Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?

Conclusion: MRCP is valuable for identification of bile duct variation and CBD stones. Preoperative MRCP can be considered, particularly in patients with elevated γ-GT, for proper preoperative management and avoidance of complications. PMID: 33029481 [PubMed]
Source: Annals of Surgical Treatment and Research - Category: Surgery Tags: Ann Surg Treat Res Source Type: research

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427Objectives: To determine the optimal cutoff timepoint for rapid gastric emptying. This is one of the items suggested for further investigation in the 2008 published Consensus Recommendations for Gastric Emptying Scintigraphy 1. Methods: In accordance with the National Standard Protocol (NSP), which is based on the consensus recommendations of the ANMS/SNMMI, patients were given a standard low-fat, egg-white meal radiolabeled with 1 mCi Tc99m Sulfur Colloid. Anterior and posterior planar gamma camera imaging was performed at 0, 0.5, 1, 1.5, 2, 2.5, and 4 hours as per combined NSP and established Miami Method (MIA). Quant...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Gastroenterology Source Type: research
Authors: Vaccari S, Cervellera M, Lauro A, Palazzini G, Cirocchi R, Gjata A, Dibra A, Ussia A, Brighi E, Isaj E, Agastra E, Casella G, Di Matteo FM, Santoro A, Falvo L, Tarroni D, D'andrea V, Tonini V Abstract BACKGROUND: Laparoscopic cholecystectomy represents the gold standard technique for the treatment of lithiasic gallbladder disease. Although it has many advantages, laparoscopic cholecystectomy is not risk-free and in special situations there is a need for conversion into an open procedure, in order to minimize postoperative complications and to complete the procedure safely. The aim of this study is to ident...
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
AbstractBackgroundBariatric surgery predisposes patients to cholelithiasis and therefore the need of a subsequent cholecystectomy; however, the incidence of cholecystectomy after bariatric surgery is debated.Aim and MethodsMedical records of 601patients hospitalized for bariatric surgery between January  2010 and July 2018 were reviewed. Our aim was to evaluate the incidence of cholecystectomy following different types of common bariatric procedures. All patients who developed cholelithiasis and a subsequent cholecystectomy were included. Cholelithiasis was diagnosed by clinical criteria and char acteristic ultra...
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractBackgroundGallbladder stone with symptom is an indication of cholecystectomy according to the current guideline. However, about 80% of gallstone patients are asymptomatic. The identification of gallbladder stone patients likely to develop symptomatic complications would be of benefit in clinical practice.AimsThe aim of this study was to investigate the risk factors for asymptomatic gallstone diseases developing into a gallstone-related biliary event.MethodsThis retrospective study evaluated 1284 patients with gallstones and received laparoscopic cholecystectomy (LC) in Peking Union Medical College Hospital. The age...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
Abstract Guidelines suggest targeting a preoperative international normalized ratio (INR) 1 to ≤1.5,>1.5 to ≤2, and>2. Thirty day postoperative mortality was the primary outcome. Multivariable logistic regressions controlled for baseline differences. Of 58,177 cholecystectomy patients, 15.2 per cent had INR ≤ 1, 80.4 per cent had INR> 1 to ≤1.5, 3.7 per cent had INR> 1.5 to ≤2, and 0.7 per cent had INR> 2. Patients with INR> 2 were older and more likely to have diabetes and hypertension (P 1 to ≤1.5 (odds ratio (OR) = 1.50 [1.10-2.05]), INR> 1.5 to ≤2 (OR = 2.96 [1.97-4.45...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
The objective of this study was to determine the safety of laparoscopic cholecystectomy (LC) in EGS patients with cirrhosis. We performed a two-year retrospective cohort analysis of adult patients who underwent LC for symptomatic gallstones. The primary outcome was the incidence of intraoperative complications. Of 796 patients, 59 (7.4%) were cirrhotic, with a median model for end-stage liver disease (MELD) score of 15 (IQR, 7). On unadjusted analysis, patients with cirrhosis were older, more likely to be male (both P
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
Despite many advances in health care, managing pain in the post-anesthetic period continues to be a challenge. With more procedures being performed on an outpatient basis, shorter lengths of stay and drive to improve patient satisfaction, providers are looking for ways to enhance the surgical care experience and reduce opioid use. In addition, the increase burden of obesity in society has contributed to a rise in co-morbidities such as diabetes, cardiovascular, and gallbladder disease making laparoscopic cholecystectomies the second most frequently performed general surgery procedure in the United States.
Source: Journal of PeriAnesthesia Nursing - Category: Nursing Authors: Tags: ASPAN National Conference Abstract Source Type: research
Authors: Choromanska B, Mysliwiec P, Hady HR, Dadan J, Mysliwiec H, Bonda T, Chabowski A, Miklosz A Abstract Obesity is characterised by imbalance in lipid metabolism manifested by high concentrations of circulating triacylglycerols and total cholesterol as well as low high-density lipoprotein (HDL) levels. Abnormalities related to these lipids lead to metabolic complications such as type 2 diabetes, arterial hypertension and cardiovascular disease. Despite extensive research, it is still unclear why a subset of obese subjects develop metabolic syndrome, while others do not. The aim of our work was to assess total ...
Source: Journal of Physiology and Pharmacology - Category: Drugs & Pharmacology Tags: J Physiol Pharmacol Source Type: research
ConclusionsWe could propose a flowchart based on our risk stratification model and develop a severity score based on the association between complications of laparoscopic cholecystectomy and sociodemographic/clinical data.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
Authors: Thiyagarajan M, Kamaraj E, Navrathan N, Thyagarajan M, Singh Krishna B Abstract Objectives: Pathogenesis of gallstone includes bile stasis due to defect in the gallbladder muscle contraction. Our aim of the study is to find out the role of 99mTc-HIDA scan in assessment of gallbladder dyskinesia in cholelithiasis patients before laparoscopic cholecystectomy and compare the gallbladder dyskinesia with various parameters like symptoms of patients, diabetic status of patients, gallstones size and number, and cholecystitis features in histopathology report after surgery. Material and Method: This is a prosp...
Source: Minimally Invasive Surgery - Category: Surgery Tags: Minim Invasive Surg Source Type: research
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