Laparoscopic cholecystectomy in empyema of gall bladder: An experience at Liaquat University Hospital, Jamshoro, Pakistan

Malik, Arshad Mahmood; Laghari, Abdul Aziz; Talpur, K. Altaf Hussain; Memon, Abdul Sattar; Mallah, Qasim; Memon, Jan Mohammad

doi:10.4103/0972-9941.33273

Cited by 21 publications

(30 citation statements)

References 19 publications

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“…Oozing from cirrhotic liver bed was the commonest cause. These are similar to what has been previously reported by some others [6,[20][21][22]. Half of these cases required conversion to control bleeding.…”

Section: Discussionsupporting

confidence: 91%

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“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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Laparoscopic cholecystectomy has revolutionized the management of symptomatic gallstone disease since its introduction more than 20 years ago. It has gained widespread acceptance and is presently the gold standard for its management. This large study spanned over last 10 years and includes prospective data on 950 elective cases of laparoscopic cholecystectomy since 2002. All cases were operated personally by the author in different teaching hospitals of West Bengal. The following were looked into: profiles of the patients including major comorbidities requiring special precautions, the frequency of "difficult cholecystectomies," conversion rate, and operative and postoperative complications. The results showed that 75 % of the patients were females. The mean age of the female patients was 35 years (range15-75), while that of the male patients was 42 (range 18-68). Thirty-two patients had major comorbidities which required special precautions in the perioperative period. Twenty-six percent of the cases were categorized as "difficult," and 6 % of the cases had to be converted to open procedure. Major complications occurred in 11 patients of which five had to be converted. Fiftyfive patients had port-site infection due to atypical mycobacteria species of which majority occurred in the last 1 year of the study. All of them responded to second-line antitubercular medications.

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Section: Discussionsupporting

confidence: 91%

“…The youngest female was 15 years of age and had chronic hemolytic anemia. This profile matches with that of some reports from this subcontinent [6,7]. None of the 21 patients with cardiac comorbidities had any problem following LC and only one patient out of 10 with cirrhosis of the liver had major bleeding from the liver bed.…”

Section: Discussionsupporting

confidence: 90%

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

et al. 2013

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“…Most of our patients have moderate (46.3%) to severe (40.5%) degree of pain over right upper abdomen. Similar results were seen in studies by Tseng etal 15 and Malik etal 16 .Pain referred to right shoulder or the inferior angle of scapula was found in 32 % of the cases. Fever was seen as a presenting symptom in 85.5% of the cases with Nausea and vomiting accompanied pain in most of the cases(73.9%).…”

Section: Discussion:-supporting

confidence: 79%

“…In 45 cases (65.2%)a tender palpable lump was found in the RHC similar to other studies where a palpable GB was noted in 58 % cases 16 . Greater awareness of these various clinical presentations is needed to reduce the considerable morbidity and mortality caused by the delay in diagnosis.…”

Section: Discussion:-supporting

confidence: 74%

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Laparoscopic Cholecystectomy in Empyema Gall Bladder - Its Safety and Feasibility.

Sahoo¹,

Rout²,

Bharadwaj³

et al. 2017

IJAR

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Objective: To study the clinical profile of Empyema Gall Bladder and to assess the feasibility of laparoscopic cholecystectomy in such cases. This prospective clinical study covers 69 cases of empyema of the gall bladder, which were admitted in the Department of General Surgery At Institute of Medical Sciences and SUM Hospital ,Bhubaneswar,Odisha,India during the period from January 2015 to December 2016. All the Cases were planned for elective laparoscopic cholecystectomy. Results: In our series which included 69 patients ranging from age group of 22 years to 68 years,maximum incidence between 40 -60 years .The male female ratio being 1: 2.13.All the cases were attempted laparoscopically out of which 66(95.6%) were successfully completed while only 3 (4.3%) were converted to open due to completed frozen calots anatomy in 2 cases while cholecystoenteric fistulas in 1 case .The mean operating time was 80 minutes. Varied operative difficulties such as bleeding, obscure Calot's anatomy, Perforated/gangrenous Gall bladder were meticulously managed. Post-operative complications were seen in 20(28.9%) patients out of which port site infection (n = 11) was the most notable while others like bile leak was seen in only 5 patients. Maximum number of patients (n=49 )were discharged within 48-96 hours with only 6 patients requiring a stay beyond 1 week. We cocluded thatLaparoscopic Cholecystectomy can be very well performed in cases with Empyema Gall Bladder with the view in mind about increased risk of intra as well as post -operative complications. Impervious patience, meticulous dissection, clarity in anatomy and the experienceof the surgeon though may play key roles in decreased conversion rates and complications.

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How Safe is Performing Cholecystectomy in the Oldest Old? A 15‐year Retrospective Study from a Single Institution

et al. 2017

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We found out that being nonagenarian, compared to octogenarian, is not a significant risk factor in terms of LOS and in-hospital mortality within 30 days postoperatively. Despite that, the mortality rate among nonagenarians is still remarkably high as almost every patient was admitted in an emergent setting. The most remarkable predictor for mortality among the two groups was an "afternoon/night emergency" surgical presentation (OR 25.5, CI 1.53-42.35, p = 0.02). Thus, the surgical emergency management for gallbladder disease at our institution should be critically reevaluated. Performing the procedure in laparoscopy predicted a significant reduction (-5 days, CI -8.5 to -1.4, p = 0.006) of LOS, while presenting with "gallbladder and bile duct stones" (+6.3 days, CI 1.5-11.1, p = 0.01) or "acalculous cholecystitis" (+4.7 days, CI 0.4-9.2, p = 0.03) had the opposite effect. Despite the remarkable mortality rate of our series, being nonagenarian should not be considered as a reason to avoid gallbladder surgery in case of need. Our study suggests that nonagenarians are more suitable surgical candidates than may have previously expected.

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Laparoscopic cholecystectomy in empyema of gall bladder: An experience at Liaquat University Hospital, Jamshoro, Pakistan

Cited by 21 publications

References 19 publications

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

“Laparoscopic Cholecystectomy: A Single Surgeon’s Experience in some of the Teaching Hospitals of West Bengal”

Laparoscopic Cholecystectomy in Empyema Gall Bladder - Its Safety and Feasibility.

How Safe is Performing Cholecystectomy in the Oldest Old? A 15‐year Retrospective Study from a Single Institution

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