Is emergent laparoscopic cholecystectomy for acute cholecystitis safe in a low volume resource poor setting?

Cawich, Shamir O; Mohanty, Sanjib K.; Simpson, Lindberg K.; Bonadie, Kimon O

doi:10.1016/j.ijsu.2014.06.006

Cited by 9 publications

(17 citation statements)

References 27 publications

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“…Laparoscopic cholecystectomy is a basic operation that is performed routinely by general surgeons in the Caribbean. Many surgeons who encounter difficulty when dissecting Calot's triangle will opt for a partial cholecystectomy to prevent iatrogenic bile duct injury (BDI) [1][2][3]. However, the gallbladder remnant may become diseased and then a completion operation to remove the remnant becomes necessary [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Completion Cholecystectomy: An Audit from the Americas Hepato-Pancreato-Biliary Association (AHPBA) Caribbean Chapter

Cawich

Mohanty

Bonadie

et al. 2020

Cureus

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Removal of a gallbladder remnant occasionally becomes necessary when retained stones become symptomatic. Although the laparoscopic approach has been described, it is not yet considered the standard of care. We sought to determine the outcomes after completion cholecystectomies in the resource-poor setting within the Caribbean. Methods We carried out an audit of the databases from all hepatobiliary surgeons in the Anglophone Caribbean. We identified all patients who had completion cholecystectomy over the five-year period from July 1, 2012 to June 30, 2018. Retrospective chart review was performed to extract the following data: patient demographics, diagnoses, presenting complaints, operative details, morbidity, mortality, and clinical outcomes. Descriptive statistics were generated using Statistical Packaging for Social Sciences (SPSS), version 12.0 (SPSS Inc., Chicago IL) Results There were 12 patients who were subjected to laparoscopic completion cholecystectomy for acute cholecystitis (7), severe biliary pancreatitis (3), and chronic cholecystitis (2) secondary to stones in a gallbladder remnant. There were 10 women and two men at a mean age of 47.4 years (range 32-60; standard deviation (SD) +/-7.81; median 48; mode 52) and a mean body mass index (BMI) of 30.8 Kg/M 2 (SD +/-3.81; range 26-38; median 29.5). The mean interval between the index operation and the completion operation was 14.8 months (SD +/-12.3; range 1-48; median 13; mode 18). Five (42%) patients had their original cholecystectomy using the open approach. Five (42%) index operations were done on an emergent basis and the gallbladder remnant was deliberately left behind in three (25%) index operations. The completion cholecystectomies were all completed laparoscopically in 130.5 minutes (SD +/-30.5; range 90-180, median 125; mode 125) without any conversions or mortality. There were two minor bile leaks that resolved without intervention through an indwelling drain. Discussion Completions cholecystectomy can be completed via the laparoscopic approach with good outcomes and acceptable morbidity and mortality rates. The patients derive the same advantages as elective cholecystectomies. Therefore, the laparoscopic approach, when performed by hepatobiliary surgeons with advanced laparoscopic expertise in specialized centers, should be the new standard of care.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic Completion Cholecystectomy: An Audit from the Americas Hepato-Pancreato-Biliary Association (AHPBA) Caribbean Chapter

Cawich

Mohanty

Bonadie

et al. 2020

Cureus

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“…The first case in the Caribbean was performed over a decade after its original description [5] and since then we have accrued considerable experience with SILS cholecystectomies [6]. Although this case was technically difficult, the cholecystectomy was completed uneventfully by following our usual techniques that have already been well documented [7]. …”

Section: Discussionmentioning

confidence: 99%

“…However, we used previously described techniques for SILS to complete this operation. The ‘hanging manoeuvre’ [7] was quite useful in this operation and allowed us to compensate for the absence of instrument triangulation that is inherent with the performance of SILS. We have used the ‘hanging manoeuvre’ liberally in our SILS experience [7].…”

Section: Discussionmentioning

confidence: 99%

“…The ‘hanging manoeuvre’ [7] was quite useful in this operation and allowed us to compensate for the absence of instrument triangulation that is inherent with the performance of SILS. We have used the ‘hanging manoeuvre’ liberally in our SILS experience [7]. It is a simple, cheap and effective manoeuvre and should be in the armamentarium of surgeons performing SILS operations.…”

Section: Discussionmentioning

confidence: 99%

“…A major obstacle to the earlier adoption of SILS in the Caribbean was the cost associated with specialized SILS equipment [7]. Apart from the basic equipment, we used one Endo-GIA universal staple handle (Covidien) and two 60 mm Endo-GIA reloads.…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic pseudocyst: combined single incision laparoscopic cystogastrostomy and cholecystectomy in a resource poor setting

et al. 2016

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Laparoscopic cystogastrostomy is a well-accepted minimally invasive modality to treat pancreatic pseudocysts. There has been one prior report of cystogastrostomy via single incision laparoscopic surgery (SILS) in which specialized instrumentation and access platforms were used.We report the challenges encountered in a low resource setting with the SILS approach to drainage using only standard laparoscopic instruments. To the best of our knowledge this is the second report of SILS cystogastrostomy and the first to be performed in a resource poor setting without specialized instruments or platforms.

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Letter to the Editor: Emergency Laparoscopic Cholecystectomy Should Be Performed for Acute Cholecystitis in Trinidad and Tobago

Cawich

Hassranah

Thomas

et al. 2021

Population Health Management

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Is emergent laparoscopic cholecystectomy for acute cholecystitis safe in a low volume resource poor setting?

Abstract: Emergent LC for acute cholecystitis is effective and safe in a low-volume setting in the Caribbean. However, the operations are technically demanding and should be performed by trained laparoscopic surgeons.

Cited by 9 publications

References 27 publications

Laparoscopic Completion Cholecystectomy: An Audit from the Americas Hepato-Pancreato-Biliary Association (AHPBA) Caribbean Chapter

Laparoscopic Completion Cholecystectomy: An Audit from the Americas Hepato-Pancreato-Biliary Association (AHPBA) Caribbean Chapter

Pancreatic pseudocyst: combined single incision laparoscopic cystogastrostomy and cholecystectomy in a resource poor setting

Letter to the Editor: Emergency Laparoscopic Cholecystectomy Should Be Performed for Acute Cholecystitis in Trinidad and Tobago

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