Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients

Biliary complications associated with laparoscopic cholecystectomy: analysis of common misconceptions

“…These include the following: * That after the initial 'learning curve' the incidence of biliary injuries is approximately the same as in the 'open' era2 * That the majority are caused by trainee surgeonslI. 12 * That injuries usually occur in the presence of unusual anatomy or difficult pathology3 * That biliary injuries are generally higher than those that occur with open cholecystectomy13 * That injuries are often recognised at the time of surgery4 14 * That most complications are easily managed, and that most can be managed non operatively15 Based on our experience we felt that these are probable misconceptions; therefore we reviewed this series of patients referred to a specialist hepatobiliary unit.…”

Production of Intraperitoneal Interleukin-6 Following Open or Laparoscopic Assisted Distal Gastrectomy

“…Key words: Interleukin (IL)-6 -Cytokine -Peritoneal fluid -Surgical stress -Gastric cancerLaparoscopic surgery -Gastrectomy R ecent advances in laparoscopy techniques have heralded a new era in the field of abdominal surgery, and laparoscopic approaches are now being employed for the treatment of malignant neoplasms of the stomach, colon and other organs. [1][2][3][4][5] It has been reported that levels of circulating proinflammatory cytokines such as interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha are related to the extent and severity of surgical procedures.6-8 Interleukin 6 is a sensitive and early marker of tissue damage, and in general the greater the surgical trauma, the greater the response of Many studies have shown that the level of IL-6, as an indicator of surgical stress, is significantly lower after laparoscopic surgery than after open surgery.9-15 Most of the studies reported so far have measured and analyzed the concentration of IL-6 in plasma or serum, 9,10,[12][13][14][15][16]18 and only rarely in peritoneal fluid, 11,12,15,17,19,20 and the results have indicated significant correlations between the level of IL-6 and several clinical parameters. However, there is some concern as to whether the concentration of IL-6 in peritoneal fluid adequately reflects the degree of surgical stress.…”

“…Key words: Interleukin (IL)-6 -Cytokine -Peritoneal fluid -Surgical stress -Gastric cancerLaparoscopic surgery -Gastrectomy R ecent advances in laparoscopy techniques have heralded a new era in the field of abdominal surgery, and laparoscopic approaches are now being employed for the treatment of malignant neoplasms of the stomach, colon and other organs. [1][2][3][4][5] It has been reported that levels of circulating proinflammatory cytokines such as interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha are related to the extent and severity of surgical procedures.…”

“…[1][2][3][4][5] It has been reported that levels of circulating proinflammatory cytokines such as interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha are related to the extent and severity of surgical procedures. [6][7][8] Interleukin 6 is a sensitive and early marker of tissue damage, and in general the greater the surgical trauma, the greater the response of IL-6.…”

Endoscopic Treatment of Biliary Leaks After Laparoscopic Cholecystectomy: Cut or Plug?

“…Biliary leaks, a well-recognized and much-feared complication of biliary tract surgery, have increased in frequency in the era of laparoscopic cholecystectomy, with estimates of the frequency of biliary leaks after laparoscopic cholecystectomy estimated at 0.3-0.5% [1]. Leakage post-cholecystectomy most commonly arises from the cystic duct or a duct of Luschka (Amsterdam type A leaks).…”