Intra operative findings such as time taken for the surgery, biliary/stone spillage, injury to duct/artery or conversion to open cholecystectomy
were noted and assessment of level of ease experienced by the surgeon was evaluated based on following factors (Randhawa and Pujahari) 2009.
The rationale of this study was that open cholecystectomy
performed by rectus sparing technique is the preferred method of laparotomy with symptomatic gall stones because of better outcome in terms of decreased postop pain and reduced incidence of incisional hernia.
The study had twin primary outcome measures: cholecystectomy
rates performed during an index hospitalization for gallstone pancreatitis and recurrent biliary events after hospitalization.
have identified incidental GBC in 6 specimens out of 220 cholecystectomy
specimens, of which 3 patients with advanced stages (T2 and T3) underwent revision surgery (16).
It has been traditionally treated with open cholecystectomy
. Routine drainage of the sub hepatic space has been a surgical trend of open cholecystectomy
, carried on to the era of laparoscopic surgery without substantial evidence.
Day-surgery laparoscopic cholecystectomy
: factors influencing same-day discharge.
As the number of cholecystectomy
operations increases, it is likely that the number of incidentally discovered GBC will also increase. An incidentally discovered GBC forces a rapid decision by the surgeon during the initial operation and presents an unexpected challenge to patients, postoperatively.
By requiring a certain level of experience, laparoscopic cholecystectomy
can be safely performed in patients with situs inversus and symptomatic cholelithiasis.
The indications for cholecystectomy
are outlined in Table 2.
Of the 34 difficult LC, 11 patients had the procedure converted to open cholecystectomy
, and hence, conversion rate was 11% [Figures 1 and 2, Tables 1 and 2].
Eleven of sixteen patients (69%) had undergone cholecystectomy
Patients are usually referred to our outpatient department by their general practitioner with symptomatic gallbladder stones and subsequently planned for an elective laparoscopic cholecystectomy
. Other indications for surgery include referral from our gastroenterologists because of a biliary pancreatitis or bile duct stones.
However, in the setting of recent cholecystectomy
, we wanted to rule out the possibility of a biliary injury.
In the article by Altuntas et al., entitled "Re: Comment on: Comparison of Intraabdominal and Trocar Site Local Anaesthetic Infiltration on Postoperative Analgesia After Laparoscopic Cholecystectomy
" that was published in the August 2017 issue of the Turkish Journal of Anaesthesiology and Reanimation, the page numbers of the first reference were not included.
Results: The rise in the levels of interleukin-1[beta], interleukin-10, and tumor necrosis factor-alpha was significantly more in the open cholecystectomy
group at 4 hours (P<0.00).