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Showing 2 results for Cholelithiasis

Diwakar Sahu, Mittu John Mathew, Prasanna Kumar Reddy,
Volume 4, Issue 1 (2-2015)
Abstract

Background

Laparoscopic cholecystectomy (LC) is the gold standard treatment for cholelithiasis.

Objectives

Our study intended to evaluate whether timing of surgery is of any influence on the course of the laparoscopic cholecystectomy (LC) following Endoscopic Retrograde Cholangio-Pancreatography ERCP/Endoscopic sphincterotomy (ES) and to identify and assess various factors that can affect the outcome in these patients.

Patients and Methods

Data of 77 patients treated for choledochocystolithiasis with ERCP/ES followed by LC were reviewed. Patients were classified into four groups, group A (n = 29): LC performed within 24 hours after ERCP; group B (n = 20): LC performed after 24 hours to 7 days; group C (n = 12): LC done between 8 to 28 days; group D (n = 16): LC done after 28 days of ERCP. Primary outcome was operating time and secondary outcomes included intra- or post-operative complications, hospital stay and hospital expenses.

Results

Mean operative time was shortest in group A (57.1 minutes) and longest in group B [63.4 (P = 0.131)]. Mean hospital stay was shortest in group A (2.1 days) and longest in group C (5.7 days) (P = 0.003). Hospital expenses were minimal in group A (P = 0.001). Male sex, serum bilirubin level, White blood cell (WBC) count, duration of ERCP/ES procedure, contracted gall bladder and large calculus size on Ultrasonography (USG) were significantly associated with primary outcome.

Conclusions

LC can be performed within 24 hours of ERCP/ES with favorable outcome and less expenses. Timing of LC after ERCP/ES is not significantly associated with outcome of the procedure. Male sex, serum bilirubin level, WBC count, ERCP/ES procedure duration, contracted gall bladder and large size of gall bladder calculus on imaging are significantly associated with difficulty in surgery.


Mohammad Taghi Rajabi Mashhadi, Abbas Abdollahi, Alireza Tavassoli, Mohammad Naser Forghani, Hossein Shabahang, Ehsan Keykhosravi, Azadeh Jabbari Nooghabi, Reza Rezaei,
Volume 4, Issue 2 (5-2015)
Abstract

Background

Today, laparoscopic cholecystectomy is considered as the gold standard treatment for cholecystectomy, which is mainly due to improved results of laparoscopic surgery compared to the open surgery, and its cosmetic benefits.

Objectives

The purpose of this study was to evaluate the results of laparoscopic cholecystectomy in our institution.

Patients and Methods

This is a retrospective study. Medical records of patients who underwent laparoscopic cholecystectomy from 2004 to 2008 were reviewed. The results and complications of surgery were collected using a checklist.

Results

Participants included 500 patients with mean age of 47 ± 11 years. Three hundred ninety-one (78.2%) were female and 109 (21.8%) were male. Four hundred (80.0%) of patients had symptomatic cholelithiasis. The mean operating time was 70 ± 8 minutes. The most common intra-operative complication was bradycardia during gas insufflation into the abdominal cavity. In 430 (86.0%) of patients length of hospital stay was less than two days. Six patients (1.2%) were complicated by hernia at incision site, 18 (3.6%) by bile leakage, and 15 (3.0%) required laparotomy. Surgical site bleeding and surgical site infection were observed respectively in 11 patients (2.2%) and 17 patients (3.4%). Totally, 52 patients (10.4%) had surgically-induced complications, two (0.4%) of whom died.

Conclusions

Laparoscopic cholecystectomy as the method of choice in treatment of gallbladder stone is associated with high success rate. This approach is increasingly being performed because of the decrease in patients’ hospital stay, morbidity, and rapid return to normal life.



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