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Anaesthesist 2019 Mar 20. Epub 2019 Mar 20.

Forum für Qualitätsmanagement und Ökonomie der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin und des Berufsverbandes Deutscher Anästhesisten, Nürnberg, Deutschland.

Background: Minimum volume thresholds for specific surgical procedures in German hospitals were established in 2004 but remain controversial. For the first time, this study investigated the relationship between hospital performance volume and surgical procedure duration in a multicenter approach. The question here was whether a concentration on frequently performed procedures leads to a reduction in surgical process times. Read More

J Perianesth Nurs 2019 Mar 17. Epub 2019 Mar 17.

Purpose: To examine opioid prescription practices, patient use of opioids after laparoscopic cholecystectomy, and patient knowledge about disposal of unused medication.

Design: Mixed methods design with a chart review and structured phone interview.

Methods: Thirty-four patients were interviewed by phone and asked how many opioids were prescribed, how many excess pills they had 6 to 10 days postoperatively, and if they knew how to dispose of them. Read More

Ulus Travma Acil Cerrahi Derg 2019 Mar;25(2):154-158

Department of General Surgery, İnönü University Faculty of Medicine, Malatya-Turkey.

Background: This study aimed to present to evaluate the results of two different approaches in the management of acute cholecystitis during pregnancy: immediate surgery and delayed surgery following conservative management.

Methods: In this study, 20 pregnant women who were treated in our clinic for acute cholecystitis between 2010 and 2018 were included in the analysis. Demographic characteristics, parameters related with acute cholecystitis (gallbladder wall thickness, laboratory data), duration of hospitalization, readmission rates, and preterm labor rate were retrospectively evaluated. Read More

Cureus 2019 Jan 7;11(1):e3833. Epub 2019 Jan 7.

Internal Medicine, Staten Island University Hospital, Staten Island, USA.

Visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) are defined as more than a 1.5 fold increase in the normal diameter of the celiac, superior, or inferior mesenteric arteries and their branches. They represent a rare finding with an incidence ranging between 0. Read More

J Pak Med Assoc 2019 Mar;69(3):409-411

South City Hospital, Karachi, Pakistan.

Operative notes are a valuable part of patient's medical record, and carry the medico-legal significance. One way of improving it is to introduce the template form operative notes. Only few studies have been done worldwide to compare both the forms of operative notes. Read More

J Perioper Pract 2019 Mar 19:1750458919838412. Epub 2019 Mar 19.

Centro Hospitalar de Setúbal, Setúbal, Portugal.

Myotonic dystrophy type 1 is a rare neuromuscular disease that represents a challenge to anaesthetic management. Most of the literature does not recommend the usage of neuromuscular blocking agents, if general anaesthesia is needed in these patients. Depolarising neuromuscular blocking agents like suxamethonium are contraindicated, and there might be an increased sensitivity to non-depolarising agents like rocuronium with greater risk of postoperative residual neuromuscular blockade and consequent respiratory failure. Read More

Updates Surg 2019 Mar 18. Epub 2019 Mar 18.

General Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy.

Gallstones are one of the most common morbidities in the world. Laparoscopic cholecystectomy is the gold standard for gallbladder stones' removal. Few studies focus on the existence of predictive factors aimed at facilitating cholecystectomy in a day surgery setting. Read More

J Gastrointest Surg 2019 Mar 18. Epub 2019 Mar 18.

Department of General Surgery, St. Vincent's University Hospital, Dublin 4, Ireland.

Background: Percutaneous cholecystostomy (PCT) is a safe method of gallbladder drainage in the setting of severe or complicated acute cholecystitis (AC), particularly in patients who are high-risk surgical candidates. Small case series suggest that PCT aids resolution of acute cholecystitis in up to 90% of patients. However, reluctance is observed in utilising PCT more frequently, due to concerns that we are committing comorbid patients to an interval surgical procedure for which they may not be suitable. Read More

J Invest Surg 2019 Mar 19:1-6. Epub 2019 Mar 19.

a Department of Surgical and Perioperative Sciences , Umeå University/Östersund , Umeå , Sweden.

Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical procedure with a low complication rate. It is performed either as an acute or as an elective procedure. Most elective LCs are performed on nonlethal diseases and this is why good quality is important. Read More

Pak J Med Sci 2019 Jan-Feb;35(1):226-229

Dr. Faheem Ullah Naz, resident surgery. Department of Surgery, Military Hospital, Rawalpindi, Pakistan.

Objective: The sub hepatic drain is often placed after laparoscopic cholecystectomy is considered to affect post operative infection, pain and sub hepatic collections. The objective of this study was to compare the degree of postoperative pain in patients with routine drainage with those without it after elective, uncomplicated laparoscopic cholecystectomy.

Methods: This randomized control trial (RCT) was done over six months from 9 June 2015 to 8 December 2015 at Military Hospital Rawalpindi. Read More

Clin Exp Gastroenterol 2019 6;12:121-128. Epub 2019 Mar 6.

Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy,

Iatrogenic bile duct injuries (BDIs) after laparoscopic cholecystectomy, being one of the most common performed surgical procedures, remain a substantial problem in gastrointestinal surgery with a significant impact on patient's quality of life. The primary aim of this review was to discuss the classification of BDIs, the proposed methods to prevent biliary lesions, the associated risk factors, and the management challenges depending on the timing of recognition of the injury, its extension, the patient's clinical condition, and the availability of experienced hepatobiliary surgeons. Early recognition of BDI is of paramount importance and limiting the diagnosis delay is crucial for an optimal postoperative outcome. Read More

J Perianesth Nurs 2019 Mar 14. Epub 2019 Mar 14.

Purpose: The present study aimed to evaluate the impact of warming on physiological indices of patients undergoing laparoscopic cholecystectomy.

Design: The study was a three-group randomized controlled clinical trial.

Methods: In the present study, 96 patients were assigned to three groups: forced-air warming system group; warmed intravenous fluid group; and control group. Read More

Asian J Surg 2019 Mar 13. Epub 2019 Mar 13.

Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

Background: In 2012, the Japanese Society for Surgical Metabolism and Nutrition introduced the Essential Strategy for Early Normalization after Surgery with Patient's Excellent Satisfaction (ESSENSE) program to improve the perioperative management of gastrointestinal surgery. The ESSENSE program aimed to minimize ineffective perioperative management practices, and achieve adequate analgesia to expedite the return to work and activities of daily living.

Methods: After educating relevant facilities about the ESSENSE program in 2012, we conducted questionnaire-based surveys in selected institutions in 2013 and 2016. Read More

Int J Surg Case Rep 2019 5;56:107-109. Epub 2019 Mar 5.

Department of General Surgery, Moruya District Hospital, 2 River Street, Moruya, NSW, 2537, Australia.

Introduction: Gallstone spillage during laparoscopic cholecystectomy is a common occurrence. Complications due to spilled gallstones occur in up to 5% of laparoscopic cholecystectomy cases, with complications having been reported up to 20 years after laparoscopic cholecystectomy.

Case Report: We report the case of a 70 year old male who presented for elective right inguinal hernia repair. Read More

J Ayub Med Coll Abbottabad 2019 Jan-Mar;31(1):3-7

General Surgery, Dudley Group NHS Foundation Trust, West Midlands.

Background: Acute presentation of gall stone disease is a common emergency. Resource limitation often results in unnecessary long waiting times and repeat hospital admissions. The aim of this study was to investigate if funding a dedicated hot gall bladder list is justified. Read More

World J Emerg Surg 2019 4;14:10. Epub 2019 Mar 4.

6Department of Surgery, University Hospital of Verona, Verona, Italy.

Background: Gallstone disease is very common afflicting 20 million people in the USA. In Europe, the overall incidence of gallstone disease is 18.8% in women and 9. Read More

Surg Endosc 2019 Mar 12. Epub 2019 Mar 12.

Department of Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Campus Mitte, Campus Virchow Klinikum, Charitéplatz 1, 10117, Berlin, Germany.

Background: Single-incision laparoscopic surgery (SILS) is growing in popularity. The increased diameter of the umbilical incision might raise questions about the possibility of a greater risk of postoperative incisional hernia in comparison to conventional laparoscopy. This study aims to disclose the frequency of incisional hernia after SILS in long-term follow-up as well as to reveal the factors predisposing patients to this feared complication. Read More

Ann Hepatobiliary Pancreat Surg 2019 Feb 28;23(1):84-86. Epub 2019 Feb 28.

HPB Surgery Unit, Hammersmith Hospital, NHS/Imperial College, London, UK.

Injuries occurring during laparoscopic bile duct exploration in the course of laparoscopic cholecystectomy may represent threatening complications and lead to inappropriate management. We present a case of patient with biliary colic who underwent laparoscopic cholecystectomy. During the procedure, a common bile duct injury occurred, compelling conversion to open approach, and the patient was treated using a manually inserted biliary stent. Read More

Ann Hepatobiliary Pancreat Surg 2019 Feb 28;23(1):69-73. Epub 2019 Feb 28.

Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

The oncologic safety and feasibility of laparoscopic radical cholecystectomy for a preoperatively suspected gallbladder cancer is continually being challenged even in an era of minimally invasive surgery. A seventy-four-year-old woman was presented in the outpatient department with a history of fever, abdominal pain, and vomiting. CT scan showed an irregular wall thickening of the body to the cystic duct of the gallbladder and portocaval lymph node. Read More

Ann Hepatobiliary Pancreat Surg 2019 Feb 28;23(1):34-40. Epub 2019 Feb 28.

Department of General Surgery, Maggiore Hospital, Parma, Italy and Department of Surgery, "Infermi" Hospital, Rimini, Italy.

Backgrounds/aims: The prevalence and risk factors of gangrenous cholecystitis in male are unknown.

Objective: To verify the prevalence and risk factors of gangrenous cholecystitis in males.

Methods: This cross-sectional study includes 95 patients (59. Read More

Ann Hepatobiliary Pancreat Surg 2019 Feb 28;23(1):20-33. Epub 2019 Feb 28.

Department of General Surgery, Tan Tock Seng Hospital, Singapore.

Backgrounds/aims: Traditional outcome measures (e.g., length of hospital stay, morbidity, and mortality) are used to determine the quality of care, but these may not be most important to patients. Read More

Pain Res Manag 2019 3;2019:2815301. Epub 2019 Feb 3.

Health Sciences University, Bursa Yüksek Ihtisas Training and Education Hospital, Department of Anesthesiology and Reanimation, Bursa, Turkey.

Background: The aim of this study was to compare the effectiveness of ultrasound-guided (USG) subcostal transversus abdominis plane (TAP) block and quadratus lumborum (QL) block as preventive analgesia methods after laparoscopic cholecystectomy.

Methods: A total of 120 patients, 18-75 years of age, were separated into 2 groups preoperatively. Patients in group TAP ( = 60) received 0. Read More

Rev Esp Anestesiol Reanim 2019 Mar 9. Epub 2019 Mar 9.

Servicio de Anestesiología y Reanimación y Terapéutica del Dolor, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España.

Laparoscopic cholecystectomy is currently assumed to be the standard gold treatment of acute biliary tract pathology. Despite its many advantages compared to classical open surgery, it is not without complications. The case is presented of an 82 year-old male patient who, after the diagnosis of cholecystitis gangrenous, was urgently intervened using laparoscopic cholecystectomy. Read More

J Opioid Manag 2019 Jan/Feb;15(1):43-49

Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy.

Objectives: An adequate perioperative analgesia reduces neuroendocrine stress response and postoperative complica-tions. Opioids are the most effective parenteral drugs to control pain and stress response.

Design: This is a prospective randomized double-blinded controlled study. Read More

Khirurgiia (Mosk) 2019 (2):32-39

The Department of hospital surgery with the course of pediatric surgery of the RUDN University, Moscow, Russia.

Aim: To develop rational tactics of surgical treatment of patients with acute calculous cholecystitis with their subsequent discharge within 1 day since admission.

Material And Methods: There were 283 patients with acute cholecystitis and 58 patients with chronic cholecystitis. All patients underwent laparoscopic cholecystectomy. Read More

Surg Laparosc Endosc Percutan Tech 2019 Mar 6. Epub 2019 Mar 6.

ICU, ChongQing Traditional Chinese Medicine Hospital, Jiangbei District, Chongqing, China.

Introduction: The efficacy of etoricoxib on pain control for laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the impact of etoricoxib on pain intensity after laparoscopic cholecystectomy.

Materials And Methods: We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2018 for randomized controlled trials assessing the effect of etoricoxib versus placebo on pain management after laparoscopic cholecystectomy. Read More

Surg Res Pract 2019 3;2019:9709242. Epub 2019 Feb 3.

General Surgery Department, IRBLleida-University Hospital Arnau de Vilanova, Avenue Alcalde Rovira Roure 80, Lleida, Spain.

Background: The aim of this study was to evaluate the characteristics, management, and outcomes of acute cholecystitis in patients ≥80 years.

Methods: This was a retrospective analysis of data from a prospective single-center patient registry.

Results: The study population was composed of 348 patients, which were divided into two groups: those younger (Group A) and those older (Group B) than the median age (85. Read More

Nihon Shokakibyo Gakkai Zasshi 2019;116(3):241-248

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

A 71-year-old female with non-dilated pancreaticobiliary maljunction (PBM) and gallbladder polypoid lesions underwent laparoscopic cholecystectomy. Histological examination of the polypoid lesions revealed gallbladder cancer. Five years after cholecystectomy, gradual dilatation of the main pancreatic duct (MPD) led to the identification of a papillary tumor growing in the MPD of the pancreatic head. Read More

Int J Surg Case Rep 2019 28;56:78-81. Epub 2019 Feb 28.

Department of Surgery/Division of Trauma and Acute Care Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI, 48202, USA.

Introduction: Anatomical variants of the extrahepatic biliary tree are numerous, adding significantly to the risk of bile duct injury during cholecystectomy, especially when laparoscopic approach is employed. Duplicated cystic ducts draining a single gallbladder are extremely rare.

Presentation Of Case: A 34-year-old female presented with signs and symptoms of acute cholecystitis which was confirmed on imaging. Read More

J Clin Anesth 2019 Mar 6;57:31-36. Epub 2019 Mar 6.

Muğla Sıtkı Koçman University, Department of Anesthesiology and Reanimation, Muğla, Turkey.

Study Objective: Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. Read More

Int J Med Robot 2019 Mar 8:e1994. Epub 2019 Mar 8.

Department of HPB Surgery, The Freeman Hospital, Newcastle upon Tyne, UK.

Background: We present the short-term outcomes of robotic fenestration of symptomatic liver cysts using the EndoWrist® One Vessel Sealer METHODS: Data from patients who underwent robotic deroofing were collected and analysed retrospectively.

Results: A total of 17 patients were treated. Mean cyst size was 14 cm (median 15 cm, range 6. Read More

Surg Clin North Am 2019 Apr;99(2):337-355

Division of Surgical Oncology, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address:

Gallbladder cancer (GBC) is an often lethal disease, but surgical resection is potentially curative. Symptoms may be misdiagnosed as biliary colic; over half of new diagnoses are made after laparoscopic cholecystectomy for presumed benign disease. Gallbladder polyps >1 cm should prompt additional imaging and cholecystectomy. Read More

Surg Clin North Am 2019 Apr 10;99(2):245-258. Epub 2019 Feb 10.

Division of Hepatobiliary, Pancreatic, and Gastrointestinal Surgery, Washington University School of Medicine, 660 South Euclid Avenue Box 8109, St Louis, MO 63110, USA. Electronic address:

Laparoscopic cholecystectomy has revolutionized the field of surgery, and is currently the gold standard in the treatment for symptomatic cholelithiasis. The goal of every laparoscopic cholecystectomy should be attainment of the critical view of safety before cutting the cystic duct and artery to reduce the risk of bile duct injury. Open cholecystectomy is most commonly performed when laparoscopic cholecystectomy is converted to open or when laparoscopic cholecystectomy is contraindicated. Read More

World J Gastrointest Surg 2019 Feb;11(2):62-84

Transplant and HPB Surgery, the Iowa Clinic-Iowa Methodist Hospital, Des Moines, IA 50309, United States.

The incidence of biliary injury after laparoscopic cholecystectomy (LC) has shown a declining trend though it may still be twice that as with open cholecystectomy. Major biliary or vasculobiliary injury is associated with significant morbidity. As prevention is the best strategy, the concept of a culture of safe cholecystectomy has been recently introduced to educate surgeons and apprise them of basic tenets of safe performance of LC. Read More

J R Coll Physicians Edinb 2019 Mar;49(1):92-94

Manchester Medical Society, Manchester, UK,

ANZ J Surg 2019 Mar 5. Epub 2019 Mar 5.

The Whiteley-Martin Research Unit, Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia.

Background: A left-sided gallbladder (LSGB) is a rare anatomical anomaly that is often not discovered until surgery. Two cases of LSGB managed with laparoscopic cholecystectomy (LC) stimulated this systematic review. The aims of this study were in LSGB to define the rate of pre-operative detection, variations in biliary anatomy, laparoscopic techniques employed and outcomes of surgery for symptomatic gallstones. Read More

Int J Surg 2019 Mar 2. Epub 2019 Mar 2.

Department of Digestive and Hepatobiliary Surgery of Robert Debré University-Hospital, Reims, France; University of Champagne-Ardennes, France.

Int J Surg 2019 Mar 2. Epub 2019 Mar 2.

Department of Surgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands.

Chirurgia (Bucur) 2019 Jan-Feb;114(1):95-102

Laparoscopy of abdominal wall defects becomes more and more actual, considering the well-known advantages of minimally invasive surgery, and the reduced incidence of post-operative ventral infections and recurrence rates compared to the the open repair with or without mesh. We hereby present the technique of the laparoscopic repair of small ventral hernias (defect 2 centimetres), using the Ventralex mesh, which is bi-faceted, polypropylene and PTFE, circular preformed, it has 8 centimeters in diameter, fixated with 4 transparietal sutures. The mesh is created for open surgery but it is placed in the intraperitoneal cavity. Read More

J Hepatobiliary Pancreat Sci 2019 Mar 4. Epub 2019 Mar 4.

Section of Hepato-Pancreato-Biliary Surgery, Siteman Cancer Center, Barnes-Jewish Hospital, , and Washington University School of Medicine in St. Louis, St Louis Missouri.

Introduction: Bile duct injuries are the most common serious complication of cholecystectomy. Avoidance of bile duct injury is a key aim of biliary surgery. The purpose of this paper is to describe laparoscopic cholecystectomy from the viewpoint of three conceptual goals. Read More

J Surg Educ 2019 Feb 28. Epub 2019 Feb 28.

Department of Surgery, Michigan Medicine, Ann Arbor, Michigan. Electronic address:

Objective: Residents and faculty identify intraoperative feedback as a critical component of surgical education. Studies have demonstrated that residents perceive lower quality and frequency of intraoperative feedback compared to faculty. These differences in perception may be due to dissimilar identification of feedback. Read More

J Coll Physicians Surg Pak 2019 Mar;29(3):294

Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore, Pakistan.

Adv Biomed Res 2019 31;8. Epub 2019 Jan 31.

Department of Anesthesiology, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Background: Epidural anesthesia (EA) today has been used extensively in surgical procedures and the management of pain associated with midwifery and chronic pain. This type of anesthesia can be done in different technical, physiological, and pharmacological ways. The aim of this study was to compare the effects of thoracic EA with general anesthesia (GA) on hemodynamic changes and its complications in patients underwent laparoscopic colonoscopy. Read More

World J Emerg Surg 2019 18;14. Epub 2019 Feb 18.

1Department of Surgical Sciences and Advanced Technologies "GF Ingrassia", Cannizzaro Hospital, University of Catania, Via Messina, 829, 95126 Catania, Italy.

The difficult laparoscopic cholecystectomy remains a surgical challenge for surgeons who must decide between laparoscopic continuation and open conversion. The balance between the lack of open surgery training of young surgeons and the risk of maintaining the laparoscopic approach in difficult laparoscopic cholecystectomy is still an unresolved problem. Furthermore, the time that must be spent in an attempt to complete laparoscopic surgery before conversion is still controversial. Read More

Am Surg 2019 Feb;85(2):e100-e103

Am Surg 2019 Feb;85(2):219-222

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Read More

Int J Surg Case Rep 2019 13;56:25-28. Epub 2019 Feb 13.

Division of Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address:

Introduction: Synchronous occurrence of different types of neoplasms is not very frequent, representing around 6% of all cases of cancer. Usually there is a lack of information on how to treat these patients, especially when both types of cancers are also uncommon. No cases of synchronous gallbladder adenocarcinoma and gastric gastrointestinal stromal tumor have been published before. Read More

Surg Laparosc Endosc Percutan Tech 2019 Feb 25. Epub 2019 Feb 25.

ChongQing Traditional Chinese Medicine Hospital, Chongqing, P.R. China.

Introduction: The efficacy of parecoxib on pain management for laparoscopic cholecystectomy remains controversial. We conducted a systematic review and meta-analysis to explore the impact of parecoxib on pain management after laparoscopic cholecystectomy.

Materials And Methods: We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library database results through September 2018 for randomized controlled trials to assess the effect of IV parecoxib versus placebo or noting on pain management after laparoscopic cholecystectomy. Read More

Med J Islam Repub Iran 2018 13;32:112. Epub 2018 Nov 13.

Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Given the importance of patients' pain after laparoscopic surgeries, this study was conducted to compare the effectiveness of intraperitoneal bupivacaine, acetazolamide, and placebo on pain relief after laparoscopic cholecystectomy surgery. Patients admitted to Rasool Akram hospital with physical status I or II, based on the American Society of Anesthesiologists (ASA) system, who were candidates for laparoscopic cholecystectomy surgery due to gallstones, were included in this study. Patients were divided into 3 groups (each group containing 20 patients) using block randomization with foursome blocks. Read More

J Glob Infect Dis 2019 Jan-Mar;11(1):47-49

Department of Infectious Diseases, Stony Brook University, School of Medicine, Stony Brook, New York, USA.

Spilled gallstones during laparoscopic cholecystectomy (LC) are common. Lost gallstones can lead to complications such as intra-abdominal abscesses, which can occur days, months, or even years after the procedure. belongs to the family of Enterobacteriaceae. Read More