Utility of Tokyo guidelines and intraoperative safety steps in improving the outcome of laparoscopic cholecystectomy in complex acute calculus cholecystitis: a prospective study

Thapar, Pinky M; Salvi, Prashant; Killedar, Madhura M; Philip, Roji; Rokade, Muktachand L

doi:10.1007/s00464-020-07905-w

Cited by 6 publications

(7 citation statements)

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“…Esses dados são fundamentais para a análise e discussão do perfil clínico de pacientes submetidos a colecistectomia. Dentre os artigos selecionados, dez (Aguila Gómez et al, 2023;Buri Parra et al, 2019;Wong et al, 2022;Irigonhê et al, 2020;Coelho et al, 2019;Wadhwa et al, 2021;Yuksekdag et al, 2021;Joshi et al, 2020;Thapar et al, 2021e Balasubramanian et al, 2018 abordam a técnica cirúrgica para a exérese da vesícula biliar; doze artigos descrevem a idade média dos pacientes e a prevalência cirúrgica entre os sexos (Aguila Gómez et al, 2023;de Almeida et al, 2020;Deo et al, 2023;Buri Parra et al, 2019;Wong et al, 2022;Irigonhê et al, 2020;Coelho et al, 2019;Wadhwa et al, 2021;Yuksekdag et al, 2021;Joshi et al, 2020;Thapar et al, 2021;Balasubramanian et al, 2018). Além disso, onze artigos discorrem sobre diferentes características clínicas.…”

Section: Resultsunclassified

“…Além disso, onze artigos discorrem sobre diferentes características clínicas. Essas características incluem detalhes do quadro clínico, sinais e/ou sintomas apresentados pelos participantes antes da cirurgia (Aguila Gómez et al, 2023;de Almeida et al, 2020;Deo et al, 2023;Buri Parra et al, 2019;Wong et al, 2022;Coelho et al, 2019;Wadhwa et al, 2021;Yuksekdag et al, 2021;Joshi et al, 2020;Thapar et al, 2021;Balasubramanian et al, 2018). Um artigo (Irigonhê et al, 2020) não contribui para essa descrição, mas oferece um histórico de saúde da amostra estudada, assim como os artigos de Almeida et al ( 2020 Research, Society and Development, v. 13, n. 2, e11313245104, 2024 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v13i2.45104 6 Foi observado que os estudos incluídos nesta revisão foram conduzidos em diferentes países, com maior prevalência no Brasil (de Almeida et al, 2020;Irigonhê et al, 2020e Coelho et al, 2019 e Nepal (Deo et al, 2023;Joshi et al, 2020).…”

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Explorando o panorama clínico de indivíduos submetidos à colecistectomia: Uma revisão de escopo

Silva,

Takagi,

Wilk

2024

RSD

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A colecistectomia consiste na cirurgia que resulta na exérese da vesícula biliar. Este estudo teve como objetivo identificar as características clínicas de pacientes submetidos à colecistectomia. Método: Realizou-se uma revisão de escopo, seguindo as diretrizes estabelecidas pelo Instituto Joanna Briggs (JBI). Resultados: Os resultados revelaram que a colecistectomia videolaparoscópica é a técnica cirúrgica mais prevalente. A faixa etária predominante dos pacientes submetidos a essa intervenção situa-se entre 40-60 anos, com uma maior prevalência no sexo feminino. Os escores ASA I e ASA II foram os mais comuns. Comorbidades frequentemente associadas incluem hipertensão arterial sistêmica, diabetes mellitus, hipotireoidismo, dislipidemia, tabagismo, doença cardíaca sistêmica e insuficiência renal. A dor abdominal, especialmente no quadrante superior direito foi o sintoma mais prevalente, acompanhado por náuseas, dispepsia, vômitos e sinal de Murphy positivo. Conclusão: Esta pesquisa destacou a importância da análise do perfil clínico de pacientes submetidos à colecistectomia, proporcionando uma visão abrangente alinhada com a literatura existente.

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Section: Resultsunclassified

Explorando o panorama clínico de indivíduos submetidos à colecistectomia: Uma revisão de escopo

Silva,

Takagi,

Wilk

2024

RSD

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“…Laparoscopic cholecystectomy is preferred over open cholecystectomy due to its minimally invasive nature, reduced postoperative pain, shorter hospital stays, and for cosmetic purposes. A multicenter study by the Indian Association of Gastrointestinal Endoscopic Surgeons (IAGES) found that 95% of all cholecystectomies performed in India were laparoscopic 9 . A total of 30 000 cholecystectomies are performed in the United States each year, where the overall incidence of cholelithiasis is 20 million, and there has been an increase in the rate of this treatment since the introduction of laparoscopic cholecystectomy by 30%–60% 16,19 .…”

Section: Discussionmentioning

confidence: 99%

“…Bile duct injury rates have increased since the introduction of laparoscopic cholecystectomy, occurring in about 3 per 1000 procedures performed 8 . The incidence of bile duct injury is 0.4%–1.5% in laparoscopy as compared with open surgery with a rate of 0.3% 9,10 . Bile duct injury leads to increased chances of morbidities and an overall decreased quality of life—turning the person into a “biliary cripple.” 11 There is minimal evidence to justify surgery for people with asymptomatic gallstones.…”

Section: Introductionmentioning

confidence: 99%

An Indian surgeon's perspective on management of asymptomatic gallstones

Virk,

Arora,

Patil

et al. 2024

Asian J Endoscop Surgery

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IntroductionCholelithiasis is widely prevalent in India, with a majority of patients being asymptomatic while a small proportion experiencing mild complications. In the laparoscopic era, the rate of cholecystectomies has increased owing to early recovery and fewer complications. In asymptomatic patients, the risk of complications must be balanced against the treatment benefit. Recent guidelines suggest no prophylactic cholecystectomy in asymptomatic patients. We aimed to find out the Indian surgeons' perspective on asymptomatic gallstone management.MethodsA cross‐sectional e‐survey was conducted of practicing surgeons, onco‐surgeons and gastrointestinal‐surgeons in India. The survey had questions regarding their perspective on laparoscopic cholecystectomy and treatment modalities in asymptomatic gallstones.ResultsA total of 196 surgeons responded to the survey. Their mean age was 42.3 years. Overall, 111 (57%) respondents worked in the private sector. Most surgeons (164) agreed that the rate of cholecystectomy has increased since the advent of laparoscopy; 137 (70%) respondents agreed that they would not operate on patients without risk factors. Common bile duct stones, chronic hemolytic diseases, transplant recipients, and diabetes mellitus were the risk factors. Majority of the participants agreed on not performing a cholecystectomy in patients with asymptomatic gallstones.ConclusionThere exists a lack of consensus among Indian surgeons on asymptomatic gallstone management in India. Where the majority of cases are asymptomatic and do not require surgery, certain comorbidities can influence the line of treatment in individual patients. Currently, the treatment guidelines for asymptomatic patients need to be established as cholecystectomies may be overperformed due to the fear of development of complications.

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“…Based on TG18, we choose conversion to LSC to cope with difficult LC in order to avoid bile duct injury or hemorrhage. Conversion rates are known to range from 3.0% to 30.0% in LC for ACC reported by the literature ( 22 ). The low open conversion rate in the current study highlights the efficacy of a bail-out procedure of LSC to resolve difficult LC and avoid direct conversion to open surgery in difficult cases when there is a failure to achieve a CVS.…”

Section: Discussionmentioning

confidence: 99%

Utility of Tokyo Guidelines 2018 in early laparoscopic cholecystectomy for mild and moderate acute calculus cholecystitis: A retrospective cohort study

Yan

Hua²,

Yuan³

et al. 2023

Front. Surg.

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BackgroundTokyo Guidelines 2018 (TG18) proposed laparoscopic cholecystectomy (LC) for acute calculus cholecystitis (ACC) irrespective of the duration of symptoms. This retrospective study assessed the impact of utility of TG18 in early LC for ACC.MethodsFrom 2018 to 2020, 66 patients with mild (grade I) and moderate (grade II) ACC who underwent early surgery were studied. Subgroup analyses were based on timing of surgery and operation time.ResultsA total of 32 and 34 patients were operated within and beyond 7 days since ACC onset. More patients with grade II ACC were in the beyond 7 days group (P < 0.05). More patients with enlarged gallbladder were in the within 7 days group (P < 0.05). The duration of symptoms to admission, symptoms to LC, and operation time were longer in the beyond 7 days group (P < 0.05). There were no significant differences regarding intraoperative blood loss, conversion to bail-out procedures, complication rate, hospital stay, and cost between the two groups (P > 0.05). Longer operation time was significantly associated with duration of symptoms to admission, symptoms to LC, and conversion to laparoscopic subtotal cholecystectomy (LSC) (P < 0.05).ConclusionIn a subset of carefully selected patients, applying TG18 in early LC for mild and moderate ACC results in acceptable clinical outcomes. Standardized safe steps and conversion to LSC in difficult cases are important.

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Utility of Tokyo guidelines and intraoperative safety steps in improving the outcome of laparoscopic cholecystectomy in complex acute calculus cholecystitis: a prospective study

Cited by 6 publications

References 23 publications

Explorando o panorama clínico de indivíduos submetidos à colecistectomia: Uma revisão de escopo

Explorando o panorama clínico de indivíduos submetidos à colecistectomia: Uma revisão de escopo

An Indian surgeon's perspective on management of asymptomatic gallstones

Utility of Tokyo Guidelines 2018 in early laparoscopic cholecystectomy for mild and moderate acute calculus cholecystitis: A retrospective cohort study

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