Surgical outcomes of laparoscopic cholecystectomy in scleroatrophic gallbladders

Akoğlu, Musa; Ercan, Metin; Bostancı, Erdal Birol; Teke, Zafer; Parlak, Erkan

doi:10.4318/tjg.2011.0188

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Ishikawa et al,2 reported drain usage after laparoscopic cholecystectomy in cases defined as complicated, such as intraoperative excessive bleeding, difficult operations, and intraoperative spread of bile 4. According to the experience and data obtained from this study, drain usage is indicated in cases such as acute complicated cholecystitis, elective scleroatrophic cholelithiasis, when smooth closure cannot be made of a cystic canal, when there is perioperative injury or bleeding, or a history of anticoagulant use.…”

Section: Discussionmentioning

confidence: 83%

“…Inclusion criteria for the study were; elective uncomplicated cholelithiasis (Grade 1, 2, 3 gallbladder), American Society of Anesthesiologists (ASA) score 1-2-3 patients, and age <70 years. Uncomplicated cholelithiasis criteria were defined by the surgeon during laparoscopic cholecystectomy according to the gall bladder adhesion scoring scale defined by Akoglu et al4 Using this scale of grade 1 = no pericholecystic adhesions, grade 2 = adhesions easily loosened with dissection, grade 3= chronic pericholecystic adhesions showing fibrotic properties permitting dissection, grade 4 = adhesions preventing the easy determination of anatomic structures and making dissection difficult, which are intense accompanied by a thickened gall bladder wall (sclera atrophic cholelithiasis). Exclusion criteria were; grade 4 gallbladder with stones4, conversion cholecystectomy, emergency cholecystectomy, previous upper abdominal surgery, predisposition for bleeding and chronic liver disease, gangrenous and emphysematous cholecystitis, intraoperative injury or bleeding, choledocholithiasis, cholangitis, pancreatitis, and unwillingness to participate in the study.…”

Section: Methodsmentioning

confidence: 99%

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The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy

Bostancı

Saydam

Koşmaz³

et al. 2019

Pak J Med Sci

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Background and Objective: To evaluate the clinical role of the routine use of a drain in an elective laparoscopic cholecystectomy operation applied to patients with symptomatic cholelithiasis not showing acute inflammation. Method: Following laparoscopic removal of the gallbladder, patients were separated into two groups of 30 each, either with subhepatic drain placement or without. The presence of subhepatic fluid collection was evaluated with transabdominal ultrasonography (USG) at 24 hours postoperatively and on the 7th day. The other parameters evaluated were postoperative morbidity, shoulder and abdominal pain. Results: No statistically significant difference was found between the two groups in respect of demographic characteristics and operative details. The median pain score was determined to be statistically significantly higher in the group with a drain applied compared to the group without a drain (p=0.007). In the comparison between the groups of fluid collection on USG at 24 hours and shoulder pain persisting until the 7th day, although seen less in the group with no drain applied, no statistically significant difference was determined (p=0.065, p=0.159). In the examinations made on the 7th day, no hematoma or significant fluid collection was determined on USG and no wound infection was observed in any patient of either group. Conclusion: The routine application of prophylactic subhepatic drain in laparoscopic cholecystectomy procedure did not show any benefit to the patient. doi: https://doi.org/10.12669/pjms.35.5.291 How to cite this:Bostanci MT, Saydam M, Kosmaz K, Tastan B, Bostanci EB, Akoglu M. The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.291 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 83%

Section: Methodsmentioning

confidence: 99%

The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy

Bostancı

Saydam

Koşmaz³

et al. 2019

Pak J Med Sci

Self Cite

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“…GB adhesion score developed by Akoğlu et al and intraoperative findings of patients were assessed and recorded by one surgeon (S. C.). [6] Adhesion scoring scale is based on the degree of inflammatory changes in the GB as a guide for predicting the course of operation. During exploration, the extent and thickness of the adhesions in the GB region were graded as follows: grade I, no adhesions; grade II, flimsy adhesions that permit easy dissection; grade III, chronic pericholecystitis and pericholecystic fibrosis making dissection difficult but permitting visualization of the anatomy; and grade IV, thickened GB wall and anatomical distortion due to dense adhesions around the GB, which do not permit safe dissection.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of power Doppler sonography in acute cholecystitis to predict intraoperative findings: Prospective clinical study

Çetinkünar

Erdem

Aktimur

et al. 2014

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:This study aimed to evaluate the diagnostic value of gray-scale and power Doppler sonography for acute cholecystitis and show a correlation between sonographic and intraoperative findings, quantitively. METHODS:Forty chronic and forty acute cholecystitis patients were examined. Early laparoscopic cholecystectomy was performed for acute cholecystitis. Demographic characteristics, sonographic findings, and adhesion scores were analyzed. Data were collected prospectively (clinicaltrials.gov: NCT02156947). RESULTS:Wall thickness (≥3 mm) and vascularity increased in acute cholecystitis (p<0.01 and <0.01). Vascularity was found to be moderately correlated with adhesion (p<0.01, r=0.59) but it did not affect the difficulty of the operation by means of perforation, conversion rate, and operation time. In addition, wall thickness did not correlate with adhesion formation (p=0.36). Sensitivity and specifity of wall thickness and vascularity were found to be 96.9%, 72.7%, and 68%, 87.2%, respectively. When both diagnostic measurements were taken into account, sensitivity was calculated 69.7% and specificity reached up to 97.6%. CONCLUSION:Vascularity correlated with adhesion but failed to predict operation difficulty. Specificity of gray-scale sonography could be improved with power Doppler examination; however, desired diagnostic accuracy could not be obtained with only quantitive measurements of sonography.

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Surgical outcomes of laparoscopic cholecystectomy in scleroatrophic gallbladders

Cited by 2 publications

References 26 publications

The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy

The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy

Evaluation of power Doppler sonography in acute cholecystitis to predict intraoperative findings: Prospective clinical study

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