Critical view of safety faster and safer technique during laparoscopic cholecystectomy?

Zarin, Mohammad; Khan, Muhammad Asim; Khan, Azeem; Shah, Syed Asad Maroof

doi:10.12669/pjms.343.14309

Cited by 13 publications

(13 citation statements)

References 19 publications

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“…It may also contribute to a relatively younger study population having a lower incidence of co-morbid conditions which is shown by an overall lower incidence of diabetes, hypertension and other conditions in our study population. The average operation time in all the three groups of our study was less as compared to other local studies [19] and difference among the group was statistically insignificant. Some authors [7] have found a statistically significant difference proving that LC done earlier takes less time.…”

Section: Discussioncontrasting

confidence: 74%

Benefits of Early Post-Ercp Laparoscopic Cholecystectomy: A Single Centre Prospective Study

Javed¹,

Saleem²,

Rehman³

et al. 2021

JUMDC

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ABSTRACT: BACKGROUND & OBJECTIVE: Laparoscopic cholecystectomy (LC) following Endoscopic retrograde cholangiopancreatography (ERCP) is associated with an increased risk of complications. ERCP is associated with increased incidence of complications during LC. Surgery may be performed in same anesthesia with ERCP or up to 6 weeks later. We aimed to determine the benefits of performing LC within 72hrs of ERCP. METHODOLOGY: After institutional ethical approval this prospective cross-sectional study was performed at Madinah Teaching Hospital Faisalabad from April 2019 to June 2020. By performing convenience sampling, all patients undergoing LC after uneventful ERCP in our hospital were included. Study population was divided based on interval between ERCP and Cholecystectomy; Group-A had LC within 72hrs of ERCP, Group B had LC in same hospital stay after 72hrs and Group-C patients were discharged after ERCP and readmitted for LC. Data was collected using custom designed questionnaire, tabulated using Microsoft Excel 2016 and subjected to statistical tests to compare outcomes. Primary outcome was incidence of complications, while operative time, hospital stay and cost were considered as secondary outcomes. p-value of <0.05 was considered significant. RESULTS: Total 75 patients were included in study, 32 in Group-A, 20 in Group-B and 23 in Group-C. Average age was 44.987 ± 14.819 and study population was predominantly female (86.67%). Complication rate, duration of hospital stay and average cost were less in Group A as compared to other groups (p<0.05). Mean operative time in 3 groups was similar. CONCLUSION: LC within 72hrs after ERCP provides superior results in terms of fewer complications, shorter hospital stays and lesser cost.

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Section: Discussioncontrasting

confidence: 74%

Benefits of Early Post-Ercp Laparoscopic Cholecystectomy: A Single Centre Prospective Study

Javed¹,

Saleem²,

Rehman³

et al. 2021

JUMDC

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show abstract

“…Compared with open cholecystectomy (OC), LC is highly preferred as it is associated with less blood loss, less pain, and confer better cosmetic outcomes (3)(4)(5)(6). Of note, reports from many studies have indicated a reduction of mortality and wound infection rates as well as improved quality of life after LC (7)(8)(9)(10). The postanesthesia care unit (PACU) is an integral component of the perioperative workflow.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for determining patients requiring prolonged postanesthesia care unit length of stay after laparoscopic cholecystectomy

Cao¹,

Li²,

Su³

et al. 2021

Ann Palliat Med

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Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure for managing gallbladder disease. Prolonged length of stay (LOS) in the postanesthesia care unit (PACU) may lead to overcrowding and a decline in medical resource utilization. In this work, we aimed to develop and validate a predictive nomogram for identifying patients who require prolonged PACU LOS.Methods: Data from 913 patients undergoing LC at a single institution in China between 2018 and 2019 were collected, and grouped into a training set (456, cases during 2018) and a test set (457, cases during 2019). The definition of PACU LOS is the duration between admission to discharge from PACU, which we can derive from the electronic medical record system. Using the least absolute shrinkage and selection operator regression model, the optimal feature was selected, and multivariable logistic regression analysis was used to build the prolonged PACU LOS risk model. The C-index, calibration plot, and decision curve analysis (DCA) were used in assessing the model calibration, discrimination, and clinical application value, respectively. For external validation, the test set data was evaluated. Results:The predictive nomogram had 8 predictor variables for prolonged PACU LOS, including age, American Society of Anesthesiologists (ASA) grade, active smoker, gastrointestinal disease, liver disease, and cardiovascular disease. This model displayed efficient calibration and moderate discrimination with a C-index of 0.662 (95% confidence interval, 0.603 to 0.721) for the training set, and 0.609 (95% confidence interval, 0.549 to 0.669) for the test set. DCA demonstrated that the prolonged PACU LOS nomogram was reliable for clinical application when an intervention was decided at the possible threshold of 7%. Conclusions:We developed and validated a predictive nomogram with efficient calibration and moderate discrimination, and can be applied to identify patients most likely to be subjected to prolonged PACU LOS. This novel tool may shun overcrowding in PACU and optimize medical resource utilization.

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“…Compared with open cholecystectomy (OC), LC is highly preferred as it is associated with less blood loss, less pain, and confer better cosmetic outcomes [3] [4] [5] [6]. Of note, reports from many studies have indicated a reduction of mortality and wound infection rates as well as improved quality of life after LC [7] [8] [9] [10]. The postanesthesia care unit (PACU) is an integral component of the perioperative work ow.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Determining Patients Requiring Prolonged Postanesthesia Care Unit Length of Stay After Laparoscopic Cholecystectomy

Cao

et al. 2020

Preprint

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Background: Laparoscopic Cholecystectomy (LC) is a common surgical procedure for managing gallbladder disease. Prolonged length of stay (LOS) in the postanesthesia care unit (PACU) may lead to overcrowding and a decline in medical resource utilization. In this work, we aimed to develop and validate a predictive nomogram for identifying patients who require prolonged PACU LOS.Methods: Data from 913 patients undergoing LC at a single institution in China between 2018 and 2019 were collected, and grouped into a training set (cases during 2018) and a test set (cases during 2019). Using the least absolute shrinkage and selection operator regression model, the optimal feature was selected, and multivariable logistic regression analysis was used to build the prolonged PACU LOS risk model. The C-index, calibration plot, and decision curve analysis were used in assessing the model calibration, discrimination, and clinical application value, respectively. For external validation, the test set data was evaluated.Results: The predictive nomogram had 8 predictor variables for prolonged PACU LOS, including age, ASA grade, active smoker, gastrointestinal disease, liver disease, and cardiovascular disease. This model displayed efficient calibration and moderate discrimination with a C-index of 0.662 (95% confidence interval, 0.603 to 0.721) for the training set, and 0.609 (95% confidence interval, 0.549 to 0.669) for the test set. Decision curve analysis demonstrated that the prolonged PACU LOS nomogram was reliable for clinical application when an intervention was decided at the possible threshold of 7%.Conclusions: We developed and validated a predictive nomogram with efficient calibration and moderate discrimination, and can be applied to identify patients most likely to be subjected to prolonged PACU LOS. This novel tool may shun overcrowding in PACU and optimize medical resource utilization.

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Critical view of safety faster and safer technique during laparoscopic cholecystectomy?

Cited by 13 publications

References 19 publications

Benefits of Early Post-Ercp Laparoscopic Cholecystectomy: A Single Centre Prospective Study

Benefits of Early Post-Ercp Laparoscopic Cholecystectomy: A Single Centre Prospective Study

Development and validation of a nomogram for determining patients requiring prolonged postanesthesia care unit length of stay after laparoscopic cholecystectomy

Development and Validation of a Nomogram for Determining Patients Requiring Prolonged Postanesthesia Care Unit Length of Stay After Laparoscopic Cholecystectomy

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