Use of Stapling Devices for Safe Cholecystectomy in Acute Cholecystitis

Odabaşı, Mehmet; Muftuoglu, M.A. Tolga; Özkan, Erkan; Eris, Cengiz; Yıldız, Mehmet Kamil; Günay, Emre; Abuoğlu, Hacı Hasan; Tekeşin, Kemal; Akbulut, Sami

doi:10.9738/intsurg-d-14-00035.1

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…The biggest problem during elective laparoscopic cholecystectomy in patients with cooled down is the dissection difficulty of the critical calot triangle area [12]. After overcoming this difficulty and encountering a large cystic canal in the next step makes the operation even more difficult [13]. In the laparoscopic cholecystectomy operation, after revealing the Calot triangle and revealing the ductus cysticus in posterior dissection, it is essential to clearly reveal the biliary anatomy by separating the gallbladder from the liver bed [5].…”

Section: Discussionmentioning

confidence: 99%

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Safe use of vascular stapling devices during laparoscopic cholecystectomy in cases with enlarged cystic canal

Fırat

Erol

2020

The European Research Journal

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Objectives: Bile duct injuries and fistulas due to bile leakage are observed at certain rates in laparoscopic cholecystectomy. In complicated cases, in patients with cholelithiasis cystic duct edema, the cystic canal may be enlarged to the extent that it cannot be closed with a clip in a standard operation. In this study we evaluated the eficiency of stapler closure of cystic canal. Methods: In this retrospective study the cases who had laparoscopic cholecystectomy and cystic canal was closed with stapler between August 2016 and December 2018 were reviewed. Patients' hospital stay and complications were noted. Results: Thirty-three patients who were electively operated and cystic canal closure was performed with vascular staples because of a wide cystic canal during the operation were included in this study. Low bile drainage was observed in only one case and this patient had spontaneous regression with conservative followup. Mean duration of hospital stay was 3.7 days. Patients were followed up from 2 months to 28 months postoperatively. Conclusions: Endo-vasculer stapler can be used safely during laparoscopic cholecystectomy with a history of stones in the main bile duct. In this group of patients, it is advisable to make preparations in this direction before the operation.

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Section: Discussionmentioning

confidence: 99%

“…Although the vascular endo-vasculer stapler (2.5 mm) has been preferred in most of the publications in stapled preference for cystic duct in laparoscopic cholecystectomy, staplers with reticulator 4.8 mm and 3.5 mm can be preferred [13].…”

Section: Discussionmentioning

confidence: 99%

Safe use of vascular stapling devices during laparoscopic cholecystectomy in cases with enlarged cystic canal

Fırat

Erol

2020

The European Research Journal

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“…Several large retrospective studies have analyzed the safety and efficacy of the Endo GIA stapler use during laparoscopic cholecystectomy in the hands of general and laparoscopic surgeons. [14][15][16]26 Alternatively, case studies have highlighted the dangers of the Endo GIA stapler, yet its use continues among surgeons. We sought to investigate two key aspects of Endo GIA stapler use specifically among acute care surgeons in cases of acute cholecystitis: (1) Independent preoperative predictors for stapler use among acute care surgeons and (2) safety and efficacy in the hands of acute care surgeons.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Traumatic Hemorrhage of the Basal Ganglia with Diffuse Axonal Injury: A Case Report and Review of Literature

Patil¹,

Tadghare²,

Rege³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Introduction: Endo GIA stapler use is a method to ligate cystic ducts during laparoscopic cholecystectomy in the elective and emergent setting. Its use has not been widely described in the acute care surgery (ACS) setting. Our study aims to determine factors predicting Endo GIA use by acute care surgeons and evaluate when applied its safety and efficacy in emergent cholecystectomy. Additionally, we investigate the use of Endo GIA stapler with respect to conversion to open surgery, reduction in postoperative morbidity, and impact on length of stay in an ACS setting. Materials and methods:A retrospective chart review was conducted for laparoscopic cholecystectomy performed by ACS in a public university training hospital over 1 year. Variables associated with Endo GIA stapler use were identified through multivariate logistic regression and subsequently, assessed after optimizing the model to control for confounding effects.Results: Of the 118 laparoscopic cholecystectomies performed, the Endo GIA Stapler was used for cystic duct ligation in 20 cases. Surgeons' dictated reason for stapler use included dilated cystic duct (45%), short cystic duct remnant (15%), inadequate room for clip ligation and division (10%), and nonspecific (45%). Patient demographic variables for Endo GIA stapled and clipped groups were not significantly different. Logistic regression revealed a significantly higher likelihood of Endo GIA stapler use in patients with comorbid biliary duct disease, preoperative endoscopic retrograde cholangiopancreatography (ERCP), and a trend towards significance in patients with previous emergency department (ED) visits. There was no significant difference in conversion to open surgery, postoperative morbidity, and postoperative length of stay. Conclusion:Comorbid biliary duct disease, previous ED visits, and preoperative ERCP are predictive of patients requiring use of the Endo GIA stapler for cystic duct ligation during emergent cholecystectomy. The use of Endo GIA stapler by Acute Care Surgeons is safe and effective.

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“…Two RCTs and 1 systematic review were found investigating various methods of cystic artery and duct division ( Table 8 ). Our search returned no prospective studies or systematic reviews evaluating stapled transection of the cystic duct or artery, although retrospective evidence supports use of a laparoscopic stapler for dilated or difficult cystic ducts [ 61 ].…”

Section: Introductionmentioning

confidence: 99%