symptomatic gall stone
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Cureus ◽  
2020 ◽  
Author(s):  
Qamar Kiani ◽  
Fareeha Farooqui ◽  
Muhammad Sohaib Khan ◽  
Aoun Z Khan ◽  
Muhammad Nauman Tariq ◽  
...  

2018 ◽  
Vol 25 ◽  
pp. 55-58
Author(s):  
SMA Taher ◽  
Jamil Raihan ◽  
M Abu Zahid ◽  
AK Azad ◽  
MI Alam ◽  
...  

Laparascopic Cholecystectomy under regional anesthesia alone has been reported only with severe chronic obstructive airway disease1,2. In a randomised trial, epidural with general anesthesia have been found to be more effective in lessening postoperative pain compare with general anesthesia alone3. Regional anesthesia has been successfully used for laparascopic cholecystectomy in patient. Hamad and Ibrahim El-Khatter4 used spinal anesthesia for laparoscopic for the first time. We performing Laparascopic Cholecystectomy with carbondioxide pneumoperitoneum under spinal anesthesia alone of healthy patients with symptomatic gall stone disease5. We design a control randomized trial to compare spinal anesthesthesia with the Gold standard general anesthesia for elective Laparascopic Cholecystectomy in healty patients.TAJ 2012; 25: 55-58


2018 ◽  
Vol 5 (10) ◽  
pp. 3368
Author(s):  
Sagar Soitkar ◽  
Divish Saxena ◽  
Nitin Wasnik ◽  
Murtaza Akhtar

Background: Majority of patient undergoing laparoscopic cholecystectomy for symptomatic gall stone disease is either cured or show improvement in their pre-operative symptoms. However, in few patients these preoperative symptoms may still persist and may continue to bother them even after surgery. The aim of this study is to evaluate and manage these patients with persistent post cholecystectomy symptoms.Methods: 62 patients of diagnosed symptomatic cholelithiasis had undergone laparoscopic cholecystectomy at a tertiary care hospital. They were evaluated with a questionnaire both before and; 3 months and 6 months after surgery. The symptoms present pre-operatively and the symptoms that persisted after laparoscopic cholecystectomy or emergence of any new symptoms were taken into consideration.Results: Out of 62 operated patients, 38 patients (61.3%) were relieved of their symptoms after cholecystectomy on follow up after 3 months whereas 24 patients (38.7%) had persistence of their symptoms. However, at 6 months follow up 16 out of these 24 patients showed improvement of their symptoms. Pain in right hypochondrium and non-specific dyspepsia were the commonest symptoms that were persistent. Thus, in this study 54 (87.1%) patients had complete relief after laparoscopic cholecystectomy and were satisfied with the treatment and in 08 (12.90%) patients the symptoms were not relieved.Conclusions: All the patients undergoing laparoscopic cholecystectomy should be evaluated in detail regarding their symptoms, psychiatric illnesses and be investigated thoroughly so as not to miss any other organic cause for their symptoms and should be counseled regarding persistence of their symptoms even after laparoscopic cholecystectomy.


2018 ◽  
Vol 9 (4) ◽  
pp. 17-22
Author(s):  
Bikash Chandra Ghosh ◽  
Ambar Gangopadhyay

Background: Laparoscopic cholecystectomy (LC), the procedure of choice for symptomatic gall stone disease. An emerging trend is to perform Low pressure pnuemoperitonium laparoscopic surgery as it has additive advantages over standard pressure to avoid complications while providing adequate working space.Aims and Objectives: The current study was designed with an aim to compare the advantage of low pressure pneumoperitoneum vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy.Materials and Methods: The study was conducted in the department of General Surgery in R.G.Kar Medical College from January 2014 to June 2015. A total of 52 patients with symptomatic gall stone disease were recruited, 26 patients in each group randomly. Some intraoperative and post-operative parameters were studied.Results: All the intra-operative (IO) cardio-respiratory parameters (Pulse, Mean Arterial Pressure (MAP), End tidal CO2, spO2) were recorded just before incision, 20 minutes intra-operatively and before reversal of general anesthesia (GA). The IO parameters in our study, were found to be significant only at 20 minutes IO and before reversal of GA. The post-operative (PO) parameters (Pulse, MAP, Respiratory rate, spO2) and pain by VAS score at 6 hours, 12 hours and 24 hours post-operatively were studied. In PO period, we observed significant differences at 2 hours post-operatively in all parameters except MAP. There was significant difference in pain at 6, 12 and 24 hours when compared in both groups. The shoulder tip pain (STP) and 2 hours PO nausea and vomiting were found to be significantly higher in Standard pressure Laparoscopic cholecystectomy (SPLC) compared to Low pressure Laparoscopic cholecystectomy (LPLC). The operative time, duration of hospital stay and return to normal life after surgery though had differences but it was statisticallyinsignificant.Conclusion: Low pressure laparoscopic surgery is safe with least post operative complications when performed by experienced surgeons even in patients of ASA III.Asian Journal of Medical Sciences Vol.9(4) 2018 17-22


2017 ◽  
Vol 5 (1) ◽  
pp. 105
Author(s):  
Indira Khedkar ◽  
Dinesh Prasad ◽  
Achal Datta

Background: Laparoscopic cholecystectomy is gold standard surgery for symptomatic gall stone disease which is the commonest disease needs surgical management. Present study was conducted to contribute UGI endoscopy as routine preoperative investigation and the importance of UGI endoscopy to evaluate the association between gastrointestinal symptoms with gallstones and reduce the prevalence of post cholecystectomy pain.Methods: Patients with Ultrasonography suggestive of single or multiple gall stones were included and investigated as per proforma. Upper GI Scopy was done 1 to 2 days prior to laparoscopic cholecystectomy as per inclusion and exclusion criteria. All patients above 18years, with ultrasonographically proven diagnosis of cholelithiasis and with symptoms (typical and atypical) were included.Results: In present study, author have evaluated the different OGD pathologies the most common site of pathology was stomach (72.5%) that was gastritis. Followed by oesophagitis (55%), and Hiatus hernia (16.5) The most common duodenal pathology was duodenitis (6.25%). In present study, 71 patients had pain in epigastrium at presentation which gradually subsided with no complains of pain in 3 months. Statistically significant reduction in pain was appraised at the end of first week itself (p-value <0.0001).Conclusions: Certain symptoms associated with gallstones are not alleviated by cholecystectomy itself and requires further exploration, therefore, patients presenting with symptomatic gall stone disease should undergo routine OGD prior to cholecystectomy as many gastrointestinal lesions may coexist which prevents the complete relief of the symptoms after cholecystectomy.


2017 ◽  
Vol 4 (4) ◽  
pp. 1335 ◽  
Author(s):  
Arun Kumar ◽  
Kunwar Vishal Singh ◽  
Jugendra Pal Singh Shakya ◽  
Sangita Sahu ◽  
Soniya Dhiman ◽  
...  

Background: Cholelithiasis (gall stone disease) is a well-known disease worldwide. Ultrasonography is the most common screening test for cholecystitis and cholelithiasis. Laparoscopic Cholecystectomy is considered the treatment of choice for symptomatic gall stone disease. It is important to know the different clinical, radiological parameter and specific predictor that give some prediction of difficult LC. The aim of this study was to predict the difficulty of LC and the possibility of conversion to OC before surgery using the clinical and ultrasonographic criteria in our set up.Methods: The present study was carried out in the Department of surgery, Sarojini Naidu Medical College Agra, from November 2014 to October 2016.  A total of 210 patients were enrolled for the laparoscopic cholecystectomy. All patients who were included in the study were undergone detailed history and clinical examination. A number of clinical and ultrasonographical parameters were noted.Results: Amongst the 210 patients admitted for laparoscopic cholecystectomy, 21 (10%) were male and 189 (90%) female, with age ranging from 12–60 years.  The conversion rate in our study was 4.5% (9 of 210). In our study significant pre-operative factors which increased the conversion rate to open cholecystectomy includes male gender, obesity, abdominal scar of previous surgery, contracted and thickened gall bladder and patients having stone impacted at the neck of gall bladder.Conclusions: From this study, we conclude that preoperative ultrasonography is a good predictor of difficult laparoscopic cholecystectomy in the majority of cases and should be used as a screening procedure.


2013 ◽  
Vol 2 (25) ◽  
pp. 4554-4558
Author(s):  
Manisha Nigam ◽  
Renu Ranwaka ◽  
Brijendra Nigam ◽  
Mahendra Singh ◽  
Devpura T. P.

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