Management of Choledocholithiasis in a Community Hospital: Laparoscopic Common Bile Duct Exploration Versus Endoscopic Retrograde Cholangiopancreatography
DISCUSSION: Since implementation of LC + CBDE, there has been reduced LOS without increasing complication rates. Operative times are increased with LC + CBDE but offset by reduced LOS, additional anesthesia events, and procedures. Our institution will continue to pursue LC + CBDE when indicated with efforts to improve resource allocation.PMID:38557206 | DOI:10.1177/00031348241241626 (Source: The American Surgeon)
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Molly M McNamee Michael P Stolz Robert Tyler Harvell Christopher A Staley Emilie E Green Hedaya D Othman Brian H Gibson Source Type: research
Challenges, Preoperative Assessment, and Surgical Strategies for the Left-Sided Gallbladder
Am Surg. 2024 Apr 1:31348241241691. doi: 10.1177/00031348241241691. Online ahead of print.ABSTRACTLeft-sided gallbladder positioning, or sinistroposition, is a rare anatomical variation that poses challenges during surgical intervention due to associated vascular and biliary anomalies. While existing literature suggests an incidence of approximately 0.04-1.1%, it remains an underreported phenomenon that falls well outside the realm of "expected" anatomical variation and are rarely identified on preoperative imaging. Here, we present a case of acute cholecystitis in a patient with unexpected left-sided gallbladder, highligh...
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Olivia A Starich Nicolas M Chanes Syed Shahyan Bakhtiyar Zain Aryanpour Magdalene A Brooke Source Type: research
A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding
We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter o...
Source: Annals of the Royal College of Surgeons of England - February 16, 2024 Category: Surgery Authors: M Kim S Lam M A Thirunavaya Kalathil A Paterson D J Bowden S-S Liau Source Type: research
A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding
We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter o...
Source: Annals of the Royal College of Surgeons of England - February 16, 2024 Category: Surgery Authors: M Kim S Lam M A Thirunavaya Kalathil A Paterson D J Bowden S-S Liau Source Type: research
A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding
We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter o...
Source: Annals of the Royal College of Surgeons of England - February 16, 2024 Category: Surgery Authors: M Kim S Lam M A Thirunavaya Kalathil A Paterson D J Bowden S-S Liau Source Type: research
A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding
We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter o...
Source: Annals of the Royal College of Surgeons of England - February 16, 2024 Category: Surgery Authors: M Kim S Lam M A Thirunavaya Kalathil A Paterson D J Bowden S-S Liau Source Type: research
Safety of laparoscopic cholecystectomy performed by trainee surgeons with different cholangiographic techniques (SCOTCH): a prospective non-randomized trial on the impact of fluorescent cholangiography during laparoscopic cholecystectomy performed by trainees
ConclusionsThese data showed that using NIRF-C did not prolong operative time but positively influenced the surgeon's satisfaction of the performance of LC. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - December 22, 2023 Category: Surgery Source Type: research
Pediatric Transplant Interventions
The field of pediatric organ transplantation has grown significantly in recent decades, with interventional radiology (IR) playing an essential role in managing pre- and post-transplant complications. Pediatric transplant patients face unique challenges compared to adults, including donor-recipient size mismatch, and complications of a growing child with changing physiology. Interventional radiologists play a major role in pediatric renal and liver transplant. IR interventions begin early in the child's pre-transplant journey, with diagnostic procedures such as biopsies, angiograms, and cholangiograms. (Source: Techniques ...
Source: Techniques in Vascular and Interventional Radiology - November 4, 2023 Category: Radiology Authors: Pareena Sharma, Ritu Shah, Vaz Zavaletta, Fred Bertino, Tina Sankhla, Jun Man Kim, Michael Leshen, Jay Shah Source Type: research
Transcystic Laparoscopic Common Bile Duct Exploration for Pediatric Patients with Choledocholithiasis: A Multi-Center Study
Patients with choledocholithiasis are often treated with endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC). Upfront LC, intraoperative cholangiogram (IOC), and possible transcystic laparoscopic common bile duct exploration (LCBDE) could potentially avoid the need for ERCP. We hypothesized that upfront LC+IOC +/- LCBDE will decrease length of stay (LOS) and the total number of interventions for children with suspected choledocholithiasis. (Source: Journal of Pediatric Surgery)
Source: Journal of Pediatric Surgery - October 20, 2023 Category: Surgery Authors: Jessica Rauh, Goeto Dantes, Marshall Wallace, Amelia Collings, Gloria D. Sanin, Gabriel E. Cambronero, Maggie E. Bosley, Aravindh S. Ganapathy, James W. Patterson, Romeo Ignacio, Jennifer Leslie Knod, Bethany Slater, Kylie Callier, Michael H. Livingston, Source Type: research
Fluorescence cholangiography for laparoscopic cholecystectomy: how, when, and why? A single-center preliminary study
CONCLUSION: Fluorescent cholangiography during LC is safe and feasible overcoming the limits of other techniques available. 2.5 mg ICG administered 10-14 h before surgery produces optimal outcomes for near-infrared (NIR) fluorescent cholangiography.PMID:37801001 | DOI:10.1080/13645706.2023.2265998 (Source: Minimally Invasive Therapy and Allied Technologies)
Source: Minimally Invasive Therapy and Allied Technologies - October 6, 2023 Category: Surgery Authors: Alessia Fassari Andrea Bianucci Sara Lucchese Emanuele Santoro Marco Maria Lirici Source Type: research
