Outcome Analysis of Laparoscopic Cholecystectomy in Patients Aged 80 Years and Older with Complicated Gallstone Disease

2007 ◽  
Vol 17 (6) ◽  
pp. 731-736 ◽  
Author(s):  
Emmanuel Leandros ◽  
Nicholas Alexakis ◽  
Fotis Archontovasilis ◽  
Konstandinos Albanopoulos ◽  
Dimitrios Dardamanis ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallstone Disease ◽  
Outcome Analysis

Time to abandon the old dictum of delayed laparoscopic cholecystectomy after acute cholecystitis has settled in Caribbean practice

2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Gold Standard ◽  
Standard Treatment ◽  
Gallstone Disease ◽  
Acute Attack ◽  
Early Laparoscopic Cholecystectomy ◽  
Delayed Surgery ◽  
Delayed Cholecystectomy ◽  
Delayed Laparoscopic Cholecystectomy

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.

IS THERE STILL A DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY? — AN EXPLORATIVE AND DESCRIPTIVE STUDY TO IDENTIFY RISK FACTORS AND TO ESTABLISH A SCORING SYSTEM FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY.

2021 ◽  
pp. 52-54
Author(s):  
Suhas Umakanth ◽  
Srinath Subbarayappa ◽  
Jayanth Bannur Nagaraja
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Gallstone Disease ◽  
Descriptive Study ◽  
Gastrointestinal Illness ◽  
Prospective Analysis ◽  
Open Conversion ◽  
Patient Demographics ◽  
Low Threshold ◽  
Distended Gallbladder

Background: Gallstone disease is among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is now the preferred approach to its treatment. When performing laparoscopic cholecystectomy, the surgeon should have the low threshold for open conversion in case of difculty. The aim of the study was Pre-operative prediction of difcult laparoscopic cholecystectomy using clinical, ultrasonographic and intraoperative parameters. Methods:This study was done on 200 patients presenting with symptomatic cholelithiasis who underwent laparoscopic cholecystectomy. A prospective analysis of parameters including the patient demographics, laboratory values, radiologic data and intraoperative parameters was performed. Results: The factors which were considered a difculty parameter were males, age>60years, preoperative ERCP, rised amylase, sonographic features of contracted or distended gallbladder and pericholecystic collection. Intraoperative parameters were adhesions around gallbladder, contracted or distended gallbladder inamed gallbladder. Conclusions: The above mentioned factors must be adequately studied and the surgeon and the patient should be prepared for difcult laparoscopic cholecystectomy.

scholarly journals AMBULATORY LAPAROSCOPIC CHOLECYSTECTOMY IS SAFE AND COST-EFFECTIVE: a Brazilian single center experience

2016 ◽  
Vol 53 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Uirá Fernandes TEIXEIRA ◽  
Marcos Bertozzi GOLDONI ◽  
Mayara Christ MACHRY ◽  
Pedro Ney CECCON ◽  
Paulo Roberto Ott FONTES ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Selection Criteria ◽  
Outpatient Surgery ◽  
Gallstone Disease ◽  
Cost Savings ◽  
Cost Effective ◽  
Single Center ◽  
Single Center Experience ◽  
Elective Laparoscopic Cholecystectomy ◽  
Liver Biopsies

ABSTRACT Background - Laparoscopic cholecystectomy is the treatment of choice for gallstone disease, and has been perfomed as an outpatient surgery in many Institutions over the last few years. Objective - This is a retrospective study of a single center in Brazil, that aims to analyze the outcomes of 200 cases of ambulatory laparoscopic cholecystectomy performed by the same Hepato-Pancreato-Biliary team, evaluating the safety and cost-effectiveness of the method. Methods - Two hundred consecutive patients who underwent elective laparoscopic cholecystectomy were retrospectively analyzed; some of them underwent additional procedures, as liver biopsies and abdominal hernias repair. Results - From a total of 200 cases, the outpatient surgery protocol could not be carried out in 22 (11%). Twenty one (95.5%) patients remained hospitalized for 1 day and 1 (4.5%) patient remained hospitalized for 2 days. From the 178 patients who underwent ambulatory laparoscopic cholecystectomy, 3 (1.7 %) patients returned to the emergency room before the review appointment. Hospital cost was on average 35% lower for the ambulatory group. Conclusion - With appropriate selection criteria, ambulatory laparoscopic cholecystectomy is feasible, safe and effective; readmission rate is low, as well as complications related to the method. Cost savings and patient satisfaction support its adoption. Other studies are necessary to recommend this procedure as standard practice in Brazil.

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

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.

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.

TP6.1.9 Prolonged post-operative stay following emergency and elective laparoscopic cholecystectomies and its contributing factors

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
James Lucocq ◽  
Ganesh Radhakishnan ◽  
John Scollay ◽  
Pradeep Patil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gallstone Disease ◽  
Contributing Factors ◽  
Surgical Decision ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Surgical Units ◽  
Emergency Group ◽  
Elective Group ◽  
Heterogenous Population

Abstract Aims Patients who undergo laparoscopic cholecystectomy (LC) for gallstone disease are a heterogenous population with many variables involved in their management. The aim was to identify the proportion of patients who have a prolonged post-operative stay (PPS; &gt;3days) following elective and emergency LC and the variables that most contribute to PPS. Methods We retrospectively collected data for all patients who underwent an elective and emergency LC across three surgical units from 2015 to 2020. Rates of PPS were compared between elective and emergency groups and variables associated with PPS were identified using multivariate logistic regression models. Results 2769 patients were included in the study (median age, 53years(range, 13-92); M:F,1:2.7; emergency:elective,1:3.6) The rate of PPS was higher in the emergency versus elective group (25.1% versus 6.6%; p&lt;0.0001). Pain was one of the major causes in both groups. In the elective group, factors associated with PPS included cholecystitis (OR,1.96; p=0.008), previous gallstone related admissions (OR,1.48; p=0.008), pre-operative ERCP (OR,3.58;p&lt;0.0001), ASA (OR,1.82; p=0.001) and age (years) (OR,1.03;p=0.001). In the emergency group, factors associated with PPS include cholecystitis (OR,5.3;p&lt;0.0001), ASA (OR,1.96; p = 0.01) and pre-operative ERCP (OR,4.44;p=0.001). Conclusions The rate of PPS following laparoscopic cholecystectomy is significant, particularly in the emergency group. Although the possibility of PPS cannot be avoided, patient information regarding the possibility of PPS is important, particularly for those at risk. The risk factors for PPS should be used to guide surgical decision making and should be followed by targeted management of these patients including optimised pain relief.

scholarly journals Outpatient Laparoscopic Cholecystectomy in Hong Kong Chinese – An Outcome Analysis

2004 ◽  
Vol 27 (4) ◽  
pp. 313-316 ◽  
Author(s):  
Kenneth Siu Ho Chok ◽  
Sheung Tat Fan ◽  
Wai Key Yuen ◽  
Hung Lau ◽  
Francis Lee
Keyword(s):  
Hong Kong ◽  
Laparoscopic Cholecystectomy ◽  
Hong Kong Chinese ◽  
Outcome Analysis
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