Endoscopic treatment of problems encountered after cholecystectomy

Manoukian, Aram V.; Schmalz, Michael J.; Geenen, Joseph E.; Hogan, Walter J.; Venu, Rama P.; Johnson, G. K.

doi:10.1016/s0016-5107(93)70002-4

Cited by 24 publications

(12 citation statements)

References 17 publications

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“…This study suggests that PEG is safe and effective in the early post laparotomy period. Similarly, no complica tions occurred in 35 patients undergoing diag nostic ERCP at a mean of 21 days after lapa roscopic cholecystectomy [108]. Moreover.…”

Section: Egd Safetymentioning

confidence: 80%

Gastrointestinal Endoscopy in High-Risk Patients

Cappell¹

1996

Dig Dis

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In America more than 100,000 high-risk patients/year have conditions normally evaluated by gastrointestinal endoscopy. This review analyzes the safety and efficacy of gastrointestinal endoscopy in high-risk patients. Endoscopy during pregnancy raises the unique issue of fetal safety. The safety of esophagogastroduodenoscopy (EGD) during pregnancy has been examined in a case-controlled study of 83 patients, a mailed survey of 73 patients, and case reports. The safety of sigmoidoscopy during pregnancy has been examined in a case-controlled study of 45 patients, a mailed survey of 26 patients, and case reports. These studies suggest that EGD and sigmoidoscopy are not contraindicated during pregnancy. For example, EGD should be performed for significant upper gastrointestinal bleeding. The safety of colonoscopy during pregnancy is inadequately analyzed. In a study of 34 EGDs performed within 3 weeks of myocardial infarction, no endoscopic complications occurred in 26 clinically stable patients with uncomplicated myocardial infarction. However, 3 major endoscopic complications occurred in 8 clinically unstable patients. In a study of 9 sigmoi-doscopies within 3 weeks of myocardial infarction, no sigmoidoscopic complications occurred in 7 clinically stable patients. Several studies have shown that EGD, sigmoidoscopy, or colonoscopy is safe in patients with advanced HIV infection. AIDS patients should generally be endoscoped with the same aggressiveness as other patients. However, endoscopy may be unwise in any terminal patient. No complication occurred in 60 patients undergoing EGD within 3 weeks of esophageal, gastric, or duodenal surgery. One minor complication occurred in 36 patients undergoing sigmoidoscopy within 3 weeks of colonic surgery. These results suggest that EGD or sigmoidoscopy is not contraindicated within 3 weeks of gastrointestinal surgery. No complications occurred in 53 chronic obstructive pulmonary disease patients undergoing EGD. EGD appears to be safe in chronic obstructive pulmonary disease patients without severe hypoxemia or acute bronchospasm. Emergency EGD can be performed in patients with severe hypoxemia after endotracheal intubation.

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Section: Egd Safetymentioning

confidence: 80%

Gastrointestinal Endoscopy in High-Risk Patients

Cappell¹

1996

Dig Dis

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“…Das interventionelle Vorgehen ist analog dem bei anderen benignen Strikturen (s. oben). Der Einsatz der ERCP ist aber bei kompletter Durchtrennung des Gallengangs limitiert [30,31], Hier muß in den meisten Fällen die Relaparotomie erfolgen [32].…”

Section: Interventionelles Vorgehen Nach Komplikationen Der Lapa Roskunclassified

Interventionelle Techniken am Gallenwegssystem

Scheurlen¹,

Sauerbruch²

1996

Chir Gastroenterol

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Erst die Einführung der endoskopischen Papillotomie (EPT) ermöglichte die Entwicklung der endoskopischen retrograden Cholangiopankreatographie (ERCP) von einem rein diagnostischen Verfahren zu einer Methode mit vielfältigen therapeutischen Möglichkeiten. Zum einen ist die elektive endoskopische Extraktion von Gallengangskonkrementen mit oder ohne vorherige Zerkleinerung in den meisten Fallen möglich geworden, zum anderen eignet sich die ERCP zur notfallmäβigen Therapie von steinbedingten Komplikationen (biliäre Pankreatitis, Cholangitis). In der palliativen Therapie maligner Gallengangsstenosen hat die Implantation von Kunststoff- oder Metallprothesen (Stents) einen festen Platz. Sie hat in den meisten Fallen die früher praktizierte externe Ableitung abgelöst. Gutartige Stenosen (Strikturen) nach operativen Eingriffen im Oberbauch (laparoskopische Cholezystektomie) oder Anastomoseninsuffizienzen nach Lebertransplantationen sind weitere Indikationen zur endoskopischen Intervention an den Gallenwegen, meist zur Implantation extrahierbarer Kunststoff-Stents.

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“…Compared with open cholecystectomy, LC is associated with less postoperative wound pain, shorter hospitalization resulting in an early return to work, and a favorable cosmetic outcome [5,6]. Since [7,8] [18].…”

Section: Introductionmentioning

confidence: 99%

Strategies for Management of Bile Duct Injury During Laparoscopic Cholecystectomy

Aoki

Tsuchida

Saitô

et al. 2000

Diagnostic and Therapeutic Endoscopy

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We encountered 10 patients with bile duct injuries during laparoscopic cholecystectomy. Their causes were electrocautery in 2 patients, misjudgment in 2, mechanical injury in 3, aberrant bile duct in 2, and weakness of the bile duct wall in one. The sites of injury were cystic duct in 4 patients, common bile duct in 2, aberrant bile duct in 2, common hepatic duct in one, and common bile duct plus right hepatic duct in one. Treatments for the injuries discovered intraoperatively consisted of T-tube drainage above in 2 patients, re-ligation of the cystic duct in one, ligation of an aberrant bile duct in one, simple suture and T-tube in one, and choledochojejunostomy in one. In the remaining 4 patients discovered postoperatively, 2 were conservatively treated by endoscopic retrograde biliary drainage. The duration of hospitalization was 9-12 days in the 4 patients with simple suture or ligation, 10-21 days in 2 cases of bile drainage, and 34-43 days in 3 with T-tube drainage. The patient with choledochojejunostomy suffered repeated cholangitis, resulting in hepatic abscess with hospitalization for 6 months. Since laparoscopic surgery should be minimally invasive, meticulous attention is necessary before and during surgery to avoid bile duct injury.

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Endoscopic treatment of problems encountered after cholecystectomy

Cited by 24 publications

References 17 publications

Gastrointestinal Endoscopy in High-Risk Patients

Gastrointestinal Endoscopy in High-Risk Patients

Interventionelle Techniken am Gallenwegssystem

Strategies for Management of Bile Duct Injury During Laparoscopic Cholecystectomy

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