolyn ◽  
R. Pace
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Nausea And Vomiting ◽  
Post Operative Period ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
The Future ◽  
Elective Cholecystectomy ◽  
Post Operative Complications

Outpatient Laparoscopic Cholecystectomy was attempted in 98 patients selected from 266 patients presenting for elective cholecystectomy (37%). Two patients required admission following conversion to “open” Cholecystectomy, one patient was admitted for observation because of a technically difficult Laparoscopic Cholecystectomy and 16 patients were admitted because of refractory nausea and vomiting in the early post-operative period. Seventy-nine patients (81%) were able to be discharged home within 4 to 6 hours of surgery, with only one patient requiring readmission to hospital because of the onset of nausea and vomiting. There were no post-operative complications attributable to the outpatient experience. We believe this approach to elective gallbladder pathology can be safely accomplished in selected patients and will be increasingly utilized in the future.

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