scholarly journals DETERMINATION OF PAIN IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS IN PATIENTS WITH CHRONIC HEPATITIS

2021 ◽  
pp. 38-40
Author(s):  
A. O. Kolotvin ◽  
M. A. Kashtalyan ◽  
L. I. Kolotvina ◽  
O. A. Kvasnevsky ◽  
E. A. Kvasnevsky ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Diagnostic Value ◽  
Chronic Viral Hepatitis ◽  
Acute Calculous Cholecystitis ◽  
Comprehensive Information ◽  
Clinical Center ◽  
Potential Risk Factors ◽  
Rapid Tests ◽  
The Military ◽  
Calculous Cholecystitis

The aim. To establish the diagnostic value of the scale for assessing the severity of pain by determining the intensity of pain in patients with acute calculous cholecystitis in patients with chronic viral hepatitis. Materials and methods of research. The study was conducted in the period from 2016 to 2021 in the Department of Emergency Surgery of the Military Medical Clinical Center. In the first stage, the diagnostic scheme included only surveys to identify potential risk factors for infection and anamnestic data on the presence of HCV diagnosed in the past. In the second stage, rapid tests for antigens and antibodies to HCV were introduced into the diagnostic scheme along with the survey. Research results. Patients respond differently to pain, and the sen sation of pain is individual and subjective. Conclusions. Quantitative assessment and registration of the inten sity of pain using a visual-analog scale can supplement the comprehensive information about the general condition of the patient, which is necessary to select the optimal treatment in emergency surgery.

scholarly journals Experience of using polymer clips in patients with acute calculous cholecystitis in combination with chronic viral hepatitis

2018 ◽  
Vol 22 (3) ◽  
pp. 485-488
Author(s):  
M.A. Kashtalian ◽  
A.O. Kolotvіn ◽  
L.I. Kolotvina ◽  
A.A. Kvasnevskiy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Viral Hepatitis ◽  
Cystic Duct ◽  
Chronic Viral Hepatitis ◽  
Study Group ◽  
Acute Calculous Cholecystitis ◽  
Domestic Literature ◽  
Lock In ◽  
Calculous Cholecystitis

In the article, the authors summarize the materials presented in the scientific foreign and domestic literature and acquired their own experience in the use of polymer and metal clips in patients with acute calculous cholecystitis (GKH) in combination with chronic viral hepatitis (CWG). The aim of the work was to optimize the clipping of the cystic duct during laparoscopic cholecystectomy in patients with acute calculous cholecystitis and chronic viral hepatitis. In the period from 2015 to 2017, 822 patients with GCS performed laparoscopic cholecystectomy (LHE). Clinching of the bladder duct and the bladder artery was carried out with metal clips in 339 (41.2%) patients and polymer clips in the type “Hem-o-lock” in 483 (58.8%) patients. In the study group, 59 (7.1%) patients with CKD in combination with CKD were included, in which for clumping of the bladder duct and bladder artery in 17 (28.8%) cases metal clips were used and in 42 (71.2%) cases polymeric. “Slipping” of clips from the clipper among the patients, in whom clapping was done with metal clips, was in 58 (17.1%) patients without CKD, and in 5 (29.4%) patients with CKD with CWG. When clumping with polymer clips, “slipping” clips from the applier was in 17 (3.5%) patients without HV and in 1 (2.4%) patients with HVC. Thus, polymer clips of the Hem-o-lock type are designed for use with an appropriate clipper, which fully repeats the structure of the clip, the problem of “slipping” in patients with GCS during the clumping of the bladder duct and bladder arteries can minimize and prevent the occurrence of complications such as bile duct and bleeding.

scholarly journals Percutaneous Aspiration, Lavage and Antibiotic Instillation. New Approach in the Management of Acute Calculous Cholecystitis

HPB Surgery ◽  
1991 ◽  
Vol 3 (3) ◽  
pp. 167-176 ◽  
Author(s):  
Aws S. Salim
Keyword(s):  
Emergency Surgery ◽  
Enhanced Recovery ◽  
The Other ◽  
First Episode ◽  
Percutaneous Aspiration ◽  
Systemic Complications ◽  
Acute Calculous Cholecystitis ◽  
Wbc Count ◽  
Calculous Cholecystitis ◽  
To Receive

Distension of the gallbladder and bacterial infection can perpetuate an attack of acute calculous cholecystitis and produce its local and systemic complications. This prospective randomized trial was conducted on patients with their first episode of acute calculous cholecystitis which was associated with pyrexia and tachycardia to examine whether ultrasound guided percutaneous aspiration and lavage of the gallbladder followed by intra-lumenal instillation of 500 mg ampicillin (PALA) enhanced recovery from cholecystitis. Twenty patients were randomized to receive 500 mg of ampicillin every 6 hours for 5 days and another 20 patients were randomized to receive this treatment in addition to PALA within 12 hours of admission. Twenty four hours after admission to hospital, all the patients treated with PALA were apyrexial and had no residual right hypochondrial tenderness or guarding, a result superior (p < 0.001) to that of the group without PALA where at least 75% of patients were still showing these signs. Two days after admission the WBC count of the PALA group was significantly (p < 0.05) lower than that of the other group (6.32 ± 0.1 × 109/L vs 10.31 ± 0.4 × 109/L, mean ± SEM, n = 20). Four days after admission, all members of the PALA group were comfortably tolerating solid food for the previous 24 hours and were, therefore, discharged home whereas all members of the other group were still in hospital and 85% of them were discharged home after hospitalization for 6 to 7 days. Three members (15%) of this group deteriorated and underwent emergency surgery.The results show that addition of PALA to the conventional non-operative treatment of acute cholecystitis enhances recovery and avoids the complications necessitating emergency surgery.

scholarly journals Erratum to: 2016 WSES guidelines on acute calculous cholecystitis

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Ansaloni ◽  
M. Pisano ◽  
F. Coccolini ◽  
A. B. Peitzmann ◽  
A. Fingerhut ◽  
...  
Keyword(s):  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Wses Guidelines

scholarly journals Mortality risk estimation in acute calculous cholecystitis: beyond the Tokyo Guidelines

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ana María González-Castillo ◽  
Juan Sancho-Insenser ◽  
Maite De Miguel-Palacio ◽  
Josep-Ricard Morera-Casaponsa ◽  
Estela Membrilla-Fernández ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Propensity Score ◽  
Mortality Risk ◽  
Characteristic Curve ◽  
Chronic Obstructive ◽  
Tokyo Guidelines ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis ◽  
Non Surgical Treatment

Abstract Background Acute calculous cholecystitis (ACC) is the second most frequent surgical condition in emergency departments. The recommended treatment is the early laparoscopic cholecystectomy; however, the Tokyo Guidelines (TG) advocate for different initial treatments in some subgroups of patients without a strong evidence that all patients will benefit from them. There is no clear consensus in the literature about who is the unfit patient for surgical treatment. The primary aim of the study is to identify the risk factors for mortality in ACC and compare them with Tokyo Guidelines (TG) classification. Methods Retrospective unicentric cohort study of patients emergently admitted with and ACC during 1 January 2011 to 31 December 2016. The study comprised 963 patients. Primary outcome was the mortality after the diagnosis. A propensity score method was used to avoid confounding factors comparing surgical treatment and non-surgical treatment. Results The overall mortality was 3.6%. Mortality was associated with older age (68 + IQR 27 vs. 83 + IQR 5.5; P = 0.001) and higher Charlson Comorbidity Index (3.5 + 5.3 vs. 0+2; P = 0.001). A logistic regression model isolated four mortality risk factors (ACME): chronic obstructive pulmonary disease (OR 4.66 95% CI 1.7–12.8 P = 0.001), dementia (OR 4.12; 95% CI 1.34–12.7, P = 0.001), age > 80 years (OR 1.12: 95% CI 1.02–1.21, P = 0.001) and the need of preoperative vasoactive amines (OR 9.9: 95% CI 3.5–28.3, P = 0.001) which predicted the mortality in a 92% of the patients. The receiver operating characteristic curve yielded an area of 88% significantly higher that 68% (P = 0.003) from the TG classification. When comparing subgroups selected using propensity score matching with the same morbidity and severity of ACC, mortality was higher in the non-surgical treatment group. (26.2% vs. 10.5%). Conclusions Mortality was higher in ACC patients treated with non-surgical treatment. ACME identifies high-risk patients. The validation to ACME with a prospective multicenter study population could allow us to create a new alternative guideline to TG for treating ACC. Trial registration Retrospectively registered and recorded in Clinical Trials. NCT04744441

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