One Thousand Consecutive Cholecystectomies

Magee, Richard B.

doi:10.1001/archsurg.1968.01330240004002

Cited by 22 publications

(4 citation statements)

References 14 publications

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“…IN recent retrospective studies that have included 1000 or more patients the mortality following cholecystectomy has been found to vary between 0.6 and 3.8 per cent (MacVicar, McNair, Wilken, and Bruce, 1967;Meyer, Capos, and Mittlepunkt, 1967;Holm, Edmunds, and Baker, 1968;Magee and MacDuffee, 1968;Seltzer, Steiger, and Rosato, 1970). MacVicar and others (1967) noted in their review of 2043 operations for benign conditions of the gall-bladder and common bile-duct that the majority of the 77 deaths (3.8 per cent) were associated with leakage of bile, and they concluded that prevention and early treatment of this complication would reduce the mortality.…”

mentioning

confidence: 99%

Drainage following cholecystectomy

Williams

Halpin

Knox

1972

Journal of British Surgery

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The effect of intraperitoneal drainage and incidental appendicectomy has been studied in 309 patients who had undergone routine cholecystectomy. Patients who did not have drainage fared better than those in which drains were used. There was an increase in postoperative morbidity when the drain was left in position for more than 48 hours. But when the drain was removed during the first 48 hours the results obtained were the same as for cases in whom no drain was used. Incidental appendicectomy while carrying out cholecystectomy did not affect the morbidity or mortality of the operation. It is concluded that in the absence of bile leakage, drains from the hepatorenal space should be removed within 48 hours, and incidental appendicectomy should be carried out when it can be performed with ease and without undue manipulation.

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mentioning

confidence: 99%

Drainage following cholecystectomy

Williams

Halpin

Knox

1972

Journal of British Surgery

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“…A presença de febre em pacientes com colecistite aguda é achado comum, mas pode estar ausente em percentagens variáveis de pacientes 34,35 . Quando presente em doentes sem complicações, ela é geralmente menor que 38,3 ºC sendo que o achado de temperaturas maiores deve aumentar a suspeita de complicações 36 .…”

Section: Discussionunclassified

Estudos dos fatores de risco pré-operatórios para bacteriobilia em doentes portadores de colecistite aguda calculosa

Linhares¹,

Paiva²,

Filho³

et al. 2001

Rev. Assoc. Med. Bras.

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“…performed at the time of operation, but occasionally preoperatively, is a usually reliable indication for exploring the bile ducts [11][12][13][14][15][16][17][18][19].…”

Section: Demonstration Of Stones By Cholangiographymentioning

confidence: 99%

Importance of surgical technique in prevention of retained and recurrent bile duct stones

Orloff

1978

World j. surg.

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Approximately 10% of the 500,000 patients who undergo cholecystectomy for gallstones each year in the U.S.A. have associated choledocholithiasis. Of the patients who have a choledocholithotomy, 10-13% are found to have retained bile duct stones in the immediate postoperative period, and an unknown additional number are found to have biliary calculi subsequently. Residual bile duct calculi come from 3 sources, namely, "retained" stones that were overlooked during the initial operation, "retained" stones that were recognized but could not be removed at the initial operation, and "recurrent" stones that re-form in the bile ducts in association with highly lithogenic bile. Most retained stones can be prevented by knowing when and how to perform common bile duct exploration. Absolute indications, which have a high yield of calculi, are: (a) palpable stones, (b) obstructive jaundice with cholangitis, (c) demonstration of stones by cholangiography, and (d) dilatation of the common duct beyond a diameter of 12 mm. Relative indications, use of which requires judgment because of a generally low yield of calculi, are: (a) jaundice without cholangitis, (b) biliary-enteric fistula, (c) small stones in the gallbladder, (d) a single-faceted gallbladder stone, and (e) pancreatitis.Technical aspects of common duct exploration that are important for prevention of retained bile duct calculi include: (a) routine use of a Kocher maneuver, (b) routine precxploratory operative cholangiography, (c) use of the balloon-tipped catheter, (d) routine completion cholangiography through a T tube, and (e) operative biliary endoscopy. A large number of retained stones results from inadequate operative cholangiography due to poor radiographic equipment, inattention to details of technique, and insufficient collaboration between radiologist and surgeon.

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One Thousand Consecutive Cholecystectomies

Cited by 22 publications

References 14 publications

Drainage following cholecystectomy

Drainage following cholecystectomy

Estudos dos fatores de risco pré-operatórios para bacteriobilia em doentes portadores de colecistite aguda calculosa

Importance of surgical technique in prevention of retained and recurrent bile duct stones

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