Identifying the Prognostic Factors Affecting the Conversion From Laparoscopic Cholecystectomy to Open Cholecystectomy in Acute Cholecystitis.

Introduction Acute cholecystitis, commonly caused by gallstones, is a prevalent surgical emergency worldwide. Laparoscopic cholecystectomy (LC) is the gold standard for treatment, but the timing is crucial, with early surgery (within seven days) reducing complications. Identifying prognostic factors such as age, sex, white blood cell (WBC) count, C-reactive protein (CRP), and gallbladder wall thickness can help predict outcomes and reduce the need for conversion to open surgery.

Ectopic pancreatic tissue in the gallbladder: A rare incidental finding in a cholecystectomy specimen - A case report.

Introduction: Ectopic pancreatic tissue (EPT) is a rare congenital anomaly characterized by the presence of pancreatic tissue in an abnormal location, separate from the pancreas, without any anatomical or vascular connection to it. This anomaly is often an incidental finding during operation or autopsy. This peculiarity poses clinical and radiological challenges for surgeons, particularly during laparoscopic or open procedures.

Intrahepatic Rupture of Acute Cholecystitis Complicated by Septic Portal Thrombosis.

Gallbladder rupture, though rare, is a serious complication often arising from choledocholithiasis and subsequent interventions such as endoscopic retrograde cholangiopancreatography (ERCP). In this case, the patient presented with acute choledocholithiasis and underwent ERCP with sphincterotomy and stone extraction, followed by placement of a fully covered metal stent in the common bile duct (CBD). While the use of covered stents is appropriate, it is important to note that these stents can obstruct the cystic duct orifice in patients with a gallbladder.

An Atypical Presentation of Acute Cholecystitis with Left Sided Chest Pain and ST Elevation - A Case Report.

Background: ST elevation combined with typical chest pain is an indication for acute coronary vascularization and is usually associated with acute myocardial infarction. Herein, we present an unusual case of ST elevation.

Case Presentation: A 57-year-old male patient presented to the emergency department with chest pain radiating to both arms and the back.

The Overuse of Hepatobiliary Scintigraphy (HIDA) Scans: Are We Unnecessarily Using Nuclear Medicine Resources Instead of Proven Clinical Guidelines for Diagnosing Acute Cholecystitis?

Background Gallstone disease significantly burdens the United States healthcare system. While ultrasonography (US), physical exam, and laboratory findings are the recommended primary workup and diagnostic modalities, hepatobiliary scintigraphy (HIDA) scans are occasionally used as an adjunct for diagnosis. This study evaluates HIDA scan utilization in comparison to clinical and US findings based on the Tokyo guidelines for diagnosing acute cholecystitis.

Laparoscopic Management of Spontaneous Gallbladder Perforation in Acalculous Cholecystitis: A Case Series.

Gallbladder perforation in acalculous cholecystitis is rare and has a high mortality rate due to biliary peritonitis and sepsis. Here, we present a case series of successful laparoscopic management of Spontaneous gallbladder perforation in acalculous cholecystitis. In the first case, a 44-year-old male patient presented to the emergency room with a history of three days of fever with chills and acute pain in the abdomen for two days.

Thickened Gallbladder Wall, Abdominal Pain, and Fever: A Rare Presentation of Dengue in Rural Australia.

Dengue is endemic in tropical and subtropical regions, affecting millions of people worldwide. While it is not endemic to Australia, outbreaks can occur in Queensland each year. The rarity of dengue in other regions of Australia may pose a diagnostic challenge when patients present at hospitals.

Gallbladder Perforation in a Pregnant Patient: A Case Report and Considerations of Surgical Approach.

Gallbladder disease is a frequent indication for non-obstetric surgical intervention during pregnancy. Gallbladder perforation (GBP) during pregnancy is an uncommon but severe pathology that usually requires immediate attention, and it represents a challenge for surgeons. We present the case of a GBP in a pregnant patient alongside a discussion of available surgical approaches.

Port site tuberculosis after laparoscopic cholecystectomy in resource limiting setup: Case series and literature review.

Introduction And Importance: Laparoscopic cholecystectomy has become the gold standard for treating symptomatic gallstones in recent years due to its minimally invasive nature, which results in less pain, scarring, and a faster recovery time compared to traditional open surgery. Port site infection is a rare complication of laparoscopic surgery, sometimes occurring early after the procedure or developing later and the cause of these infections can vary. Port site tuberculosis (TB) is a particularly uncommon type of port site infection and represents a rare form of extra pulmonary TB.

Role of Minimally Invasive Reoperation for Postoperatively Diagnosed T2 Gallbladder Cancer: Multicenter Retrospective Cohort Study.

Background: Although T2 gallbladder cancer (GBC) incidentally diagnosed after cholecystectomy requires additional resection, the surgical approaches are technically difficult due to inflammatory adhesion or fibrosis around the hepatoduodenal ligament and gallbladder bed. In this study, we sought to compare the surgical and oncologic outcomes of open and minimally invasive reoperation for postoperatively diagnosed T2 GBC.

Study Design: Patients who underwent open (n = 110) and laparoscopic (n = 38) reoperation for T2 GBC between November 2004 and October 2022 at five tertiary referral centers were included in this multicenter retrospective cohort study.

Analgesic effect of external oblique intercostal block in laparoscopic cholecystectomy: A retrospective study.

Objective: The aim of this study was to assess the impact of the external oblique intercostal block (EOIB) on early postoperative pain in patients who underwent laparoscopic cholecystectomy.

Methods: 120 patients were divided into two groups: the EOIB group (Group E) and the control group (Group C). The assessed variables were mainly intraoperative remifentanil usage, numerical rating scale (NRS) pain scores at 0, 1, 2, 4, 6, 12, and 24 h postoperatively, cumulative fentanyl consumption within 24 h postoperatively and within the first-hour post-anesthesia care unit.

Comparison of Ropivacaine and Bupivacaine in Intraperitoneal Instillation for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Randomized Controlled Trial.

Introduction Laparoscopic cholecystectomy, despite its several advantages, is sometimes associated with discomfort due to pain in the immediate postoperative period. Effective management of this pain is critical for enhancing recovery, minimizing complications, and facilitating early discharge. The use of local anesthetics for intra-abdominal analgesia, specifically bupivacaine and ropivacaine, has been investigated as a means to improve postoperative pain control.

Cholecystocolonic Fistula: A Case of Chronic Diarrhoea and Hidden Stones.

A cholecystocolonic fistula (CCF) is a rare cause of chronic diarrhoea. It most often occurs in elderly women as a result of chronic inflammation due to gallstone disease or, rarely, malignancy. Curative treatment consists of cholecystectomy with excision of the fistula tract, but it is often overlooked preoperatively and thus entails a higher risk of postoperative complications.

Effect of surgical timing on postoperative outcomes in patients with acute cholecystitis after delayed percutaneous transhepatic gallbladder drainage.

Background: To date, the optimal timing for percutaneous transhepatic gallbladder drainage (PTGBD), particularly for patients who have missed the optimal window for emergency laparoscopic cholecystectomy (LC) (within 72 hours of symptom onset) has not been determined.

Aim: To study the effects of LC timing on outcomes of grade II/III acute cholecystitis (AC) in patients with delayed PTGBD.

Methods: Data of patients diagnosed with Tokyo Guidelines 2018 grade II or III AC who underwent delayed PTGBD followed by LC at a single hospital between 2018 and 2022 were retrospectively studied.

Laparoscopic cholecystectomy plus common bile duct exploration for extrahepatic bile duct stones and postoperative recurrence-associated risk factors.

Background: There remain controversies regarding the surgical treatment of extrahepatic bile duct stones (EHBDSs) in clinical practice.

Aim: To explore the curative effect of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE) for the surgical treatment of EHBDSs and to analyze the risk factors that affect postoperative stone recurrence.

Methods: Eighty-two patients with EHBDSs admitted between March 2017 and March 2023 were selected.

A Systematic Review of the Learning Curves of Novices and Trainees to Achieve Proficiency in Laparoscopic Skills: Virtual Reality Simulator Versus Box Trainer.

Laparoscopic surgery, established in the 1980s, has become a primary treatment method across various surgical specialities due to its advantages over open surgery, including shorter recovery times and fewer complications. Mastery of laparoscopic skills is essential for novice and junior trainees, who must develop hand-eye coordination, depth perception, and instrument handling. This systematic review examines the learning curves of novices using box trainers compared to those using virtual reality (VR) simulators to attain proficiency in laparoscopic skills.

An institutional approach to thick wall gall bladder and our experience of 5450 gallstone disease.

Introduction: Gallstone disease (GSD) has a high prevalence in India. GSD presentation varies from being asymptomatic to severe complications. Laparoscopic cholecystectomy (LC) is the procedure of choice.

A Case of Porcelain Gallbladder Showing High Levels of CA19-9.

Porcelain gallbladder is a rare condition characterized by an extensive calcification of the gallbladder wall. It is associated with an increased risk of gallbladder cancer and elevated levels of tumor marker CA19-9, which is typically seen in pancreatic and biliary cancers. We present a case of a 60-year-old woman who presented with upper abdominal pain and nausea.