The impossible gallbladder: aspiration as an alternative to conversion

Kharytaniuk, Natallia; Bass, Gary Alan; Dumbrava, Bogdan; Healy, Paul; Viani-Walsh, Dylan; Tiwary, Tej; Abassi, Tahir; Murphy, Matthew P.; Griffin, Emma; Walsh, T. N.

doi:10.1007/s00464-019-07268-x

Cited by 5 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The calculated BMI showed a condition of overweight or obesity in all patients apart from two cases of Rett syndrome, which were normal-weight, with a mean BMI of 29 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). In 20 cases (58.8%), the diagnosis of cholecystitis followed an episode of acute localized abdominal pain; in 13 cases (38.2%), the diagnosis was accidental, secondary to a screening for recurrent non-specific abdominal pain; while in 1 case (2.9%), diagnosis followed an episode of pancreatitis.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Gallbladder Stones in Pediatric Age: An Emerging Problem: The Risk of Difficult Cholecystectomy and the Importance of a Preoperative Evaluation

Todesco,

Molinaro,

Nascimben

et al. 2023

Children

View full text Add to dashboard Cite

The need for cholecystectomy during pediatric age has significantly increased in the last two decades. As biliary pathology increases, the probability of complicated cholecystectomies increases too. The aim of this article is to analyze our experience with difficult laparoscopic pediatric cholecystectomy, focusing on the importance of an accurate pre-operative imaging study. We retrospectively analyzed all patients affected by cholelithiasis who underwent laparoscopic cholecystectomy at the Pediatric Surgery Department of San Camillo Forlanini hospital of Rome and Santa Maria alle Scotte University Hospital of Siena from 2017 to 2022. Demographic data, body mass index (BMI), recovery data, laboratory tests, imaging exams, surgical findings, post operative management and outcome were taken into account. Overall, 34 pediatric patients, with a mean age of 14.1 years (6–18 years) were included, with a mean BMI of 29. All patients underwent abdominal ultrasonography and a liver MRI with cholangiography (cMRI). We identified five cases as “difficult cholecystectomies”. Two subtotal cholecystectomies were performed. Cholecystectomy in pediatric surgery can be difficult. The surgeon must be able to find alternative strategies to total cholecystectomy to avoid the risk of possible bile duct injury (BDI). Pre-operative imaging study trough ultrasound and especially cMRI is crucial to recognize possible difficulties and to plan the surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Another possible lifejacket is proposed by Kharytaniuk et al: laparoscopic aspiration of the gallbladder [ 24 ]. Aspiration draws on the principle of “ubi pus, ibi evacua”.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Stones in Pediatric Age: An Emerging Problem: The Risk of Difficult Cholecystectomy and the Importance of a Preoperative Evaluation

Todesco,

Molinaro,

Nascimben

et al. 2023

Children

View full text Add to dashboard Cite

show abstract

“…Punción de la vesícula y aspiración, colocación de drenaje y diferir la colecistectomía, como una alternativa a convertir. (Kharytaniuk et al, 2020).…”

Section: Otras Opciones Descritas Sonunclassified

Procedimientos de rescate en colecistectomía laparoscópica: cómo finalizar con seguridad por laparoscopía

et al. 2023

View full text Add to dashboard Cite

Los procedimientos de rescate en colecistectomía laparoscópica son variados. Objetivos: Describir los procedimientos de rescate usados en el Hospital Regional ISSSTE Puebla durante el 2022. Material y métodos: Estudio observacional descriptivo, prospectivo de corte trasversal, en donde se incluyeron pacientes en los cuales no se pudo completar la visión crítica de seguridad y por lo tanto se tuvo que usar algún procedimiento de rescate para completar la colecistectomía por laparoscopía. Resultados: Se realizaron 193 colecistectomías laparoscópicas, en 40 (20.7%) pacientes se empleó algún procedimiento de rescate, se convirtieron 4 (2%) pacientes. Mediante el análisis multivariado no hubo relación significativa entre el tipo de procedimiento y el género, la edad, así como el grado de severidad de Tokyo; pero si hubo relación significativa el puntaje de Parkland ≥4 con los siguientes procedimientos: "Fundus first" más "punción y aspiración", colecistectomía reconstitutiva, abordaje infundibular, abordaje del segmento IV, colocación de un puerto adicional, colecistectomía parcial con o sin colangiografía, y el abordaje del ganglio cístico. Los días de estancia hospitalaria mayores se relacionaron con la colecistectomía reconstitutiva, colecistectomía parcial y la conversión. El sangrado se relacionó con la necesidad de conversión y con el uso de la "punción y aspiración".

show abstract

“…Although this Review stated that 2% to 15% of patients undergoing laparoscopic cholecystectomy “must be converted” to open cholecystectomy, we contend that there are safer alternatives, such as gallbladder aspiration, which allows time for the inflammation to subside. This procedure permits safer laparoscopic cholecystectomy after a 6-week interval or, if dissection difficulty is anticipated, allows time for a referral to a tertiary medical center.…”

mentioning

confidence: 99%