Laparoscopic cholecystectomy: consensus conference-based guidelines

Agresta, Ferdinando; Campanile, Fabio Cesare; Vettoretto, Nereo; Silecchia, Gianfranço; Bergamini, Carlo; Maida, Pietro; Lombari, Pietro; Narilli, P; Marchi, Domenico; Carrara, Alessandro; Esposito, Maria; Fiume, Stefania; Miranda, Giuseppe; Barlera, Simona; Davoli, Marina

doi:10.1007/s00423-015-1300-4

Cited by 97 publications

(78 citation statements)

References 296 publications

(299 reference statements)

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“…Laparoscopic cholecystectomy (LC) is considered as the "gold standard" surgical technique for treatment of GB disease [10]. Conversion of LC to open surgery (CTO) is used to prevent intra-abdominal organ injury (IOI), for common bile duct (CBD) exploration and to repair IOI.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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Background: Laparoscopic cholecystectomy is the preferred surgical operation for symptomatic gallstone disease. Conversion of laparoscopic cholecystectomy to open surgery is used to prevent intra-abdominal organ injury, for open common bile duct exploration and to repair intra-abdominal organ injury. Objective:The objective of this chapter is to review risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery, and surgical quality outcome measures. Methods:A narrative literature review using Pubmed, Medline, Cochrane library databases and Google search engine is described.Results: From the literature review, patient-and surgeon-related risk factors and predictive models for conversion of laparoscopic cholecystectomy to open surgery were identified. Patient-dependent risk factors included preoperative and intraoperative variables. Current conversion of laparoscopic cholecystectomy to open surgery predictive models use only patient-dependent risk factors and were not tested on an independent sample of patients. Surgical quality outcome measures incorporate an association between conversion and intra-abdominal organ injury that demonstrates that conversion was used as an emergency strategy to repair injuries rather than a safety measure. Conclusion:Conversion of laparoscopic cholecystectomy to open surgery risk stratification based on patient-and surgeon-dependent variables may allow a better management of the patient to keep conversion at low rates and to maintain benefits of minimally invasive surgery.

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Section: Introductionmentioning

confidence: 99%

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Beliaev¹,

Booth²

2016

Actual Problems of Emergency Abdominal Surgery

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“…Para realizar la extracción, inicialmente se debe cortar tanto la arteria cística como el conducto que transporta la bilis (conducto cístico). Esta cirugía consta de las siguientes etapas [20], [21]: Fuente: [12] 1. Exposición del conducto y arteria císticos: Procedimiento por medio del cual se tira de la vesícula de manera que quede expuesto el tejido que cubre tanto el conducto cístico como la arteria cística.…”

Section: Extracción De Vesícula (Colecistectomía)unclassified

Herramienta software para la práctica de la robótica quirúrgica

Villamarín¹,

Albán²

2015

IyU

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Este artículo presenta el desarrollo de una herramienta software para la práctica de la robótica quirúrgica que integra la utilización de robots quirúrgicos en un entorno virtual 3D y que lleva por nombre RoboSurgery. La herramienta ha sido diseñada para que los ingenieros puedan comprender el uso de los asistentes robóticos en operaciones de laparoscopia. Integra dos tipos de robots, un robot porta endoscopio (robot Hibou) y dos robots quirúrgicos (robots Lapbot), manipulados por joystick. El sistema permite observar en una ventana el interior del abdomen del paciente, imagen virtual que es generada por el endoscopio situado en el órgano terminal del robot Hibou, mientras que se manipulan los dos robots quirúrgicos con el fin de realizar una colecistectomía (extracción de la vesícula). Los resultados muestran un sistema virtual bastante útil para la comprensión del funcionamiento de los asistentes quirúrgicos, que permitirá en un futuro adicionar otros robots y otros procedimientos, además de mayor realismo al incluir algoritmos de deformación de órganos.

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“…Laparoscopic cholecystectomy has been the standard of care since its introduction in 1987. 2 The acute care surgery (ACS) model for treatment of gallbladder disease has decreased incidence of conversion to open surgery, decreased hospital length of stay, improved outcomes, 3 and decreased complication rates. [4][5][6] The study of current practice patterns among acute care surgeons that routinely encounter complicated acute gallbladder disease may help to identify patients who will go on to require alternatives to cystic duct ligation, and lead to improved safety in the operating room in regard to alternatives of duct ligation.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Traumatic Hemorrhage of the Basal Ganglia with Diffuse Axonal Injury: A Case Report and Review of Literature

Patil¹,

Tadghare²,

Rege³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Introduction: Endo GIA stapler use is a method to ligate cystic ducts during laparoscopic cholecystectomy in the elective and emergent setting. Its use has not been widely described in the acute care surgery (ACS) setting. Our study aims to determine factors predicting Endo GIA use by acute care surgeons and evaluate when applied its safety and efficacy in emergent cholecystectomy. Additionally, we investigate the use of Endo GIA stapler with respect to conversion to open surgery, reduction in postoperative morbidity, and impact on length of stay in an ACS setting. Materials and methods:A retrospective chart review was conducted for laparoscopic cholecystectomy performed by ACS in a public university training hospital over 1 year. Variables associated with Endo GIA stapler use were identified through multivariate logistic regression and subsequently, assessed after optimizing the model to control for confounding effects.Results: Of the 118 laparoscopic cholecystectomies performed, the Endo GIA Stapler was used for cystic duct ligation in 20 cases. Surgeons' dictated reason for stapler use included dilated cystic duct (45%), short cystic duct remnant (15%), inadequate room for clip ligation and division (10%), and nonspecific (45%). Patient demographic variables for Endo GIA stapled and clipped groups were not significantly different. Logistic regression revealed a significantly higher likelihood of Endo GIA stapler use in patients with comorbid biliary duct disease, preoperative endoscopic retrograde cholangiopancreatography (ERCP), and a trend towards significance in patients with previous emergency department (ED) visits. There was no significant difference in conversion to open surgery, postoperative morbidity, and postoperative length of stay. Conclusion:Comorbid biliary duct disease, previous ED visits, and preoperative ERCP are predictive of patients requiring use of the Endo GIA stapler for cystic duct ligation during emergent cholecystectomy. The use of Endo GIA stapler by Acute Care Surgeons is safe and effective.

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Laparoscopic cholecystectomy: consensus conference-based guidelines

Cited by 97 publications

References 296 publications

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Risk Factors and Predictive Models for Conversion of Laparoscopic Cholecystectomy to Open Surgery, and Surgical Quality Outcome Measures

Herramienta software para la práctica de la robótica quirúrgica

Bilateral Traumatic Hemorrhage of the Basal Ganglia with Diffuse Axonal Injury: A Case Report and Review of Literature

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