Objective:The objective of the study was to determine the success rate of ambulatory laparoscopic cholecystectomy with an enhanced recovery after surgery (ERAS) protocol, in patients with symptomatic cholelithiasis. Materials and methods: Prospective cohort of patients with symptomatic cholelithiasis underwent elective surgery at the General and Endoscopic Surgery Division of the General Hospital "Dr. Manuel Gea González" from July 2015 to September 2017. Results: 160 patients were included, the mean age was 36.8 years (15-73 years), and 83.7% were women. We obtained a success rate of 95.6% with this protocol. Two patients required postoperative unplanned hospitalization (1.2%), one of them had surgical treatment (0.6%). Five patients presented post-operative complications (3.1%): one with acute pancreatitis (0.6%) and four (2.5%) were diagnosed with surgical site infection. Overall satisfaction with procedure was close to 99%. Conclusion: The performance of ambulatory laparoscopic cholecystectomy with an ERAS protocol in patients with symptomatic cholelithiasis has an adequate success rate, as well as postoperative evolution. Our study shows its safety, reliability, and possibility for routinely implementation without presenting a significant number of complications.
Introduction Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder(GB). It has been classified as an uncommon variant of chronic cholecystitis with a prevalence of 0.7 to 10%. It is a difficult diagnosis because macroscopic appearance may be confused with gallbladder cancer (GC). Laparoscopic cholecystectomy is the gold standard for the management of benign gallbladder disease. Laparoscopic cholecystectomy in XGC is associated with a high conversion rate to open cholecystectomy with a rate of 10.6 to 80%. Material and methods A descriptive, observational, retrospective, and cross-sectional study was carried out over a period of 18 years at a general hospital on Mexico City. Patients with histopathological diagnosis of xanthogranulomatous cholecystitis were included. This study was retrospectively registered and approved by the board of ethical committee in our institution on 2018. Results We recorded 142 patients, and 106 surgeries were performed totally laparoscopically (74.6%). 52 were emergency surgeries (49%) and 54 elective (51%). The conversion rate to open cholecystectomy was 3.7% (4 patients). There were 5 post-surgical complications (4.7%) one biloma, one surgical site infection, and 3 pancreatitis. Conclusions XGX represents a surgical challenge from diagnosis to surgical management and is associated to a higher number of perioperative complications. Nevertheless, a laparoscopic approach is safe in high volume centers with experience in laparoscopy.
Background: Abnormalities of liver morphology are rare, divided into two categories: those resulting from overgrowth of liver tissue, such as the Riedel lobe and other accessory lobes, and those with poor liver development include agenesis, hypoplasia and aplasia of the hepatic lobes. Presentation of the case: 57-year-old man, subjected to laparoscopic programmed inguinal surgery, finding liver hypoplasia. Conclusions: Hepatic hypoplasia is rare, has no symptoms or long-term clinical repercussions, is usually an incidental finding during an imaging study or during an abdominal surgical procedure.
Background Xanthogranulomatous cholecystitis (XG) is a rare inflammatory disease of the gallbladder (GB), macroscopic appearance may be confused with gallbladder cancer (GC) making the diagnosis challenging. Laparoscopic cholecystectomy (LC) is considerate the gold standard for the management of benign gallbladder disease however LC in XGC is associated with a high conversion rate to open cholecystectomy with a rate of 10.6 to 80%. The aim of this study was to determinate the rate of laparoscopic cholecystectomy on patients with histopathological diagnosis of CXG and the associated morbidity to the procedure. Material and methods This study is an observational, retrospective, and cross-sectional study carried out over a period of 18 years in a single institution. Patients underwent to laparoscopic cholecystectomy with histopathological diagnosis of xanthogranulomatous cholecystitis were included. The primary outcome was the rate of conversion to open surgery; secondary outcomes were the morbidity and mortality. The data were reported on percentages and averages. Statistical Package for the Social Sciences (SPSS, version 26) was used to analyze the data. The study was approved by the board of ethical committee in our institution in 2018. Results We registered 142 patients operated from cholecystectomy with histopathologic results of XGC and 106 surgeries were performed laparoscopically (74.6%); 52 were emergency surgeries (49%) and 54 elective (51%). The conversion rate to open cholecystectomy was 3.7% (4 patients). There were 5 post-surgical complications (4.7%) one biloma, one surgical site infection, and 3 pancreatitis. Conclusions XGX represents a surgical challenge from diagnosis to surgical management and is associated to a higher number of perioperative complications; nevertheless, a laparoscopic approach is safe in high volume centers with experience in laparoscopy.
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