Aim: When there is excess inflammation, fibrosis and portal hypertension around gall bladder or in presence of Mirizzi syndrome, bile ducts and hepatic artery may be possibly damaged during dissection of Calot triangle. In this study, we examined safety and efficiency of partial cholecystectomy operation which we perform when dissection of Calot triangle is challenging.
Method And Material: Eighteen patients who were undergone partial cholecystectomy in our clinic between 1996 and 2008 were retrospectively evaluated. Mean age of patients was 66 years (range: 55-88 years) and ratio of male/female was 2/1 (12 men, 6 women). Fourteen patients were undergone general anesthesia, whereas 4 patients were operated under epidural anesthesia. Partial cholecystectomies were performed by right subcostal incision in 16 patients and by right paramedian incision in 2 patients.
Results: No intra-operative or early post-operative mortality was found among patients. Post-operative subhepatic abscess occurred in one patient (5.5%) and superficial wound site infection occurred in 4 patients (22,2%). Controlled bile fistula occurred in early post-operative period in two patients (11.1%) and fistula spontaneously closed without requiring additional surgical procedure. Escherichia coli were most common microorganism found in bile culture. Mean hospitalization period of patients was 8 days (range: 15-14 days) and mean follow-up period was 80 months (8-150 months). During follow up, hepatobiliary ultrasonography could be re-performed in 8 patients and no new stone formation was observed. In 7 patients, it was understood verbally that no postoperative gastrointestinal symptoms were present.
Conclusion: Where dissection of Calot triangle is changeling, partial cholecystectomy can be safely and efficiently performed.
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Cureus
December 2024
Surgical Oncology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
We report a rare case of adenosquamous carcinoma of the gall bladder (GB) causing portal vein tumor thrombus. A 40-year-old gentleman presented with acute-onset right upper abdominal pain. Ultrasonography revealed multiple calculi in the GB with wall thickening, suggesting acute cholecystitis.
View Article and Find Full Text PDFArq Bras Cir Dig
January 2025
Universidade Estadual de Campinas, Faculty of Medical Sciences, Department of Surgery, Digestive Diseases Surgical Unit - Campinas (SP), Brazil.
Background: Gastric stump neoplasia is defined as a neoplasia that arises in the gastric remnant after at least 5 years of interval from the first gastric resection.
Aims: The aim of this study was to analyze 51 patients who underwent total and subtotal gastrectomy and multi-visceral resections in patients with gastric stump cancer.
Methods: The hospital records of 51 patients surgically treated for gastric stump cancer between 1989 and 2019 were reviewed.
Int J Surg
December 2024
Department of Surgery, Azienda Unità Sanitaria Locale Ferrara, University of Ferrara, Via Valle Oppio, Lagosanto, Ferrara, Italy.
Background: Currently, there is limited scientific evidence regarding the effectiveness of fluorescent cholangiography in emergency cholecystectomy for acute cholecystitis. The primary aim of this study was to assess the efficacy of near-infrared fluorescent cholangiography (NIRF-C) in different severity degrees of acute cholecystitis.
Materials And Methods: Inclusion criteria were patients with a clinical and radiological (abdominal ultrasound and/or computed tomography) diagnosis of acute cholecystitis based on the revised 2018 Tokyo guidelines who underwent laparoscopic cholecystectomy within 24-72 h from the onset of symptoms and patients with ASA score of 0-3.
Curr Opin Gastroenterol
January 2025
Reference Center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, European Reference Network on Hepatological Diseases (ERN Rare-Liver), Saint-Antoine Hospital, Assistance Publique - Hôpitaux de Paris; Sorbonne University, INSERM, Saint-Antoine Research Center (CRSA).
Purpose Of Review: Low phospholipid-associated cholelithiasis (LPAC) syndrome is a rare genetic form of intrahepatic cholesterol lithiasis, affecting mainly young adults. This review describes the recent advances in genetic and clinical characterization, diagnosis and management of LPAC syndrome.
Recent Findings: Recent publications report data from several retrospective cohorts.
J Med Case Rep
December 2024
Department of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Background: Thrombotic microangiopathy (TMA) is a rare, life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage. Atypical hemolytic uremic syndrome (aHUS) is even less common, comprising less than 10% of hemolytic uremic syndrome (HUS) cases. aHUS in postpartum is associated with poor maternal outcomes, with the majority of cases resulting in end-stage renal disease.
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