• Title/Summary/Keyword: laparoscopic cholecystectomy

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The Analgesic Effect of Nefopam with Fentanyl at the End of Laparoscopic Cholecystectomy

  • Lee, Ju Hwan;Kim, Jae Hong;Cheong, Yong Kwan
    • The Korean Journal of Pain
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    • v.26 no.4
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    • pp.361-367
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    • 2013
  • Background: Nefopam is a centrally acting analgesic that is used to control pain. The aim of this study was to find an appropriate dose of nefopam that demonstrates an analgesic effect when administered in continuous infusion with fentanyl at the end of laparoscopic cholecystectomy. Methods: Ninety patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive analgesia with fentanyl alone (50 ${\mu}g$, Group 1, n = 30), or with fentanyl in combination with nefopam 20 mg (Group 2, n = 30) or in combination with nefopam 40 mg (Group 3, n = 30) at the end of surgery. Pain and side effects were evaluated at 10 minutes, 30 minutes, 1 hour, 2 hours, 6 hours, and 12 hours after arrival in the post-anesthesia care unit (PACU). Results: Pain was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes, 2 hours, and 6 hours after arrival in the PACU. Nausea was statistically significantly lower in Group 2 than in Groups 1 and 3 at 10 minutes after arrival in the PACU. Shivering was statistically significantly lower in Groups 2 and 3 than in Group 1 at 10 minutes after arrival in the PACU. Conclusions: Nefopam is a drug that can be safely used as an analgesic after surgery, and its side effects can be reduced when fentanyl 50 ${\mu}g$ is injected with nefopam 20 mg.

Pediatric Cholecystectomy: Clinical Significance of Cases Unrelated to Hematologic Disorders

  • Kim, Hae-Young;Kim, Soo-Hong;Cho, Yong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.2
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    • pp.115-120
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    • 2015
  • Purpose: Cholecystectomy is rarely performed in the child and adolescent. However, it is associated with several conditions. This study was conducted to describe the characteristics of pediatric patient who underwent cholecystectomy unrelated to hematologic disorders, and then to suggest its clinical significance in management by comparing a simple and complicated gallbladder disease. Methods: We reviewed cases of cholecystectomy in pediatric patients (under 18 years old) at a single institution between January 2003 and October 2014. There were 143 cases during the study period and 24 were selected as the subject group. Results: There were 7 male (29.2%) and 17 female (70.8%) patients. The mean age was 13.1 years old, and 66.6% of patients were older than 12 years. Mean body weight was 52.7 kg, and body mass index was $21.7kg/m^2$, with 41.7% of patients being overweight or obese. We could identify a female predominance and high proportion of overweight or obesity in a complicated disease. There were also significantly increased levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP) and bilirubin in this group. Most patients (87.5%) underwent laparoscopic cholecystectomy. Conclusion: Cholecystectomy for diseases unrelated to hematologic disorders is rarely performed in the child and adolescent. In general, female patients who are overweight or obese, and those older than 12 years old, require laparoscopic cholecystectomy owing to multiple gallstones. This condition has a tendency to show a complicated gallbladder disease and significantly increased levels of AST, ALT, ALP, and bilirubin.

Penetrating gallbladder injury in a pediatric patient in the United States: a case report

  • Nelimar Cruz-Centeno;Shai Stewart;Derek R. Marlor;Charlene Dekonenko;Richard J. Hendrickson
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.295-297
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    • 2023
  • Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

Effects of Frozen Gauze with Normal Saline and Ice on Thirst and Oral Condition of Laparoscopic Cholecystectomy Patients: Pilot Study (생리식염수를 이용한 냉동거즈와 얼음 제공이 복강경 담낭절제술 환자의 갈증 및 구강상태에 미치는 효과-Pilot study)

  • Cho, Eun-A;Kim, Kye-Ha;Park, Jun-Yeong
    • Journal of Korean Academy of Nursing
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    • v.40 no.5
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    • pp.714-723
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    • 2010
  • Purpose: The purpose of this study was to examine the effects of using gauze frozen with normal saline or ice on thirstrelief and oral condition of laparoscopic cholecystectomy patients. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=53) received either gauze frozen with normal saline (n=17), ice (n=18) or wet gauze (n=18) for thirst-relief. The subjective thirst level and oral condition of the participants were assessed before the intervention, 15 min after the first intervention and 15 min after the second intervention. Results: After oral care was provided twice, there were significant differences in thirst level among the groups. When oral care was provided twice, the oral condition of tongue, saliva, mucosal membrane, and gingiva was improved in patients receiving gauze frozen with normal saline or ice. Conclusion: Gauze frozen with normal saline and ice can be effective for oral care in reducing the thirst level and improving the condition of the oral cavity.

Effects of Forced Air Warming on Body Temperature, Shivering and Pain in Laparoscopic Cholecystectomy Patients (공기가온요법이 복강경 담낭절제술 환자의 체온, 전율 및 통증에 미치는 효과)

  • Park, Sung Joo;Kim, Sook Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.3
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    • pp.287-296
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of forced air warming on intraoperative and postoperative body temperature, postoperative shivering and pain in patients undergoing laparoscopic cholecystectomy. Methods: A quasi-experimental design with nonequivalent control group was utilized. Fifty eight patients scheduled for laparoscopic cholecystectomy were recruited and assigned to the experimental group (n=29) or control group (n=29). For the experimental group, forced air warming was applied from right after induction and up to one hour after surgery. Body temperature, shivering score and pain score were measured in both groups at 15 minute intervals. Data were collected from September, 2013 to April, 2014. Data were analyzed using t-test, Bonferroni test and repeated measures ANOVA. Results: The experimental group showed higher body temperature than the control group during surgery. After surgery the experimental group showed higher body temperature, lower shivering and less pain compared to the control group. Conclusion: Results show that forced air warming is effective in enhancing body temperature and reducing shivering and pain. Therefore, forced air warming is recommended as an operative nursing intervention.

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.