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

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

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 Comparative Study of the Effect of Laparoscopic and Open Surgery on Acute Cholecystitis

2015 ◽  
Vol 4 (3) ◽  
pp. 23
Author(s):  
Jian Lin
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Operation Time ◽  
Surgical Indications ◽  
Method Clinical Data ◽  
Function Recovery ◽  
Stay Time ◽  
Strict Condition

<strong>Objective:</strong> To compare the clinical effect of laparoscopic and open surgery on acute cholecystitis. Method: clinical data of 200 cases of acute cholecystitis patients in our hospital from July 2006 to July 2010 were divided into laparoscopic cholecystectomy(LC) group and open cholecystectomy(OC) group. Comparison was made from various aspects to show the feasibility of laparoscopic cholecystectomy of acute cholecystitis. <strong>Results:</strong> the operation time, off-bed activity time, postoperative gastrointestinal function recovery time and hospital stay time of LC group were all lower than OC group (<em>t </em>= 2.785, <em>t</em> = 2.825, <em>t</em> = 2.831, <em>t</em> = 2.904, <em>p</em> &lt; 0.05); OC group’s postoperative complications was 23.0%, higher than that (9.0%) of LC group(χ<sup>2 </sup>= 3.764, <em>p</em> &lt; 0.05). <strong>Conclusion:</strong> Under the chosen strict condition of surgical indications and delicate surgery operation, the application of laparoscopic cholecystectomy in the treatment of acute cholecystitis is safe and feasible.

scholarly journals Laparoscopic Cholecystectomy for Acute Gallbladder Disease During Index Admission- 11 the Optimum Timing for Surgery

2013 ◽  
Vol 16 (1) ◽  
pp. 11-17
Author(s):  
Md Ibrahim Siddique ◽  
Md Atiar Rahman ◽  
Md Shahadot Hossain Sheikh ◽  
Khander Manzoor Murshed ◽  
Samia Mubin ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Index Admission ◽  
Laparoscopic Procedure ◽  
Complication Rates ◽  
Financial Benefit ◽  
Conversion To Open Cholecystectomy

Background: Laparoscopic cholecystectomy, initially considered a contraindication for the treatment of acute gallbladder disease, is now being practiced for treating acute cholecystitis worldwide. The purpose of the study is to evaluate the outcome of laparoscopic procedure in the management of acute gallbladder disease during the index admission in terms of safety and feasibility, hospital stay and the rates of complications and conversion to open cholecystectomy. Methods: Between January 2009 to December 2011, 174 patients (103 female, 71 male) with median age 43.5 years (range 27-73 years) with the diagnosis of acute gallbladder disease underwent laparoscopic cholecystectomy. Diagnosis of acute cholecystitis was made from history, physical findings and ultrasound evidence of acute inflammatory changes. Results: Median time from onset of symptoms to surgery was 70 hours. Median operative time was 76.5 minutes. Conversion rate was 1.7%. Minor post-operative complications occurred in 13.5% cases of laparoscopic procedure, which did not require further intervention. Median post-operative hospital stay was 2.5 days and total length of hospital stay was median 4.4 days. There was no mortality. Conclusion: In expert hands laparoscopic cholecystectomy for acute gallbladder disease during the index admission is safe with better clinical results, shorter hospital stay and an acceptable conversion and complication rates with additional financial benefit to the patients. DOI: http://dx.doi.org/10.3329/jss.v16i1.14442 Journal of Surgical Sciences (2012) Vol. 16 (1) : 11-17

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.

A Prospective Study of Bile Leaks after Laparoscopic Cholecystectomy for Acute Cholecystitis

2006 ◽  
Vol 72 (3) ◽  
pp. 265-268 ◽  
Author(s):  
Edward P. Dominguez ◽  
Dave Giammar ◽  
John Baumert ◽  
Oscar Ruiz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Prospective Study ◽  
Acute Cholecystitis ◽  
Effective Treatment ◽  
Open Cholecystectomy ◽  
Bile Leak ◽  
Elective Setting ◽  
A Prospective Study ◽  
Bile Leaks

Surgeons are increasingly performing laparoscopic cholecystectomy in the setting of acute cholecystitis. The acutely inflamed gallbladder poses a more technically demanding dissection with potential for an increase in bile leak rates. Clinical and subclinical bile leak rates after laparoscopic and open cholecystectomy in the elective setting are known. This study prospectively evaluates the rate of clinical and subclinical bile leaks after laparoscopic cholecystectomy in the setting of acute cholecystitis. One hundred patients underwent laparoscopic cholecystectomy for acute cholecystitis, as determined intraoperatively and by history, ultrasound, fever, or leukocytosis. On postoperative Day 1, the patients underwent cholescintigraphy (PIPIDA scan) analyzed by a board-certified radiologist for evidence of bile leaks. Postoperative cholescintigraphy revealed eight scans positive for bile leaks. Regardless of scan result, no patient experienced a clinically symptomatic bile leak. Laparoscopic cholecystectomy is a safe and effective treatment for acute cholecystitis with acceptable clinical and subclinical bile leak rates.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

scholarly journals LAPAROSCOPY REPRESENTS THE GOLD STANDARD FOR ACUTE CHOLECYSTITIS EVEN IN ELDERLY PATIENTS

2015 ◽  
Vol 2 (2) ◽  
pp. 59-62
Author(s):  
I. Negoi ◽  
I. Tănase ◽  
B. Stoica ◽  
S. Păun ◽  
S. Hostiuc ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Morbidity Rate ◽  
Open Approach

Nowadays the laparoscopic approach represents the gold standard for acute cholecystitis, but we are facing little evidence regarding the elderly patients. The purpose of this study is to define the benefits in terms of early outcome for laparoscopic cholecystectomy in patients over 70 years old and to compare them with the open cholecystectomy through a retrospective study of patients that underwent a cholecystectomy during 12 months in the Emergency Hospital of Bucharest, Romania. Out of 49 patients, 20 had a laparoscopic cholecystectomy (LC) and 29 an open approach (OC). The mean age was 74,6 ± 4,2 (LC) vs. 77,2 ± 5,4 (OC) (P>0.05). There were 7 (33,3%) (LC) vs. 2 (7,1%) (OC) catarrhal cholecystitis, 13 (62%) (LC) vs. 9 (32,1%) (OC) phlegmonous cholecystitis, and 1 (4,8%) (LC) vs. 17 (60,7%) (OC) gangrenous cholecystitis (P=0.001, Cramer’s V=0,590). The median operative time was 90 (LC) vs. 60 (OC) minutes (P=0.001). There were no differences regarding the ASA risk scale (P=0,253). The median number of days to resume the diet was 3 (LC) vs. 4 (OC) (P=0.009). The median length of hospital stay was 72 hours (LC) vs. 120 hours (OC) (P=0.011). One patient died in the OC group and none in the LC group.To conclude, the laparoscopic approach in acute cholecystitis of elderly patients is safe. It is followed by a lower morbidity rate, a shorter length of hospital stay and by a more rapid return to normal activities.

scholarly journals Successful treatment of emphysematous cholecystitis by laparoscopic surgery

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Hitoshi Funahashi ◽  
Tetsuya Komori ◽  
Naoki Sumita
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Cholecystitis ◽  
Rare Variant ◽  
Successful Treatment ◽  
Gold Standard ◽  
Open Cholecystectomy ◽  
Gallbladder Wall ◽  
Emphysematous Cholecystitis ◽  
Bacterial Proliferation ◽  
Calot’S Triangle

Abstract Emphysematous cholecystitis (EC) is a severe and rare variant of acute cholecystitis characterized by ischemia of the gallbladder wall with gas-forming bacterial proliferation. Open cholecystectomy is traditionally the gold standard approach to treatment due to difficulty in isolating Calot’s triangle in the setting of intense inflammation. We present a case of EC successfully and safely treated by laparoscopic surgery.

EVALUATION OF CLINICO-RADIOLOGICAL FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

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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