The Bad Gallbladder

Buhavac, Miloš; Elsaadi, Ali

doi:10.1016/j.suc.2021.06.004

Cited by 4 publications

(7 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Harry et al en su revisión sistemática identificaron una variación considerable en las complicaciones informadas en la colecistectomía laparoscópica, una de las complicaciones más frecuentes fue la conversión a la técnica abierta informada en el 58% de los estudios de este tema, la hernia se informó en 50 estudios (21%), la infección de la herida se informó en 118 (51%), también se informaron tasas de cálculos biliares retenidos, derramados, cálculos en el colédoco, residuos o muñón cístico. (25,26) pág. 5913…”

Section: Complicaciones Con Técnicas Colecistectomía Laparoscópica Es...unclassified

Técnicas de Colecistectomía Laparoscópica Subtotal como Estrategias de Manejo en Colecistectomías Difíciles

Castro López,

Cadena Baquero

2024

Ciencia Latina

View full text Add to dashboard Cite

Introducción: La colecistectomía laparoscópica es uno de los procedimientos quirúrgicos más frecuentes en patología biliar sintomática con o sin complicación. Existen factores que son determinantes para el hallazgo de una colecistectomía difícil como la falta de experiencia del cirujano, o condiciones clínicas que producen variaciones de la anatomía biliovascular lo que limita la disección del triángulo hepatocístico, impidiendo alcanzar la visión crítica de seguridad acarreando mayor riesgo de lesiones iatrogénicas y mayor tasa de complicaciones. La colecistectomía convencional continúa siendo el Gold Standard en casos difíciles. Por lo cual, surge la consideración de optar por técnicas quirúrgicas alternativas entre los que se encuentra la colecistectomía subtotal laparoscópica, la cual ha ganado relevancia como estrategia de manejo en la vesícula difícil. Objetivo: Analizar las técnicas de colecistectomía subtotal laparoscópicas como estrategias de manejo en colecistectomías difíciles mediante la revisión de evidencia científica existente. Material y métodos: La sustentación teórica del presente estudio descriptivo se obtiene mediante análisis de la literatura de bases de datos biomédicas con la correcta selección y extracción de datos relevantes para la presente revisión. Conclusiones: La colecistectomía subtotal ha sido propuesta como estrategia de manejo en casos difíciles en los que la colecistectomía total se complica por factores anatómicos, inflamación grave, adherencias u otras complicaciones. las técnicas de colecistectomía subtotal, incluidas la fenestrada y la reconstructiva, se han convertido en opciones viables como estrategias de rescate. Sin embargo, sus resultados dependen de la experiencia del cirujano, de su uso selectivo y de la consideración riesgo-beneficio para cada paciente.

show abstract

Section: Complicaciones Con Técnicas Colecistectomía Laparoscópica Es...unclassified

Técnicas de Colecistectomía Laparoscópica Subtotal como Estrategias de Manejo en Colecistectomías Difíciles

Castro López,

Cadena Baquero

2024

Ciencia Latina

View full text Add to dashboard Cite

show abstract

“…This complexity arises from intricate pathologies, including severe inflammation, pericholecystic fibrosis, adhesions, and variations in anatomy. 1,2 Varying presentations such as gangrenous cholecystitis, perforation, empyema, and Mirizzi syndrome can pose additional unique challenges. 1,2 The critical view of safety is a method aimed at preventing common bile duct injuries, but achieving it can be a persistent dilemma, often necessitating bail out procedures.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Varying presentations such as gangrenous cholecystitis, perforation, empyema, and Mirizzi syndrome can pose additional unique challenges. 1,2 The critical view of safety is a method aimed at preventing common bile duct injuries, but achieving it can be a persistent dilemma, often necessitating bail out procedures. 3 In order to completely remove the gallbladder and decrease patient complications and symptoms, the most defined as conversion to a laparoscopic subtotal fenestrated cholecystectomy, open subtotal fenestrated cholecystectomy, open total cholecystectomy, or an aborted cholecystectomy with cholecystostomy tube placement.…”

Section: Introductionmentioning

confidence: 99%

Bailout Surgery for Difficult Gallbladders: Surgical Approach and Outcomes

Ledezma Dominguez,

Tariq,

Martins

et al. 2024

The American Surgeon™

View full text Add to dashboard Cite

Introduction Inflammation in acute cholecystitis may cause a cholecystectomy to be more challenging. Due to the difficult dissection, conversion to subtotal cholecystectomy via laparoscopic or open procedure may be required. This is done to reduce the risk of bile duct injury and hemorrhage. We sought to describe the incidence and risk factors, safety, morbidity, and outcomes associated with bailout procedures. Methods A single academic center, retrospective review of laparoscopic cholecystectomies that resulted in bailout procedures performed between January 2015 and December 2020. Data collected from the chart review included demographics, comorbidities, length of presenting symptoms, vital signs, laboratory and imaging, intraoperative findings, length of surgery, and outcome. Results A total of 1892 cholecystectomies were performed with 147 bailout procedures. For bailout 92 (63.4%) were converted to open, with 66% resulting in complete cholecystectomy. Hypertension and diabetes were the most common comorbidities. The median duration of symptoms was 4 days. Difficult anatomy in the hepatocystic triangle (66%) and dense adhesions (31%) were the most common reasons for bailout. The mean duration of surgery was 145.76 (SD 102.94) minutes. There were 2 bile duct injuries, both in open total cholecystectomy subgroup. Bile leak occurred in 23.8% with majority in subtotal cholecystectomy group. There was no difference in hospital length of stay, surgical site infection, or mortality among different bailout procedures. Conclusions Subtotal cholecystectomy represents a safe alternative to total cholecystectomy during challenging cases to avoid damaging surrounding structures. The choice of laparoscopic or open subtotal approach is dependent on the surgeons’ expertise.

show abstract

“…Cholecystitis and gallbladder stones are common biliary diseases that require hepatobiliary surgery, and laparoscopic cholecystectomy (LC) is currently the preferred treatment option. 1,2 LC is a minimally invasive procedure with minimal trauma and minimal impact on the body's internal environment and aesthetic appearance. 3 It has replaced traditional cholecystectomy as the conventional method and 'gold standard' for the treatment of chronic cholecystitis, gallbladder stones, and other gallbladder diseases.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of dexmedetomidine on surgical site wound pain in patients undergoing laparoscopic cholecystectomy: A meta‐analysis

Weng

Cheng

2023

International Wound Journal

View full text Add to dashboard Cite

This study aimed to evaluate the effectiveness of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in reducing surgical site wound pain in patients undergoing laparoscopic cholecystectomy. The Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, and Wanfang databases were searched from the time of database creation until February 2023. We performed a randomised controlled trial on the effect of dexmedetomidine as an adjunct to local wound infiltration anaesthesia on postoperative wound pain in patients undergoing laparoscopic cholecystectomy. Two investigators independently screened the literature, extracted data, and evaluated the quality of each study. This study was performed using the Review Manager 5.4 software. Ultimately, 13 publications with 1062 patients were included. The results showed that dexmedetomidine was effective as an adjunct to local wound infiltration anaesthesia at 1 h (standardised mean difference [SMD]: −5.31, 95% confidence intervals [CIs]: −7.22 to −3.40, P < .001), 4 h (SMD: −3.40, P < .001), 12 h (SMD: −2.11, 95% CIs: −3.10 to −1.13, P < .001) and 24 h postoperatively (SMD: −1.98, 95% CIs: −2.76 to −1.21, P < .001) significantly reduced surgical site wound pain. However, there was no significant difference in the analgesic effect at 48 h postoperatively (SMD: −1.33, 95% CIs: −3.25 to −0.58, P = .17). Dexmedetomidine provided good postoperative wound analgesia at the surgical site when used for laparoscopic cholecystectomy.

show abstract

The Bad Gallbladder

Cited by 4 publications

References 41 publications

Técnicas de Colecistectomía Laparoscópica Subtotal como Estrategias de Manejo en Colecistectomías Difíciles

Técnicas de Colecistectomía Laparoscópica Subtotal como Estrategias de Manejo en Colecistectomías Difíciles

Bailout Surgery for Difficult Gallbladders: Surgical Approach and Outcomes

Effects of dexmedetomidine on surgical site wound pain in patients undergoing laparoscopic cholecystectomy: A meta‐analysis

Contact Info

Product

Resources

About