Cystic artery lymph node-is it a fixed important landmark during cholecystectomy?

Tiang, Kor Woi; Peng, Jia Xin; Wysocki, Arkadiusz Peter

doi:10.15761/lps.1000114

Cited by 2 publications

(3 citation statements)

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“…The node may not be solitary and uniformly present first reported some 50 years ago by Williams and Whittaker in 80 postmortem examinations [ 15 ]. A triple cystic artery lymph node has been reported [ 16 ]. Similar to our cystic artery LN excision rate of 18.7%, Katri et al intraoperatively identified the LN in 85.7% of LCs (126/147) and excided the LN in 20.6% (26/126) [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Controlling for surgeon case-mix, differences may be incomplete given the limited literature as to which factors influence LN excision. The frequency of multiple cystic artery lymph nodes is likely to be very low but is unknown [ 16 ], meaning that a small proportion of the patients may have had multiple nodes where one was left behind while the other excised and thus been classified as LN present. Some lymph nodes may have been purposefully excised, e.g., the surgeon was suspicious of the gallbladder or LN appearance – this number is likely very low.…”

Section: Discussionmentioning

confidence: 99%

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Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy

Wysocki¹,

Murphy²,

Baade

2018

Cureus

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IntroductionExpert opinion recommends that surgeons perform a laparoscopic cholecystectomy (LC) in a standardized manner by dissecting the hepatobiliary triangle lateral to the cystic artery lymph node (LN) to minimize the rate of a major bile duct injury.MethodsTo determine whether surgeons performed a laparoscopic cholecystectomy in a standardized manner, the study assessed the variability in the frequency of an LN excision. All LCs that were performed at a single hospital were identified from a prospective dataset. The presence of an LN was retrospectively determined from the histology report.ResultsTwenty-seven surgeons were recorded to have performed 2332 laparoscopic cholecystectomies. Out of the total number of patients, 76.8% were female. The median patient age was 42.4 years. About 60.8% of the LCs were elective, while 39.2% of them were acute. Nineteen pathologists reported that in 99% of the specimens – the LN status of 1831 (78.5%) gallbladders was reported and analyzed. Overall, the LN yield per surgeon varied from 0% to 50% (mean 18.7%).Conclusion The high inter-surgeon variability in the rate of LN excision during laparoscopic cholecystectomy shows that surgeons dissect the hepatobiliary triangle differently. The LN yield may also represent a surrogate marker of surgical technique (which is easy to measure).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy

Wysocki¹,

Murphy²,

Baade

2018

Cureus

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“…El ganglio cístico se encuentra comúnmente cerca de la arteria cística, por lo tanto, este procedimiento de rescate sugiere identificar esta estructura e iniciar la disección lateralmente al ganglio para reducir el riesgo de lesión de vía biliar. (Woi Tiang et al, 2017). Aunque aún se desconoce si el ganglio se puede identificar durante cada colecistectomía ya que no hay reportes acerca de la constancia, así como de la presencia de más de un ganglio.…”

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Procedimientos de rescate en colecistectomía laparoscópica: cómo finalizar con seguridad por laparoscopía

et al. 2023

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Los procedimientos de rescate en colecistectomía laparoscópica son variados. Objetivos: Describir los procedimientos de rescate usados en el Hospital Regional ISSSTE Puebla durante el 2022. Material y métodos: Estudio observacional descriptivo, prospectivo de corte trasversal, en donde se incluyeron pacientes en los cuales no se pudo completar la visión crítica de seguridad y por lo tanto se tuvo que usar algún procedimiento de rescate para completar la colecistectomía por laparoscopía. Resultados: Se realizaron 193 colecistectomías laparoscópicas, en 40 (20.7%) pacientes se empleó algún procedimiento de rescate, se convirtieron 4 (2%) pacientes. Mediante el análisis multivariado no hubo relación significativa entre el tipo de procedimiento y el género, la edad, así como el grado de severidad de Tokyo; pero si hubo relación significativa el puntaje de Parkland ≥4 con los siguientes procedimientos: "Fundus first" más "punción y aspiración", colecistectomía reconstitutiva, abordaje infundibular, abordaje del segmento IV, colocación de un puerto adicional, colecistectomía parcial con o sin colangiografía, y el abordaje del ganglio cístico. Los días de estancia hospitalaria mayores se relacionaron con la colecistectomía reconstitutiva, colecistectomía parcial y la conversión. El sangrado se relacionó con la necesidad de conversión y con el uso de la "punción y aspiración".

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Cystic artery lymph node-is it a fixed important landmark during cholecystectomy?

Cited by 2 publications

References 9 publications

Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy

Inter-surgeon Variability in Cystic Artery Lymph Node Excision during Laparoscopic Cholecystectomy

Procedimientos de rescate en colecistectomía laparoscópica: cómo finalizar con seguridad por laparoscopía

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