scholarly journals Comparison of three port laparoscopic cholecystectomy with four port laparoscopic cholecystectomy

2022 ◽  
Vol 21 (1) ◽  
pp. 151-157
Author(s):  
Ram Kirti Garg ◽  
Rajesh Kumar ◽  
Bir Singh ◽  
Rikki Singal ◽  
Kiran Kumar Singal ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Operative Time ◽  
Standard Treatment ◽  
Medical Science ◽  
Cosmetic Appearance

Objective: Laparoscopic cholecystectomy, gold standard treatment for cholelithiasis, has traditionally been done using 4 ports. We compared four port procedure with newer 3-port cholecystectomy. Methods: Sixty patients were operated by equally dividing them into two groups and using two procedures mentioned in the objective. Results and Discussion: Assessment was carried out using parameters like operative time, cosmetic appearance and complications. Results were similar except operative time which was much less with 4-port procedure. Conclusion: It will require lot of training before three port laparoscopic cholecystectomy can become popular and beneficial compared to four-port procedure. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 151-157

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

scholarly journals Gallbladder volvulus: a case report

2019 ◽  
pp. 1-2
Author(s):  
Tomas Urbonas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Computer Tomography ◽  
Small Proportion ◽  
Gold Standard ◽  
Crucial Role ◽  
Standard Treatment ◽  
Rare Condition ◽  
Computer Tomography Scan ◽  
Tomography Scan

The gallbladder volvulus is a rare condition. There have been around 500 cases described worldwide. It is virtually impossible to diagnose it clinically as symptoms are analogous to those of acute cholecystitis. Small proportion of gallbladder volvulus cases get accurately diagnosed preoperatively according to available literature. The imaging such as computer tomography plays a crucial role in diagnosing this condition. Laparoscopic cholecystectomy is considered to be a gold standard treatment for this condition. In our report we present a case of gallbladder volvulus which was successfully diagnosed by means of computer tomography scan

EVALUATION OF HAEMODYNAMIC AND CAPNOGRAPHIC CHANGES IN OPEN AND LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 58-60
Author(s):  
Bimal Krushna Panda ◽  
Mahendra Ekka ◽  
Sagarika Rout ◽  
Shreemayee Mohapatra ◽  
Anish Rajan ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Standard Treatment ◽  
Open Cholecystectomy ◽  
Inclusion Criteria ◽  
P Values ◽  
Duration Of Surgery ◽  
Intraoperative Period ◽  
Bladder Pathology ◽  
Elective Cholecystectomy

Introduction: Laparoscopic cholecystectomy is one of the most commonly performed operations worldwide and gold standard treatment for benign gall bladder pathology. Increasing practice of lap cholecystectomy demands concurrent advancement in anaesthetic technique and monitoring standard. Objectives: Comparison of haemodynamic and ETCO2 changes intraoperatively during laparoscopic and open cholecystectomy and evaluation of any additional effects of insufated CO2. Study Design: Hospital based observational study done over 24 months Subjects and methods: 60 patients of both sex scheduled to undergo elective cholecystectomy under general Anaesthesia, selected on the basis of the inclusion criteria , were included in this study. Patients are assigned into two groups namely Group O[ planned for open cholecystectomy] and Group L[laparoscopic cholecystectomy], each group having 30 patients. Heart rate, systolic BP, diastolic BP, mean arterial pressure, EtCO2, SpO2 and ECG monitored continuously and record maintained before surgery, during induction, intubation, extubation and every 10 min interval up to the completion of surgery in both group.CO2 insufation and exsufation time also noted in laparoscopic cholecystectomy cases. Result: Age, sex, weight, height, ASA grade and duration of surgery of all the patients of both the groups were comparable. The HR, MAP and ETCO2 of group L started increasing during the intraoperative period and P values these were statistically signicant from t=20 minutes after intubation to t=60 min. In our study CO2 insufation done within 8 to 15 minutes after intubation. .It is clear from our study that pneumoperitoneum created during laparoscopic cholecystectomy might have caused this increase in HR,MAP and ETCO2. There was a decrease in SpO in Group L during the intraoperative period i.e from t=20 minutes after intubation to t=80 min after intubation and the P values during this 2 period were statistically signicant. Conclusion: From our study we come to the conclusion that in laparoscopic cholecystectomy there is signicant increase in HR, MAP, ETCO2 and decrease in SPO2 following insufation of the abdomen with CO2 and institution of the reverse Trendlenberg position.

scholarly journals Laparoscopic Cholecystectomy In Acute Calculus Cholecystitis-Experience At District Level Hospital

1970 ◽  
Vol 5 (1) ◽  
pp. 3-6 ◽  
Author(s):  
SK Biswas ◽  
JC Saha ◽  
MM Rahman ◽  
MA Rahman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Operation Time ◽  
District Level ◽  
A Prospective Study ◽  
Level Hospital

Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gallbladder disease. Its role in surgical treatment of acute cholecystitis has also been well defined. Here a prospective study was conducted over a 3 year period of 28 patients with acute cholecystitis at district level hospitals of Bangladesh, where many modern surgical facilities were lacking. Out of 28 patients of acute cholecystitis, 24 were operated by laparoscopic methods and rests 4 were converted to open cholecystectomy. Mean operation time was 87.95 minutes and only 2 patients had postoperative complications. This study showed the appropriate time of laparoscopic cholecystectomy for acute cholecystitis, conversion rate and complications. It may be concluded that laparoscopic cholecystectomy is feasible and beneficial to the patient with acute cholecystitis in its early phase, if necessary support and expertise is available. Key Words: Acute cholecystitis; Laparoscopic cholecystectomy; Conversion DOI: 10.3329/fmcj.v5i1.6804Faridpur Med. Coll. J. 2010;5(1):3-6

scholarly journals Percutaneous Extraction of Big Kidney Stone without Fragmentation: The Novel Technique in Percutaneous Nephrolithotomy (EN BLOCK PCNL)

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Karami HOR ◽  
◽  
Vahidi SRJ ◽  
Abouei SA ◽  
Gholizadeh HAM ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Gold Standard ◽  
Kidney Stone ◽  
Renal Stone ◽  
Operative Time ◽  
Standard Treatment ◽  
The Novel ◽  
Novel Technique ◽  
Percutaneous Extraction ◽  
First Time

PCNL is gold standard treatment of pelvis stone more than 2 cm. Since 1970 that PCNL was introduced, multiple methods including mini PCNL, Lap assisted PCNL and etc. were used to increase the efficacy and decrease the complications of PCNL in different patients. We describe a new method of PCNL for the first time for extracting 7 cm renal stone without fragmentation and we called it EN BLOCK PCNL. Our technique had no complication and caused lower operative time and hospital stay.

scholarly journals Delayed unilateral pneumocephalus after bilateral endoscopic dacryocystorhinostomy in an elderly patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241540
Author(s):  
Jaekyoung Lee ◽  
Dong Cheol Lee
Keyword(s):  
Elderly Patient ◽  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
Standard Treatment ◽  
Nasolacrimal Duct ◽  
Intravenous Antibiotic ◽  
Duct Obstruction ◽  
Orbital Wall ◽  
Silicone Intubation ◽  
Endoscopic Dcr

Dacryocystorhinostomy (DCR) is the ‘gold standard’ treatment for nasolacrimal duct obstruction (NLDO). However, despite its recent technical advancements, complications are possible. Herein, to the best of our knowledge, we present the first reported case of delayed unilateral pneumocephalus after bilateral endoscopic DCR. An 85-year-old man with bilateral NLDO underwent endoscopic DCR with silicone intubation. After 1 month, he became lethargic and was admitted to emergency room. Brain CT demonstrated left pneumocephalus and a suspected microfistula in left orbital wall. Intravenous antibiotic therapy was started, and cerebrospinal fluid studies showed no evidence of meningitis. After 13 days of antibiotic treatment, his mental state recovered with no signs of pneumocephalus. Although DCR has high success rate and is relatively safe, surgeons should be aware of the risk, although low, of pneumocephalus, especially in elderly patients who are vulnerable to fractures and who exhibit headache or mental status changes after endoscopic DCR.

scholarly journals Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far?

2021 ◽  
Vol 28 (4) ◽  
pp. 2317-2325
Author(s):  
Luigi Bennardo ◽  
Francesco Bennardo ◽  
Amerigo Giudice ◽  
Maria Passante ◽  
Stefano Dastoli ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Gold Standard ◽  
Systemic Chemotherapy ◽  
Standard Treatment ◽  
Case Reports ◽  
Case Series ◽  
Surgical Removal ◽  
Local Chemotherapy

Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition’s gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient’s ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.

Treatment of vertigo and postural instability using visual illusions

2014 ◽  
Vol 128 (11) ◽  
pp. 1005-1007 ◽  
Author(s):  
G van Kerckhoven ◽  
A Mert ◽  
J A De Ru
Keyword(s):  
Gold Standard ◽  
Prosthetic Valve ◽  
Standard Treatment ◽  
Vestibular Function ◽  
Prosthetic Valve Endocarditis ◽  
Postural Instability ◽  
Risk Of Falling ◽  
Important Advance ◽  
Dizziness Handicap Inventory ◽  
Increased Risk

AbstractBackground:Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current ‘gold standard’ treatment available.Case report:A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.Results:The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.Conclusion:Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

scholarly journals Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Avinash Chennamsetty ◽  
Jason Hafron ◽  
Luke Edwards ◽  
Scott Pew ◽  
Behdod Poushanchi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Incisional Hernia ◽  
Operative Time ◽  
Patient Counseling ◽  
Incisional Hernias ◽  
Prostate Weight ◽  
History Of ◽  
Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

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