A Case of Hemorrhagic Cholecystitis Undergoing Laparoscopic Cholecystectomy After Conservative Treatment

Background: Cholecystectomy is the standard and the only curative treatment for acutecholecystitis. The complications of acute cholecystitis are disastrous to the patients; on the other hand, conservative treatment is associated with recurrence of symptoms and other complications as common bile duct stone. The aim of this study is to weight out the complication of emergency surgery against the complications of conservative treatment in patients with acute cholecystitis. Materials andmethods: A total of 80 patients were included in the study. All Patients underwent early laparoscopiccholecystectomy or interval laparoscopic cholecystectomies for acute calcularcholecystitis from October 2017 to September 2019 were included in the study. Results: The overall complication rate was 15% (6 of 40 in early group and 10% (4 of 40) in the delayed group. One case of delayed group suffering recurrent acute attack and the other one suffering common bile duct stone, there was no major bile duct injury in the delayed group. Conclusion: Laparoscopic cholecystectomy is a safe and cost-eﬀective approach for the treatment of acute cholecystitis within 72 h after the onset of attack.

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Complications of laparoscopic cholecystectomy: an analysis of 1,695 laparoscopic operations

International Surgery Journal ◽

10.18203/2349-2902.isj20173885 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3049

Author(s):

Dasharadha Jatothu ◽

Rajkumar Sade ◽

Kirthana Sade ◽

. Taruni ◽

Nagababu Pyadala

Keyword(s):

Laparoscopic Cholecystectomy ◽

Conservative Treatment ◽

Minimally Invasive ◽

Treatment Options ◽

Gallstone Disease ◽

Minimally Invasive Treatment ◽

Medical Sciences ◽

Invasive Treatment ◽

Gold Standard Method ◽

Operative Complication

Background: Laparoscopic cholecystectomy (LCs) is the gold standard method to treat gallstone disease. But there are some complications which occur frequently as compared to open cholecystectomy.Methods: The prospective study was conducted in the Department of Surgery, Kamineni Institute of Medical Sciences, Telengana during the period of 2 years; March 2015 to February 2017. A total of 1,695 laparoscopic cholecystectomy cases were included in this study. Several treatment options such as, conservative treatment, minimally invasive treatment and open surgery was performed based on the severity of the disease.Results: Majority of patients were female (83.9%) and most common age group affected was above 40 years. Intra-operative and post-operative complication occurred in 4.5% and 1.9% patients respectively. Majority complications were treated by conservative treatment and minimally invasive treatment. So, in conclusion, we can use conservative and minimally invasive treatment to manage the complications from laparoscopic cholecystectomy.Conclusions: Conservative treatment options and minimally invasive treatment was more efficient to overcome the post-operative complication of laparoscopic cholecystectomy.

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Early versus Delayed Laparoscopic Cholecystectomy in Acute Calculus Cholecystitis in Southern Odisha - A Prospective Comparative Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/281 ◽

2021 ◽

Vol 8 (20) ◽

pp. 1484-1488

Author(s):

Manoj Kumar Sethy ◽

Siva Rama Krishna M ◽

Jagannath Subudhi S ◽

Biswa Ranjan Pattanaik ◽

Manita Tamang ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Conservative Treatment ◽

Hospital Stay ◽

Acute Cholecystitis ◽

Morbidity And Mortality ◽

Early Laparoscopic Cholecystectomy ◽

Delayed Laparoscopic Cholecystectomy ◽

Conversion To Open Cholecystectomy ◽

The Mean ◽

Antibiotic Coverage

BACKGROUND Acute cholecystitis is a pathology of inflammatory origin, usually associated with cholelithiasis, with a high incidence in the world. Its treatment involves an important socioeconomic impact. There are two surgical therapeutic options: early laparoscopic cholecystectomy (ELC) done within 72 hours of onset of pain or delayed laparoscopic cholecystectomy (DLC) done after 6 weeks of conservative treatment. The present study intends to compare between the effectiveness of ELC vs DLC in the management of acute cholecystitis in a tertiary care setup. METHODS The study sample included 65 patients who were clearly documented and radiologically proven cases of acute calculous cholecystitis, met the inclusion criteria, admitted to the surgery department of MKCG MCH, Berhampur, between August 2018 and July 2020. Out of 65 patients, 33 and 32 patients were selected randomly for ELC and DLC respectively. In ELC group surgery was done within 72 hours of the onset of pain while in DLC group surgery was done after 6 weeks of initial conservative treatment. The study was conducted using a case record proforma, prepared in their local language. The questionnaire included timing of cholecystectomy, duration of antibiotic coverage, mean duration of hospital stay, number of intraoperative and postoperative complications, conversion to open cholecystectomy, and follow-up. The data was compiled and tabulated in MS ® Excel and statistically analysed using IBM ® SPSS 22.0. RESULTS The overall morbidity and mortality were less in ELC compared to DLC. The mean duration of surgery was less in ELC (47.36 minutes) compared to DLC (65.75 minutes). The mean duration of antibiotic coverage was lesser in ELC (3.58 days) compared to DLC (5.50 days).The mean hospital stay was less in ELC (4.67 days) to DLC (6.50 days). The overall morbidity and mortality were less in ELC. CONCLUSIONS ELC is considered to be a safe modality of treatment in patients with acute cholecystitis and leads to an economical treatment. KEYWORDS Acute Calculus Cholecystitis, Early Laparoscopic Cholecystectomy, Delayed Laparoscopic Cholecystectomy

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Hemorrhagic cholecystitis during anticoagulant therapy in a patient with systemic lupus erythematosus and antiphospholipid syndrome undergoing elective laparoscopic cholecystectomy

International Surgery ◽

10.9738/intsurg-d-15-00319.1 ◽

2017 ◽

Author(s):

Yukio Oshiro ◽

Shuntaro Tsukamoto ◽

Yohei Owada ◽

Kazuhiro Takahashi ◽

Tatsuya Oda ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Abdominal Pain ◽

Laparoscopic Cholecystectomy ◽

Antiphospholipid Syndrome ◽

Anticoagulant Therapy ◽

Lupus Erythematosus ◽

Blood Clot ◽

Systemic Lupus ◽

Elective Laparoscopic Cholecystectomy ◽

Hemorrhagic Cholecystitis

Abstract Hemorrhagic cholecystitis is a rare cause of abdominal pain that presents in traumatic settings, malignancy, and bleeding diathesis. Herein, we report a case of hemorrhagic cholecystitis during anticoagulant therapy in a patient with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) who underwent a laparoscopic cholecystectomy. A 61-year-old female presented with abdominal pain and melena during hospitalization for SLE. She had a history of SLE and APS before this episode. She was diagnosed with hemorrhagic cholecystitis by ultrasonography (US), computed tomography (CT), and duodenoscopy. CT revealed a distended gallbladder containing a hy¬podense material suggestive of blood. The duodenoscopy revealed blood-mixed bile appearing from the papilla. Following conservative treatment, hemostasis was confirmed, and an elective laparoscopic cholecystectomy was performed based on the diagnosis of hemorrhagic cholecystitis. The open¬ing of the gallbladder revealed a large blood clot that gushed out, and multiple gallstones were also observed. The postoperative course was uneventful, and the patient has remained healthy without any complications.

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Emergency laparoscopic cholecystectomy for hemorrhagic cholecystitis: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106631 ◽

2021 ◽

pp. 106631

Author(s):

Toshikatsu Nitta ◽

Ryo Iida ◽

Masatsugu Ishii ◽

Masahiko Ueda ◽

Sadakatsu Senpuku ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Case Report ◽

Hemorrhagic Cholecystitis

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Timing of early laparoscopic cholecystectomy for acute calculous cholecystitis revised: Protocol of a systematic review and meta-analysis of results

World Journal of Emergency Surgery ◽

10.1186/s13017-019-0285-7 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 2

Author(s):

Giuseppe Borzellino ◽

Safi Khuri ◽

Michele Pisano ◽

Subhi Mansour ◽

Niccolò Allievi ◽

...

Keyword(s):

Systematic Review ◽

Laparoscopic Cholecystectomy ◽

Early Intervention ◽

Conservative Treatment ◽

Acute Cholecystitis ◽

Meta Analysis ◽

Early Cholecystectomy ◽

Early Laparoscopic Cholecystectomy ◽

Pooled Data ◽

Delayed Cholecystectomy

Abstract Background Early laparoscopic cholecystectomy has been adopted as the treatment of choice for acute cholecystitis due to a shorter hospital length of stay and no increased morbidity when compared to delayed cholecystectomy. However, randomised studies and meta-analysis report a wide array of timings of early cholecystectomy, most of them set at 72 h following admission. Setting early cholecystectomy at 72 h or even later may influence analysis due to a shift towards a more balanced comparison. At this time, the rate of resolving acute cholecystitis and the rate of ongoing acute process because of failed conservative treatment could be not so different when compared to those operated with a delayed timing of 6–12 weeks. As a result, randomised comparison with such timing for early cholecystectomy and meta-analysis including such studies may have missed a possible advantage of an early cholecystectomy performed within 24 h of the admission, when conservative treatment failure has less potential effects on morbidity. This review will explore pooled data focused on randomised studies with a set timing of early cholecystectomy as a maximum of 24 h following admission, with the aim of verifying the hypothesis that cholecystectomy within 24 h may report a lower post-operative complication rate compared to a delayed intervention. Methods A systematic review of the literature will identify randomised clinical studies that compared early and delayed cholecystectomy. Pooled data from studies that settled the early intervention within 24 h from admission will be explored and compared in a sub-group analysis with pooled data of studies that settled early intervention as more than 24 h. Discussion This paper will not provide evidence strong enough to change the clinical practice, but in case the hypothesis is verified, it will invite to re-consider the timing of early cholecystectomy and might promote future clinical research focusing on an accurate definition of timing for early cholecystectomy for acute cholecystitis.

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