Laparoscopic Cholecystectomy for Gallbladder Dysfunction and Polyps: Incidence and Follow up

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

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Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Advances in Urology ◽

10.1155/2015/457305 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Avinash Chennamsetty ◽

Jason Hafron ◽

Luke Edwards ◽

Scott Pew ◽

Behdod Poushanchi ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Incisional Hernia ◽

Operative Time ◽

Patient Counseling ◽

Incisional Hernias ◽

Prostate Weight ◽

History Of ◽

Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

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Moy.02Using aboutmyop.org as an alternative method for post-operative follow-up after elective laparoscopic cholecystectomy – a feasibility study

British Journal of Surgery ◽

10.1093/bjs/znab310.001 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Prita Daliya ◽

Jody Carvell ◽

Judith Rozentals ◽

Maria Ubhi ◽

Dileep Lobo ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Feasibility Study ◽

Controlled Trial ◽

Digital Data ◽

National Guidelines ◽

Patient Acceptability ◽

Safe Alternative ◽

Operative Care ◽

Elective Laparoscopic Cholecystectomy

Abstract Introduction The majority of institutions no longer offer routine post-operative follow-up after elective laparoscopic cholecystectomy. National guidelines however recommend the use of post-operative hotlines or planned telephone follow-up for day-case procedures. At a time when NHS resources are limited, a digital solution may provide a safe alternative to telephone or physical follow-up. Our aim was to identify if digital follow-up with aboutmyop.org; a digital data-sharing platform, was equivalent to telephone follow-up. Method Study participants were invited to use aboutmyop.org before and after surgery. Patients were given free choice on whether they opted to use post-operative digital follow-up or routine post-operative care (no follow-up or telephone follow-up). In addition to follow-up compliance, the outcomes measured included 30-day post-operative complications, readmission, and re-operation. Results Of 597 laparoscopic cholecystectomy patients who were offered follow-up, 16.4% opted for digital follow-up, and 33.3% phone follow-up. Over 5 times as many patients who opted for telephone follow-up missed their appointment when compared to those who chose digital follow-up (5.6% vs. 30.9%, p < 0.001). Digital follow-up had a high sensitivity (68.2%-100%) and specificity (100%) for identifying complications at 30-days post-operatively and was completed significantly earlier than phone follow-up (median 6 days vs. 13.5 days, p = 0.001) with high patient acceptability. Conclusion This feasibility study demonstrates that digital follow-up utilising the aboutmyop.org platform is an acceptable alternative modality to telephone follow-up in elective laparoscopic cholecystectomy patients. Future work should aim to compare matched cohorts of patients undergoing digital follow-up, telephone follow-up, and no follow-up as a randomised controlled trial.

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Management of a pseudo-aneurysm in the hepatic artery after a laparoscopic cholecystectomy

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0182 ◽

2016 ◽

Vol 98 (7) ◽

pp. 456-460 ◽

Cited By ~ 5

Author(s):

MP Senthilkumar ◽

N Battula ◽

MTPR Perera ◽

R Marudanayagam ◽

J Isaac ◽

...

Keyword(s):

Computed Tomography ◽

Laparoscopic Cholecystectomy ◽

Hepatic Artery ◽

Computed Tomography Angiography ◽

Rare Complication ◽

Artery Pseudoaneurysm ◽

Pseudo Aneurysm ◽

High Index Of Suspicion ◽

Time Of Presentation

Introduction Symptomatic hepatic-artery pseudoaneurysm (HAP) after bile-duct injury (BDI) is a rare complication with a varied (but clinically urgent) presentation. Methods A prospectively maintained database of all patients with BDI at laparoscopic cholecystectomy (LC) referred to a tertiary specialist hepatobiliary centre between 1992 and 2011 was searched systematically to identify patients with a symptomatic HAP. Care and outcome of these patients was studied. Results Eight (6 men) of 236 patients with BDI (3.4%) with a median age of 65 (range: 54?6) years presented with symptomatic HAP. Median time of presentation of the HAP from the index LC was 31 (range: 13?16) days. Bleeding was the dominant presentation in 7 patients. One patient presented late (>2 years) with abdominal pain alone. Computed tomography angiography was the most useful investigation. Angioembolisation was successful in 7 patients. One patient died, and another patient developed liver infarction. Three patients (38%) developed biliary strictures after embolisation. Seven patients are alive and well at a median follow-up of 66 months. Conclusions Presentation of HAP is often delayed. A high index of suspicion is necessary for the diagnosis. Computed tomography angiography is the first-line investigation and selective angioembolisation can yield successful outcomes.

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Delayed Perforation of the Large Bowel due to Thermal Injury during Laparoscopic Cholecystectomy

Journal of International Medical Research ◽

10.1177/147323000503300312 ◽

2005 ◽

Vol 33 (3) ◽

pp. 360-363 ◽

Cited By ~ 15

Author(s):

A Polychronidis ◽

AK Tsaroucha ◽

AJ Karayiannakis ◽

S Perente ◽

E Efstathiou ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Laparoscopic Surgery ◽

Large Bowel ◽

Thermal Injury ◽

Clinical Signs ◽

Exploratory Laparotomy ◽

Hepatic Flexure ◽

Temporary Ileostomy ◽

Delayed Perforation

We report a case of delayed perforation of the large bowel because of thermal injury during a laparoscopic cholecystectomy. A 78-year-old male with symptomatic cholelithiasis underwent a difficult laparoscopic cholecystectomy because of multiple adhesions resulting from two previous cholecystitis episodes. The patient recovered well after surgery and was discharged on post-operative day 2. On postoperative day 10, the patient returned to the hospital with peritonitis. An exploratory laparotomy revealed perforation of the wall of the hepatic flexure of the large bowel, which was centred in a necrotic area 1 cm in diameter. The perforation was sutured and a temporary ileostomy performed, which was closed at a later date. The patient was doing well at a 10-month follow-up review. A delayed rupture of any part of the bowel after laparoscopic surgery can be potentially fatal if not treated during an emergency exploratory laparotomy, even if the clinical signs are not severe.

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Right lumbar abscess containing a gallstone—an unexpected late complication of laparoscopic cholecystectomy

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa248 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

André Marçal ◽

Ricardo Vaz Pereira ◽

Ana Monteiro ◽

José Dias ◽

António Oliveira ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Late Complication ◽

Late Complications ◽

Gallbladder Perforation ◽

Past Medical History ◽

Symptomatic Gallstones ◽

History Of ◽

Gallstone Spillage ◽

Saline Lavage

Abstract During laparoscopic cholecystectomy, gallbladder perforation may occur leading to gallstone spillage and despite being rare, early or late complications may therefore develop. We report a case of a 79-year-old female, with a past medical history of a laparoscopic cholecystectomy 3 years earlier for symptomatic gallstones, admitted in the emergency department with a subcutaneous right lumbar abscess confirmed by computed tomography. Emergent abscess surgical drainage was performed and a gallstone was identified during saline lavage. Postoperative evolution was unremarkable and follow-up within a year was uneventful. Split gallstones due to gallbladder perforation during laparoscopic cholecystectomy should be retrieved in order to reduce future complications.

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EUS-guided gallbladder drainage versus laparoscopic cholecystectomy for acute cholecystitis: a propensity score analysis with 1-year follow-up data

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.06.066 ◽

2020 ◽

Cited By ~ 1

Author(s):

Anthony Yuen Bun Teoh ◽

Chi Ho Leung ◽

Prudence Tai Huen Tam ◽

Kitty Kit Ying Au Yeung ◽

Richard Chung Ying Mok ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Propensity Score ◽

Acute Cholecystitis ◽

Propensity Score Analysis ◽

Gallbladder Drainage ◽

Score Analysis

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Synchronous Open Heart Surgery and Laparoscopic Cholecystectomy: An Observational Case Study with 28 Patients

The American Surgeon ◽

10.1177/000313481708300329 ◽

2017 ◽

Vol 83 (3) ◽

pp. 314-321

Author(s):

Mustafa Bilge Erdogan ◽

Mehmet Kaplan ◽

Hakki Kazaz ◽

Bulent Salman

Keyword(s):

Laparoscopic Cholecystectomy ◽

Heart Surgery ◽

Open Heart Surgery ◽

Acalculous Cholecystitis ◽

Tricuspid Valve Repair ◽

Inhospital Mortality ◽

Open Heart ◽

Severe Problem

Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital. Among these, 28 (1%) patients underwent concomitant LC in the same session by the same experienced surgeon. The mean age of the patients was 61.4 ± 9.1 years, and the proportion of males was 71.4 per cent. Acalculous cholecystitis was found in 42.9 per cent of the patients. Patients stayed in the intensive care unit for 3.1 ± 1.4 days and were discharged from the hospital after 16.5 ± 6.3 days. Postoperative 2-year follow-up was completed in all patients with a mean follow-up period of 3.4 ± 2.0 years. The overall complication rate was 28.6 per cent. LC-related complications were seen in four patients. No inhospital mortality was observed. Only one patient who underwent mitral valve replacement and tricuspid valve repair died in the second year after the operation due to congestive heart failure. Three patients died due to noncardiac reasons in the follow-up period. By increasing the experiences of surgeons in laparoscopic surgery in critically ill patients, LC can be safely performed concurrently in patients scheduled for OHS.

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