• Title/Summary/Keyword: laparoscopic cholecystectomy

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Acute cholecystitis in pregnant women: A therapeutic challenge in a developing country center

  • Mohamed Fares Mahjoubi;Anis Ben Dhaou;Mohamed Maatouk;Nada Essid;Bochra Rezgui;Yasser Karoui;Mounir Ben Moussa
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.388-393
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    • 2023
  • Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

Effects of Open versus Laparoscopic Cholecystectomy on Oxidative Stress in Dogs (개에서 산화 스트레스 상태에 대한 일반 개복술 대 복강경 수술을 통한 담낭절제술의 영향)

  • Lee, Jae-Yeon;Jeong, Seong-Mok;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.297-300
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    • 2012
  • In the present study, we investigated and compared the oxidant-antioxidant status of dogs undergoing open and laparoscopic cholecystectomy. Ten male beagle dogs, 4-6 years old, weighing 7-12 kg were used. The animals were randomly assigned to one of two groups according to the type of surgical procedure; open (group 1, n = 5) or laparoscopic cholecystectomy (group 2, n = 5). Heart rate, mean arterial pressure, end-tidal carbon dioxide, peripheral oxygen saturation, and respiratory rates were measured. Plasma total oxidant status (TOS) and total antioxidant status (TAS) levels for the evaluation of oxidative stress were measured. The ratio of the TOS to the TAS gave oxidative stress index (OSI), which is an indicator of the degree of oxidative stress. TOS, OSI and TAS levels were significantly changed after surgery in comparison to levels of before anesthesia. There were no significant different between groups. In the present study, we showed that oxidative stress parameters were found similar in dogs underwent laparoscopic or open cholecystectomy.

Hepatobiliary Scanning of the Common Bile Duct Injury after Laparoscopic Cholecystectomy (내시경 담낭절제술에 발생한 담도손상의 간담도스캔)

  • Zeon, Seok-Kil;Lee, Hee-Jung;Cho, Won-Hyun
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.141-144
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    • 1994
  • As the laparoscopic cholecystectorny is performed more widely, complication associated with the procedure, although rare, are encountered occasionally. Injury to the bile duct occurs somewhat more frequently after the laparoscopic cholecystectorny than the open method. The bile leakage following a bile duct injury can be detected non-invasively either by ultrasonography or radionuclide hepatobiliary scan, but the former is not very specific. Hepatobiliary scan can show the bile leakge and the localization of the bile accumulation. We report two cases of the common bile duct injury following laparoscopic cholecystectorny, accurately detected by hepatobiliary scan using $^{99m}Tc$-diisoprophylimi-nodiacetic acid (DISIDA).

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Management of Asymptomatic Gallstones in Renal Transplantation

  • Lee, Ru Da;Youn, Seok Hwa;Shin, Dong Hoon
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.160-164
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    • 2014
  • Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

Anaphylaxis occurred immediately after prophylactic antibiotics injection with negative intradermal skin test during laparoscopic cholecystectomy

  • Jeong, Hyung Joo;Kung, Hsi Chiang;Park, Tae Woo;Kang, Dong Hee;Shin, Yu Som;Kim, Ju Deok
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.245-251
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    • 2018
  • Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

A Case Report of Intractable Hiccups after Laparoscopic Cholecystectomy (복강경 담낭절제술 후 발생한 난치성 딸꾹질 환자 증례)

  • Shin, Cho-Young;Jung, Hye-Mi;Hwang, Min-Young;Kim, Sol-Li;Yoon, Cheol-Ho
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.901-907
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    • 2010
  • Hiccups are defined as abrupt involuntary contractions of diaphragm and intercostal muscles with sudden closure of the glottis. Hiccups are one of the common transient symptoms but when hiccups last more than 48 hours, or have no response to treatment, they are defined as intractable hiccups. Intractable hiccups can induce multiple problems such as weight loss, dehydration and sleep disturbance. We report a 76-year-old male patient who suffered from intractable hiccups for 6 days after laparoscopic cholecystectomy. Hiccupping was so severe as to continue all day long and limit sleeping and eating. We succeeded in cure intractable hiccups with acupuncture and herbal formula; Gyulyeohwadam-tang.

The Effect of Intraperitoneal Instillation and Trocar Site Infiltration of 0.25% Levobupivacaine on the Postoperative Pain after Performing Laparoscopic Cholecystectomy under Remifentanil Based Anesthesia (Remifentanil을 이용한 전신마취하에 시행된 복강경 담낭절제술에서 0.25% Levobupivacaine의 트로카 부위침윤과 복강 내 점적주입이 수술 후 진통에 미치는 효과)

  • Lee, Cheol;Song, Yoon Kang
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.44-50
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    • 2008
  • Background: The use of regional local anesthetics or opioids during laparoscopic cholecystectomy (LC), in combination with general anesthesia, has been investigated in several interventional studies. Methods: We studied a total of 240 (n = 60, each) patients who were undergoing LC, and they received local infiltration and intraperitoneal instillation with normal saline or 0.25% levobupivacaine 60 ml. Group R (S) received infiltration of normal saline 20 ml before incision and at the end of surgery and then 40 ml intraperitoneal instillation after removal of the gall bladder under remifentanil-based anesthesia. Group R (L) received 0.25% levobupivacaine instead of normal saline in the same method like group R (S). Group S (S) received the same method as group R (S) under sevoflurane based anesthesia in place of remifentanil. Group S (L) received 0.25% levobupivacaine instead of normal saline with the same method as group S (S). Pain was assessed on a visual analog scale at 1, 6, 12 and 24 hours after operation. Results: The pain intensity of Group R (L) was significantly lower than that of group R (S), and the the incisional pain of group S (L) was significantly lower than that of group S (S) in the first six hours. The time delay to first operative analgesics in group R (S) and group S (S) was significantly shorter than that of group R (L) and group S (L). Conclusions: Infiltration and instillation of levobupivacaine reduced the postoperative pain and remifentanil did not increase the pain severity and opioid requirement when performing the LC.