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Jabeen, Mudassar, Bushra Jamil, and Shehzad Amjad Khan. "LAPAROSCOPIC CHOLECYSTECTOMY." Professional Medical Journal 25, no. 10 (2018): 1503–9. http://dx.doi.org/10.29309/tpmj/18.4838.
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Introduction: Since the first laparoscopic cholecystectomy (LC) was reportedin 1990, it has widespread acceptance as a standard procedure using four trocars. The fourth(lateral) trocar is used to grasp the fundus of the gall bladder to expose calot`s triangle. Withincreasing surgeon experience, LC has undergone many refinements including reductionin port number and size. Three port LC has been reported to be safe and feasible in manyclinical trials. Objectives: To compare the operative time and of three ports versus four portlaparoscopic cholecystectomy. Study Design: Randomized Controlled Trials. Setting: SurgicalDepartments, Allied & Civil Hospitals Faisalabad. Period: 15-09-2010 to 15-03-2011. Materialand Methods: 132 Patients who underwent elective laparoscopic cholecystectomy wererandomized to undergo either the 4-port. (Group A) or the 3-port LC (group B).66 patients ineach group. Results: Mean Operative time was 25.14±4.19 minutes in group A and 25.35±4.34in group B. (p value-0.774). Mean VAS score at 12th postoperative hour was 5.37±0.993 ingroup A and 4.52±0.986 in group B. (p value <0.0001). Conclusion: Three port Laparoscopiccholecystectomy did not affect, operative time. However it resulted in less early postoperativepain in three port LC.
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Umman, Philip, Clyde R. Menezes, Ashish Bosco, and Nandakumar Menon. "An ergonomic modification of the American position for laparoscopic cholecystectomy in a rural setting." International Surgery Journal 6, no. 8 (2019): 2982. http://dx.doi.org/10.18203/2349-2902.isj20193354.
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Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstone disease. As a result of the significant investments in setting up a laparoscopy unit and training nursing staff in laparoscopic techniques, the cost of laparoscopic surgery is higher. However, the urban poor and rural population of India stand to benefit most from laparoscopy, owing to the shorter recovery times and reduced post-operative pain. The American and French positions have been described for laparoscopic cholecystectomy. Studies on ergonomics in laparoscopy deal mainly with issues related to the operating surgeon. There is not much literature on the issues faced by the team members during laparoscopy, especially in resource constrained settings. The authors propose a modification of the American position for LC, which enhances comfort and vision for the scrub nurse and also helps the surgeon guide the novice staff in LC.
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Begum, Mst Mamtaz, Mohammad Farid Hossain, and Agatha Prianka Rozario. "Surgical Outcomes of Needlescopic Cholecystectomy Versus Laparoscopic Cholecystectomy- A Comparative Study in A Specialized Hospital in Bangladesh." SAS Journal of Surgery 10, no. 02 (2024): 178–83. http://dx.doi.org/10.36347/sasjs.2024.v10i02.010.
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Background: Needlescopic cholecystectomy (NSC) and laparoscopic cholecystectomy (LC) are both minimally invasive surgical techniques used for the removal of the gallbladder in patients with gallbladder disease, primarily gallstones. The comparison of surgical outcomes between needlescopic cholecystectomy (NSC) and laparoscopic cholecystectomy (LC) has been a subject of interest among surgeons and researchers. Aim of the study: The aim of the study was to compare the surgical outcomes of needlescopic cholecystectomy versus laparoscopic cholecystectomy. Methods: This was a prospective observational study conducted in the Department of General & Laparoscopy Surgery, Evercare Hospital, Dhaka-Bangladesh from December 2022 to November 2023. A total of 50 symptomatic cholelithiasis patients were randomly selected as the study population. The total 50 patients were equally divided into two groups, Group A underwent Needlescopic cholecystectomy, and Group B underwent laparoscopic cholecystectomy. Data analysis was performed using MS Office tools and SPSS version 23.0 program. Results: In this study, intraoperative incidents were less frequent, with 28% in the Needlescopic group and 36% in the Laparoscopic group. Wound length in the epigastrium was significantly smaller in the Needlescopic group (3.9 mm vs. 13.1 mm in Laparoscopic). In the hypochondrium, Needlescopic patients had a 3.7 mm wound, while Laparoscopic patients had 7.9 mm. In the flank region, Needlescopic patients had a 4.2 mm wound, compared to 8.8 mm in Laparoscopic patients. According to a 10-grade VAS scale, satisfaction scores were 9.8 for Needlescopic and 9.6 for Laparoscopic cholecystectomy patients. Conclusion: Needlescopic cholecystectomy has clear advantages over laparoscopic cholecystectomy, with fewer intraoperative incidents, reduced post-operative pain, and smaller wounds, resulting in less discomfort, minimal scarring, and a quicker recovery. Late postoperative complications are also less .........
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Helic, Bakir, Larisa Helic, and Hajrudin Osmic. "Reasons for laparosopic cholecystectomy conversion in a small general hospital." South-East European Endo-Surgery Journal 2, no. 2 (2024): 169–75. http://dx.doi.org/10.55791/9g5bqk64.
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Background: Laparoscopic cholecystectomy is one of the most common procedures in abdominal surgery. This procedure is the gold standard for the treatment of symptomatic cholelithiasis and acute cholecystitis. However, thedifficulty and possibility of safely performing laparoscopic cholecystectomy vary considerably due to the variety of local findings and the course of the procedure. If it is not possible to complete the procedure safely by laparoscopy, due to intraoperative complications or to avoid the occurrence of complications, it is necessary to convert laparoscopic cholecystectomy to open cholecystectomy.Methods: We performed retrospective research on cases of cholecystectomy performed on all patients at the Dr. Mustafa Beganović General Hospital in Gračanica from 2014 to 2020, which were started by laparoscopy and finished using laparoscopy or converted to open cholecystectomy. Results: There were 888 cases that started as laparoscopic cholecystectomy. In 43, or 5.39% of cases laparoscopic cholecystectomy was converted to open cholecystectomy. The most common reasons for conversion from LC to OC were adhesions, the inability to identify anatomical structures, and inflammation.Conclusion: The number of conversions in our sample is in accordance with the data from the relevant research and at the same time the incidence of bile duct injuries is very low.
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Rihan, Maged. "Laparoscopic subtotal cholecystectomy in severe cholecystitis with unclear anatomy." International Surgery Journal 7, no. 12 (2020): 3929. http://dx.doi.org/10.18203/2349-2902.isj20205345.
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Background: Aim of the study was to determine the differences between laparoscopic cholecystectomy and laparoscopic subtotal cholecystectomy as regards bile duct injury and post-operative complications rates in patients with severe cholecystitis and obscure anatomy.Methods: We retrospectively reviewed the charts and postoperative outcomes of 293 patients with severe cholecystitis who underwent either laparoscopic cholecystectomy or laparoscopic subtotal cholecystectomy between September 2011 and January 2020. Patients with intraoperative altered anatomy which leaded to difficult dissection were defined as having severe cholecystitis.Results: There were 304 cholecystectomies done for patients with severe cholecystitis. Of those, 203 underwent laparoscopic cholecystectomy (LC group), 90 underwent laparoscopic subtotal cholecystectomy (LSC group). There was no significant difference in male to female ratio, age, cases performed on an elective or emergency basis, hospital length of stay or initial operative findings. There were 5 patients with detected intraoperative biliary injury in LC group only. Postoperative bile leaks were significantly higher in the LSC (11.1%) than in the LC group (3.9%). Postoperative collections which needed percutaneous aspiration were also significantly higher in the LSC group (18.9%) than in the LC group (7.4%). Reoperation for collection was required in 8 patients in LC group and in 5 patients in LSC group. The rates of retained common bile duct stones, port site hernia, wound infections, and total complications were not significantly different between the two groups (28.1% v. 45.6%).Conclusions: Our study demonstrated that laparoscopic subtotal cholecystectomy is a safe procedure which reduces the risk of bile duct injury and is comparable to laparoscopic cholecystectomy in patients with severe cholecystitis with unclear anatomy.
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Murshid, Dr Mohsin Yahya, Dr Abdulhamed Jameel Murshid, and Dr Farrukh Alim Ansari. "Early vs. Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis – A Single Center Study." SAS Journal of Surgery 9, no. 02 (2023): 59–64. http://dx.doi.org/10.36347/sasjs.2023.v09i02.002.
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Introduction: Laparoscopic cholecystectomy is regarded as the gold standard for the treatment of acute cholecystitis; however the timing of the procedure is controversial. There exist studies that support both early and delayed laparoscopic cholecystectomy. Aim: The aim of the study is to determine which modality: early or delayed laparoscopic cholecystectomy is the preferred timing in the treatment of acute cholecystitis by examining: duration of hospitalization, conversion rate, duration of surgery and intraoperative, postoperative complications. Materials and Methods: This was a retrospective study of 300 patients. Laparoscopic cholecystectomy was performed within 72 hours of admission for patients in the Early LC Group. Patients in the Delayed LC group were treated conservatively and discharged They were readmitted 6-12 weeks later for elective laparoscopic. Results: The mean operating time was 83.55 mins vs. 60.72 mins in the delayed group, conversion rate in Early LC Group was 5.3% vs. 8.0 % in the delayed LC group. The mean postoperative hospital stay was 1.98 days in the earlier group and 3.35 days in the delayed group. Overall mortality was zero. Conclusion: Early laparoscopic cholecystectomy within 72 hours of symptom onset offers both medical and economic benefits and should be the preferred method for patients treated by surgeons with adequate laparoscopic cholecystectomy experience.
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Brune, Iris B., K. Schönleben, and S. Omran. "Complications After Laparoscopic and Conventional Cholecystectomy: A Comparative Study." HPB Surgery 8, no. 1 (1994): 19–25. http://dx.doi.org/10.1155/1994/59865.
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The growing popularity of laparoscopic cholecystectomy (LC) has made extensive series comparing laparoscopic and conventional cholecystectomy in a prospective, randomized way nearly impossible. To evaluate LC we compared retrospectively 800 laparoscopic with 748 conventional cholecystectomies (CC). Of the 800 LC, 10 (1.2%) were converted to laparotomy. 6 conversions were related to aberrant anatomical features or features making dissection very difficult, 4 conversions were due to complications. There were 5 (0, 6%) intraoperative complications during LC and 4 (0.5%) during CC. Postoperative morbidity was 2.1% (n = 17) after LC and 3.7% (n = 28) after CC. Particularly the incidence of wound problems was only 0.5% (n = 4) after LC while it was 1.3% (n = 10) after CC. Overall morbidity was 2.7% (n = 22) for LC and 4.2% (n = 32) for CC. Mortality rate after CC was 0.4% (n = 3), there were no deaths after LC. Common bile duct-injury rate was 0.2% (n = 2) for both groups. Complication rates after LC have been rapidly decreasing with growing experience. Laparoscopic cholecystectomy can safely be performed by appropriately trained surgeons in more than 90% of patients suffering from gallbladder disease. The low morbidity and mortality together with the significant advantages to patient recovery makes laparoscopic cholecystectomy the treatment of choice for symptomatic cholecystolithiasis.
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Bohara, Tanka Prasad, Adarsh Gurung, Ellina Dangol, Salina Neupane, and Mukund Raj Joshi. "Comparison of Quality Of Life Before and After Laparoscopic Cholecystectomy." Journal of KIST Medical College 6, no. 11 (2024): 68–72. http://dx.doi.org/10.61122/jkistmc291.
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Introduction: Laparoscopic cholecystectomy (LC) is a treatment of choice for symptomatic cholelithiasis. LC is one of the most commonly done operations in our country. Patient-reported quality of life is an important outcome measure following all medical and surgical interventions. However, there are only a few papers available addressing quality of life-issues following laparoscopic cholecystectomy. Hence, we conducted a study to compare the quality of life to compare before and after LC. Methods: This is a longitudinal study. Patients who underwent laparoscopic cholecystectomy during the study period were included. Gastrointestinal quality of life (GIQLI) was measured before and six months after laparoscopic cholecystectomy. Result: Seventy-two patients, 11 (15.28 %) males and 61 (84.72 %) females were included in the study. The mean age was 44.97 years and the mean duration of symptoms was found to be 5.20 months. No complications were recorded. There was a statistical increase in the mean total GIQLI before and after LC (111.625 Vs 133, p < 0.0001). Conclusion: There was a significant increase in GIQLI after laparoscopic cholecystectomy in symptomatic patients.
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Leander, P., O. Ekberg, and P. Almqvist. "Radiology in Laparoscopic Cholecystectomy." Acta Radiologica 35, no. 5 (1994): 437–41. http://dx.doi.org/10.1177/028418519403500508.
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Laparoscopic cholecystectomy (LC) is attempted in all our patients scheduled for cholecystectomy. The related standard radiologic procedures are preoperative ultrasonography (US) and peroperative cholangiography (PCA). In a retrospective study of 214 patients scheduled for LC over a 2-year period we have reviewed the radiologic and clinical records. Preoperative US revealed stones in the common bile duct (CBD) in 8 patients, all treated with endoscopic papillotomy before or after operation. PCA was successful in 176 patients (82%) and gave crucial information in 22 patients including 8 with stones in the CBD not preoperatively diagnosed, 6 with anomalous anatomy, and 8 with malpositioned surgical clip on the cystic duct. In 26 patients LC was converted into open surgery, but in only one case due to CBD stone revealed at PCA. Seventeen patients had minor postoperative complications, all managed conservatively. We consider preoperative US and PCA appropriate radiologic investigations in conjunction with LC.
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Slater, M., MI Booth, and TCB Dehn. "Cost-Effective Laparoscopic Cholecystectomy." Annals of The Royal College of Surgeons of England 91, no. 8 (2009): 670–72. http://dx.doi.org/10.1308/003588409x12486167521154.
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INTRODUCTION There is wide variation in costs, both theatre and ward, for the same operation performed in different hospitals. The aim of this study was to compare the true costs for a large number of consecutive laparoscopic cholecystectomy (LC) cases using re-usable equipment with those from an adjacent trust in which the policy was to use disposable LC equipment. PATIENTS AND METHODS Data were collected prospectively between January 2001 and December 2007 inclusive for all consecutive patients undergoing LC by two upper gastrointestinal (UGI) consultants at the Royal Berkshire Hospital. Data were collected for all the instruments used, in particular any additional disposable instruments used at surgeons' preference. Sterilisation costs were calculated for all re-usable instruments. Costs were also obtained from an adjacent NHS trust which adopted a policy of using disposable ports and clip applicators. Disposable equipment such as drapes, insufflation tubing, and camera sheath were not considered as additional costs, since they are common to both trusts and not available in a re-usable form. RESULTS Over 7 years, a total of 1803 LCs were performed consecutively by two UGI consultants at the Royal Berkshire Hospital. The grand total for 1803 LC cases for the re-usable group, including initial purchasing, was £89,844.41 (an average of £49.83 per LC case). The grand total for the disposable group, including sterilisation costs, was £574,706.25 (an average of £318.75 per LC case). Thus the saving for the trust using re-usable trocars, ports and clip applicators was £268.92 per case, £69,265.98 per annum and £484,861.84 over 7 years. CONCLUSIONS This study has demonstrated that considerable savings occur with a policy of minimal use of disposable equipment for LC. Using a disposable set, the instrument costs per procedure is 6.4 times greater than the cost of using re-usable LC sets. It behoves surgeons to be cost-effective and to reduce unnecessary expenditure and wastage. There is no evidence to support use of once-only laparoscopic instruments on grounds of patient safety, ease of use or transmission of infection. If the savings identified in this study of two surgeons' work (savings of £484,861.84 in a 7-year period) was extended not only across the hospital but across the NHS, large savings could be made for laparoscopic cholecystectomy. Even greater savings would accrue if the results were extrapolated to cover all laparoscopic surgery of whatever discipline.
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Lada, Paul Eduardo. "Mini-laparotomia vs. video-laparoscopia en el tratamiento de la litiasis biliar. Estudio prospectivo y comparativo." Revista de la Facultad de Ciencias Médicas de Córdoba 72, no. 3 (2015): 152–60. http://dx.doi.org/10.31053/1853.0605.v72.n3.9205.
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Background: Laparoscopic cholecystectomy is considerated as the gold standard for the gallbaldder stones treatment, however, in the international literature the adapted smaller incisions is still an alternative procedure. Objetives: To compare the results of the laparoscopic cholecystectomy with the cholecystectomy by adapted smaller incisions. Design: Prospective and comparative protocolized study. Materials and Methods: Between January 1994 and December 2011, we have performed 3822 cholecystectomy in the General Surgic Service “Pablo Luis Mirizzi” of the National Clinic Hospital of Córdoba. In 1735 patients we made laparoscopic cholecystectomy (LC) and in 2087 cholecystectomy by adapted smaller incisions (ASI). This two groups are comparable in age, gender, previous surgeries and preoperative diagnostic. Results: We had non mortality, 115 cases (6.62 %) in the laparoscopic cholecystectomy were converted to open surgery. Postoperative complications for LC were 2.40 % and for ASI 6.37 %. Bilirraghe was superior and more serious in LC with an incidence of 0.55 % while for ASI was 0.23%. Conclusions: In expert hands, laparoscopic cholecystectomy is the gold standard for the treatment of gallbaldder stones. However, in place with restricted butget the cholecystectomy by adapted smaller incisions can be an alternative gold standard. It´s a sure and economic proceedment, with a reasonable complexity and less index of surgical lesions.
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Kalkan, Mustafa, Yüksel Arıkan, Sezgin Yılmaz, and Rüçhan Bahadır Celep. "Comparative analysis of surgical outcomes: post-ERCP laparoscopic cholecystectomy versus elective laparoscopic cholecystectomy." Journal of Comprehensive Surgery 2, no. 2 (2024): 21–28. http://dx.doi.org/10.51271/jocs-0029.
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Aims: Gallstones are widespread in the adult population. In some patients, the stones are not confined to the gallbladder but are also found in the biliary tract. Although the treatment approach for this group of patients is controversial, the most widely accepted treatment is laparoscopic cholecystectomy (LC) after removal of the stones by endoscopic retrograde cholangiopancreaticography (ERCP). Opinions differ as to whether LC should be performed early or late. With this study, we wanted to shed light on this question based on our own clinical experience. Methods: A total of 100 patients who underwent LC in our clinic were included in the study. These patients were divided into two groups: 50 patients who underwent ERCP and early cholecystectomy (group 1) and 50 patients who underwent elective LC for gallstones (group 2). Patients who underwent ERCP for malignant or benign stricture, patients with porcelain sac, patients with previous abdominal surgery, patients who underwent emergency LC, patients younger than 18 years old, and patients with incomplete data, incomplete records, or patients whose necessary information could not be accessed were excluded. Results: There was no statistically significant difference between age and preoperative amylase levels. The mean length of hospital stay was 3.9±1.6 days in patients who underwent elective LC and 5.5±3.2 days in patients who underwent LC after ERCP. There was a statistically significant difference between postoperative amylase level, hemoglobin level and length of hospital stay (p<0.05). Postoperative amylase levels and length of hospital stay were higher in group 1. There was a significant difference between the groups in terms of surgical procedure (p<0.05). In group 1, laparoscopic cholecystectomy (LC) was performed in 76% of patients, while in group 2, LC was performed in 94% of patients. It was found that the rate of conversion to patency was higher in group 1. There was no statistically significant difference between the groups in terms of postoperative and preoperative complications Conclusion: In conclusion, our study highlights early cholecystectomy after ERCP to reduce potential complications in the treatment of gallstones, while emphasising the need for close patient follow-up and further research validation.
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Rajdip Hazra and Avijit Roymondol. "Laparoscopic cholecystectomy under spinal anesthesia in a 5-year-old child: A case report." Asian Journal of Medical Sciences 14, no. 1 (2023): 226–28. https://doi.org/10.71152/ajms.v14i1.3802.
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Symptomatic cholelithiasis in pediatric patients should be dealt with cholecystectomy. Due to its minimally invasive nature, laparoscopic approach is better than conventional open approach. Although safety of spinal anesthesia (SA) in adult laparoscopic surgeries including cholecystectomy is well established, its use in pediatric laparoscopic surgeries is extremely limited with only a few studies being published till date. Here, we report a case of laparoscopic cholecystectomy (LC) in a 5-year-old child which was successfully managed with SA. This may be the very first case report of pediatric LC under SA.
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Hazra, Rajdip, and Avijit Roymondol. "Laparoscopic cholecystectomy under spinal anesthesia in a 5-year-old child: A case report." Asian Journal of Medical Sciences 14, no. 1 (2023): 226–28. http://dx.doi.org/10.3126/ajms.v14i1.49330.
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Symptomatic cholelithiasis in pediatric patients should be dealt with cholecystectomy. Due to its minimally invasive nature, laparoscopic approach is better than conventional open approach. Although safety of spinal anesthesia (SA) in adult laparoscopic surgeries including cholecystectomy is well established, its use in pediatric laparoscopic surgeries is extremely limited with only a few studies being published till date. Here, we report a case of laparoscopic cholecystectomy (LC) in a 5-year-old child which was successfully managed with SA. This may be the very first case report of pediatric LC under SA.
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Hassan, Iram, Muhammad Sohaib Khan, Naveed Akhtar Malik, Jahangir Sarwar Khan, Saadia Zaman, and Muhammad Mussadiq Khan. "CHOLECYSTECTOMY;." Professional Medical Journal 21, no. 01 (2014): 005–9. http://dx.doi.org/10.29309/tpmj/2014.21.01.1782.
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Objective: To compare the operative time, blood loss, postoperative pain andlength of hospitalization between open (OC) and laparoscopic cholecystectomy (LC) in Livercirrhotic patients with Child –Pugh class A & B. Study Design: Randomised Control Trial (RCT).Setting and Duration: This study was conducted at Surgical department, Holy Family Hospital,Rawalpindi from Jan 2010 to Dec 2011. Subjects and Methods: A total of 142 patients havingLiver cirrhosis secondary to Hepatitis A & Hepatitis B, who presented in OPD and ER with signsand symptoms of gall stones were randomly allocated into two groups for open (OC) andlaproscopic cholecystectomy (LC). All of them were either in Child–Pugh class A or B. Data on theabove two groups( LC &OC) was collected and analyzed for operative time, blood loss andlength of hospitalization after operation. Results: The mean blood loss in LC group was61.33+39.64 ml vs 90.84+29.88 ml in OC group, Mean operation time was 50.49+18.26 min inLC group vs 59.22+15.66 in OC group which is statistically significant (p<.05). In LC group, themean hospital stay was 1.8+.97 days, while in OC group is 2.4+.91 days which is alsostatistically significant. Conclusions: LC (laparoscopic cholecystectomy) is a safe and effectiveapproach for the treatment of symptomatic cholelithiasis in patients with mild cirrhosis with lessblood loss, less postoperative pain, shorter operative time and decreased hospital stay.
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Rakan, Alqahtani, Ghnnam Wagih, Alqahtani Mohammad, Qatomah Abdulrahman, AlKhathami Awdah, and Alhashim Adel. "ROLE OF MALE GENDER IN LAPAROSCOPIC CHOLECYSTECTOMY OUTCOME." International Journal of Surgery and Medicine 1, no. 2 (2015): 38–42. https://doi.org/10.5455/ijsm.20150903081650.
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Laparoscopic cholecystectomy (LC) is one of the most commonly performed laparoscopic procedures. Problems occurring during laparoscopic cholecystectomy include bile duct injury, conversion to open operation, and other postoperative complications. Male gender is a risk factor for LC conversion rate.Our goal is to determine the effect of male gender on the outcome of laparoscopic cholecystectomy for Chronic Cholecystitis. We have done that through a retrospective clinical trial was carried out at our Hospital to evaluate the sex difference as predictor for difficult laparoscopic cholecystectomy. From a total number of 638 patients, who underwent laparoscopic cholecystectomy for Chronic Cholecystitis from 1st January 2012 to 1st of January 2015) two hundred and seventeen patients were excluded according to exclusion criteria and the remaining 421 patients were included.All the operation were done according to standard four-port technique through an open method was used, with first entry port in the periumblical region. 1 Anesthetic technique and perioperative management were the same for all patients during the study period. Results: Patients who were candidates for elective cholecystectomy , were mostly females with (F:M ratio= 4/1), mean age 40 years (range 13-101 years) with mean age of 45 years(range 20-78 years) for the males, 40years (range 13-100 years) for the females. There were more difficult cholecystectomies in males in comparison to female patients for chronic cholecystitis. The outcome of this study is male gender is a predictor for difficult laparoscopy for symptomatic gallstones presented as chronic cholecystitis.
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Stanisic, V., M. Bakic, M. Magdelinic, H. Kolasinac, and M. Miladinovic. "Laparoscopic cholecystectomy in elderly patients." Acta chirurgica Iugoslavica 56, no. 2 (2009): 87–91. http://dx.doi.org/10.2298/aci0902087s.
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Laparoscopic cholecystectomy (LC ) is the method of choice of surgical treatment of gallbladder diseases. Operations in elderly people over 65 years because of chronic diseases, are often associated with high operative and postoperative morbidity and mortality. The aim of this study was to analyze the outcome of LC in the treatment of cholelithiasis in patients older than 65 years. For evaluation of LC effectiveness and security in old patients, we did this prospective analysis of 81 patients surgically treated because of symptomatic cholelithiasis . We had analyzed associated diseases, operative and postoperative complications, the reasons of conversion to open cholecystectomy. The research points to the small percentage of operative and postoperative complications, short hospital stay, less postoperative pain, quick recovery and savings in treatment. The age can not be contraindication for LC in older patients. In uncomplicated symptomatic cholelithiasis in elderly people, LC is a successful and safe procedure. Complicated symptomatic cholelithiasis, because of longer duration of operations is looking for a good assessment of general condition and associated diseases for LC.
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Ningshen, Phungreikan, Khumallambam Ibomcha Singh, Ningombam Minita Devi, et al. "Revisiting Mini-Cholecystectomy in Laparoscopic Era – A Retrospective Study." Journal of Evidence Based Medicine and Healthcare 7, no. 45 (2020): 2617–20. http://dx.doi.org/10.18410/jebmh/2020/539.
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BACKGROUND Mini-cholecystectomy (MC), with its varied incision length, has long been considered feasible with comparable results to laparoscopic cholecystectomy (LC) 1-6,7 We undertook this study, driven by resource-constraints, by well-experienced surgeons, using 3 - 5 cm incision length, in our patients with low BMI. The aim of this study is to compare the results and outcomes between MC and LC. METHODS In this retrospective study of a prospectively maintained database, first 50 patients each were selected for MC and LC respectively. Operative time, pain-score, SSI (Surgical Site Infection), hospital stay, return to normal activity and complications were compared. RESULTS Both groups were matched for age, sex, BMI (Body Mass Index) and American Society of Anesthesiologists (ASA) grading. The mean operating time for MC was 43 minutes and for LC, 64 minutes. Hospital stay for MC was 1.9 days and for LC was 1.8 days, which was statistically not significant. Return to normal activity was 8 days for MC and 6.6 days for LC. In a subset analysis of eight lean and thin patients using 3 - 3.5 cm length incision with rectus muscle splitting, the return to normal activity was 6.9 days which is comparable to LC patients. CONCLUSIONS Mini-cholecystectomy and laparoscopic cholecystectomy produce comparable patient outcomes. In lean and thin patient, MC may be slightly more advantageous than LC in terms of less operating time. KEYWORDS Mini-Cholecystectomy, Laparoscopic Cholecystectomy, Outcome, Lean and Thin Patient
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Khalil, Mohammad Ibrahim, Haridas Saha, Azmal Kader Chowdhury, Imarat Hossain, and AZM Mostaque Hossain. "Bile Duct Injuries Following Laparoscopic Cholecystectomy." Journal of Science Foundation 15, no. 1 (2018): 14–19. http://dx.doi.org/10.3329/jsf.v15i1.34778.
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Background: Laparoscopic cholecystectomy (LC) is the gold standard procedure for the gall stone diseases.Objective: This study aimed to assess the outcome of laparoscopic cholecystectomy (LC) by determining the frequency of complications especially of bile duct injuries.Methodology: This retrospective study was conducted in the Department of surgery at Dhaka Medical College and Hospital, Dhaka, Bangladesh. The case files of all patients undergoing laparoscopic cholecystectomy (LC) from the year of 2013 to 2015 were retrospectively analyzed. The data were collected according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open surgery.Results: During the three years a total number of 336 patients were underwent LC for chronic cholecystitis (CC) of which 22(6.5%) developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%); other 43(12.8%) patients had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC.Conclusion: The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.Journal of Science Foundation 2017;15(1):14-19
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Ni, Xiu, Xiang Zhao, Mengzhu Li, Quan Li, and Zhiqiang Liu. "Thoracic epidural anesthesia for gas-free trans-umbilical single port laparoscopic cholecystectomy: a case report." International Surgery Journal 4, no. 1 (2016): 420. http://dx.doi.org/10.18203/2349-2902.isj20164483.
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Laparoscopic cholecystectomy (LC) is usually performed under general anaesthesia (GA). With the advancement of surgical and anaesthetic technique, there were many LC have been successfully performed under epidural anaesthesia in recent years. Surgeons in our hospital have performed gas-free trans-umbilical single port laparoscopic cholecystectomy since 2015. However, the description of thoracic spinal epidural anesthesia (TEA) for gas-free trans-umbilical single port laparoscopic cholecystectomy has not been reported yet. The goal of anesthetic management in gas-free trans-umbilical single port laparoscopic cholecystectomy procedures includes achieving an adequate level of sensory blockade without any respiratory compromise, providing good postoperative pain relief, and mild pain at early ambulation. Epidural anaesthesia fulfils all the mentioned criteria and can contribute to quick recovery and thus has been suggested to be a suitable alternative to general anaesthesia for laparoscopic surgeries. We present a case of the successful application of the thoracic epidural anaesthesia combined with laryngeal mask for gas-free trans-umbilical single port laparoscopic cholecystectomy and postoperative pain.
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Romano, O., C. Romano, D. Cerbone, et al. "Two Case Reports of Biliary Tract Injuries during Laparoscopic Cholecystectomy." ISRN Gastroenterology 2011 (February 21, 2011): 1–4. http://dx.doi.org/10.5402/2011/868471.
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Background and Study Aims. Biliary tract injuries (BTI) represent the most serious and potentially life-threatening complication of cholecystectomy occurring also during laparoscopic approaches. Patients and Methods. We describe and discuss two different cases of BTI occurring during laparoscopic cholecystectomy (LC). Results. Two patients developed BTI during LC and one evidenced the complication during the LC itself and was treated during the same LC in real time. The other patient evidenced BTI only after the primary intervention and was successfully reoperated in laparotomy after 10 days from the LC. Conclusions. The factors that predispose to the occurrence of BTI during cholecystectomy and the cautions to be used to prevent BTI are discussed.
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Cheeyandira, Abhiman. "Laparoscopic cholecystostomy tube placement." MOJ Clinical & Medical Case Reports 10, no. 3 (2020): 70–72. http://dx.doi.org/10.15406/mojcr.2020.10.00346.
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Laparoscopic cholecystectomy is one of the most common procedures performed in the world today Acute calculus cholecystitis is the most frequent complication of cholelithiasis. Laparoscopic cholecystectomy is the best treatment for acute calculus cholecystitis when performed within 72 hours. Acute cholecystitis tends to be one of the highest risks for conversion to open surgery-due to unclear anatomy, excessive bleeding or technical complications. Here we present 2 cases with severe acute cholecystitis that required placement of laparoscopic cholecystostomy (LC) tube. Patient subsequently underwent interval cholecystectomy, when the inflammation had subsided. LC tube placement can be a safe alternative in such situations to avoid complications and conversion to open procedure.
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Alakh, Narayan, Akhtar Jawed, Dutta Verma Pranava, Chandran Rajnish, and Vaibhav Vivek. "A Study of Three-Port versus Four-Port Laparoscopic Cholecystectomy." International Journal of Pharmaceutical and Clinical Research 16, no. 2 (2024): 861–64. https://doi.org/10.5281/zenodo.11074986.
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<strong>Background and Objectives: </strong>Kelling introduced a visualizing scope for the first time in the peritoneum of a dog, it was a landmark in the history of surgery The objective of this study was to investigate the technical feasibility, safety and benefit of three-port laparoscopic cholecystectomy (LC) over the conventional standard four-port LC as routine setup. <strong>Materials and Methods: </strong>A total of 50 patients willing to participate in the study with valid consent were allocated into two groups by computer generated chit system. The first group, three-port LC group consisted of 25 cases and the second group, the standard four-port LC group consisted of 25 cases were analyzed for the following outcome measures namely conversion rates, operating time, intra-operative complications, post-operative pain score, analgesic requirement and hospital stay. <strong>Conclusion: </strong>three-port LC is technically safe and feasible with less post-operative pain score, less analgesic requirement, less hospital stay with comparable operating time and complications when compared to four- port LC. Three-port is also associated with less scars and cosmetic superiority.
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Alius, Catalin, Dragos Serban, Dan Georgian Bratu, et al. "When Critical View of Safety Fails: A Practical Perspective on Difficult Laparoscopic Cholecystectomy." Medicina 59, no. 8 (2023): 1491. http://dx.doi.org/10.3390/medicina59081491.
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The incidence of common bile duct injuries following laparoscopic cholecystectomy (LC) remains three times higher than that following open surgery despite numerous attempts to decrease intraoperative incidents by employing better training, superior surgical instruments, imaging techniques, or strategic concepts. This paper is a narrative review which discusses from a contextual point of view the need to standardise the surgical approach in difficult laparoscopic cholecystectomies, the main strategic operative concepts and techniques, complementary visualisation aids for the delineation of anatomical landmarks, and the importance of cognitive maps and algorithms in performing safer LC. Extensive research was carried out in the PubMed, Web of Science, and Elsevier databases using the terms ”difficult cholecystectomy”, ”bile duct injuries”, ”safe cholecystectomy”, and ”laparoscopy in acute cholecystitis”. The key content and findings of this research suggest there is high intersocietal variation in approaching and performing LC, in the use of visualisation aids, and in the application of safety concepts. Limited papers offer guidelines based on robust data and a timid recognition of the human factors and ergonomic concepts in improving the outcomes associated with difficult cholecystectomies. This paper highlights the most relevant recommendations for dealing with difficult laparoscopic cholecystectomies.
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Negoi, I., I. Tănase, B. Stoica, et al. "LAPAROSCOPY REPRESENTS THE GOLD STANDARD FOR ACUTE CHOLECYSTITIS EVEN IN ELDERLY PATIENTS." Journal of Surgical Sciences 2, no. 2 (2015): 59–62. http://dx.doi.org/10.33695/jss.v2i2.107.
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Nowadays the laparoscopic approach represents the gold standard for acute cholecystitis, but we are facing little evidence regarding the elderly patients. The purpose of this study is to define the benefits in terms of early outcome for laparoscopic cholecystectomy in patients over 70 years old and to compare them with the open cholecystectomy through a retrospective study of patients that underwent a cholecystectomy during 12 months in the Emergency Hospital of Bucharest, Romania. Out of 49 patients, 20 had a laparoscopic cholecystectomy (LC) and 29 an open approach (OC). The mean age was 74,6 ± 4,2 (LC) vs. 77,2 ± 5,4 (OC) (P>0.05). There were 7 (33,3%) (LC) vs. 2 (7,1%) (OC) catarrhal cholecystitis, 13 (62%) (LC) vs. 9 (32,1%) (OC) phlegmonous cholecystitis, and 1 (4,8%) (LC) vs. 17 (60,7%) (OC) gangrenous cholecystitis (P=0.001, Cramer’s V=0,590). The median operative time was 90 (LC) vs. 60 (OC) minutes (P=0.001). There were no differences regarding the ASA risk scale (P=0,253). The median number of days to resume the diet was 3 (LC) vs. 4 (OC) (P=0.009). The median length of hospital stay was 72 hours (LC) vs. 120 hours (OC) (P=0.011). One patient died in the OC group and none in the LC group.To conclude, the laparoscopic approach in acute cholecystitis of elderly patients is safe. It is followed by a lower morbidity rate, a shorter length of hospital stay and by a more rapid return to normal activities.
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Adil Mehmood, Shao Ying Mei, Abuduhaiwaier abuduhelili, and Ba dengcairenanrui. "Laparoscopic cholecystectomy versus open cholecystectomy." World Journal of Biology Pharmacy and Health Sciences 17, no. 2 (2024): 396–404. http://dx.doi.org/10.30574/wjbphs.2024.17.2.0097.
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This review article provides a comparison of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) for the treatment of gallbladder disease. Laparoscopic cholecystectomy, characterized by its minimally invasive approach, has gained popularity over open cholecystectomy due to its perceived advantages in safety, reduced postoperative pain, shorter hospital stays, improved cosmesis, and potential cost savings. However, the choice between the two procedures remains subjective and depends on various factors such as patient characteristics, surgical expertise, and specific clinical scenarios. This review synthesizes current evidence from clinical trials and studies to aid clinicians in making informed decisions regarding the selection of the most appropriate surgical approach for individual patients.
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Adil, Mehmood, Ying Mei Shao, abuduhelili Abuduhaiwaier, and dengcairenanrui Ba. "Laparoscopic cholecystectomy versus open cholecystectomy." World Journal of Biology Pharmacy and Health Sciences 17, no. 2 (2024): 396–404. https://doi.org/10.5281/zenodo.11297367.
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This review article provides a comparison of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) for the treatment of gallbladder disease. Laparoscopic cholecystectomy, characterized by its minimally invasive approach, has gained popularity over open cholecystectomy due to its perceived advantages in safety, reduced postoperative pain, shorter hospital stays, improved cosmesis, and potential cost savings. However, the choice between the two procedures remains subjective and depends on various factors such as patient characteristics, surgical expertise, and specific clinical scenarios. This review synthesizes current evidence from clinical trials and studies to aid clinicians in making informed decisions regarding the selection of the most appropriate surgical approach for individual patients.
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Khan, Hosni Mubarak, Manjunath B. G., and Vasanth G. Shenoy. "Laparoscopic subtotal cholecystectomy: a safe approach in difficult cholecystectomy." International Surgery Journal 6, no. 5 (2019): 1767. http://dx.doi.org/10.18203/2349-2902.isj20191904.
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Background: Laparoscopic cholecystectomy (LC) has been recognized as the new "gold standard" for the treatment of symptomatic gallstone disease. In order to prevent serious bile duct and vascular injuries, conversion is advocated for unclear anatomy at the Calot’s. Our aim was to assess the safety and effectiveness of laparoscopic subtotal cholecystectomy (LSC) in difficult cholecystectomy in order to reduce the incidence of bile duct injury and conversion rates.Methods: An analysis of retrospectively collected data of 452 patients who underwent LC was done at our Hospital during the period of January 2010 to December 2013. In few cases of difficult GB when Calot’s could not be dissected, laparoscopic retrograde cholecystectomy (LRC) was attempted and if that failed we adopted the technique of LSC.Results: A total of 452 patients were included. The median age was 48 years. All the 452 patients were posted for LC. Of the 452 patients, 404 patients underwent LC and the remaining 48 patients had difficult GB. Among the 48 patients having a difficult GB, 44 cases underwent LSC (3 cases underwent LSC Type-1 and 41 cases underwent LSC Type-2) and the remaining 4 cases underwent conversion to open cholecystectomy. The mean operative time was 130mins and median post op stay was 2 days.Conclusions: In our technique of LSC the conversion rates were <1% with no bile duct injury and believe that it is feasible and safe for operating on difficult GB’s.
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Karthik, Abishek H., Kundan Gedam, and Sameer Kadam. "Outcome of comparative study of mini-laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy." International Journal of Research in Medical Sciences 10, no. 10 (2022): 2209. http://dx.doi.org/10.18203/2320-6012.ijrms20222525.
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Background: Laparoscopic cholecystectomy (LC) is considered the gold standard for cholecystectomy procedures. In recent years, many investigators have attempted to further improve the established technique of LC with the goal of minimising invasiveness of this procedure by reducing the number and size of the operating ports and instruments.Methods: This was a retrospective study done in a tertiary care hospital comparing the safety and efficacy of mini-laparoscopic cholecystectomy (MLC) with conventional laparoscopic cholecystectomy (CLC) done during the time period of June 2020 to January 2022 based on the variables like total operating time, post-operative pain, conversion rate to open procedure, duration of hospital stay and cosmetic results.Results: Out of 40 cases were collected and analysed, MLC has an advantage over CLC like postop pain on postop day 1 (p=0.016) and on postop day 3 (0.025) and postoperative scar (p<0.001). In aspects like duration of hospital stay (p=0.359) and operating time (p=0.805) MLC is equally comparable to CLC. CLC is proved to be better than MLC in one aspect- conversion to open cholecystectomy (p=0.042).Conclusions: Miniaturised instrumentation is an area of research which is studied for the past 3 decades. Although improved instrument durability and better optics are needed for widespread use of miniport techniques, this MLC approach can be routinely offered to many properly selected patients undergoing elective LC.
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Justo-Janeiro, Jaime Manuel, Gustavo Theurel Vincent, Fernando Vázquez de Lara, René de la Rosa Paredes, Eduardo Prado Orozco, and Luis G. Vázquez de Lara. "One, Two, or Three Ports in Laparoscopic Cholecystectomy?" International Surgery 99, no. 6 (2014): 739–44. http://dx.doi.org/10.9738/intsurg-d-13-00234.1.
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Abstract Single-port laparoscopic cholecystectomy (LC) has been compared with 3- or 4-port LC. To our knowledge, there are no studies comparing the 3-, 2-, and 1-port techniques. Patients were randomized into 3 groups: LC 1-port using SILS, LC 2-port using a laparoscope with a working channel, and LC 3-port using the standard ports. Pain was evaluated at recovery, 4 hours, 24 hours, day 5, and day 8, using an analog visual scale. Homogenous groups in their demographic characteristics; all confirmed gallbladder lithiasis. At recovery, there was less pain in group 1 (P = 0.002); at 4 hours pain was similar in all groups (P = 0.899); at 24 hours there was less pain in groups 2 and 3 (P = 0.031); and at days 5 and 8 there was marginal (P = 0.053) and significant (P = 0.003) relevance. In terms of pain perception, LC performed through 1 port does not offer advantages when compared with 2 or 3 ports. More clinical trials are needed to confirm these data.
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Subhadip Sarkar, Biswarup Bose, and Banyeswar Pal. "10-mm versus 5-mm umbilical port in laparoscopic cholecystectomy: A comparative study in a medical college in Eastern India." Asian Journal of Medical Sciences 13, no. 8 (2022): 220–25. http://dx.doi.org/10.3126/ajms.v13i8.44264.
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Background: Laparoscopic cholecystectomy (LC) the most common laparoscopic surgery performed worldwide. The surgical technique of LC has undergone many modifications; in respect to reduction of port sizes or number of ports. Conventionally, 10-mm 30° laparoscope is being used but, 5-mm 30° laparoscopes through 5-mm umbilical port (modified LC) are also being utilized by many surgeons worldwide. Aims and Objectives: The aims of this study were to compare the outcome of conventional LC with modified LC, in terms of feasibility, safety, and efficacy. Materials and Methods: This prospective randomized study was carried out in the Department of Surgery, ESIC-PGIMSR, Joka during June 2017–December 2018. One hundred and fifty patients of diagnosed symptomatic gall stone disease were randomly allocated into two study groups. Group-I contained 75 patients, who underwent LC by conventional method whereas, and 75 patients in Group-II underwent LC by modified method. Follow-up was done at 6 weeks, 6 months, and 1 year after surgery. Data were analyzed by appropriate statistical tests. Results: The mean operating time and mean pain score over umbilical wound were found to be statistically significant. However, no significant differences were obtained in terms of average hospital stay, post-surgical complications such as post-site bleeding, cystic artery bleeding, biliary spillage, and wound infection. Only one patient in the 10-mm umbilical port group, having body mass index of 31 developed umbilical port-site hernia. Regarding wound cosmesis, no significant difference was obtained. Conclusion: Performing LC with a 5-mm 30° laparoscope through 5-mm umbilical port is a safe and feasible option for laparoscopic surgeons.
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Subhadip Sarkar, Biswarup Bose, and Banyeswar Pal. "10-mm versus 5-mm umbilical port in laparoscopic cholecystectomy: A comparative study in a medical college in Eastern India." Asian Journal of Medical Sciences 13, no. 8 (2022): 220–25. https://doi.org/10.71152/ajms.v13i8.3878.
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Background: Laparoscopic cholecystectomy (LC) the most common laparoscopic surgery performed worldwide. The surgical technique of LC has undergone many modifications; in respect to reduction of port sizes or number of ports. Conventionally, 10-mm 30° laparoscope is being used but, 5-mm 30° laparoscopes through 5-mm umbilical port (modified LC) are also being utilized by many surgeons worldwide. Aims and Objectives: The aims of this study were to compare the outcome of conventional LC with modified LC, in terms of feasibility, safety, and efficacy. Materials and Methods: This prospective randomized study was carried out in the Department of Surgery, ESIC-PGIMSR, Joka during June 2017–December 2018. One hundred and fifty patients of diagnosed symptomatic gall stone disease were randomly allocated into two study groups. Group-I contained 75 patients, who underwent LC by conventional method whereas, and 75 patients in Group-II underwent LC by modified method. Follow-up was done at 6 weeks, 6 months, and 1 year after surgery. Data were analyzed by appropriate statistical tests. Results: The mean operating time and mean pain score over umbilical wound were found to be statistically significant. However, no significant differences were obtained in terms of average hospital stay, post-surgical complications such as post-site bleeding, cystic artery bleeding, biliary spillage, and wound infection. Only one patient in the 10-mm umbilical port group, having body mass index of 31 developed umbilical port-site hernia. Regarding wound cosmesis, no significant difference was obtained. Conclusion: Performing LC with a 5-mm 30° laparoscope through 5-mm umbilical port is a safe and feasible option for laparoscopic surgeons.
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Dr., Kaynat Shafique Dr. Angbeen Zafar Dr. Hala Shafique. "A CROSS SECTIOANL STUDY ABOUT MEASURING CRP LEVEL BY VALUATION OF STRESS RESPONSE AFTER OPEN CHOLECYSTECTOMY AND LAPAROSCOPIC CHOLECYSTECTOMY." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 06, no. 01 (2019): 1976–81. https://doi.org/10.5281/zenodo.2549659.
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<strong><em>Objective and Design</em></strong><em>: We designed a cross-sectional and observational study to measure the CRP Level by evaluating operative stress response after Laparoscopic Cholecystectomy (LC) and Open Cholecystectomy (OC).</em> <em>Venue and Time-Period: </em><em>This study was managed </em><em>in the General and Vascular Surgery Department of Bahawal Victoria Hospital, Bahawalpur and the time period was of 11 months year (June, 2017 to April, 2018).</em> <strong><em>Methods:</em></strong><em> We enrolled patients for the study, who were admitted in our hospital with </em><em>symptomatic cholelithiasis disease</em><em>. Patients admitted in our hospital on the bases of their demographic data and pathologic diagnosis for the diagnostic of </em><em>cholelithiasis and then decided for cholecystectomy. The </em><em>cases were randomly allocated to open </em><em>cholecystectomy</em><em> and laparoscopic </em><em>cholecystectomy groups. CRP levels were measured preoperatively and postoperatively.</em> <strong><em>Results</em></strong>: <em>All patients (total=92, men=51, women=41) admitted for the </em><em>Laparoscopic Cholecystectomy </em><em>LC and </em><em>Open Cholecystectomy </em><em>OC have </em><em>38.19 ±9.263the</em><em> mean age and the SD. The two randomized groups of LC and OC were undergoing for the comparison of CRP levels for the postoperative follow up of 4 hours,8 hours and 24 hours. Postoperative mean CRP readings in mg/dl for </em><em>LC group were 8.12 ±2.89, 15.19 ±6.63 and 25.11 ±9.92 and for OC group were11.90± 1.52, 22.67 ±3.72 and 35.28 ±6.34 after 4, 8 and 24 hours respectively. Means of both groups were compared by T-Test and found no significant difference between two, i.e P-value is 0.000. Our study did not face any complication and mortality case.</em> <strong><em>Conclusion: </em></strong><em>CRP level is a beneficial indicator tool to measure the postoperative stress response in patients after Laparoscopic Cholecystectomy (LC) and Open Cholecystectomy (OC).</em> <strong>Keywords: </strong><em>Laparoscopic Cholecystectomy, Open Cholecystectomy, CRP level, Stress response, Cholelithiasis.</em>
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Akoglu, Musa, Erdal Birol Bostanci, Muhammet Kadri Colakoglu, and Erol Aksoy. "Three-Port, Two Located on the Pfannenstiel Line, Laparoscopic Cholecystectomy Comparison with Traditional Laparoscopic Cholecystectomy." American Surgeon 83, no. 3 (2017): 260–64. http://dx.doi.org/10.1177/000313481708300321.
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Laparoscopic cholecystectomy (LC) is seen as a gateway to minimally invasive surgery. We defined a new three-port technique with different port sites and compared the postoperative results with traditional four-port LC procedure in a case-match study. Between June 2012 and May 2013, 104 consecutive patients underwent three-port LC by same experienced surgeon. In the same center, 2963 consecutive patients underwent four-port LC, and of these 2963 patients, a matched group of 104 patients was selected. Data included patient age, gender, body mass index, American Society of Anesthesiologists score, history of abdominal operations, intraoperative data about operating time and conversion to open surgery, and postoperative data about length of hospital stay and postoperative complications were recorded prospectively. We concluded that our new three-port technique with different port sites is as feasible and safe as traditional four-port technique.
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Asghar, Muhammad Sheheryar, Mohiuddin Saleem, and Qurat Ul Ain. "Changes in Liver Function Tests after Laparoscopic Cholecystectomy." Pakistan Journal of Medical and Health Sciences 16, no. 2 (2022): 1171–73. http://dx.doi.org/10.53350/pjmhs221621171.
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Introduction: Laparoscopic cholecystectomy (LC) has developed to be the typical treatment for benign diseases of the gallbladder. Though, it was observed that the serum levels of some liver enzymes increased significantly after LC in patients with normal preoperative liver enzyme levels. Objective: The aim of this study was to estimate the consequence of pneumoperitoneum on serum bilirubin concentration and liver enzymes in laparoscopic cholecystectomy compared to open cholecystectomy (OC). Study Design: A prospective case-control study. Place and Duration: In the Department of Surgery of LGH, Lahore for one-year duration from November 2020 to October 2021. Methods: This analysis encompassed 80 patients treated for laparoscopic cholecystectomy and 40 patients treated for open cholecystectomy as a control group in the surgical department. Blood samples were drawn 24-hours before and 24 hours later to surgery for bio-chemical studies. Results: Despite a substantial increase in aspartate aminotransferase (AST), bilirubin, lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) in the postoperative period, no remarkable change in serum alkaline phosphatase was observed in the LC group in comparison to the OC group. Conclusion: It was found that the increase in liver enzymes and serum bilirubin can be accredited to the adverse effect of pneumoperitoneum on hepatic flow of blood. Although these variations do not appear to be significant clinically, caution must be exercised in determining whether to accomplish laparoscopic cholecystectomy in subjects with hepatic impairment. Keywords: Laparoscopic cholecystectomy, Pneumoperitoneum, Liver enzymes.
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Ranjan, Rajiv, Kishore K. Sinha, and Mahesh Chaudhary. "A comparative study of laparoscopic (LC) vs. open cholecystectomy (OC) in a medical school of Bihar, India." International Journal of Advances in Medicine 5, no. 6 (2018): 1412. http://dx.doi.org/10.18203/2349-3933.ijam20184748.
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Background: Gallstone disease is a significant health problem world over (in both developing and developed nations). The incidence of gallstone disease increases after age of 40years and it becomes 4-10 times more common in old age. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. Laparoscopic cholecystectomy introduced in 1985 has become the procedure of choice for surgical removal of the gallbladder. The aim is to compare laparoscopic cholecystectomy and open cholecystectomy in patients of cholelithiasis by measuring parameters such as use of post-operative analgesia, operative time, post-operative hospital stays, morbidity, mortality and patient satisfaction.Methods: It is a prospective randomized study of 120 patients of cholelithiasis aged between 20years to 80years operated during 2015-2018 at of Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. They were divided into open and laparoscopic Cholecystectomy groups by drawing a lottery.Results: The median (range) operation time for laparoscopic cholecystectomy was 55-155 min (mean=102 min) and 40-105 min (mean=72 min) for open cholecystectomy (p <0.001). Form LC group 5 cases had to be converted to OC. Rate of conversion was 5/60=8.3% which is within limits of worldwide laparoscopic cholecystectomy conversion rate of 5% to 10%. LC was found to be superior to OC.Conclusions: Laparoscopic cholecystectomy is better than open cholecystectomy However, open cholecystectomy is preferable in cases of complicated cholecystectomy.
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SUBHAN, SF, and F. AKBAR. "USE OF G10 SCORING SYSTEM TO PREDICT DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY AND CONVERSION TO OPEN CHOLECYSTECTOMY." Pakistan Journal of Intensive Care Medicine 5, no. 01 (2025): 53. https://doi.org/10.54112/pjicm.v5i01.53.
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Background: Laparoscopic cholecystectomy (LC) is the gold standard for treating gallbladder disease; however, some cases present technical challenges that necessitate conversion to open cholecystectomy (OC). Identifying factors associated with difficult LC and conversion to OC can help optimize surgical planning and patient counseling. Objective: To evaluate the frequency of difficult laparoscopic cholecystectomies and the rate of conversion to open cholecystectomies in patients undergoing laparoscopic cholecystectomy (LC). Study Design: Observational cross-sectional study. Setting: The study was conducted at Saidu Teaching Hospital in Swat. Duration of Study: The study was conducted over six months, from August 16, 2024, to February 16, 2025. Methods: A total of 126 patients undergoing laparoscopic cholecystectomy (gallbladder surgery) were included. Surgical difficulty was assessed using the G10 scoring system, which evaluates factors such as inflammation, adhesions, and anatomical variations. Conversion rates from LC to OC were recorded. Demographic characteristics, surgical difficulty, and outcome variables were analyzed using SPSS version 20. The statistical significance of the predictive factors was assessed, with p-values of less than 0.05 considered significant. Results: Difficult labor was observed in 14 patients (11.1%), while conversion to cesarean section was required in 8 cases (6.3%). Age and gender were significant predictors of difficult LC and conversion to OC. Patients with a higher BMI (>24.9 kg/m²) had an increased likelihood of complex surgery and conversion; however, the association was not statistically significant. Conclusion: The frequency of difficult laparoscopic cholecystectomy was 11.1%, and the conversion rate to open surgery was 6.3%. Age and gender were notable predictive factors for surgical difficulty and conversion. Preoperative risk assessment using scoring systems, such as G10, can aid in surgical decision-making and improve patient outcomes.
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Merrick, B., D. Yue, MH Sodergren, and LR Jiao. "Portobiliary fistula following laparoscopic cholecystectomy." Annals of The Royal College of Surgeons of England 98, no. 7 (2016): e123-e125. http://dx.doi.org/10.1308/rcsann.2016.0174.
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The laparoscopic approach has replaced open surgery as the gold standard for cholecystectomy. This technique is, however, associated with a greater incidence of bile duct injuries (BDIs). We report a case of portobiliary fistula (PBF), a rare complication of BDI, occurring post laparoscopic cholecystectomy (LC). PBF has been reported after procedures such as endoscopic retrograde cholangiopancreatography and pathologies such as liver abscesses, but only once previously in the setting of LC. We discuss the management of this patient with apparent dual pathology, and summarise other aetiologies that may give rise to this condition.
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Kaushik, Bhanu, Shalu Gupta, Somendra Bansal, et al. "The role of C-reactive protein as a predictor of difficult laparoscopic cholecystectomy or its conversion." International Surgery Journal 5, no. 6 (2018): 2287. http://dx.doi.org/10.18203/2349-2902.isj20182239.
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Background: Laparoscopic cholecystectomy (LC) can be the easiest or the most difficult laparoscopic operation. Conversion to open surgery has been a traditional marker of difficult LC. Recent studies have shown that C-reactive protein (CRP) may be helpful to surgeon in knowing the pathological condition of gall bladder before removal. Aim of this study was to evaluate the role of CRP as a predictor of difficult LC or its conversion.Methods: This study was done from 1 march 2016 to may 2017 in department of general surgery, SMS hospital Jaipur, under single unit. All patients with cholelithiasis admitted in single unit of SMS hospital undergoing LC were included in this study. Exclusion criteria were high BMI (>35), proven congenital anomaly of gall bladder, previous abdominal surgery, any conditions increasing CRP and immunocompromised patients. CRP was done for each patient.Results: Mean age of our 148 patients was 50.41 years. Female to male ratio was 4.28:1. Mean CRP was 22.2±18.2 mg/dl for simple cholecystectomy, 46.5±32.0 mg/dl for difficult cholecystectomy and 83.6±22.4 mg/dl for laparoscopic converted to open cholecystectomy, which was statistically significant (p value 0.0002).Conclusions: CRP is a potent predictor of difficult laparoscopic cholecystectomy and its conversion preoperatively. Patients with preoperatively high CRP have higher chance of complication intraoperative and high chances of conversion to open.
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Nivesh, Agrawal, Gupta Amit, Gupta Kumkum, and Khare Satyam. "Feasibility of Laparoscopic Cholecystectomy Under Spinal Anaesthesia." PJSR 5, no. 2 (2012): 17–21. https://doi.org/10.5281/zenodo.8266573.
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Laparoscopic Cholecystectomy (LC) has been conventionally done under general anaesthesia (GA). Regional anaesthesia is usually preferred in patients where GA is contraindicated. In this study, we present experience of using spinal anaesthesia (SA) for LC with the contention that it is a good alternative to GA. Spinal anaesthesia was used in 134 patients in whom LC was planned. There was no modification in the technique, and the intra abdominal pressure was kept at 8mm Hg to 12 mm Hg. Sedation was given if required, and conversion to GA was done in patients not responding to sedation or due to failure of SA. Results were compared with 100 patients who had undergone LC under GA. Out of 134 patients, two patients required conversion to GA. Hypotension requiring support was recorded in 28 (20.89%) patients, and 32 (23.88%) experienced neck or shoulder pain, or both. Postoperatively, 2.9% (4) of patients had vomiting as compared to 33% (33) of patients who were administered GA. Injectable diclofenac was required in 36.56% (49) for abdominal pain within 2 hours postoperatively and oral analgesic was required in 106 (79.10%) patients within the first 24 hours in SA group. However, 96% of patients operated under GA required injectable analgesics in the immediate postoperative period. Postural headache was experienced by 8 (5.9%) patients postoperatively. Average time of discharge was 1.9 days in patients operated under SA.
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Thiyagarajan, Deepu, and Prince Deva Ruban. "Early versus late laparoscopic cholecystectomy in the management of acute cholecystitis: a retrospective study." International Surgery Journal 6, no. 11 (2019): 3897. http://dx.doi.org/10.18203/2349-2902.isj20194634.
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Background: Early laparoscopic cholecystectomy (LC) is a life-saving procedure in the management of acute cholecystitis as it helps in prevention of late complications like development of adhesions, haemorrhage and sepsis. The study aims at comparing the outcomes of early versus late laparoscopic cholecystectomy in the management of acute cholecystitis.Methods: A retrospective study was done by analyzing the past 5 years medical records of 250 patients admitted to the emergency department with diagnosis of acute cholecystitis established according to the Tokyo criteria. The relevant clinio-social demographic data of the patients, clinical and radiological parameters, intra-operative and post-operative findings and follow-up data were compared between early and late LC group of patients.Results: The study included 125 middle aged patients who underwent early LC (within 24 hours) and 125 patients who underwent late LC (after 24 4hours). The complication rate, conversion to open cholecystectomy and duration of surgery showed no significant differences between early and late laparoscopic cholecystectomy except for an increased duration of stay among the late LC group.Conclusions: Early LC is an efficient procedure for acute cholecystitis but it has risks of complications which can be minimized by careful selection of patients after clear clinical and radiological evaluation.
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Goyal, Kirti Savyasacchi, Maneshwar Singh Utaal, and Pramod Kumar Bhatia. "Comparative study of standard laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy: outcome and complications." International Journal of Research in Medical Sciences 7, no. 11 (2019): 4310. http://dx.doi.org/10.18203/2320-6012.ijrms20195007.
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Background: Laparoscopic cholecystectomy (LC) has evolved to be as gold standard treatment for gall bladder disease and is the most common laparoscopic procedure performed worldwide. In recent times, the innovative techniques of Natural orifice Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) have been applied as a step forward towards scar less surgery with added benefits of less pain and less analgesic requirement, shorter hospital stay, quick return to work.Methods: A retrospective study of 50 patients admitted with gall bladder disease through outdoor for laparoscopic cholecystectomy from November 2018 to January 2019 in Maharishi Markandeshwar Institute of Medical Sciences and Research Mullana (AMBALA) were randomized into two groups of 25 each for Single Incision Laparoscopic Cholecystectomy (SILC) and standard laparoscopic cholecystectomy (LC) comparing the operative time, outcome and complications.Results: 50 patients admitted to MMIMSR Mullana from November 2018 to January 2019 with gall bladder disease were divided into two groups of 25 each who underwent three port SILC and four port laparoscopic cholecystectomy (4PLC). The average intra-operative time in SILC (80.56 mins) was significantly more than standard laparoscopic cholecystectomy. The average length of stay in the hospital for SILC was 1.8 days (1-3 days), was significantly less than in standard four port laparoscopic cholecystectomy. Incidence of Intraoperative complications were more in SILC than standard LC.Conclusions: SILC as the newer novel technique had better outcomes in terms of cosmesis, early discharge, shorter stay at hospital.
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Singh, Pramod, Sumit Kumar Gupta, and Mukesh Kumar. "A comparative study of open cholecystectomy and laparoscopic cholecystectomy in patients with cholelithiasis." International Surgery Journal 5, no. 1 (2017): 253. http://dx.doi.org/10.18203/2349-2902.isj20175905.
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Background: Cholelithiasis is a major cause of morbidity among Indians with a female preponderance. Most of the cases of gallstones are asymptomatic. For a long time, open cholecystectomy (OC) used to be the surgical treatment for cholelithiasis. But with the advent of laparoscopic cholecystectomy (LC) there has been a gradual shift in the treatment with most surgeons preferring LC over OC. Apart from the benefits of decreased hospital stay, lesser postoperative pain and earlier return to normal activity LC are also cosmetically better as compared to OC. Longer operative time and increased incidence of biliary leakage are some pitfalls of LC in initial phase of surgical practice.Methods: A prospective study of 100 patients was carried out in the department of surgery in IQ city medical college and Durgapur city hospital, Durgapur between January 2017 and August 2017 with the aim of comparing open cholecystectomy with laparoscopic cholecystectomy. The patients were randomly assigned into two groups. Group A consisted of patients who underwent laparoscopic surgery while Group B patients underwent open surgery for cholelithiasis.Results: Duration of surgery was longer in OC than LC (72.4min versus 44.7min.). Mean duration of post-operative pain was 18.3hrs in group A as compared to mean duration of 30.7hrs in group B patients. The mean period of post-operative hospital stay was 1.8 days in group A and 4.8 days in group B. Post-operative resumption of normal diet was possible in 2.1 days in OC while it took lesser time (1.2 days) in LC. The rate of surgical site infection was higher in OC as compared to LC.Conclusions: Laparoscopic cholecystectomy can be recommended as first choice operative treatment for patients with cholelithiasis as it provides better cosmetic results, lesser pain, lesser post-operative hospital stay and fewer incidence of surgical site infection.
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Reem, Abduljaleel Khaleel Al Thabit, Abd Kadhim Aljuboory Mohammed, and Hameed Al-Helfy Sajid. "Ultrasound findings in predicting difficult laparoscopic cholecystectomy." GSC Advanced Research and Reviews 18, no. 3 (2024): 173–81. https://doi.org/10.5281/zenodo.11217282.
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<strong>Background</strong>: Multiple technical intra-operative problems that raise the risk of complications and greatly lengthen the operating time are referred to as difficult laparoscopic cholecystectomy (LC). <strong>Aim:</strong> to assess preoperative ultrasound (US) findings that indicate a difficult (LC) and the potential benefits for improvement of patient care. <strong>Patients and method:</strong>100 patients underwent LC over a period of 9 months. Of these, 74 were female and 26 were male. Abdominal US was performed 48 hours prior to the surgery. The gallbladder (GB) wall thickness, GB size, gallstone (GS) multiplicity, GS mobility, GB empyema, and presence of pericholecystic fluid are the six parameters that were examined by ultrasound. The surgical procedure was rated as easy or difficult based on some surgical parameters, these include the length of the procedure, the occurrence of intraoperative bleeding, and the presence of significant adhesions or inflammation surrounding the GB and the Calot's triangle that obscure the dissection planes. The results of the ultrasound and the operation were compared. <strong>Results</strong>: According to the statistical analysis, all ultrasound parameters were significantly correlated with the degree of surgical difficulty. 21 of the patients had a difficult laparoscopic cholecystectomy; of them, 2 had an open procedure performed because of severe adhesion. When predicting a difficult laparoscopic cholecystectomy, the thick wall gallbladder > 3mm has the highest sensitivity (83.3%) and the presence of pericholecystic fluid or empyema has the highest specificity (100%). <strong>Conclusion:</strong> preoperative ultrasound results can be useful in anticipating problems that may arise during LC and necessitate conversion to open cholecystectomy (OC).
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Islam, Md Rafiqul, Md Showkat Ali, SM Golam Azam, and Md Ridwanul Islam. "Comparative Study between Laparoscopic and Open Cholecystectomy: Complications and Management." Medicine Today 33, no. 1 (2021): 19–21. http://dx.doi.org/10.3329/medtoday.v33i01.52152.
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Introduction: Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones. The aim of the study was to analyze and compare the postoperative results of patients undergoing laparoscopic cholecystectomy or open cholecystectomy (OC) with regard to complications, recovery time and hospital stays.
 Materials and Methods: This is a retrospective study which was conducted at the General Hospital Khulna and some of the private Hospital in Khulna City from January 2015 to December 2019. This study which analyzed among 950 patients, 20-65 years old, diagnosed with gallstones undergoing LC or OC. We evaluated postoperative respiratory complications, surgical site infection, deep vein thrombosis, time to oral feeding and ambulation, use of antibiotics and duration of the postoperative period.
 Results: We analyzed 570(60%) patients undergoing LC and 380 (40%) OC. Most patients were female (55%). Patients' comorbidities were hypertension (12.8%), diabetes mellitus (4.5%) and asthma (1.00%). LC resulted in lower prevalence of postoperative complications (2.8%) than OC (3.4%). Postoperative hospitalization for 2-3 days was found in LC patients and 5-7 days in OC.
 Conclusion: Laparoscopic cholecystectomy showed higher benefits for patients with lower prevalence of postoperative complications, feeding earlier and shorter mean hospital stay compared with open cholecystectomy.
 Medicine Today 2021 Vol.33(1): 19-21
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Coco, Danilo, and Silvana Leanza. "Laparoscopic Cholecystectomy (LC): Toward Zero Error." Open Access Macedonian Journal of Medical Sciences 8, F (2020): 52–57. http://dx.doi.org/10.3889/oamjms.2020.3791.
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In 1990, laparoscopic cholecystectomy (LC) was considered the new beginning of an exciting period in the management of pathologies associated with gallbladder. Two decades later, biliary morbidity alongside LC is nearly thrice higher compared to conventional open surgery. In the 1990s, Strasberg et al. explained the manner, in which a critical view of safety can be attained and the manner in which vascular injuries and accidental biliary caused by unclear anatomy, incautious control of bleeding, or rare variations could be prevented. The aforementioned principles have been overlooked until recently, only gaining recognition in the past 15 years. This review seeks to explore the aspect of safety in LC based on various techniques.
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Pirah, Sarika, Anila Ahmed, et al. "Frequency of Common Bile Duct Injury in Open Cholecystectomy versus Laparoscopic Cholecystectomy." Indus Journal of Bioscience Research 3, no. 3 (2025): 707–12. https://doi.org/10.70749/ijbr.v3i3.1075.
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Background: Laparoscopic cholecystectomy has replaced open cholecystectomy as the standard treatment for cholelithiasis. However, it is associated with a higher incidence of common bile duct (CBD) injury. (LC) has become the preferred treatment for cholelithiasis; however, it carries a higher risk of common bile duct (CBD) injury compared to open cholecystectomy. It is a largely replaced open cholecystectomy (OC) but is associated with higher rates of common bile duct (CBD) injury. This study compares the frequency of CBD injury between the two techniques. To compare the frequency of CBD injury in open cholecystectomy versus laparoscopic cholecystectomy. Methodology: A randomized controlled trial was conducted at the Department of Surgery, People Medical College Hospital Nawabshah, from July 1 to December 31, 2020. A total of 320 patients aged 20–50 years with cholelithiasis were randomly divided into two groups: 160 underwent open cholecystectomy and 160 laparoscopic cholecystectomy CBD injuries were diagnosed clinically (jaundice) and confirmed via MRCP. Frequency of CBD injury was observed and analyzed statistically using SPSS 22.0, with significance at p ≤ 0.05. Results: Out of 320 patients (160 in each group) Mean age was 33.5±8.7 years; 54.7% were female, CBD injury was observed in 3.8% of patients in the open cholecystectomy group compared 9.4% of the laparoscopic group. The difference was statistically significant (p = 0.042). Indicating a significantly higher rate in laparoscopic procedures and those with diabetes had higher injury rates in the LC group. Conclusion: Laparoscopic cholecystectomy is associated with a higher frequency of CBD injury compared to open cholecystectomy. Enhanced surgical training and safety protocols are essential.
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Muhammad, Salman Yamna Khalid Dr Maham Habib. "POST LAPAROSCOPIC CHOLECYSTECTOMY, TRANSIENT DERANGEMENT OF LIVER ENZYMES." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES o6, no. 05 (2019): 8997–9001. https://doi.org/10.5281/zenodo.2671814.
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<strong><em>Aims</em></strong><em>: We intend to enquire the change in blood levels of aspartate aminotransferase(AST), gamma-glutamyl-transferase (GGT), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) in patients who underwent laparoscopic cholecystectomy (LC) and collate these alterations with those happening after open cholecystectomy (OC). </em> <strong><em>Methods</em></strong><em>: Out of total 194 patients studied in May 2016 to April 2017, 156 underwent laparoscopic cholecystectomy while 58 had undergone open cholecystectomy during the same period of time. OC patients were enrolled as control group. Lab investigations were done within 24 hours preoperatively and again after 24 hours postoperatively for biochemical evaluation. </em> <strong><em>Results</em></strong><em>: Statistical analysis brings to light a significant increase in the levels of ALT, GGT, AST, and LDH levels in the laparoscopic cholecystectomy group postoperatively. In comparison with the open cholecystectomy group, the variation between elevations of enzymes levels was also pronounced for LC group. </em> <strong><em>Conclusion</em></strong><em>: It is thus concluded that these elevations of levels of enzymes could mostly be associated to the damaging effects of the pneumoperitoneum on the blood flow of liver. Although these alterations are transient and do not seem to be clinically significant, attention should be given before planning to perform LC in patients with liver insufficiency.</em> <strong>Key words: </strong><em>Laparoscopic cholecystectomy – pneumoperitoneum - liver function tests.</em>
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Sana, Sadia, Muhammad Jawed, Ubedullah Shaikh, and Shazia Ubed Shaikh. "BILE DUCT INJURIES." Professional Medical Journal 21, no. 05 (2018): 841–44. http://dx.doi.org/10.29309/tpmj/2014.21.05.2504.
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Objective: To find out frequency of bile duct injuries during cholecystectomyprocedures either open or laparoscopic. Study design: Prospective observational study. Placeand duration of study: This study was conducted at Surgical department, Liaquat UniversityHospital Jamshoro and Dow International Hospital Karachi, from July 2012 to December2013. Methodology: This study consisted of hundred patients. Patients were divided in twogroups. Group A for open cholecystectomy (OC) comprising of 50 patients who underwentelective open cholecystectomy. Group B for Laparoscopic cholecystectomy (LC) comprisingof 50 patients who underwent elective Laparoscopic cholecystectomy. Inclusion criteria wereall patients diagnosed case of gallstones on the basis of ultrasound abdomen, any age andboth gender. Exclusion criteria included not willing for surgery, General anesthesia problem,pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructivejaundice. Results: Out of 100 cases of gallstone were operated for either laparoscopic / opencholecystectmy. In open cholecystectomy group 20(40 % ) were male and 30(60 %) female.Ratio male: female ratio of 1:1.5. In laparoscopic cholecystectomy group 11(22 % ) were maleand 39(78 %) female with male: female ratio of 1:3.5. There was wide variation of age rangingfrom a minimum of 10 year to 70 year in both group. The mean age was 41.28+12.30 yearsfor OC group and 38.44+13.50 years for LC group (p 0.02). Common bile duct injury wereoccurred 2(4%) patients in laparoscopic cholecystectomy group while 3(6%) patients observedin open cholecystectomy group. Conclusions: We conclude that found bile duct injury 2(4%)patients in laparoscopic cholecystectomy group while 3(6%) patients observed in opencholecystectomy group
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Shrestha, Rahul, Suresh Maharjan, Manoranjan Dwa, Om Prakash Patel, and Pushkar Bhandari. "A comparative study on early versus late laparoscopic cholecystectomy in a post ERCP patient with cholelithiasis with choledocholithiasis: a single institutional study in a tertiary centre in Nepal." International Surgery Journal 12, no. 4 (2025): 494–99. https://doi.org/10.18203/2349-2902.isj20250804.
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Background: An accepted surgical modality for cholelithiasis with secondary choledocholithiasis is the laparoscopic cholecystectomy (LC) following endoscopic retrograde cholangiopancreatography (ERCP). Despite recommendation for early cholecystectomy, there is no consensus about the time interval between LC and ERCP. The study aims to compare Early (<72 hours) versus Late (>6 weeks) laparoscopic cholecystectomy in post-ERCP patient with cholelithiasis with choledocholithiasis in terms of intra operative and post operative complications. Methods: 58 patients who underwent ERCP were followed up in two groups with 29 patients each for those who had early (<72 hours) laparoscopic cholecystectomy (LC) (Group 1) and late (>6 weeks) LC (Group 2) and compared for intraoperative and post operative complications. Patients’ age, gender, abdominal ultrasonography findings, ERCP findings, time interval between ERCP and LC, conversion rate, length of hospital stay, operation time, intraoperative complication and postoperative complication rates were collected. Results: The mean±SD age of the study participants in this study was 45.5±15.8 years. No patients underwent conversion to open cholecystectomy. Operative time were similar in both groups (p=0.941). There was no statistically significant difference in difficult in Calot’s dissection and time to achieve critical view of safety. No biliary tract injury was reported while requirement for blood transfusion (p=0.490) and drain placement (p=0.610) were similar in both groups. Conclusions: The intra operative and post operative outcome with early (<72 hours) and late (>6 weeks) laparoscopic cholecystitis post ERCP in patients with cholelithiasis and choledocholithiasis is similar.