scholarly journals Prospective evaluation of outcome following laparoscopic cholecystectomy in patients with symptomatic gallstone disease

2015 ◽  
Vol 4 (1) ◽  
pp. 14
Author(s):  
Sanjay Marwah ◽  
Siddharth Pandey ◽  
Himanshu Sharma ◽  
Mahavir Singh ◽  
Hardeep Singh ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallstone Disease ◽  
Prospective Evaluation ◽  
Symptomatic Gallstone Disease

scholarly journals A prospective observational study to study and correlate the clinical and microbiological profile of bile cultures in patients with symptomatic cholelithiasis

2020 ◽  
Vol 7 (5) ◽  
pp. 1566
Author(s):  
Ramakrishnan Shankaran ◽  
Chaminda Amarasekara
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gallstone Disease ◽  
Significant Proportion ◽  
Antibiotic Sensitivity ◽  
Klebsiella Species ◽  
Duration Of Symptoms ◽  
Symptomatic Cholelithiasis ◽  
Bile Culture ◽  
Symptomatic Gallstone Disease

Background: Biliary infection has been reported in a significant proportion of patients developing gallstones. Many studies have found biliary microflora in 20% to 46% patients with a post-operative infection rate of 7% to 20% in those who undergo cholecystectomy for symptomatic gallstone disease. Various antibiotics are also used empirically as prophylaxis against post-operative infection. The study was conducted in order to determine the bacteriology and to test its sensitivity to commonly used antibiotics of aspirated bile samples taken during laparoscopic cholecystectomy, and to correlate it with the clinical profile recorded in patients with symptomatic cholelithiasis.Methods: A total of 266 patients who underwent laparoscopic cholecystectomy were included in the study over a two year period. Intra operatively, bile was aspirated from gall bladder and sent for culture and antibiotic sensitivity testing.Results: 14.66% (39 out of 266) patients had positive growth with Escherichia coli most commonly isolated in 9.77% (26/266) patients, followed by the Klebsiella species in 4.89% (13 out of 266) patients. All the cultures were sensitive to amikacin and meropenem, 97.44% to imipenem, and only 43.39% were sensitive to ampicillin. A statistically significant correlation was observed between a positive bile culture with the duration of symptoms (p=0.01874) and gall bladder thickness (p<0.0001). No correlation was seen between bile culture and history of acute cholecystitis, number or size of calculi.Conclusions: The results of this study can help develop local guidelines and recommendations based on Indian data to ensure the rational use of prophylactic antibiotics in patients with symptomatic cholelithiasis.

scholarly journals Acute Laparoscopic Cholecystectomy: Delays in Acute Surgery and Cost Analysis of Aproposed New Service

2011 ◽  
Vol 93 (7) ◽  
pp. 261-265
Author(s):  
AJ Cockbain ◽  
AL Young ◽  
E McGinnes ◽  
GJ Toogood
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Meta Analysis ◽  
Gallstone Disease ◽  
Cochrane Review ◽  
Length Of Hospital Stay ◽  
Biliary Colic ◽  
Complication Rates ◽  
Acute Surgery ◽  
Symptomatic Gallstone Disease

Acute laparoscopic cholecystectomy (ALC) is widely considered the most appropriate management for patients presenting with acute cholecystitis as supported by a recent meta-analysis and Cochrane review. Although the benefit of ALC is less clear in patients with biliary colic, few would disagree that earlier cholecystectomy is preferable for most patients with symptomatic gallstone disease. ALC has similar complication rates to elective laparoscopic cholecystectomy (ELC) and a reduced total length of hospital stay. Recurrent symptoms from untreated gallstone disease are common, with the risk of developing more severe complications such as acute cholecystitis, acute pancreatitis or cholangitis while waiting for an operation. It has been reported that patients awaiting ELC after an acute admission have significantly more general practitioner (GP) attendances than those who receive ALC, that they have an average of one emergency department attendance for symptom recurrence and that one in six requires hospital admission due to the severity of recurrent symptoms.

scholarly journals Laparoscopic management of rare “ H type” duplication of gall bladder

2020 ◽  
Vol 6 (6) ◽  
pp. 354-357
Author(s):  
Dr. Anurag Mishra ◽  
◽  
Dr. Md Abu Masud Ansari ◽  
Dr. Shivanshu Misra ◽  
◽  
...  
Keyword(s):  
Congenital Anomaly ◽  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gallstone Disease ◽  
Current Case ◽  
Rare Congenital Anomaly ◽  
Live Births ◽  
Cholecystoenteric Fistula ◽  
Double Gallbladder ◽  
Symptomatic Gallstone Disease

A duplicated gallbladder is a rare congenital anomaly with an incidence of 1:4000 live births. Theycan remain asymptomatic and identified incidentally or present as acute cholecystitis, empyema,torsion, cholecystoenteric fistula, Gall bladder lump, or carcinoma. Here the current case is aboutdiscussing a case of a 25-year-old female who presented with symptomatic gallstone disease with aduplicated gallbladder having multiple stones in both the gallbladders. MRCP performedpreoperatively revealed Y type duplication (double Gall bladder with common cystic duct).Laparoscopic cholecystectomy was performed and it finally revealed H type duplication (double Gallbladder with separate cystic ducts for each Gall Bladder).

Time trend and variability of open versus laparoscopic cholecystectomy in patients with symptomatic gallstone disease

2013 ◽  
Vol 27 (9) ◽  
pp. 3254-3261 ◽  
Author(s):  
Mario Saia ◽  
Domenico Mantoan ◽  
Alessandra Buja ◽  
Chiara Bertoncello ◽  
Tatjana Baldovin ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Time Trend ◽  
Gallstone Disease ◽  
Symptomatic Gallstone Disease ◽  
Open Versus

scholarly journals Course and outcomes of complicated gallstone disease in pregnancy: a single centre experience

2019 ◽  
Vol 7 (7) ◽  
pp. 2686
Author(s):  
Nihida Akhter ◽  
Irfan Nazir Mir ◽  
Sheikh Viqar Manzoor
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Average Length ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Length Of Hospital Stay ◽  
Delay In Diagnosis ◽  
Medical College ◽  
Skilled Personnel ◽  
Symptomatic Gallstone Disease ◽  
In Pregnancy

Background: The incidence of acute abdomen during pregnancy is approximately 1 in 500 pregnancies. The incidence of symptomatic gallstone disease in pregnancy is reported in approximately 0.2-0.5 per 1,000 pregnancies. Symptoms are similar to those in the nonpregnant state. A delay in diagnosis may increase the risk of perforation. Treatment in most cases is conservative. However, recent trends, newer instrumentation and skilled personnel encourage arranging laparoscopic cholecystectomy at the time of diagnosis.Methods: This study was a retrospective study, included 117 pregnant patients with acute gallstone disease, who were treated and followed-up at Government Medical College, Srinagar, Department of General Surgery and Department of Gynae And Obstetrics, between January 2015 and April 2017.Results: The mean age of patients in our study was 28.6 years. Majority of patients 56 (47.86%) were in is trimester of pregnancy. Parity of the patients varied from 1 to 6, with a mean parity of 2.67. The presentation of majority of patients was colicky pain right upper abdomen,108 (92.30%). All patients had gallstones on USG scan.101(86.32%) patients had acute cholecystitis, while 8 (6.83%) patients had predominant features of acute pancreatitis,8(6.83%) patients had accompanying choledocholithiasis The average wall thickness of gallbladder in our patients was 4.62 mm. Majority 106 (90.59%) patients were managed conservatively. 8 (6.83%) patients underwent cholecystectomy in same admission, after failure of conservative management, 7 patients underwent laparoscopic cholecystectomy and one underwent open cholecystectomy. 3 patients (2.56%), who had features of cholangitis were managed by ERCP. The average length of hospital stay in our patient group was 8.61 days. There was one maternal death reported in our study, there were a total of 8 (6.83%) preterm deliveries.Conclusions: Symptomatic gallstone disease in pregnancy is a common surgical problem. Diagnosis during pregnancy can be difficult, majority of cases can be managed conservatively, intervention whenever indicated must be undertaken.

Elective Laparoscopic Cholecystectomy for Symptomatic Gallstone Disease in Patients Receiving Anticoagulant Therapy

2005 ◽  
Vol 15 (4) ◽  
pp. 357-360 ◽  
Author(s):  
Emmanuel Leandros ◽  
Ilias P. Gomatos ◽  
Panagoula Mami ◽  
Eleftherios Kastellanos ◽  
Konstantinos Albanopoulos ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Anticoagulant Therapy ◽  
Gallstone Disease ◽  
Elective Laparoscopic Cholecystectomy ◽  
Symptomatic Gallstone Disease

scholarly journals An ergonomic modification of the American position for laparoscopic cholecystectomy in a rural setting

2019 ◽  
Vol 6 (8) ◽  
pp. 2982
Author(s):  
Philip Umman ◽  
Clyde R. Menezes ◽  
Ashish Bosco ◽  
Nandakumar Menon
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Urban Poor ◽  
Gallstone Disease ◽  
Rural Setting ◽  
Team Members ◽  
Post Operative Pain ◽  
Recovery Times ◽  
Symptomatic Gallstone Disease ◽  
Laparoscopic Techniques ◽  
The Cost

Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstone disease. As a result of the significant investments in setting up a laparoscopy unit and training nursing staff in laparoscopic techniques, the cost of laparoscopic surgery is higher. However, the urban poor and rural population of India stand to benefit most from laparoscopy, owing to the shorter recovery times and reduced post-operative pain. The American and French positions have been described for laparoscopic cholecystectomy. Studies on ergonomics in laparoscopy deal mainly with issues related to the operating surgeon. There is not much literature on the issues faced by the team members during laparoscopy, especially in resource constrained settings. The authors propose a modification of the American position for LC, which enhances comfort and vision for the scrub nurse and also helps the surgeon guide the novice staff in LC.

scholarly journals Pre-operative assessment of difficult laparoscopic cholecystectomy: a scoring method

2021 ◽  
Author(s):  
Vamsi K. Malligurki ◽  
Bhaskaran A.
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Standard Procedure ◽  
Gallstone Disease ◽  
Previous History ◽  
Scoring Method ◽  
Medical College ◽  
Symptomatic Gallstone Disease ◽  
A Prospective Study ◽  
Operative Assessment ◽  
Difficult Cases

Background: Laparoscopic cholecystectomy (LC) has become the gold standard procedure for management of symptomatic gallstone disease. At times, it is difficult and takes longer time or has to be converted to an open procedure. The study was undertaken to determine the factors which predict difficult LC. The aim of the study was to evaluate a pre-operative scoring method to predict difficult LC.Methods: This was a prospective study conducted in the department of general surgery, MVJ Medical College, Bangalore from December 2020 to August 2021. There were 100 cases operated by experienced surgeons. Scoring method which included parameters from history, clinical and sonological findings with maximum score up to 15. Score up to 5 predicted easy, 6-10 difficult and 11-15 is very difficult.Results: Pre-operative scoring system correlated with 85.7% for easy, 83.3% in difficult cases and 100% in very difficult cases. The factors like previous history of hospitalization (p=0.004), clinically palpable gallbladder (GB) (p=0.009), impacted GB stone (p=0.001), pericholecystic collection (p=0.04), and abdominal scar due to previous abdominal surgery (p=0.009) were found statistically significant in predicting difficult LC.Conclusions: Pre-operative prediction of risk factors to assess the operative difficulty is an important point for planning the surgery and the high-risk patients may be informed accordingly.

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