scholarly journals Interval Laparoscopic Cholecystectomy in the Management of Acute Biliary Pancreatitis

HPB Surgery ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. 319-323 ◽  
Author(s):  
M. D. Pinhas Schachter ◽  
M. D. Timor Peleg ◽  
M. D. Oded Cohen
Keyword(s):  
Acute Pancreatitis ◽  
Laparoscopic Cholecystectomy ◽  
Traditional Approach ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Operating Time ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Calot’S Triangle ◽  
Mild Acute Pancreatitis

The timing of laparoscopic cholecystectomy following an attack of acute biliary pancreatitis is controversial. The traditional approach of interval cholecystectomy has been challenged recently. The present study was designed to evaluate the benefits of interval laparoscopic cholecystectomy for patients with mild acute pancreatitis (Ranson less than 3). Nineteen patients with mild pancreatitis underwent ultrasonographic evaluation to confirm the biliary etiology. ERCP was performed in all patients on the first available endoscopy list, and endoscopic sphincterotomy was performed in two patients with calculi or dilated common bile duct on ultrasonographic examination. Medical treatment was administered and laparoscopic cholecystectomy was scheduled after 8–12 weeks to allow the inflammatory process to settle. There were no recurrent attacks of pancreatitis during this period. The degree of difficulty of the laparoscopic procedure was assessed by the presence of adhesions to the gallbladder area, difficulty of dissection in the Calot's triangle, intraoperative bleeding and the need for a drain. Six patients (31.5%) had severe adhesions, difficult dissection of the cystic duct and artery, bleeding and prolonged operating time. In two of these patients (10.5%) the procedure was converted to open cholecystectomy. In conclusion, our results suggest that postponing laparoscopic cholecystectomy in acute pancreatitis patients is not advantageous surgically and does not justify the risk of further morbidity caused by the gallbladder disease.

scholarly journals Laparoscopic cholecystectomy: Conversion rate and complcation

2016 ◽  
Vol 18 (3) ◽  
pp. 43
Author(s):  
BR Malla ◽  
HN Joshi ◽  
N Rajbhandari ◽  
YR Shakya ◽  
B Karki ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Conversion Rates ◽  
Conversion To Open Cholecystectomy ◽  
Previous Laparotomy ◽  
History Of

Introduction and Objective: Laparoscopic Cholecystectomy is the standard surgical treatment for gallbladder disease. However, conversion to open surgery is not the complication. Different centers have reported different conversion rates and post operative complications. The objective of this study is to identify conversion rate and post operative complication of laparoscopic cholecystectomyMaterials and Methods: This retrospective study included all laparoscopic cholecystectomies attempted in Dhulikhel hospital during the year 2015. Files of all patients were reviewed to find out the demography of the patients and the indication of Laparoscopic cholecystectomy. The rate of conversion to open cholecystectomy, the underlying reasons for conversion and postoperative complications were analyzed.Results: Out of 324 cases attempted laparoscopic cholecystetomies, two cases with the history of previous laparotomy were excluded to rule out the bias in the result. Out of 322 cases 226(70.18%)were female and 96(29.81%) were male . The mean age was 38 years. Over all conversion rate to open cholecystetomy was 1.86% with frozen calot’s triangle as the most common reason for conversion. The over all postoperative complication was 1.24% with no major bile duct injury.Conclusion: Laparoscopic cholecystectomy can safely be done with low conversion rate and complication.

scholarly journals Conversion of laparoscopic cholecystectomy to open cholecystectomy in a single center

2021 ◽  
Vol 9 (2) ◽  
pp. 14-18
Author(s):  
Suttam Kumar Biswas ◽  
Shilpi Rani Roy ◽  
Subbrata Sarker ◽  
Md Mustafizur Rahman ◽  
Kamrul Islam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Preoperative Assessment ◽  
College Hospital ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Number Of Patients ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversions to open cholecystectomy are still inevitable in certain cases. Knowledge about the rate and underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion of our LC series. This study included 320 consecutive laparoscopic cholecystectomies from January 2017 to December 2019 at Community Based Medical College Hospital Bangladesh, Mymensingh. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 15 (4.6%) patients. Out of 15 cases, the highest number of patients 10(66.6%) were in age group 50 to 59 years with a mean age of 60.1 years and standard deviation (SD) of 9.8 years. Of them 9 (60%) were male. The most common reasons for conversion of them were severe adhesions at calot's triangle 6 (40%) and acutely inflamed gallbladder 5 (33.3%), bleeding 2 (13%). No surgical procedures are complication free. The most common complication was superficial wound infection 8(2.5%). Delayed complications seen in our series is port site incisional hernia 2 (0.62%). Male gender, age older than 60 years, previous upper abdominal surgery, diabetes, and severity of inflammation were all significantly correlated with an increased conversion rate to laparotomy. LC is the preferred method even in difficult cases. This study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery. CBMJ 2020 July: Vol. 09 No. 02 P: 14-18

scholarly journals Gall Stones in Acute Pancreatitis - A Prospective Study

2020 ◽  
Vol 7 (46) ◽  
pp. 2690-2693
Author(s):  
Venkata Prakash Gandikota ◽  
Tharaka Mourya Nutulapati ◽  
Purushotham Gangapalli ◽  
Ajay Babu Korchapati ◽  
Sahithi Priya Boddukura ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Laparoscopic Cholecystectomy ◽  
Prospective Study ◽  
Hospital Stay ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Gall Stones ◽  
A Prospective Study

BACKGROUND Multiple practice guidelines from different American and European societies recommend index hospitalization cholecystectomy following an episode of gallstone pancreatitis. We wanted to analyse the outcome of patients presenting with acute pancreatitis in the presence of gall stones, analyse the sensitivity and specificity of liver function tests in early prediction of acute biliary pancreatitis and establish the advantages of early intervention in acute biliary pancreatitis. METHODS This is a prospective study conducted at a tertiary care hospital for a period of 12 months among 100 cases of acute pancreatitis who presented with abdominal pain with serum amylase level 3 times the normal limits in the absence of hypercalcemia or hyperlipidaemia. Presence of gallstones was confirmed on ultrasonography. Patients were subjected to preoperative ERCP and endoscopic sphincterotomy. Intraoperative and postoperative morbidity and mortality, and postoperative hospital stay were reported. RESULTS Gall stones were the cause of pancreatitis in 16 out of 100 cases (16 %). Male to female ratio was 1 : 3. Mean occurrence of age was 51.1 years. Preoperative ERCP was done 10 cases (63 %). Laparoscopic Cholecystectomy was performed in all the 16 cases (100 %) of which 12 cases (75 %) underwent Lap cholecystectomy in the same admission and 4 cases were subjected to interval cholecystectomy. 1 case was converted to open procedure. Post-operative complications include nausea and vomiting in 2 cases, chest infection in 2 and bile leak in 1. CONCLUSIONS Management of acute pancreatitis in the presence of gallstones requires prompt diagnosis and timely intervention. Laparoscopic cholecystectomy can be safely performed for mild to moderate acute biliary pancreatitis after clinical and biochemical resolution of the attack during the same admission with acceptable morbidity and mortality rates. This strategy will lead to reducing the recurring acute biliary pancreatitis, number of admissions and hospital stay. KEYWORDS Acute Pancreatitis, Gallstones, LFT, Lipase, Amylase, ERCP, Laparoscopic Cholecystectomy

scholarly journals Endoscopic retrograde cholangio-pancreatograhy and laparoscopic cholecystectomy in single session management of acute biliary pancreatitis

2017 ◽  
Vol 4 (10) ◽  
pp. 3218
Author(s):  
Ahmed Gaber ◽  
Mohamed S. Ammar ◽  
Hatem Soltan
Keyword(s):  
Acute Pancreatitis ◽  
Laparoscopic Cholecystectomy ◽  
Single Step ◽  
University Hospital ◽  
Biliary Pancreatitis ◽  
Single Session ◽  
Endoscopic Retrograde ◽  
Acute Biliary Pancreatitis ◽  
Laboratory Investigations ◽  
A Prospective Study

Background: World widely, the annual incidence of acute pancreatitis ranges from 5 to 50 per 100000. The major cause of acute pancreatitis is biliary calculi, which occur in 50-70% of patients. Aim of this study is to evaluate Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and Laparoscopic Cholecystectomy (LC) as a single step management of early acute biliary pancreatitis.Methods: A prospective study included 25 patients complaining of acute biliary pancreatitis. The study was done between December 2012 and February 2016 at Menofia University Hospital. All patients had acute biliary pancreatitis with obstructive jaundice proved by laboratory investigations and imaging. ERCP and LC in the same session were aimed in all patients. Results: Successful same session was done in 24 (96%) cases and 1 (4%) case failed (just had ERCP only). Twenty cases (80%) were females and five cases (20%) were males. By ERCP, multiple small stones were extracted in 15 (60%) cases, biliary mud in 3 (12%) cases, a big stone in 2 (8%) cases and no stones were extracted in 5 (20%) cases. During laparoscopic cholecystectomy, bile stained ascites was present in 15 (60%) cases and absent in 9 (36%) cases. Calcium soap in 7 (28%) cases and absent in 17 (68%) cases. 17 (68%) patients stayed 24 hours in hospital while 6 (24%) patients stayed 48 hours and 2 (8%) cases stayed 72 hours. No mortality was recorded.Conclusions: ERCP and LC as a single step is a good option for management of early acute biliary pancreatitis.

scholarly journals Rate of Conversion and Postoperative Complications of Laparoscopic Cholecystectomy in District Level Hospital of Bangladesh

1970 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
SK Biswas ◽  
JC Saha ◽  
ASMT Rahman ◽  
ASMZ Rahman ◽  
MM Rahman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Key Words Laparoscopic Cholecystectomy ◽  
Biliary Leakage ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy and postoperative complications are still inevitable in certain cases. Knowledge of the rate and underlying reasons for conversion and postoperative complications could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion and postoperative complications of our LC series. This study included 760 consecutive laparoscopic cholecystectomies from July 2006 to June 2011 at Faridpur Central Hospital and Faridpur Medical College Hospital. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 19 (2.5%) patients. The most common reasons for conversion were severe adhesions at calot's triangle (6, 0.83%) and acutely inflamed gallbladder (5, 0.66%). The incidence of postoperative complications was 1.58%. The most common complication was wound infection, which was seen in 5 (0.66%) patients followed by biliary leakage in 3 (0.40%) patients. Delayed complications seen in our series is port site incisional hernia (2, 0.26%). LC is the preferred method even in difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery and it should not be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon. Key words: Laparoscopic cholecystectomy (LC); Open cholecystectomy; Conversion; Complications; Calot's triangle DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9204 FMCJ 2011; 6(2): 74-77

scholarly journals MILD TO MODERATE ACUTE BILIARY PANCREATITIS;

2014 ◽  
Vol 21 (03) ◽  
pp. 519-523
Author(s):  
Muhammad Sohaib Khan ◽  
Jahangir Sarwar Khan ◽  
Muhammad Mussadiq Khan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Admission ◽  
Conversion Rate ◽  
Statistical Significance ◽  
Open Cholecystectomy ◽  
Definitive Treatment ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Male Patients ◽  
Index Hospital

Introduction: Acute biliary pancreatitis is a serious complication of biliarycalculous disease and is associated with significant morbidity and mortality. Incidence is moreoften in females and cause is the gall stones in majority of the cases. Definitive treatment ischolecystectomy and with the advancement of minimal invasive surgery, laparoscopiccholecystectomy has been considered as a gold standard for the management of acute BiliaryPancreatitis. The optimal timing when to perform laparoscopic cholecystectomy is still underdebate. Many surgeons recommend early surgery whereas others are in favor of delayedsurgery. This study is carried out to compare the timing of laparoscopic cholecystectomy in casesof acute biliary pancreatitis. Objective: To compare the frequency of conversion fromlaparoscopic to open cholecystectomy in early versus delayed laparoscopic cholecystectomy inmild to moderate acute biliary pancreatitis. Study design: Randomised Control trial (RCT).Setting: Department of surgery, Holy Family Hospital, Rawalpindi. Duration: Six months, fromJanuary 2010 to June 2012. Material and methods: 306 patients, diagnosed as mild tomoderate acute Biliary Pancreatitis were randomly allocated into two groups for laparoscopiccholecystectomy. Those who were operated within two weeks of index hospital admission werelabeled as Early laparoscopic cholecystectomy (EC) group whereas those undergoing surgeryafter 02 weeks of index hospital admission were considered as Delayed laparoscopiccholecystectomy group(DC). Conversion rate from laparoscopic to open cholecystectomy wascompared in two groups. Results: Out of 153 patients enrolled as EC group, 138 were female and15 were male patients. Mean age was 39.19 ± 11.25years where as in DC group , there were 134female and 19 male patients in a total of 153 patients, and the mean age was 39.54 ±10.37 years.Conversion from laparoscopic surgery to open cholecystectomy was 8.5%(13 patients) and13.1%(20 patients) in EC and DC groups respectively. The overall conversion rate was 10.8%.There was no statistical significance between conversion rate of the two groups. (p = 0.197)Conclusions: Acute Biliary Pancreatitis should be managed by laparoscopic cholecystectomyregardless of the time elapsed since the start of symptoms. There is no statistical significance ofconversion rate from laparoscopic to open cholecystectomy associated with the timing ofsurgical intervention in the case of acute Biliary Pancreatitis.

scholarly journals Laparoscopic cholecystectomy during COVID-19 pandemic- Retrospective analysis of tertiary care centre

2021 ◽  
Vol 2 (2) ◽  
pp. 82-86
Author(s):  
Uttam Laudari ◽  
Rosi Pradhan ◽  
Dibesh Shrestha ◽  
Bibek Timilsina ◽  
Suhail Sapkota ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Analysis ◽  
Infection Prevention ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Biliary Colic ◽  
Tertiary Care Centre ◽  
Duration Of Hospitalization

INTRODUCTION: Laparoscopic cholecystectomy is the most commonly performed general surgical procedure. During the COVID-19 pandemic, general recommendation worldwide is to postpone elective surgeries as far as possible to decrease the resource utilization and also aerosol-related transmission among hospital staff and patients. We conducted this study to see the burden of gallbladder disease, their management and outcomes of all patients who presented to our centre during first wave of COVID-19 pandemic. METHODS: We conducted a retrospective analysis of all patients who underwent laparoscopic cholecystectomy at the Hospital for Advanced Medicine and Surgery (HAMS) after the commencement of strict lockdown in the first wave of the COVID-19 pandemic. Ethical approval for the study was taken from Nepal Health Research Council. All the surgeries were performed as per HAMS interim policy for infection prevention and control during the COVID-19 pandemic. Data were extracted from the discharge sheet and outcomes in terms of duration of hospitalization, morbidity, mortality, and COVID -19 infection among patient and operating team staff after surgery were assessed. RESULTS: Out of 110 cases operated for gallbladder disease, 90 patients were included in the study with complete data. The most common presentations were dyspepsia (28) and biliary colic (22). Patients were managed with laparoscopic cholecystectomy (79), percutaneous cholecystostomy (4), laparoscopic subtotal cholecystectomy (5), open cholecystectomy (1). The median duration of hospitalization 22 hours. There was no COVID-19 transmission among staff and patients. CONCLUSIONS: Laparoscopic cholecystectomies are feasible during COVID-19 pandemic and safely performed following infection prevention guidelines. It can be still be performed in day case basis to decrease the bed occupancy and avoiding crowd in hospitals.  

Early versus Delayed Single-Stage Laparoscopic Eradication for Both Gallstones and Common Bile Duct Stones in Mild Acute Biliary Pancreatitis

2005 ◽  
Vol 71 (8) ◽  
pp. 682-686 ◽  
Author(s):  
John Griniatsos ◽  
Evangelos Karvounis ◽  
Alberto Isla
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Single Stage ◽  
Definitive Treatment ◽  
Morbidity Rate ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Laparoscopic Management ◽  
Significant Difference

Several studies addressed that preoperative endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct (CBD) clearance, followed by interval laparoscopic cholecystectomy (two-stage approach), constitutes the most common practice in cases of uncomplicated mild acute biliary pancreatitis. Between June 1998 and December 2002, 44 patients (35 females and 9 males with a median age of 62 years) suffering from uncomplicated mild acute biliary pancreatitis were treated in our unit. All patients were electively submitted to surgery after subsidence of the acute symptoms, and for definitive treatment we favored the single-stage laparoscopic management, avoiding preoperative ERCP. All patients underwent laparoscopic cholecystectomy plus fluoroscopic intraoperative cholangiogram (IOC). If filling defect(s) were detected in the IOC, a finding suggestive of concomitant choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) was added in the same sitting. Twenty patients were operated upon within 2 weeks since the attack of the acute symptoms and constitute the early group (n = 20), whereas 24 patients underwent an operation later on and constitute the delay group (n = 24). We retrospectively compare the safety, effectiveness, and outcome after the single-stage laparoscopic management between the two groups of patients. Laparoscopic cholecystectomy alone constituted the definitive treatment in 38 patients, while an additional LCBDE was performed in the remaining 6 patients (14%), and all operations were achieved laparoscopically. There was no statistically significant difference between the groups in terms of operative time, incidence of concomitant choledocholithiasis, morbidity rate, and postoperative hospital stay. During the follow-up, none of the patients experienced recurrent pancreatitis. In uncomplicated mild acute biliary pancreatitis cases, a single-stage definitive laparoscopic management, avoiding preoperative ERCP, can be safely performed during the same admission, after the improvement of symptoms and local inflammation. Postoperative ERCP should be selectively used in patients in whom the single-stage method failed to resolve the problem.

scholarly journals Timing of Cholecystectomy in Mild Acute Biliary Pancreatitis.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Orhan Alimoğlu ◽  
Nuray Colapkulu ◽  
Tunç Eren
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Surgical Outcomes ◽  
Gold Standard ◽  
Definitive Treatment ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Timing Of Cholecystectomy ◽  
Safe Approach ◽  
First Admission

Acute biliary pancreatitis (ABP) is one of the most common gastrointestinal events that requires acute admission to the hospital with considerable risks of mortality & morbidity. Laparoscopic cholecystectomy has become the gold standard for the treatment of ABP. Our aim was to determine the safety of cholecystectomy during the first admission by performing a review of the current literature. Waiting for 6 - 8 weeks to perform cholecystectomy may result with an increased incidence of recurrent ABP attacks, which may increase morbidity and the length of the hospital stay. On the contrary, cholecystectomy during the index admission for mild ABP appears to be a preferable and safe approach with better surgical outcomes providing a definitive treatment.

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