Traditional cholecystectomy has been the standard surgical treatment of the gallstone disease for more than 100 years. The technical development led to a new surgical procedure and its rapid acceptance. This is laparoscopic cholecystectomy. Its application is becoming widespread in therapy too. But most of the surgeons are lack of technical experiences in this field. Currently it restricts the indications those are anyway the same of standard cholecystectomy. Besides its many advantages, laparoscopic cholecystectomy has its own disadvantages and being an invasive procedure, there are possibilities of complications. The latest can be reduced by the adequate choice of patients, the careful learning of the operative technic and by turning to open surgery (conversion) when it is necessary. Its morbidity is nearly equal to complications of standard cholecystectomy, but mortality rate is lower (0.05-0.2%). Our morbidity of performed 300 laparoscopic cholecystectomies was 6.4%. We had no death. The hospitalization became as short as 4 days. Our early clinical results (90%) are the same of traditional cholecystectomy. Laparoscopic cholecystectomy as a new surgical procedure involves the efficiency of the standard cholecystectomy and the noninvasive endoscopic technic. Laparoscopic cholecystectomy performed by well trained surgeons is a safe surgical procedure, its early results are excellent and makes the choice of surgical treatment, used in bile surgery richer.
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Langenbecks Arch Surg
January 2025
Alexandria Main University Hospital, Alexandria, Egypt.
Background: Patients with prior abdominal surgeries are at higher risk of intra-peritoneal adhesions near the trocar entry site, increasing the likelihood of organ injury during laparoscopic cholecystectomy (LC). This study evaluates a novel technique where the epigastric trocar is inserted first, after creating pneumoperitoneum, to allow safe dissection of adhesions under direct vision before placing the umbilical trocar.
Methods: This prospective study included 244 patients with symptomatic uncomplicated gallstone disease and a history of previous abdominal surgeries extending to the umbilicus.
Postgrad Med J
January 2025
Department of Medical Biochemistry, Faculty of Medicine, Niğde Omer Halisdemir University, Niğde, 51000, Turkey.
Background: Epoxyeicosatrienoic acids (EETs) are closely associated with lipoprotein metabolism, and changes in lipid profiles potentially affect their levels and functions. Given the alterations in lipid metabolism after cholecystectomy, this study aimed to investigate the levels of four EET regioisomers (free and esterified) and lipid profiles in patients with cholelithiasis after laparoscopic cholecystectomy (LC) and explore correlations between these parameters.
Methods: This prospective study involved 40 patients with symptomatic cholelithiasis who underwent LC.
Cureus
December 2024
Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR.
Cholecystoenteric fistulas are a rare complication of chronic gallstone disease. If not diagnosed on time, they can cause several complications such as gallstone ileus, gastric outlet obstruction (Bouveret syndrome), cholangitis, or liver abscess. We present a case of a patient with chronic calculous cholecystitis, who was admitted due to unspecific abdominal discomfort and impaired liver function with increased cholestatic liver enzymes.
View Article and Find Full Text PDFFront Pediatr
January 2025
Department of General Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
Gallbladder torsion (GT), characterized by the axial rotation of the cystic duct and cystic artery, is a critical condition that predominantly affects elderly women and is infrequently observed in children. Chronic cholecystitis associated with incomplete GT is a particularly rare phenomenon. This article presents a pediatric case of chronic cholecystitis associated with incomplete GT.
View Article and Find Full Text PDFJ Laparoendosc Adv Surg Tech A
January 2025
General Surgery Department, GIT and Liver Unite, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
In the past, most patients with acute cholecystitis (AC) were treated conservatively. However, strong evidence from various studies has shown that laparoscopic cholecystectomy (LC) is safe and should be the primary treatment for AC. However, this may not be the case for all AC grades.
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