scholarly journals Comparative Study between Laparoscopic and Open Cholecystectomy: Complications and Management

2021 ◽  
Vol 33 (1) ◽  
pp. 19-21
Author(s):  
Md Rafiqul Islam ◽  
Md Showkat Ali ◽  
SM Golam Azam ◽  
Md Ridwanul Islam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Open Cholecystectomy ◽  
Oral Feeding ◽  
Lower Prevalence ◽  
Vein Thrombosis ◽  
Postoperative Respiratory Complications ◽  
Hospital Stays ◽  
Medicine Today ◽  
Deep Vein

Introduction: Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones. The aim of the study was to analyze and compare the postoperative results of patients undergoing laparoscopic cholecystectomy or open cholecystectomy (OC) with regard to complications, recovery time and hospital stays. Materials and Methods: This is a retrospective study which was conducted at the General Hospital Khulna and some of the private Hospital in Khulna City from January 2015 to December 2019. This study which analyzed among 950 patients, 20-65 years old, diagnosed with gallstones undergoing LC or OC. We evaluated postoperative respiratory complications, surgical site infection, deep vein thrombosis, time to oral feeding and ambulation, use of antibiotics and duration of the postoperative period. Results: We analyzed 570(60%) patients undergoing LC and 380 (40%) OC. Most patients were female (55%). Patients' comorbidities were hypertension (12.8%), diabetes mellitus (4.5%) and asthma (1.00%). LC resulted in lower prevalence of postoperative complications (2.8%) than OC (3.4%). Postoperative hospitalization for 2-3 days was found in LC patients and 5-7 days in OC. Conclusion: Laparoscopic cholecystectomy showed higher benefits for patients with lower prevalence of postoperative complications, feeding earlier and shorter mean hospital stay compared with open cholecystectomy. Medicine Today 2021 Vol.33(1): 19-21

scholarly journals Audit of Laparoscopic Cholecystectomy: 5 years experience in a University Hospital

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Salman Yousuf Guraya ◽  
Gamal Eldin A Khairy ◽  
Khalid Rida Murshid
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hepatic Duct ◽  
Open Cholecystectomy ◽  
University Hospital ◽  
Common Hepatic Duct ◽  
Colonic Injury ◽  
Vein Thrombosis ◽  
Male Patients ◽  
Deep Vein ◽  
Male Subjects

All patients, who underwent laparoscopic cholecystectomy for cholelithiasis, from September 1998 to September 2003 were retrospectively reviewed. There were 549 patients and out of those, 507 were female and 42 male subjects. The age ranged from 17-71 years for females and 18-69 years for male patients: median age 41.4 years. 476(86.7%) cases presented with chronic cholecystitis, 63(11.4%) acute cholecystitis, 6(1%) mucocele of the gallbladder and 2(0.4%) had empyema of the gallbladder. Sixteen cases were converted to open cholecystectomy (conversion rate of 2.9%) with a success rate of 97% for laparoscopic cholecystectomy. The reasons for conversion were found to be 8(1.4%) difficult dissection, 4(0.7%) bleeding from cystic artery, 2(0.3%) suspected duodenal injury, 1(0.1%) suspected colonic injury and 1(0.1%) Mirizzi`s syndrome. Postoperative hospital stay ranged from 1-13 days (mean 1.23). Atelactasis was reported to be the most frequent complication found in 9(1.6%) patients followed by deep vein thrombosis and subumbilical wound infection noted in 6(1%) cases each (P<0.00). Four patients had common bile duct injury and one case sustained common hepatic duct injury. All these patients had successful Roux-en-Y hepaticojejunostomy. There was no mortality in this series. Laparoscopic cholecystectomy is a safe and feasible procedure and should be the first line of treatment for symptomatic cholelithiasis.

Low Frequency of Phlebographic Deep Vein Thrombosis After Laparoscopic Cholecystectomy—A Pilot Study

2006 ◽  
Vol 12 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Fredrik Lindberg ◽  
Martin Björck ◽  
Ib Rasmussen ◽  
Rickard Nyman ◽  
David Bergqvist
Keyword(s):  
Deep Vein Thrombosis ◽  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Low Frequency ◽  
Low Molecular Weight ◽  
Thromboembolism Prophylaxis ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer ◽  
Rule Out

To investigate the rate of deep vein thrombosis (DVT) after laparoscopic surgery, 50 patients underwent bilateral phlebography 7-11 days after laparoscopic cholecystectomy (LC). All received thromboembolism prophylaxis, either low molecular weight heparin (LMWH) or dextran. Three patients were converted to open cholecystectomy. D-dimer was investigated preoperatively, on day 1 and on the day of phlebography. One asymptomatic DVT was found. One phlebogram was incomplete. Seven phlebograms were not optimal but of sufficient quality to rule out DVT. The frequency of DVT was thus 1 of 49 or 2.0% (95% confidence interval, 0-6.0%). No anticoagulants were prescribed after discharge. No patient developed late thromboembolic complications. D-dimer values increased significantly at day 1 and were further increased at the time of phlebography. The frequency of phlebographical DVTs thus seems to be low despite prophylaxis of questionable efficacy. The D-dimer values, however, suggest that the effects of LC on coagulation/fibrinolysis have a duration of longer than 1 week.

scholarly journals Prevalence of venous thromboembolism in admissions and readmissions with and without syncope: a nationwide cohort study

2019 ◽  
Author(s):  
Amer N Kadri ◽  
Misam Zawit ◽  
Raed Al-Adham ◽  
Ismail Hader ◽  
Leen Nusairat ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Independent Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Lower Prevalence ◽  
Multivariable Model ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Nationwide Readmission Database ◽  
Patient Presentation

Abstract Aims The Pulmonary Embolism in Syncope Italian Trial reported 17.3% prevalence of pulmonary embolism (PE) in patients admitted with syncope. We investigated the prevalence of venous thromboembolism [VTE, including PE and deep vein thrombosis (DVT)] in syncope vs. non-syncope admissions and readmissions, and if syncope is an independent predictor of VTE. Methods and results We conducted an observational study of index admissions of the 2013–14 Nationwide Readmission Database. We excluded patients <18 years, December discharges, died during hospitalization, hospital transfers, and missing length of stay. Encounters were stratified by the presence or absence of DVT/PE and syncope diagnoses. Multivariable logistic regression analysis was used to evaluate the association between syncope and VTE. There were 38 655 570 admissions, of whom 285 511 had syncope. In the overall cohort, syncope occurred in 1.6% of VTE and 1.8% in non-VTE admissions. In a multivariable model, syncope was associated with a lower prevalence of VTE [odds ratio (OR) 0.76, 95% confidence interval (CI) 0.75–0.78; P < 0.001]. In index syncope vs. non-syncope admissions, the prevalence of DVT, PE, and VTE were 0.4 ± 0.06% vs. 1.3 ± 0.12%, 0.2 ± 0.04% vs. 1.2 ± 0.11%, and 0.5 ± 0.07% vs. 2.1 ± 0.14% (all P < 0.001), respectively. At 30 days, the prevalence of DVT, PE, and VTE in syncope vs. non-syncope were 2.2 ± 0.14% vs. 2.1 ± 0.14% (P = 0.38), 1.4 ± 0.12% vs. 1.2 ± 0.11% (P = 0.01), and 2.6 ± 0.17% vs. 3.0 ± 0.17% (P = 0.99), respectively. Conclusion Syncope admissions were associated with a lower prevalence of VTE as compared to non-syncope admissions. Syncope should not trigger an automatic PE workup, rather, should be put into context of patient presentation.

More than one in two venous thromboembolism treated in French hospitals occurs during the hospital stays

2015 ◽  
Vol 31 (6) ◽  
pp. 390-396 ◽  
Author(s):  
Francois-André Allaert ◽  
Eric Benzenine ◽  
Catherine Quantin
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Hospital Stay ◽  
Principal Diagnosis ◽  
Vein Thrombosis ◽  
Icd 10 ◽  
Hospital Stays ◽  
Deep Vein

Objective The objective was to describe the prevalence of venous thromboembolism, pulmonary embolism, and deep vein thrombosis among hospitalized patients and the percentages of those occurring during the hospital stays. Methods French DRG gave now the opportunity to investigate the frequency of venous thromboembolism occurring during the hospital stay. Statistics are issued from the national PMSI MCO databases encoded using the CIM10. Since 2010–2011 it is possible to differentiate the reason for hospital admission from the pathologies which secondly occurred. Any stay with the ICD-10 codes selected was considered as a hospital-occurred thrombosis unless it was the principal diagnosis of the first medical unit summary. To eliminate outpatient consultations or in day care, stays of <48 h were excluded. Results The results pertain to the 78,838,983 hospitalizations in France from 2005 to 2011 and on the 18,683,603 hospital stays in 2010–2011. The incidence of hospital stays came to 860,343 (1.09%) for venous thromboembolism, with 428,261 (0.543%) for deep vein thrombosis without pulmonary embolism and 432,082 (0.548%) for pulmonary embolism. It corresponds to an incidence of 189 per 100,000 inhabitants. Out of 100 hospital stays involving venous thromboembolism, for 40.3% venous thromboembolism was the cause of hospitalization whereas 59.7% can be considered to have occurred during hospital stay. These distributions are of 25.6 and 74.4% for deep vein thrombosis, respectively, 53.8 and 46.2% for pulmonary embolism. Conclusion The high proportion of hospital-occurred venous thromboembolism is an alarming situation that should question the quality of prevention and/or its effectiveness.

scholarly journals Elective orthopaedic surgery

2020 ◽  
pp. 249-286
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Patient Education ◽  
Postoperative Complications ◽  
Nursing Staff ◽  
Orthopaedic Surgery ◽  
Nursing Management ◽  
Vein Thrombosis ◽  
Episode Of Care ◽  
Deep Vein

This chapter on orthopaedic surgery reviews the specialist nursing management of patients undergoing (elective) orthopaedic surgery during the preoperative, perioperative, and postoperative phases of treatment. In particular, the management of pain during a surgical episode of care and the potential postoperative complications including deep vein thrombosis, pulmonary embolism, infection, and the prevention of pressure ulcers are detailed. A review of the most common orthopaedic procedures including surgery to the spine, hip, knee, wrist, hand, elbow, and shoulder is also given, with details on the specific nursing management, rehabilitation, and patient education pertinent to each procedure. This chapter is written for qualified nursing staff.

scholarly journals Laparoscopic cholecystectomy of acute cholecystitis

2010 ◽  
Vol 63 (5-6) ◽  
pp. 404-408 ◽  
Author(s):  
Veselin Stanisic ◽  
Milorad Bakic ◽  
Milorad Magdelinic ◽  
Hamdija Kolasinac ◽  
Igor Babic
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Operative Procedure ◽  
Course Of Disease ◽  
Quick Recovery ◽  
Preoperative Risk Factors ◽  
Severe Pathology ◽  
Duration Of Operation

Introduction. Laparoscopic cholecystectomy is a method of choice for surgical treatment of diseases of gallbladder. Although most surgeons today use laparoscopic cholecystectomy in treatment of severe acute cholecystitis, most surgeons still consider acute cholecystitis a relevant contraindication for laparoscopic cholecystectomy because of ?confused? anatomy and ?severe? pathology. Aim of the study was to analyze laparoscopic cholecystectomy outcomes in treatment of acute cholecystitis. Material and methods. A prospective analysis included 78 patients operated for acute calculose cholecystitis from Jan 2007 to Dec 2008. We analyzed clinical characteristics of the course of disease, associated diseases, duration of operation, operative and postoperative complications, reasons for conversion into open cholecystectomy. Results. The study indicated a low percentage of operative and postoperative complications, short stay in hospital, quick recovery and saving in treatment. The length of preoperative and postoperative hospitalization was 1.4?0.5 days and 2.5?1.6 days, respectively. 25 (32%) patients were operated within 72 hours from the onset of symptoms, some operative difficulties were present in 56 (71%) patients, light identification of artery and ductus cysticus in 30 (38.5%) patients, intraoperative lesion of ductus choledohus in 1 (1.3%); in 6 (7.7%) patients conversion into open cholecystectomy was done, the average duration of laparascopic cholecystectomy was 58.1?26.2 min. There were no lethal outcomes. Conclusion. Laparoscopic cholecystectomy is an efficient and reliable operative procedure in treatment of acute cholecystitis. It is much easier to select patients for laparoscopic cholecystectomy when preoperative risk factors predicting difficulties during the operation are known. An early conversion into open cholecystectomy is a rational choice of any surgeon when anatomy is not clear and in cases of advanced inflammatory process in order to decrease operative and postoperative morbidity.

Coagulation status and the presence of postoperative deep vein thrombosis in patients undergoing laparoscopic cholecystectomy

2007 ◽  
Vol 21 (9) ◽  
pp. 1588-1592 ◽  
Author(s):  
D. J. Milic ◽  
V. D. Pejcic ◽  
S. S. Zivic ◽  
S. Z. Jovanovic ◽  
Z. A. Stanojkovic ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Laparoscopic Cholecystectomy ◽  
Vein Thrombosis ◽  
Postoperative Deep Vein Thrombosis ◽  
Coagulation Status ◽  
Deep Vein

Can total joint arthroplasty be safely performed in patients with chronic kidney disease?

2020 ◽  
Author(s):  
Meng Fan ◽  
Kai Sun ◽  
Wenxue Jaing
Keyword(s):  
Postoperative Complications ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Vein Thrombosis ◽  
Knowledge Infrastructure ◽  
Increased Risk ◽  
Statistical Heterogeneity ◽  
Deep Vein

BACKGROUND: Patients suffered from chronic kidneydisease are at greater risk of perioperative and postoperative complications. Actually there is no systerm review study demonstrating advantages of total joint arthroplasty can be safely performed in patients with chronic kidney disease.METHODS: Literature search was performed inPubMed, Embase, Web of Science, China National Knowledge Infrastructure(CNKI),Wanfang and Cochrane Library for information from the earliest date of data collection to September 2018. Studies comparing the perioperative, postoperative outcomes of No-CKD with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P&lt;0.10 or I2 &gt; 50%.RESULTS:Three papers consisting of 38,209 patients were included (35,363 No-CKD patients; 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, re-admission and mortality(P&lt;0.1). No differences inlength of surgery, length of stay, pulmonary embolism and revision (P&gt;0.10).CONCLUSIONS:Compared with No-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications and clear difference about complications between No-CKD and CKD about patients with chronic kidneydisease.

scholarly journals Rate of Conversion and Postoperative Complications of Laparoscopic Cholecystectomy in District Level Hospital of Bangladesh

1970 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
SK Biswas ◽  
JC Saha ◽  
ASMT Rahman ◽  
ASMZ Rahman ◽  
MM Rahman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Key Words Laparoscopic Cholecystectomy ◽  
Biliary Leakage ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy and postoperative complications are still inevitable in certain cases. Knowledge of the rate and underlying reasons for conversion and postoperative complications could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion and postoperative complications of our LC series. This study included 760 consecutive laparoscopic cholecystectomies from July 2006 to June 2011 at Faridpur Central Hospital and Faridpur Medical College Hospital. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 19 (2.5%) patients. The most common reasons for conversion were severe adhesions at calot's triangle (6, 0.83%) and acutely inflamed gallbladder (5, 0.66%). The incidence of postoperative complications was 1.58%. The most common complication was wound infection, which was seen in 5 (0.66%) patients followed by biliary leakage in 3 (0.40%) patients. Delayed complications seen in our series is port site incisional hernia (2, 0.26%). LC is the preferred method even in difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery and it should not be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon. Key words: Laparoscopic cholecystectomy (LC); Open cholecystectomy; Conversion; Complications; Calot's triangle DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9204 FMCJ 2011; 6(2): 74-77

scholarly journals Safety of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly: A Multivariate Analysis of Risk Factors for Intra and Postoperative Complications

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 230
Author(s):  
Dragos Serban ◽  
Bogdan Socea ◽  
Simona Andreea Balasescu ◽  
Cristinel Dumitru Badiu ◽  
Corneliu Tudor ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
The Elderly ◽  
Early Postoperative Period ◽  
Invasive Approach ◽  
Physical Status Classification ◽  
The Impact

Background and Objectives: This study investigates the impact of age upon the safety and outcomes of laparoscopic cholecystectomy performed for acute cholecystitis, by a multivariate approach. Materials and Methods: A 2-year retrospective study was performed on 333 patients admitted for acute cholecystitis who underwent emergency cholecystectomy. The patients included in the study group were divided into four age subgroups: A ≤49 years; B: 50–64 years; C: 65–79 years; D ≥80 years. Results: Surgery after 72 h from onset (p = 0.007), severe forms, and higher American Society of Anesthesiologists Physical Status Classification and Charlson comorbidity index scores (p < 0.001) are well correlated with older age. Both cardiovascular and surgical related complications were significantly higher in patients over 50 years (p = 0.045), which also proved to be a turning point for increasing the rate of conversion and open surgery. However, the comparative incidence did not differ significantly between patients aged from 50–64 years, 65–79 years and over 80 years (6.03%, 9.09% and 5.8%, respectively). Laparoscopic cholecystectomy (LC) was the most frequently used surgical approach in the treatment of acute cholecystitis in all age groups, with better outcomes than open cholecystectomy in terms of decreased overall and postoperative hospital stay, reduced surgery related complications, and the incidence of acute cardiovascular events in the early postoperative period (p < 0.001). Conclusions: The degree of systemic inflammation was the main factor that influenced the adverse outcome of LC in the elderly. Among comorbidities, diabetes was associated with increased surgical and systemic postoperative morbidity, while stroke and chronic renal insufficiency were correlated with a high risk of cardiovascular complications. With adequate perioperative care, the elderly has much to gain from the benefits of a minimally invasive approach, which allows a decreased rate of postoperative complications and a reduced hospital stay.

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