Laparoscopic Cholecystectomy in Cirrhotic Patients: The Role of Subtotal Cholecystectomy and Its Variants

Palanivelu, C.; Rajan, Pidigu Seshiyer; Jani, Kalpesh; Shetty, Alangar Roshan; Sendhilkumar, K.; Senthilnathan, Palanisamy; Parthasarthi, R.

doi:10.1016/j.jamcollsurg.2006.04.019

Cited by 118 publications

(132 citation statements)

References 25 publications

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“…A case control study showed the conversion and morbidity rate was higher in the cirrhosis group than in the control group (Fernandes, 2000), (Treatment studies 3b); and two case series shows similar results than the previous RCT reported in patients with cirrhosis and portal hypertension Child A and B (Palanivelu, 2006;da Silveira, 2006).…”

Section: (Treatment Studies 2b)supporting

confidence: 57%

“…Low quality: it very likely that future studies change our confidence in the estimate of effect, therefore our confidence is low. Table. 2001; Elder, 1996;Finan, 2006;Zacks, 2002;Collet, 1997;Ibrahim, 2006;Weber, 2003;Feldman, 1994;Perez Lara, 2006;Sungler, 2000;Daradkeh, 1999;Ji, 2005;Fernandes, 2000;Palanivelu, 2006;da Silveira, 2006;Gurusamy, 2006;Chandler, 2000;Kiviluoto, 1998;Glavic, 2001;Eldar, 1998;Lujan, 1995;Tan, 2006;Perez-Morales, 2005;Bagia, 2001;Schafer, 2003;Kwon, 2001;Woods, 1996).…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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SUMMARY:The aim of the present study was to evaluate the available evidence on the effectiveness of laparoscopic surgery for treating gallstones and common bile duct lithiasis (CBDL). A systematic overview was performed. Medline, EMBASE and The Cochrane Library were searched (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Systematic reviews (SR), clinical practice guidelines (CPG), randomised clinical trials (RCT) and observational studies were included. Internal validity and overall quality of the evidence were assessed. The available evidence was classified according to the Oxford Centre for Evidence Based Medicine proposal. 87 studies were included in this review (12 SR, 23 RCT, 3 CPG, 13 cohort studies, 3 cross-sectional studies, 2 case and control studies and 31 case series). Compared with open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with shorter operating time, shorter hospital stay and better quality of life (high quality evidence). The use of antibiotic prophylaxis does not appear to reduce the infection rate in low-risk patients (high quality evidence). Although many techniques have been advocated to perform LC their effectiveness is as yet inconclusive (low-quality evidence). Two-stage surgery is the most appropriate strategy for high-risk patients with CBDL (high-quality evidence). Mortality is similar to open surgery, as the effectiveness is similar to that of endoscopic treatment (high-quality evidence). As a conclusion we can state that the evidence concerning the effectiveness of laparoscopic surgery for gallstones and CBDL is scarce and of low methodological quality and that better quality studies are warranted to assess these techniques more adequately.

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Section: (Treatment Studies 2b)supporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

et al. 2010

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“…17 Though a uniform consensus for predictors of intraoperative difficulty cannot be reached at, commonest risk factors can be identified from the randomized controlled trials carried out by various authors. 20 Patients with recent history of Myocardial Infarction are at higher risk of perioperative morbidity.…”

Section: Discussionmentioning

confidence: 99%

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Menon¹

2017

Int Surg J

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Laparoscopic cholecystectomy is the most common laparoscopic procedure performed all over the world. It has now become the gold standard management for symptomatic gallstones. Aim of the study was to identify and highlight the predictive factors determining intra operative technical difficulty in laparoscopic cholecystectomy. A database search was done in Medline, Google scholar and Journal seek using keywords ‘Laparoscopic Cholecystectomy’, ‘difficult cholecystectomy’ and ‘predictive factors’. 54 abstracts were shortlisted out of which 15 were selected based on the time of publication (after 2005), size of study group, relevance to the title, level of evidence and the journal of publication. Results were compared and reviewed and the conclusion was reached. Fifteen papers were reviewed based on literature search and statistically significant variables predicting the technical difficulty in Laparoscopic cholecystectomy was found. These were age, sex, obesity, previous upper abdominal surgeries, comorbid diseases like Diabetes, acute cholecystitis, raised WBC counts, gall bladder wall thickness more than 3mm, presence of pericholecystitic collection, single impacted stone, multiple stones, contracted gall bladder, adhesions at Calot’s triangle, intrahepatic gall bladder, complications like gangrenous GB and fistulisation. The predictive risk factors reviewed here need to be kept in mind by the laparoscopic surgeon during a laparoscopic cholecystectomy. Though none of them is an absolute contraindication, presence of these factors demand modifications in technique for a safe laparoscopic surgery.

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“…In case of severe Calot's triangle inflammation and fibrosis, the rate of injury to the biliary tract and portal structures increase. Several damage-control procedures have been described in the literature for such circumstances (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Damage-control laparoscopic partial cholecystectomy with an endoscopic linear stapler

et al. 2017

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Laparoscopic Cholecystectomy in Cirrhotic Patients: The Role of Subtotal Cholecystectomy and Its Variants

Cited by 118 publications

References 25 publications

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

Effectiveness of Laparoscopic Surgery for Gallstones and Common Bile Duct Lithiasis: a Systematic Overview

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Damage-control laparoscopic partial cholecystectomy with an endoscopic linear stapler

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