Laparoscopic Cholecystectomy for Patients with Chronic Obstructive Pulmonary Disease

Hsieh, Chi-Hsun

doi:10.1089/109264203321235395

Cited by 44 publications

(31 citation statements)

References 13 publications

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“…4,5,7,20,21 This was demonstrated in all the patients in our series, where there was no evidence of postoperative morbidity except for 1 patient in our series who developed an AMI.…”

Section: Discussionsupporting

confidence: 66%

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Chia

Wijaya

Wong

et al. 2015

International Surgery

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This study aims to demonstrate the safety and feasibility of laparoscopic management of complicated foreign body (FB) ingestion in a series of 5 patients. We present the merits of a minimally-invasive approach in this clinical setting from our series as well as published case reports. FB ingestion is occasionally complicated by abscess formation or perforation, requiring surgical intervention. Anecdotal reports of such cases managed by laparoscopic surgery have alluded to its merits over the conventional approach of open surgery. Over an 18-month period, 5 of 256 patients with FB ingestion at our unit were managed by laparoscopic surgery. Clinical and operative data were collected for this study. In all 5 cases, patients could not recall their FB ingestion and had normal plain radiographs. The diagnosis was made on a computed tomography (CT) scan. Laparoscopy was successfully employed to retrieve all FBs (fish bones), deroof abscesses, and primarily repair gastrointestinal perforations. The mean operative time was 69 minutes (55-85), utilizing 2 to 4 noncamera ports. There was no operative mortality and patients were discharged on average postoperative day (POD) 5 (2-8). Laparoscopic surgery is safe and feasible in small-diameter, complicated FB ingestion requiring surgical intervention and should be considered in similar patients. ed FB ingestion were successfully managed with minimally-invasive surgery (MIS). [4][5][6][7][8][9][10] The potential benefits of a laparoscopic approach in abdominal surgery are well known and include reduced postoperative ileus and pain, smaller incisions and superior cosmetic results, shorter duration of hospitalization, and earlier return to work and a decreased incidence of postoperative hernias. 4,11 This paper presents the largest case series to date of 5 consecutive patients, who were managed via laparoscopic approach for complicated FB ingestion. We aim to review and report the salient clinical features of this series of patients to demonstrate that laparoscopic management is safe, feasible, and should be considered when managing FB ingestions in a similar clinical setting. Materials and MethodsOver an 18-month period, 256 patients presented with FB ingestion to our center. Of these, 5 patients were managed surgically via laparoscopic approach. Records of relevant clinical and demographic data, presenting symptoms, investigations, operative procedures, and length of hospitalization were reviewed after obtaining Institutional Review Board (IRB) approval. Operative findings and data were collected. These included FB size, location, number of ports used, and total operative time.

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“…4,5,7,20,21 This was demonstrated in all the patients in our series, where there was no evidence of postoperative morbidity except for 1 patient in our series who developed an AMI.…”

Section: Discussionsupporting

confidence: 66%

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Chia

Wijaya

Wong

et al. 2015

International Surgery

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“…Clonidine also provided postoperative analgesia as compared to control group for considerable time interval. Our observations coincide with Hsiech CH (2003), 8 Koivusalo AM et al (1998), 9 Hirvonen EA et al (2000), 10 Joris et al (1995), 4 Goyagi T et al (1996), 3 Melek et al (1999), 5 Sung et al (2000) 6 and Yu et al (2003). 7 Thus, Clonidine was found to be relatively safe, effective for providing stable haemodynamic status in laparoscopic operative procedures under general anaesthesia.…”

Section: Discussionsupporting

confidence: 85%

Evaluation of Inj. Clonidine in Maintaining Haemodynamics During Laparoscopic Operative Procedures

Kiran¹,

S²,

G³

2016

jemds

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Pneumoperitoneum usually with CO2 insufflations created during laparoscopic operative procedures affects several homeostatic systems leading to adverse effects on cardiovascular and pulmonary physiology and produces stress response. There is increase in pulse rate, systolic blood pressure and decrease in cardiac output and increase in systemic vascular resistance. Clonidine an α2 agonist with its central sympatholytic action attenuates the cardiovascular adverse effects and provide intraoperative as well as postoperative analgesia. In the present study, 60 ASA grade I and II of either sex between age range of 18-60 years and weight range of 45-70 kg were divided into 2 equal groups of 30 each. Group A served as control group A, received inj. Midazolam 0.03 mg/kg and inj. Pentazocine 0.3 mg/kg as premedication 15 minutes prior to induction of anaesthesia and group B received inj. Clonidine 1 µgm/kg as premedication before induction of anaesthesia. Anaesthesia was induced with inj. Thiopentone 5 mg/kg and inj. Vecuronium 0.1 mg/kg in all patients. All patients were maintained on oxygen, nitrous oxide and inj. Propofol infusion on IPPV. Pneumoperitoneum was created with CO2 and intra-abdominal pressure was maintained on 15 mmHg. All patients were observed for changes in pulse rate, systolic blood pressure, EtCO2 throughout intraoperative period. Normocapnia was maintained. It was observed that Clonidine group provided statistically significant cardiovascular stability with less increase in pulse rate and systolic blood pressure. The requirement of additional analgesic drugs was minimum in Clonidine group with minimal sedation. Thus, it was concluded that premedication with inj. Clonidine in dose of 1 µgm/kg prior to induction of anaesthesia provides effective cardiovascular stability and attenuates the increase in pulse rate, systolic blood pressure, decrease in cardiac output and increase in systemic vascular resistance secondary to sympathetic stimulation secondary to pneumoperitoneum during laparoscopic surgeries.

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“…This can be reliably excreted only by compensatory hyperventilation, as the renal excretion of excessive H+ is a much slower response (3-5 days). [6,22] Despite increasing the tidal volume of ventilation, respiratory acidosis and increased CO 2 excretion persists up to 1 hr postoperatively. In patients with compromised cardiopulmonary function, CO 2 retention may reach dangerous levels.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with compromised cardiopulmonary function, CO 2 retention may reach dangerous levels. [22] Increased IAP leads to increased intrathoracic pressure, restricting lung expansion and decreasing functional residual lung capacity by up to 50%. The peak and plateau airway pressures are increased, leading to increased ventilationperfusion mismatch and intrapulmonary shunting.…”

Section: Discussionmentioning

confidence: 99%

“…This may worsen the risk for developing hypoxemia in patients of chronic obstructive pulmonary disease (COPD). [22,23] The anesthesiologist usually attempts to avoid hypercapnia and acidosis by increasing the tidal volume or by using positive end-expiratory pressure (PEEP), however, overuse of these maneuvers can cause ventilator-induced lung injury or further reduction of cardiac output, respectively. The routine use of other gases like argon, helium, etc., is still under study.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and Safety of Low Pressure Pneumoperitoneum for Laparoscopic Cholecystectomy: A Prospective, Randomized, Triple-Blinded Trial

Nitin¹,

Sharma²,

Gupta³

et al. 2017

JGPLD

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Laparoscopic Cholecystectomy for Patients with Chronic Obstructive Pulmonary Disease

Abstract: LC can be safely performed in COPD patients with mild or even a moderate degree of airway obstruction. Intraoperative CO(2) retention did not complicate the postoperative recovery in terms of the complication rate or the duration of the postoperative hospital stay.

Cited by 44 publications

References 13 publications

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Laparoscopic Management of Complicated Foreign Body Ingestion: A Case Series

Evaluation of Inj. Clonidine in Maintaining Haemodynamics During Laparoscopic Operative Procedures

Feasibility and Safety of Low Pressure Pneumoperitoneum for Laparoscopic Cholecystectomy: A Prospective, Randomized, Triple-Blinded Trial

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