Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 649
Filtrar
1.
Scanning ; 2022: 9661506, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832300

RESUMO

To explore the clinical efficacy of microscope combined with Wechat smart platform in patients with cholecystolithiasis and choledocholithiasis, this paper proposes the effect of microscope combined with Wechat smart platform intervention after laparoscopic lithotomy and choledocholithotomy on the clinical efficacy and gastrointestinal function of patients with cholecystolithiasis combined with choledocholithiasis. From February 2018 to March 2019, 78 patients with gastric cancer were selected by our clinic and included in the research team. Evaluate the efficacy of endoscopic biliary lithotomy (LBL) + bile duct lithotomy (TBL) + T-tube drainage therapy to provide reliable evidence for improved efficacy and efficacy in order to provide a strong reference for improving the effectiveness and safety of surgical treatment of choledocholithiasis. Safety of surgical treatment of diseases. Gallstone disease. The experiments did not show any significant differences between the two groups during surgery. Diabetes was lower in the control group, and hospital incidence was lower in the control group. There were no significant differences between the two groups for preoperative WHOQOL-100 scores. Two weeks and four weeks after surgery, the man-key-100 score was higher than that of the control group. Endoscopic cholecystectomy + choledocholithotomy + choledochoscopic lithotomy + T-tube fluid have been shown to be effective in promoting rapid intestinal function and improving patient quality of life and are appropriate for therapeutic use.


Assuntos
Colecistolitíase , Coledocolitíase , Colecistolitíase/complicações , Colecistolitíase/cirurgia , Coledocolitíase/complicações , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Ducto Colédoco/cirurgia , Humanos , Qualidade de Vida , Resultado do Tratamento
2.
Comput Math Methods Med ; 2022: 9110676, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35693272

RESUMO

Objective: Evaluate the influence of laparoscopy combined with choledochoscopy on operation-related indexes, serum total bilirubin (TBIL) level, and abdominal drainage tube extraction time within cases carrying cholecystolithiasis/choledocholithiasis. Methods: 86 cases of cholecystolithiasis together with choledocholithiasis were chosen for this investigation, and cases were randomly segregated within the control cohort (43 cases, open surgery) and observation cohort (43 cases, laparoscopy combined with choledochoscopy).The operation-related indexes, complete stone clearance rate, postoperative visual analogue scale (VAS) scoring, serum TBIL level, and postsurgical complications/recovery incidence were observed and comparatively analyzed across cohorts. Results: Compared with the control cohort, the incision length, operation duration, postoperative exhaust duration, abdominal drainage tube extraction time, and postsurgery hospitalization in observation cohort were markedly reduced (P < 0.05), the intrasurgical hemorrhaging was markedly reduced (P < 0.05), and the postoperative complication incidences were markedly reduced (P < 0.05). Furthermore, the complete stone clearance rates in the observation cohort were elevated compared with control, but the difference was not statistically significant (P > 0.05).VAS scoring for the observation cohort at 6, 12, 24, and 48 hours postsurgery was markedly reduced (P < 0.05). On the first day after the operation, the serum TBIL levels for the two cohorts were very high and gradually decreased, and the serum TBIL levels in the observation cohort were markedly reduced during day 1, 3, and 5 postsurgery (P < 0.05). Conclusion: Laparoscopy combined with choledochoscopy surgical treatment might reduce the surgery duration, intrasurgery hemorrhaging, postsurgical pain, and liver function damage.


Assuntos
Colecistolitíase , Coledocolitíase , Laparoscopia , Colecistolitíase/complicações , Colecistolitíase/cirurgia , Coledocolitíase/complicações , Coledocolitíase/diagnóstico por imagem , Coledocolitíase/cirurgia , Drenagem , Humanos , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento
3.
Chirurgie (Heidelb) ; 93(6): 542-547, 2022 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-35107623

RESUMO

Approximately 10% of patients with symptomatic cholecystolithiasis also have choledocholithiasis. The probability of this can be estimated on the basis of sonographic and laboratory chemistry parameters. If the probability is high, endoscopic retrograde cholangiography (ERC) or cholangiopancreatography (ERCP) should be performed and if the probability is low, cholecystectomy can be performed without further diagnostics. If the findings are equivocal, further work-up should be performed to detect or exclude choledocholithiasis by endoscopic ultrasound (EUS) or magnetic resonance cholangiopancreatography (MRCP). If choledocholithiasis is detected, it can be treated by ERC preoperatively, intraoperatively or postoperatively or alternatively by laparoscopic cholangiography. Regarding the temporal sequence, there is no clear advantage of a specific time point; however, considering the high availability of ERCP in German-speaking countries, preoperative clearance of choledocholithiasis seems reasonable. With respect to the time interval between clearance of choledocholithiasis and cholecystectomy, a number of multicenter studies and a meta-analysis have shown that a short time interval or a procedure during the same period of hospitalization is advantageous.


Assuntos
Colecistectomia Laparoscópica , Colecistolitíase , Coledocolitíase , Ductos Biliares , Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica/métodos , Colecistolitíase/diagnóstico por imagem , Coledocolitíase/diagnóstico por imagem , Humanos
4.
Medicine (Baltimore) ; 101(5): e28767, 2022 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-35119038

RESUMO

ABSTRACT: Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative treatment option for acute cholecystitis. However, the disease may recur after PTGBD catheter removal. This study aimed to evaluate the role of endoscopic sphincterotomy and other risk factors in reducing the recurrence of cholecystitis.We retrospectively analyzed data from 1088 patients who underwent PTGBD for cholecystitis at Kyungpook National University Hospital, Republic of Korea, between January 2011 and April 2018.A total of 115 patients were enrolled in the study. The recurrence rate of cholecystitis was 17.4% (n = 20) during a median follow-up period of 1159 (range, 369-2774) days. Endoscopic biliary sphincterotomy did not significantly affect the recurrence rate of cholecystitis (P = .561). In multivariable analysis, cystic duct stones (P = .013) and PTGBD catheter migration before the prescheduled removal time (P = .002) were identified as independent risk factors for cholecystitis recurrence after PTGBD.To reduce post-PTGBD recurrence in cholecystitis, caution must be exercised to avoid inadvertent dislodging of the PTGBD catheter. In cases of cholecystitis with cystic duct stones, cholecystectomy should be considered only after careful assessment of postoperative risks. Instead, transluminal endoscopic gallbladder drainage could represent a promising option for the prevention of recurrent cholecystitis.


Assuntos
Colecistite Aguda , Colecistolitíase , Colecistostomia , Cateteres , Colecistite Aguda/etiologia , Colecistite Aguda/cirurgia , Remoção de Dispositivo , Drenagem , Vesícula Biliar/cirurgia , Humanos , Recidiva , Estudos Retrospectivos , Esfinterotomia Endoscópica , Resultado do Tratamento
6.
Vet Clin Pathol ; 50 Suppl 1: 37-46, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34031917

RESUMO

BACKGROUND: Hepatic cholesterol accumulation in small breed dogs is a leading risk factor for hepatic fatty changes, gallbladder hypomotility, and cholelith development, which, if not discovered early, could lead to life-threatening choledocholithiasis and acute pancreatitis. OBJECTIVE: This study proposed to assess the use of hepatocyte-derived canine familiaris (cfa)-microRNAs (miRNA-122, -34a, and -21) as new diagnostic serum biomarkers of liver steatosis or fibrosis, for which both processes have been implicated in canine cholecystolithiasis. METHODS: Forty client-owned dogs diagnosed with cholecystolithiasis and hepatic steatosis (C+HS) or fibrosis (C+HF) based on ultrasonographic, biochemical, and histopathologic findings, and 20 healthy dogs used as controls were included in the study. Serum cfa-miRNA expression was determined using a real-time polymerase chain reaction assay. RESULTS: Serum cfa-miRNA-122 and -34a expression was significantly upregulated in the C+HS (P < .001) and C+HF (P < .01) groups compared with the control group and showed a positive correlation with alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), total cholesterol (TC), and triglycerides (TG) levels in the C+HS group. Cfa-miRNA-122 and -34a expression discriminated the diseased groups from the control group better than traditional serum-derived liver biomarkers, as evidenced by areas under the receiver operating characteristic (AUC-ROC) curve of 0.99 and 0.97 for cfa-miRNA-122 expression in the C+HS and C+HF groups, and 1.0 and 0.96 for cfa-miRNA-34a in the C+HS and C+HF groups, respectively. Cfa-miRNA-21 expression was upregulated only in the C+HF group compared with the C+HS (P < .01) and control (P < .001) groups and showed a positive correlation with serum ALT, AST, TBIL, ALP, and GGT and negative correlation with serum TC and TG levels. Cfa-miRNA-21 expression could also differentiate the C+HF group from the control and C+HS groups with a diagnostic performance superior to that of the conventional serum biochemical variables as evidenced by AUCs of 1.0 and 0.98, respectively. CONCLUSIONS: Serum cfa-miRNA-122, -34a, and -21 expression was significantly upregulated in dogs with cholecystolithiasis with hepatic steatosis or fibrosis compared with control dogs. These miRNAs could serve as novel biomarkers for hepatic steatosis or fibrosis, which have been implicated in the pathogenesis of cholecystolithiasis.


Assuntos
Colecistolitíase , Doenças do Cão , Fígado Gorduroso , MicroRNAs , Pancreatite , Doença Aguda , Alanina Transaminase , Animais , Biomarcadores , Colecistolitíase/patologia , Colecistolitíase/veterinária , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Cães , Fígado Gorduroso/patologia , Fígado Gorduroso/veterinária , Fibrose , Hepatócitos , Fígado/patologia , MicroRNAs/genética , Pancreatite/veterinária
8.
J Int Med Res ; 49(9): 3000605211043415, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34496647

RESUMO

Gastrointestinal bleeding and gallbladder stones are common diseases of the digestive system. However, duodenal necrosis and bleeding caused by gallbladder stone compression is relatively rare. The present report describes a patient with repeated hematemesis and melena that relapsed after several symptomatic treatments. The patient and his family elected surgical treatment. Intraoperative examination revealed necrosis of the duodenal bulb with hemorrhage, which was related to compression of the gallbladder neck. Because the imaging manifestations of this disease lack specificity, early diagnosis is difficult.


Assuntos
Colecistolitíase , Hemorragia Gastrointestinal , Hematemese , Humanos , Melena , Necrose
11.
Medicine (Baltimore) ; 100(19): e25896, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106647

RESUMO

BACKGROUND: Early diagnosis of cholecystolithiasis is significant for prevention of further development of situation. Ultrasound is the best choice for the diagnosis of cholecystolithiasis with a sensitivity of >95% and specificity of practically 100%. However, ultrasound is not perfect for it is not so clear sometimes. So, MRI is needed to assist the diagnosing of cholecystolithiasis. Some studies have been conducted to investigate the diagnostic value of ultrasound combined with MRI in cholecystolithiasis, however, the evidence was not enough. METHODS: We will search the following sources for the identification of trials: The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technique Journals Database (VIP), and the Wanfang Database. The searches were limited to articles published before 1st, April, 2021, and the language were limited to Chinese and English. Statistical analyses will be conducted with Sata 14.0 software and the evaluation of the quality of the included studies will be performed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). RESULTS: This study will provide a rational synthesis of current evidences for MRI combined with ultrasound for cholecystolithiasis. CONCLUSION: The conclusion of this study will provide evidence for the diagnostic value of MRI combined with ultrasound for cholecystolithiasis. ETHICS AND DISSEMINATION: This protocol will not evaluate individual patient information or affect patient rights and therefore does not require ethical approval. Results from this review will be disseminated through peer-reviewed journals and conference reports. PROSPERO REGISTRATION NUMBER: INPLASY202130003.


Assuntos
Colecistolitíase/diagnóstico , Imageamento por Ressonância Magnética/métodos , Ultrassonografia/métodos , Colecistolitíase/diagnóstico por imagem , Humanos , Imagem Multimodal , Projetos de Pesquisa
12.
Surgery ; 170(4): 1014-1023, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33926707

RESUMO

BACKGROUND: Subtotal cholecystectomy is recognized as a rescue procedure performed in grossly suboptimal circumstances that would deem a total cholecystectomy too risky to execute. An earlier systematic review based on 30 studies published between 1985 and 2013 concluded that subtotal cholecystectomy had a morbidity rate comparable to that of total cholecystectomy. This systematic review appraises 17 clinical outcomes in patients undergoing subtotal cholecystectomy. METHODS: The study protocol was registered with the International Prospective Register for Systematic Reviews (CRD42020172808). MEDLINE, Embase, Cochrane bibliographic databases, and Google Scholar were used to identify papers published between 1985 and June 2020. Data related to the surgical setting, approach, intervention on the hepatic wall of the gallbladder, type of completion of subtotal cholecystectomy, year of study, and study design were collected. Seventeen clinical outcomes were considered. Meta-analyses were performed using a random-effects model, and the effect size was presented as risk ratios with 95% confidence intervals. RESULTS: From 1,017 records, 85 eligible studies were identified and included. These included 3,645 patients who underwent subtotal cholecystectomy. Laparoscopic (80.1%, n = 2,918) and reconstituting (74.6%, n = 2,719) approaches represented the majority of all subtotal cholecystectomy cases. Seven (0.2%) cases of injury to the bile duct were reported. Bile leak was reported in 506 (13.9%) patients. Reconstituting subtotal cholecystectomy was associated with a lower risk for 11 clinical outcomes. Open subtotal cholecystectomy was associated with an increased rate of 30-day mortality and wound infections. CONCLUSION: Subtotal cholecystectomy is associated with significant morbidity. Laparoscopic and reconstituting surgery may reduce the risks of some perioperative complications and long-term sequelae after subtotal cholecystectomy.


Assuntos
Colecistectomia Laparoscópica/métodos , Colecistolitíase/cirurgia , Vesícula Biliar/cirurgia , Publicações Periódicas como Assunto , Complicações Pós-Operatórias/epidemiologia , Colecistectomia Laparoscópica/efeitos adversos , Saúde Global , Humanos , Morbidade/tendências , Estudos Retrospectivos , Taxa de Sobrevida/tendências
13.
BMC Gastroenterol ; 21(1): 125, 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33736598

RESUMO

BACKGROUND: This study was performed to understand the prevalence of and possible risk factors for cholecystolithiasis in Uyghur, Kazakh, Han, and other ethnic groups in the Xinjiang Uyghur autonomous region of China. METHODS: Subjects were enrolled using typical case sampling and multistage stratified random sampling. We collected epidemiological data regarding cholecystolithiasis using a standard questionnaire of risk factors for gallbladder disease in Xinjiang. The subjects completed the questionnaire and underwent an abdominal ultrasound examination of the liver and gallbladder. RESULTS: This study included 5454 Xinjiang residents aged ≥ 18 years. The prevalence of cholecystolithiasis was 15% (11.3% in men and 17.1% in women), and the sex difference was statistically significant (male-to-female odds ratio [OR] 1.867; p < 0.001). The cholecystolithiasis prevalence was also significantly different among the Han, Uyghur, Kazakh, and other ethnic groups (13.1%, 20.8%, 11.5%, and 16.8%, respectively; p < 0.001). The prevalence of cholecystolithiasis in northern Xinjiang was 13.5% and that in southern Xinjiang was 17.5%; this difference was also statistically significant (OR 1.599; p < 0.001). Across all ethnic groups, the cholecystolithiasis prevalence significantly increased with age (all p < 0.01) and body mass index (BMI) (all p < 0.01). A multivariate logistic regression analysis indicated that cholecystolithiasis prevalence was associated with sex, age, BMI, smoking, diabetes, fatty liver disease, and geographical differences between northern and southern Xinjiang. CONCLUSIONS: The prevalence of cholecystolithiasis was significantly higher in the Uyghur ethnic group than in the Han, Kazakh, and other ethnic groups; in women than in men; in southern Xinjiang than in northern Xinjiang; in patients with fatty liver disease; and increased with age and BMI. Our findings could provide a theoretical basis for the formulation of control measures for cholecystolithiasis.


Assuntos
Colecistolitíase , Idoso , China/epidemiologia , Colecistolitíase/diagnóstico por imagem , Colecistolitíase/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários
15.
Ann Ital Chir ; 92: 260-267, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33650990

RESUMO

BACKGROUND: The management of cholelithiasis and choledocholithiasis combined is controversial. The more frequent approach is a two-stage procedure, with endoscopic sphincterotomy and stone removal from the bile duct followed by laparoscopic cholecystectomy. This study aims to demonstrate how, on the basis of the personal experience, the Rendez-vous technique, that combines the two techniques in a single-stage operation is better than the sequential treatment. METHODS: Between June 2017 to December 2019, 40 consecutive patients with cholelithiasis and choledocholithiasis combined were enrolled for the study: 20 were treated with the sequential treatment and 20 with the Rendez-vous method. The preoperative diagnostic work-up was similar in the two group. The endpoints of the study included incidence of endoscopic and surgical complications, rate of hospitalization and cost analysis. RESULTS: The study showed no difference in demographic parameters between the two groups, but the success rate of clearance of CBD was significantly smaller for sequential arm, with the need of additional procedures. We found a statistical reduction of postoperative acute pancreatitis, hospital stay and charges in Rendez-vous group, at the expense of a prolonged total operating time. CONCLUSIONS: The data of the study confirm the superiority of the Rendez-vous technique because it resolves cholelithiasis associated with choledocholithiasis in a single surgical act, with greater acceptance of the patient who avoids a second invasive surgical act, and with a reduction in complications; moreover, it requires shorter hospitalization, resulting in reduced costs. We propose this option in the management of cases where preoperative ERCP-ES has failed. KEY WORDS: Common bile duct stones, Cholecysto-choledocholithiasis, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy, Laparoscopic cholecystectomy, Laparo-endoscopic Rendez-vous.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica , Colecistolitíase , Coledocolitíase , Esfinterotomia Endoscópica , Idoso , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica/economia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colecistectomia Laparoscópica/economia , Colecistectomia Laparoscópica/métodos , Colecistolitíase/complicações , Colecistolitíase/economia , Colecistolitíase/cirurgia , Coledocolitíase/complicações , Coledocolitíase/economia , Coledocolitíase/cirurgia , Custos e Análise de Custo , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Estudos Retrospectivos , Esfinterotomia Endoscópica/economia , Esfinterotomia Endoscópica/métodos , Resultado do Tratamento
16.
Chirurgia (Bucur) ; 116(1): 34-41, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33638324

RESUMO

Introduction: Cirrhosis is a leading cause of morbidity and mortality around the world. Although cirrhotic patients are considered to have a higher risk for surgical procedures than non-cirrhotic ones, there are certain pathologies such as gallstones cholecystitis that cannot be treated otherwise. The focus of this study is to evaluate the main characteristics of the patients with lithiasic cholecystitis and liver cirrhosis and to assess if there is a correlation between them and postoperative morbidity evaluated with Dindo-Clavien classification. Material and Methods: This is a retrospective study. The database from General Surgery Department of Fundeni Clinical Institute was queried between 2014-2018 using as key words "cirrhosis" and "cholecystitis". The initial interrogation reveled 57 cases out of which 3 were excluded since other resections were associated. Results: This study identified that Dindo-Clavien classification positively correlates with the open approach (0.405, p=0.002), emergency surgery (0.599, p=0.000), acute cholecystitis (0.476, p=0.000), high MELD score (0.291, p=0.008) and Child score (0.346, p=0.007) and furthermore with high levels of total bilirubin (0.220, p=0.047), high INR (0.286, p=0.010), the presence of ascites (0.303, p=0.022) and portal hypertension (0.266, p=0.044). It also correlates negatively with the levels of hemoglobin (-0.295, p=0.044). Conclusion: Adequate estimation of perioperative mortality and morbidity is generally limited by the retrospective nature of most studies and the patient's selection criteria. Emergency surgery, acute cholecystitis and the open approach carry the highest risk for unfavorable results of cholecystectomy in cirrhotic patients.


Assuntos
Colecistectomia Laparoscópica , Colecistite , Colecistolitíase , Cirrose Hepática , Criança , Colecistectomia Laparoscópica/efeitos adversos , Colecistite/etiologia , Colecistite/cirurgia , Colecistolitíase/complicações , Colecistolitíase/cirurgia , Humanos , Cirrose Hepática/complicações , Estudos Retrospectivos , Resultado do Tratamento
19.
Asian J Endosc Surg ; 14(3): 496-503, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33264814

RESUMO

BACKGROUND: Although laparoscopic cholecystectomy (LC) is the gold standard for symptomatic gallbladder disease, a single-incision approach may be a new challenge in order to achieve minimization of surgical trauma. Single-site robotic cholecystectomy (SSRC) is able to offset the ergonomic limitation of laparoscopic single-site cholecystectomy and improves cosmesis. METHODS: We present a single-institution initial experience of SSRC for cholecystolithiasis. Intra-operative and post-operative data of patients were reviewed to assess the technical feasibility and cosmetic outcome. RESULTS: We evaluated a series of 27 consecutive patients retrospectively analyzed and prospectively collected who underwent SSRC. One patient was excluded from the final analysis because they converted to open procedure. The female/male ratio was 17/9, with mean age of 48 ± 12 years. The body mass index mean value was 26.0 ± 4.2. The mean operative time was 99.6 ± 21.5 minutes. No intra- or post-operative complications and readmissions were recorded. At 12 months follow up, every patient received the Body Image Questionnaire (BIQ) and a Photo Series Questionnaire. We recorded three patients (11.5%) with post-operative incisional hernia. Scores of the BIQ subscale for body image perception were 6 ± 1.2, while the scores of scar cosmesis were 21.1 ± 3.0. A statistically significant improvement in scar self-rating from T0 to T1 (P < .01) was found. CONCLUSION: In our initial experience SSRC may be preferred to treat patients with higher needs in terms of cosmesis and body image perception. Lower costs for rent, maintenance and consumables may allow the spread of robotic surgery also for singe site cholecystectomy.


Assuntos
Colecistectomia , Colecistolitíase/cirurgia , Procedimentos Cirúrgicos Robóticos , Adulto , Colecistectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento
20.
World J Surg ; 45(1): 81-87, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32888062

RESUMO

BACKGROUND: Bile duct injury and vasculobiliary injury are possible complications during laparoscopic cholecystectomy which can lead to increased morbidity, mortality, costs of hospitalization and litigation. Proper documentation of the critical view of safety and safe plane of dissection may play a crucial role for archivization, teaching and medicolegal purposes. METHODS: The study group consisted of 100 patients with symptomatic cholecystolithiasis qualified for laparoscopic cholecystectomy. The critical view of safety was documented on two photographs and safe plain of dissection obtained with laparoscopic ultrasound was documented on one photograph as well as the whole procedure was recorded. The photographs were printed in the operating theatre and videos were stored on an external hard drive. RESULTS: The mean time to obtain and analyse photographs was significantly shorter than video, and the size of the stored data was significantly smaller for photographs than videos. The cost of one documentation procedure was significantly lower for video than photographs. Critical view of safety was obtained in 91 patients, and laparoscopic ultrasound was successful in 99 patients. The conversion rate was 2%, and fundus-first cholecystectomies were performed in 6% of patients. We did not observe any biliary and vascular complications. CONCLUSIONS: Photographic documentation of the critical view of safety and safe plane of dissection should be an inherent part of laparoscopic cholecystectomy. Our proposal of documentation prepared in the operating theatre and stored in the patient's documentation is an example of an easy, fast and cheap method of data archivization.


Assuntos
Colecistectomia Laparoscópica , Colecistolitíase/cirurgia , Fotografação , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças dos Ductos Biliares/etiologia , Ductos Biliares/lesões , Colecistectomia Laparoscópica/efeitos adversos , Dissecação , Documentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia , Lesões do Sistema Vascular/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...