SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY IN HUE CENTRAL HOSPITAL

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

RETROPERITONEALS SINGLE INCISION LAPAROSCOPIC NEPHRECTOMY: MINI-INVASIVE TECHNICAL, SAFETY AND COSMETIC

2018 ◽  
Vol 8 (6) ◽  
pp. 23-26
Author(s):  
Liem Ngo Thanh ◽  
Hung Nguyen Khoa ◽  
Tung Hoang Van
Keyword(s):  
Single Incision ◽  
Single Port ◽  
Operating Time ◽  
Laparoscopic Nephrectomy ◽  
Central Hospital ◽  
Hospital Patients ◽  
Sils Port ◽  
A Prospective Study ◽  
Objective Outcome ◽  
Technical Safety

Objective: Outcome of 45 retroperitoneal single incision laparoscopic nephrectomy of benigns nonfunction kidneys at Hue Central Hospital. Patients and method: A prospective study was perform on 45 patients with benign nonfuncion kidney, treated by retroperitoneal single incision laparoscopic nephrectomy at Department of General Surgery - Hue Central Hospital from May 2015 to August 2018. Results: Success: 42/45 patients. Mean operating time 87.5mins (50 - 155 mins), postoperative hospital stay 5-7 days. SILS Port of Covidien was inserted by 2.5 cm skin transverse incision, standard straight laparoscopic instruments were used instead of roticular instruments. Conclusion: This is a mini-invasive technical, safety and cosmetic Keywords: retroperitoneal single incision laparoscopic nephrectomy, single port nephrectomy.

scholarly journals P-BN21 Diagnostic accuracy of transabdominal ultrasound for assessing gallbladder polyps

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
John Young ◽  
Anas Belhasan ◽  
Nisheeth Kansal ◽  
Sanjay Taribagil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Chronic Cholecystitis ◽  
Malignant Potential ◽  
Transabdominal Ultrasound ◽  
Gallbladder Polyps ◽  
Asymptomatic Patients ◽  
Normal Gallbladder ◽  
Pathology Reports ◽  
Current Guidelines

Abstract Background Gallbladder polyps are common findings on transabdominal ultrasound (TAUS) and their implications are not entirely clear. Current guidelines advise monitoring with serial TAUS and to offer laparoscopic cholecystectomy if criteria are met to minimise risk of malignant transformation. TAUS is easily accessible and useful at identifying gallbladder polyps, however, has limitations when differentiating between pseudopolyps and true gallbladder polyps with malignant potential. This study looks at a district general hospital’s outcomes for patients undergoing laparoscopic cholecystectomy for gallbladder polyps. Methods This retrospective study identified patients who had polyps identified on TAUS and subsequently undergone laparoscopic cholecystectomy from 2011 to 2021. We identified patients using hospital coding and subsequently assessed their pre-operative imaging and clinic letters to ensure gallbladder polyps were the reason for cholecystectomy. The size of polyp on TAUS was noted and pathology reports were assessed to determine if polyps had been correctly identified on TAUS and if these were true or pseudopolyps. Clinic letters were assessed to determine if patients were symptomatic pre-operatively. Results 66 patients were identified as having polyps pre-operatively. The size of polyp ranged from 2-19mm with a mean of 7.4mm. 39 (59%) patients were symptomatic pre-operatively. TAUS findings correlated with pathology findings of polyps in 45 (68%) patients. Of the 21 patients with no polyps on pathology: 11 had gallstones, 9 had chronic cholecystitis and 1 normal gallbladder. Of the polyps identified 44 were pseudopolyps and only 1 was a true adenoma – 39 cholesterol polyps, 3 inflammatory polyps and 2 adenomyomatosis. There was no evidence of dysplasia on the adenoma, it measured 5mm on TAUS and the patient was symptomatic. Conclusions This study highlights the limitations of TAUS in correctly identifying true polyps. The 41% of asymptomatic patients all had benign findings on pathology and likely had no benefit from surgery. Whilst TAUS is a useful method of identifying potential polyps these findings would suggest that other methods of identifying true polyps should be sought to minimise patients undergoing unnecessary surgery.  

scholarly journals GALLBLADDER CARCINOMA;

2011 ◽  
Vol 18 (01) ◽  
Author(s):  
AHMAD HASSAN KHAN ◽  
SAIFULLAH GORAYA ◽  
HAROON-UR- RASHID
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gallbladder Carcinoma ◽  
Open Cholecystectomy ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Surgical Department ◽  
Carcinoma Gallbladder ◽  
Average Operating ◽  
Average Operating Time

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. 

scholarly journals Triple Umbilical Incision for Videlaparoscopic Cholecystectomy

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Héctor Rolando Herrera Cabral
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Single Incision ◽  
Single Port ◽  
Cystic Artery ◽  
Advanced Training ◽  
Surgical Time ◽  
Umbilical Incision ◽  
Intraabdominal Bleeding ◽  
Initial Results

Introduction: The laparoscopic surgery is done by using a single port. You place a device through a single incision between 18mm to 50mm and 3-4 trocars can be used. Our work consists of making 3 little incisions to put the three trocars which measure 5 mm and use conventional instruments that measure 36 cm of length of laparoscopic surgery within the internal limits of the umbilicus. Objective: Describe the surgery technique and evaluate the initial results of a laparoscopic cholecystectomy option through three intraumbilical incisions. Methods: It is a retrospective, descriptive, multicentre and observational study. Since June 2014 to August 2019, 20 patients, 17 females and 3 males, were operated using this method from the age ranges of 16 to 65 years old. The average surgical time was 65 minutes. Results: In all cases the procedures were concluded by the intraumbilical approach. One of the cases had to be re-operated due to intraabdominal bleeding from the posterior branch of the cystic artery. Conclusions: The technique is reproducible; the usual triangulation of the ports is not available. Therefore, fort this technique the surgeon needs to have experience and have had advanced training in laparoscopic surgery. The cases must be selective.

scholarly journals P-BN22 The use of virtual clinics in gallbladder polyp surveillance

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
John Young ◽  
Anas Belhasan ◽  
Nisheeth Kansal ◽  
Sanjay Taribagil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Risk Groups ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Lost To Follow Up ◽  
Current Guidelines ◽  
Gallbladder Malignancy ◽  
Virtual Clinic

Abstract Background Gallbladder polyps are common findings on ultrasound with a prevalence between 0.3-9.5%. Their significance is not clear but are theorised to have potential risk of transformation into gallbladder malignancy which have poor prognosis if not caught early. Current guidelines recommend surveillance of polyps and that laparoscopic cholecystectomy should be offered if certain criteria are met. Most patients are asymptomatic and regular reviews in clinic is time consuming for patients and adds to strain on services. This study looks at the use of virtual clinics in gallbladder polyp surveillance. Methods Since January 2019 patients identified with gallbladder polyps have been added to virtual clinic. Each patient is added to a database which is maintained by one upper GI surgeon. Current guidelines are followed: laparoscopic cholecystectomy is offered if polyps are greater than 1cm, there is an increase greater than 2mm between scans, and in high-risk groups or in symptomatic patients. All other patients are offered interval scans as per guidelines and a template letter is generated informing patients of their scan results and date of their follow up scan. Results Since January 2019, 70 patients have been identified to have gallbladder polyps. Of these 48 patients so far have benefitted from involvement from follow up in virtual clinic to date, this has resulted in 88 clinic appointments being saved. 12 patients have undergone laparoscopic cholecystectomy due to increase in size of their gallbladder polyps or secondary to symptoms. 7 patients have been lost to follow up, 2 discharged due to the gallbladder polyps disappearing and the other 49 remain under surveillance in the virtual clinic. Conclusions Long term polyp surveillance can be time consuming for both the patient and clinician. This model of a virtual clinic maintains clear communication with patients about their scan findings, the risks associated and plans for future scans. This is an efficient method of monitoring these patients that has good compliance and identifies patients appropriate for surgery.

scholarly journals Retrospective Study of Three-port versus Standard Four-port Laparoscopic Cholecystectomy: A Single Surgical Unit Experience of 1456 Patients

2020 ◽  
Author(s):  
Vivek Srivastava ◽  
Mumtaz Ahmad Ansari ◽  
Vijay Kumar Shukla ◽  
Somprakas Basu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Conversion Rate ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Early Recovery ◽  
Significant Difference ◽  
The Mean

Introduction: Although laparoscopic surgeries have proven beyond doubt their benefit in terms of early recovery, better patient care and cost-effectiveness, the quest for reduction in either the size or number of ports still continues. Aim: To compare the safety, outcome, and advantages between three-port versus four-port Laparoscopic Cholecystectomy (LC) in acute and chronic cholecystitis. Materials and Methods: Medical records of 1456 patients that underwent LC (three- or four-port) for acute and chronic cholecystitis from January 2015 to December 2019 (60 months) were retrospectively analysed. All patients were given the same anaesthetic drugs for induction and maintenance, with standard anaesthetic protocol. The results were compared for both the techniques in terms of operating time, conversion rate, intraoperative complications, immediate postoperative complications, pain score, analgesic requirement and hospital stay. Results: Total 1456 patients underwent LC; 1282 were female and 174 were male. The mean age of the patients was 39.2 years (range 18-70 years). The three-port LC technique was performed on 816 (56.04%) patients, while the traditional four-port LC technique was performed on 640 (43.96%) patients. Visual Analog Score (VAS) in the postoperative period at six hour was 2.11±0.82 in three-port group versus 3.17±1.12 in four-port group, this suggests that there was a significant difference in pain in these two groups in the early postoperative period (p<0.001). In three-port group, the requirement of analgesic drug was significantly less as compared to four-port group (2.86±0.98 versus 3.22±0.87; p<0.001). There was no statistically significant difference in the mean operating time, duration of hospital stay, intra and postoperative complications, days to return to normal activity, satisfaction score and conversion rate (p=0.087, p=0.061, p=0.578, p=0.555, p=0.572 and p=0.145, respectively). Conclusion: Three-port LC is a feasible, effective and safe technique that further enhances the surgical outcome in terms of postoperative pain, fewer needs for analgesic medication.

scholarly journals Single-Port Laparoscopic Cholecystectomy Using the Innovative E. K. Glove Port: Our Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Elbert Khiangte ◽  
Iheule Newme ◽  
Karabi Patowary ◽  
Hitesh Kalita
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Developing Country ◽  
Single Port ◽  
Operating Time ◽  
Biliary Colic ◽  
Conventional Laparoscopic ◽  
Access System ◽  
Single Port Surgery ◽  
Port Access ◽  
Glove Port

The technique of laparoscopic cholecystectomy continues to evolve with a trend towards decreasing use of working ports. One of the emerging concepts of 21st century is single-port surgery. It has further minimized the minimally invasive surgery. However, the main drawbacks of this technique are the lack of “triangulation” to which the laparoscopic surgeons have grown accustomed to, the clustering of instruments, and the costly multichannel ports, which are very costly and, in fact, are not affordable by the majority of the population in a developing country like India. From September 2009 to December 2011, 210 patients identified as having biliary colic, chronic cholecystitis, and previous biliary pancreatitis or obstructive jaundice due to stones (managed by ERCP) underwent single-port laparoscopic cholecystectomy using the E. K. glove port. The operating time was reasonable and can be lessened with experience. Excellent exposure of the critical view was obtained in all cases. This technique is safe, feasible, reproducible, cheap, and easy to learn. It may be an alternative to the currently available single-port access system, especially in a developing country like India. If required, placement of the remaining two to three ports for a more conventional laparoscopic cholecystectomy can be done.

SONOGRAPHIC CHARACTERISTIC OF GALLBLADDER POLYPS

2015 ◽  
pp. 105-109
Author(s):  
Thi Thuy Trang Nguyen ◽  
Van Toan Le ◽  
Minh Loi Hoang
Keyword(s):  
Ultrasound Imaging ◽  
Chronic Cholecystitis ◽  
Key Words Ultrasound ◽  
Gallbladder Polyp ◽  
Cross Sectional ◽  
Gallbladder Polyps ◽  
Positive Diagnosis ◽  
Characteristic Imaging ◽  
Results Of Surgery

Objective: To evaluate ultrasound characteristic imaging of gallbladder polyps. And to compare ultrasound imaging with the results of surgery and histopathologyfor positive diagnosis of gallbladder polyps. Subjects and methods: Study on 32 patients (14 male and 18 female, mean age 43,5±18,5 years) with clinical suggestion, ultrasound imaging of gallbladder polyp, and surgery -histopathology positive diagnosis. Cross-sectional descriptive study, from 5/2014 to 3/2015 at the Hospital of Hue Medical and Pharmacy College. Results: Among of 32 patients, 18 patients (56,2%) had results postoperative histopathology of chronic cholecystitis, 14 patients (43,8%) was the type of polyps and adenoma. Thus the specificitive of ultrasound in diagnosis of gallbladder polyps was 43,75% only. Conclusion: The role of ultrasound in diagnosis of gallbladder polyps is the firstscreening for the other indications and ultimate treatment. Key words: ultrasound imaging, histopathology, gallbladder polyps.

Gallbladder polyp

2018 ◽  
Vol 1 (1) ◽  
pp. 23-24
Author(s):  
Watcharasak Chotiyaputta
Keyword(s):  
Gall Bladder ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Upper Abdomen ◽  
Bladder Polyp

Gall bladder polyp เป็นภาวะที่พบได้บ่อย คาดว่าพบได้ประมาณร้อยละ 5 ของประชากรทั่วไป การวินิจฉัยที่สำคัญคือการตรวจด้วยอัลตร้าซาวนด์บริเวณถุงน้ำดีซึ่งต้องแยกให้ดีระหว่าง gall bladder polyp และ gallstone การรักษาที่สำคัญคือการผ่าตัดถุงน้ำดีออกเมื่อติ่งเนื้อมีขนาดเกิน 1 ซม ถ้าขนาดไม่เกินควรทำการติดตามดุว่าติ่งเนื้อมีขนาดใหญ่ขึ้นหรือไม่ โดยเฉพาะในช่วง 2 ปีแรก Figure 4 CT of upper abdomen แสดง multiple gallbladder polyps และ gallstones โดยลักษณะของ gallstones เป็น densed hyperdensity มากกว่า gallbladder polyps

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