Emergency cholecystectomy: risk factors and impact of delay on electively booked patients, a 5-year experience of a tertiary care center.

Background: Gallstone disease is one of the most resource-intensive surgical conditions. Despite the significant burden of emergency cholecystectomy on healthcare system, there is lack of research assessing the risk factors predisposing scheduled elective cholecystectomy patients to emergency surgery. Characterization of patients with gallstones helps to prioritize delivery of health care to avoid urgent surgery.

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.

A fatal case of Vibrio cholerae-associated diarrhea and bacteremia in a 30-year-old carrier of beta-thalassemia.

Bacterial infections leading to bacteremia and septicemic shock constitute an emerging public health concern globally, especially in areas where sanitation is poor and safe drinking water is scarce. Enteric pathogens such as Vibrio cholerae are responsible for many deaths caused by contaminated food and water in these areas. While cholera is the prominent clinical threat posed by V.

Mood instability and risk of gastrointestinal diseases - a univariable and multivariable mendelian randomization study.

Background: Mood instability, characterized by sudden and unpredictable mood shifts, is prevalent in psychiatric disorders and as a personality trait. Its association with gastrointestinal diseases has been recognized but remains poorly understood in terms of causality.

Methods: This study aims to investigate the causal relationship between mood instability and a spectrum of gastrointestinal diseases by univariable and multivariable mendelian randomization analysis.

Time from drainage to surgery is an independent predictor of morbidity for moderate-to-severe acute cholecystitis: a multivarirble analysis of 259 patients.

Background: Acute cholecystitis (AC) is an acute inflammatory disease of the gallbladder and one of the most frequent causes of acute abdominal pain. Early cholecystectomy is recommended for mild cholecystitis. However, the optimal surgical timing for moderate-to-severe cholecystitis requiring percutaneous transhepatic gallbladder drainage (PTGBD) remains unclear.

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.

[Progress in the diagnosis and treatment of acute pancreatitis complicated by biliary tract diseases].

Acute pancreatitis is a common surgical emergency characterized by severe local or systemic complications during its progression. Diseases of the biliary system are among the serious local complications of acute pancreatitis, primarily including acute acalculous cholecystitis (AAC) and biliary stricture. AAC often occurs in the later stages of acute pancreatitis, exacerbating systemic inflammation and leading to organ failure and life-threatening conditions in severe cases.

Predictors of failure of conservative management of cholecystitis: a systematic review of the literature.

Objectives: While emergency cholecystectomy is the preferred treatment for acute cholecystitis, conservative management can be used as a bridge to definitive surgical management in situations where emergency surgical services are limited. The objective of this systematic review is to identify factors associated with conservative management failure as defined as either failed resolution of symptoms on initial presentation, or the recurrence of symptoms whilst awaiting an elective cholecystectomy. This study aims to allow clinicians to make evidence-based recommendations for conservative versus operative management.

Preoperative Waiting Time Affects the Length of Stay of Patients Treated via Laparoscopic Cholecystectomy in an Acute Care Surgical Setting.

Acute cholecystitis (AC) presents a significant burden in emergency surgical settings. Early laparoscopic cholecystectomy (ELC) is the standard of care for AC, yet its implementation varies. This study aims to assess the impact of preoperative waiting time (WT) on postoperative length of stay (LOS) in patients undergoing urgent cholecystectomy.

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.

Outcomes of Gallbladder Drainage Techniques in Acute Cholecystitis: Percutaneous Versus Endoscopic Methods.

Acute cholecystitis, often caused by gallstones obstructing the cystic duct, is a potentially life-threatening condition that requires timely intervention. High-risk patients, particularly those with significant comorbidities, may not be suitable candidates for laparoscopic cholecystectomy, necessitating alternative drainage techniques such as percutaneous cholecystostomy (PC) and endoscopic gallbladder drainage (EGD). This systematic review aims to compare the efficacy, safety, and outcomes of PC and EGD in managing acute cholecystitis in high-risk surgical patients.

ArtiSential laparoscopic cholecystectomy: a comparative analysis with robotic single-port cholecystectomy.

Purpose: Laparoscopic cholecystectomy is the gold standard procedure for benign gallbladder disease. However, reducing ports still causes frustration when using various instruments. We investigated early perioperative outcomes of laparoscopic single site + 1 cholecystectomy using ArtiSential instruments (ArtiSential laparoscopic cholecystectomy [ALC], LIVSMED).

Synchronous gangrenous cholecystitis and appendicitis secondary to appendiceal diverticulum perforation.

Acute appendicitis and acute cholecystitis are among the commonest pathologies in acute general surgery. They are characterized by distinct symptoms, clinical examination findings and typical elements of the history which direct further investigations. In the absence of these classic findings, these diagnoses can be missed, particularly where they occur synchronously.

Medical management or surgery for acute cholecystitis: Enhancing treatment selection with decision trees.

Background: This study aimed to create an algorithm using the decision tree method to classify patients with suspected acute cholecystitis into those who may improve with medical treatment, those who should undergo surgery for acute cholecystitis, and those with complicated cholecystitis, using laboratory parameters alone.

Methods: A total of 1,352 patients treated for acute cholecystitis at our hospital over four years were retrospectively analyzed. Patients were divided into groups based on whether they received medical treatment or surgery.

Hemorrhagic cholecystitis: the forgotten differential diagnosis.

Hemorrhagic cholecystitis, a rare complication of acute cholecystitis, poses diagnostic challenges due to its varied clinical presentation and relative infrequency. This case involves a 59-year-old male with untreated diabetes and obesity, who presented with nonspecific abdominal pain. Initial results were inconclusive, leading to a delayed diagnosis.

Unveiling the therapeutic role of Dachaihu decoction in acute cholecystitis: a comprehensive systematic review and meta-analysis of its efficacy and safety.

Background: Dachaihu decoction (Dachaihu tang) plays a crucial role in treating acute illnesses. Recently, a significant number of clinical studies on Dachaihu decoction for acute cholecystitis (AC) have been published. This study was conducted to assess the efficacy and safety of Dachaihu decoction in patients with this condition.

Percutaneous Cholecystostomy: Procedural Guidance and Future Directions for Clinical Management.

Percutaneous cholecystostomy (PC) is a recognized treatment option for the management of acute cholecystitis and is an integral component of the treatment algorithm in the 2018 Tokyo Guidelines. The utilization of PC has significantly increased over the past 30 years, particularly in the setting of critically ill patients and those with extensive comorbidities who are poor surgical candidates. The indications, complications, patient selection considerations, and technical complexities of the procedure will be discussed.

Unique presentation of perforated gallbladder and gangrene in third trimester pregnancy: management and other considerations.

Acute cholecystitis during pregnancy presents significant risks, requiring careful management to balance maternal and fetal health. Conflicting viewpoints exist on conservative versus surgical treatment, particularly in the third trimester. Here, we present a case of a woman in her early 40s at 34 weeks of gestational age with acute cholecystitis and signs of preterm labour.