scholarly journals Laparoscopic Cholecystectomy - A Cross Sectional Study

2015 ◽  
Vol 2 (1) ◽  
pp. 53
Author(s):  
Pari A. Pulate ◽  
Tushar Narkhede ◽  
Sushma S. Chandak
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Complication Rate ◽  
Open Cholecystectomy ◽  
Cross Sectional Study ◽  
Chronic Cholecystitis ◽  
Histopathological Diagnosis ◽  
Early Recovery ◽  
Cross Sectional ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Bladder Polyp

<strong>Aims and Objectives:</strong> 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. <strong>Methodology:</strong> Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. <strong>Results:</strong> Highest age incidence was seen in 4<sup>th</sup> decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. <strong>Conclusion:</strong> Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4<sup>th</sup> decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.

Feasibility and safety in difficult laparoscopic cholecystectomies; a single surgeon experience.

2020 ◽  
Vol 11 (4) ◽  
pp. 12-16
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Cross Sectional Study ◽  
City Hospital ◽  
Class Iii ◽  
Cross Sectional ◽  
Surgeon Experience ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: laparoscopic cholecystectomy is commonly used for the treatment of gallstones. Objective: To determine the feasibility and safety of difficult laparoscopic cholecystectomies. Methodology: This cross sectional study was based on retrospective collection of data from patient records, including 323 patients with difficult laparoscopic cholecystectomies was conducted in Department of Surgery, Sharif Medical City Hospital, and Rasheed Hospital, Lahore from June 2010 to December 2019. Difficult cholecystectomy was defined on intraoperative findings based on Nassar intraoperative scoring system. Feasibility was defined as successful accomplishment of procedure without complication and safety was defined as having no intraoperative or postoperative complications. Results: There were 75 (23.21%) male and mean age was 48±8 years. Class I difficulty was observed in 185 (57.3%) patients, class II difficulty in 83 (25.7%) patients, class III difficulty in 44 (13.6%) patients and class IV difficulty in 11 (3.4%) patients. Mean duration of surgery and mean hospital stay were 98.87±11.76 minutes and 1.91±1 days, respectively. Conversion to open cholecystectomy was done in 10 (3.1%). The procedure was feasible in 313 (96.9%) patients. Overall complications were seen in 19 (5.9%) patients. The complications included Common Bile Duct injury in 1 (0.31%) patient, intraoperative bleeding in 1 (0.3%) patients, bile leakage in 2 (0.62%) patients, postoperative jaundice in 3 (0.93%) patients, superficial infections in 10 (3.1%) patients and deep infections in 2 (0.62%) patients. Safety of laparoscopic surgery was seen in 304 (94.1%) patients. Conclusion: Laparoscopic cholecystectomy in difficult situations was found to be feasible and safe in majority of patients. However, it was associated with a longer operative time.

scholarly journals National Trends in the Adoption of Laparoscopic Cholecystectomy over 7 Years in the United States and Impact of Laparoscopic Approaches Stratified by Age

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Anahita Dua ◽  
Abdul Aziz ◽  
Sapan S. Desai ◽  
Jason McMaster ◽  
SreyRam Kuy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Open Cholecystectomy ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Discharge Disposition ◽  
Open Versus ◽  
National Trends

Introduction. The aim of this study was to characterize national trends in adoption of laparoscopic cholecystectomy and determine differences in outcome based on type of surgery and patient age.Methods. Retrospective cross-sectional study of patients undergoing cholecystectomy. Trends in open versus laparoscopic cholecystectomy by age group and year were analyzed. Differences in outcomes including in-hospital mortality, complications, discharge disposition, length of stay (LOS), and cost are examined.Results. Between 1999 and 2006, 358,091 patients underwent cholecystectomy. In 1999, patients aged ≥80 years had the lowest rates of laparoscopic cholecystectomy, followed by those aged 65–79, 64–50, and 49–18 years (59.7%, 65.3%, 73.2%, and 83.5%, resp.,P<0.05). Laparoscopic cholecystectomy was associated with improved clinical and economic outcomes across all age groups. Over the study period, there was a gradual increase in laparoscopic cholecystectomy performed among all age groups during each year, though elderly patients continued to lag significantly behind their younger counterparts in rates of laparoscopic cholecystectomy.Conclusion. This is the largest study to report trends in adoption of laparoscopic cholecystectomy in the US in patients stratified by age. Elderly patients are more likely to undergo open cholecystectomy. Laparoscopic cholecystectomy is associated with improved clinical outcomes.

scholarly journals Cholecystectomy, Conversion and Complications

HPB Surgery ◽  
2000 ◽  
Vol 11 (6) ◽  
pp. 373-378 ◽  
Author(s):  
M. H. Thompson ◽  
J. R. Benger
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Complication Rate ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Consecutive Series ◽  
Intention To Treat ◽  
Open Operation ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Complication Score ◽  
Small Advantage

Background Faced with a difficult laparoscopic cholecystectomy the surgeon may feel that conversion to open operation would risk greater complications because of the laparotomy. Information on the effect of conversion is lacking. The purpose of this study is to measure the complications of laparoscopic cholecystectomy and observe the effect of the conversion rate.Methods A total of 957 patients were studied. There were three consecutive series of patients; the first undergoing open cholecystectomy (384 patients), the second laparoscopic cholecystectomy with a 5.8% conversion rate (412 patients) and the third laparoscopic cholecystectomy with a 1.3% conversion rate (161 patients). Data was collected prospectively using a continuous audit, and the complication rate compared on an intention to treat basis. In addition a panel of experienced surgeons was asked to score the complications depending on their severity and a composite complication score calculated. Comparison between the 3 groups was then undertaken. Results Open cholecystectomy produced a postoperative complication rate of 6%. Initially this appeared to fall to 3.1% with the introduction of laparoscopic cholecystectomy, but when the complications occurring in the converted patients were included (i.e., on an intention to treat basis) the rate increased to 5.6% in the first group of laparoscopically- treated patients and 3.1% in the second. These differences were not statistically significant. A similar pattern emerged when scoring the severity of the complications as judged by the expert panel. The inclusion of intra-operative complications appears to remove any small advantage for laparoscopic cholecystectomy. The reduction in the conversion rate between the two laparoscopic groups from 5.8% to 1.2% was statistically significant.Conclusion When considered on an intention to treat basis laparoscopic cholecystectomy offers no advantage over open operation in terms of the frequency or severity of complications. Reducing the frequency of conversion from a laparoscopic to an open procedure also has no significant effect on the complications encountered. We conclude, therefore, that the complication rate is independent of the conversion rate and that the surgeon, when faced with difficulty at laparoscopic cholecystectomy, should not be deterred from converting to open operation for fear of the post-operative consequences.

scholarly journals Factors Affecting Conversion From Laparoscopic Cholecystectomy to Open Cholecystectomy at a Tertiary Care Facility in Saudi Arabia: A Cross-Sectional Study

2020 ◽  
Vol 104 (3-4) ◽  
pp. 166-170
Author(s):  
Thamer Nouh ◽  
Faris Alanazi ◽  
Abdulellah S. Abunayan ◽  
Abdallah F. Alsaadoun ◽  
Mohamed A. Alsehly ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Conversion Rates ◽  
Conversion To Open Cholecystectomy ◽  
Preoperative Factors

Background: Despite the growing importance and increased use of laparoscopy for gallbladder diseases in Saudi Arabia, several factors reportedly result in conversion to open surgery. This leads to increased operative time and increased hospital resource utilization, and, importantly, it impacts patient welfare. Although laparoscopic cholecystectomy and its conversion rates have been investigated in Saudi Arabia, there is little information on the factors associated with this conversion. Therefore, we analyzed the prevalence and factors associated with the conversion from laparoscopic to open cholecystectomy. Materials and methods: This was a quantitative, retrospective, observational, cross-sectional study. We reviewed the health care records of all patients who underwent laparoscopic cholecystectomy during the study period (January 2014–December 2015). We analyzed patient demographics, preoperative factors, ultrasound findings, and intraoperative factors associated with higher conversion rates. We calculated means, SDs, and medians for numerical variables and percentages and frequencies for nominal variables. The χ2 and two-tailed t tests were used to compare the categorical and continuous variables, respectively, between patients who underwent laparoscopic cholecystectomy and those who underwent conversion to open cholecystectomy to analyze their relationship with the possibility of conversion. Statistical significance was considered at P &lt; 0.05. Results: Age &gt; 40 years, diabetes, history of admission for gallstones, and increased total bilirubin, direct bilirubin, and alkaline phosphatase levels were the preoperative factors and adhesions, bleeding, and stone spillage were the intraoperative factors associated with conversion. Conclusion: Recognizing the factors for conversion would improve treatment planning and help predict when conversion may be necessary.

scholarly journals Role of transvaginal sonography in the detection of endometrial carcinoma

2014 ◽  
Vol 39 (2) ◽  
pp. 80-85
Author(s):  
MS Showkat ◽  
S Nabi ◽  
L Khondker ◽  
B Bhowmik ◽  
SN Tushar ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Sensitivity Specificity ◽  
Transabdominal Sonography

Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. Objective of this study is to evaluate the clinical usefulness of transvaginal ultrasonography (TVS) in pre, peri and post menopausal women suspected to have endometrial carcinoma. This cross sectional study was done with 40 patients who are clinically suspected having thickened endometrium. The study was carried out January 2007 to November 2008 for a period of two years. The patients having endometrial carcinoma diagnosed by TVS was correlated with histopathological diagnosis following collection of the report from the respective cases. Of total 40 cases, 2(5.0%) cases were endometrial carcinoma and 38(95.0%) were negative for endometrial carcinoma respectively in TVS findings. On the other hand 3(7.5%) cases were endometrial carcinoma and 37 (92.5%) cases were negative for endometrial carcinoma in histopathological findings. The validity of TVS in diagnosis of endometrial carcinoma were studied by calculating sensitivity, specificity, accuracy, positive predictive value and negative predictive value, which were 67 percent, 100 percent, 98 percent, 100 percent and 97 percent respectively. As the TVS findings of the present study correlated well with the histopathology findings and the validity test values were higher than observed by others, it can be concluded that TVS is sensitive and accurate modality in the evaluation of endometrial carcinoma. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19647 Bangladesh Med Res Counc Bull 2013; 39: 80-85

scholarly journals Role of Squash Cytology in Intraoperative Diagnosis of Meningioma

2021 ◽  
Author(s):  
Gowri Prakasam ◽  
K Karkuzhali ◽  
Veeraraghavan Gurusamy
Keyword(s):  
Tamil Nadu ◽  
Frozen Section ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Suspected Case ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College ◽  
Cost Effective Technique

Introduction: Primary Central Nervous System (CNS) tumours constitute less than 2% of overall cancers in adults and are the second most frequently encountered tumours in children. Meningiomas form 24-30% of primary intracranial tumours. Most intrinsic brain tumours are soft and gelatinous in consistency, smear preparation can readily made which gives excellent cytological details when compared to frozen section as the latter produces ice crystal artifacts. Aim: To assess the diagnostic utility of squash cytological evaluation of meningiomas and its comparison with final histopathological diagnosis. Materials and Methods: The cross-sectional study was done at Thanjavur Medical College, Thanjavur, Tamil Nadu, India for period of three years from January 2015 to December 2017. Total of 54 clinically diagnosed and radiologically suspected case of meningiomas were selected. Smears were prepared from the biopsy samples sent in normal saline and stained by Haematoxylin and Eosin (H&E) method. The cytological features were noted and matched with biopsy findings. Descriptive statistics were used to analyse the results. Results: Total of 54 squash smears with male to female ratio was 1:1.5. Maximum number of cases were seen between 41- 50 years followed by 51-60 years. Complete concordance was obtained in 51 cases (94.44%) and partial concordance was noted in a case due to underestimation of malignancy grade in squash cytology. Out of 54 cases, two cases were found to be discordant with final histopathological diagnosis. Conclusion: Intraoperative squash cytology is easy, rapid, reliable and cost-effective technique for neurosurgical consultation with fairly high accuracy in diagnosing meningiomas.

scholarly journals An Audit of Indications for Hysterectomy in a District Hospital, Madikeri

2020 ◽  
Author(s):  
Sumanashree Mallappa ◽  
Aishwarya Ramanujam ◽  
Priyadarshini Monnappa ◽  
Padmaja Kulkarni
Keyword(s):  
District Hospital ◽  
Cross Sectional Study ◽  
Common Type ◽  
Common Finding ◽  
Histopathological Diagnosis ◽  
Fallopian Tubes ◽  
Cross Sectional ◽  
Histopathological Findings ◽  
Abdominal Approach ◽  
Nonsurgical Management

Introduction: Hysterectomy is the removal of the uterus and is the most common gynaecological operation done in females worldwide. In the early 20th century, hysterectomies were done for many conditions like leiomyoma, Dysfunctional Uterine Bleeding (DUB), chronic pelvic pain, endometriosis, adenomyosis, prolapse, and malignancies. Considering that the procedure has a 20-35% life risk, it calls for a thorough justification before consideration. A hysterectomy has mental, physical, social, economic and psychosexual impact, apart from intraoperative and postoperative complications. Thus, an audit on hysterectomies was done to help students, medical fraternity, and the women of Kodagu in having a better understanding of hysterectomies. Aim: To conduct an audit on hysterectomies performed for gynaecological indications to correlate pre-operative diagnosis with the histopathological diagnosis. Materials and Methods: This was a cross-sectional study which included all elective hysterectomies performed for gynaecological indications conducted at the District Hospital of Kodagu Institute of Medical Sciences, Madikeri from January 2018-June 2019. All cases of hysterectomies were considered except Caesarean peripartal hysterectomies. The histopathological findings of the endometrium, myometrium, cervix, ovaries and fallopian tubes were recorded. Findings were tabulated as frequency and percentage. Then, using the data, preoperative indications were compared with postoperative histopathological findings to know if hysterectomy was justified. Results: A total of 238 hysterectomies were performed during 18 months in the District Hospital. Abdominal and vaginal approaches were used. Panhysterectomy via abdominal approach was the most common type of hysterectomy. The most common age group where hysterectomy occurred was 41-60 years. The most common indication for hysterectomy was found to be Fibroid uterus. Analysis of the myometrial findings revealed that the most common finding was leiomyoma. Majority of ovaries and fallopian tubes did not show significant pathology. Conclusion: Panhysterectomy was the most common type of hysterectomy. Fibroid were the most common histopathological findings and medium and small sized fibroids can be given a trial of nonsurgical management. Injudicious use of hysterectomy procedure has multiple loop holes involving medical fraternity, socioeconomic conditions of women and attitude of society towards female reproductive health.

scholarly journals Evaluation of female pelvic mass - correlation of clinical and histopathological findings in female patients attending at Birat Medical College and Teaching Hospital, Morang, Nepal

2020 ◽  
Vol 4 (3) ◽  
pp. 845-849
Author(s):  
Seema Kumari Mishra ◽  
Roshan Pradhan ◽  
Hanoon P Pokharel
Keyword(s):  
Clinical Diagnosis ◽  
Teaching Hospital ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Female Pelvis ◽  
Cross Sectional ◽  
Medical College ◽  
Pelvic Masses

Introduction: The female pelvis is a quite complex anatomical region consisting of uro-genital system as its main part and other structures like blood vessels, gastrointestinal tracts, lymphatics, nerves and a part of musculoskeletal system. Thus, the differential diagnosis of pelvic masses may be of gynecological or non gynecological origin. Gynecological pelvic masses are uterine, ovarian or adnexal masses which may be benign or malignant. Objective: The objective of this study was to evaluate the type of various gynecological pelvic masses and to correlate the preoperative diagnosis with histopathological diagnosis. Methodology: This was a hospital based cross sectional study conducted on 107 patients from September 2018 to September 2019 at Birat Medical College and Teaching Hospital (BMCTH) with presenting complian of lump in the abdomen. These patients underwent clinical examination, routine and specific investigations along with ultrasonographic evaluation and tumour markers to reach a preoperative clinical diagnosis. Patients were admitted and preanesthetic consultation was done. Patients were taken for therapeutic or diagnostic laparoscopy or exploratory laparotomy and diagnosis were confirmed with histopathological diagnosis. Results: Total 107 patients were enrolled in the study with age ranging from 21 to ≥70 years and among them majority (42.1%) were in the age group of 41-50 years. The most common presenting complain of patients were lower abdominopelvic pain (58.87%). The most common clinical diagnosis was leiomyoma in 39.25% patients followed by adenomyosis in 24.29% patients. The most common histopathological diagnosis was fibroid uterus seen in 42.05% patients. There were 2 (1.86%) patients of ovarian malignancies and 1 (0.93%) patient of uterine malignancy.

scholarly journals Why women with advanced carcinoma cervix do not seek medical help early: a tertiary hospital based Indian study

2019 ◽  
Vol 9 (1) ◽  
pp. 110
Author(s):  
Aastha Raheja ◽  
Krishna Agarwal ◽  
Anoosha K. Ravi
Keyword(s):  
Rural Areas ◽  
Pap Smear ◽  
Screening Program ◽  
Clinical Stage ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Histopathological Diagnosis ◽  
Carcinoma Cervix ◽  
Cross Sectional ◽  
Advanced Carcinoma

Background: Cervical cancer is a disease which claims maximum number of deaths in developing countries. Objective of this study was to understand the reason for delayed approach to medical help in women with advanced carcinoma cervix.Methods: It was a cross-sectional study. Information obtained from women with carcinoma cervix clinical stage IIb and above with proven histopathological diagnosis was recorded in the predetermined format.Results: Almost all the subjects were illiterate and were from lower socioeconomic strata and rural areas. None of them knew about the disease and its symptomatology. About 82% of the patients were symptomatic since 5-10 years however took no medical care during the period and 2/3rd of them even did not reveal their problem to any of the family members. About 79% of the subjects had never used any contraception and none had knowledge about its role in preventing infection. Majority of them (98%) had no idea about the role of PAP smear in screening carcinoma cervix. All of them said if they had knowledge about the disease, they would have sought medical help much earlier.Conclusions: The most important reason for delayed approach in our study was found to be lack of knowledge about the disease. Therefore, till such time that we have national screening program in place, these women who are at high risk of developing carcinoma of cervix should be targeted and educated through mass media so that these women could seek medical help in early stages.

scholarly journals Ultrasonographic Evaluation of Solitary Thyroid Nodule with Histopathological Comparison

2020 ◽  
Vol 25 (2) ◽  
pp. 76-84
Author(s):  
Samia Quadir ◽  
Sabiha Quadir ◽  
Md Momin Uddin ◽  
Kazi Shameemus Salam ◽  
Mohammad Sazzad Hossain ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Follicular Adenoma ◽  
Nodular Goiter ◽  
Cross Sectional Study ◽  
The Body ◽  
Histopathological Diagnosis ◽  
Sectional Study ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Solitary Thyroid Nodule

Background: Thyroid gland is the largest gland of the body which secretes thyroid hormones named T3 & T4. Incidence of solitary thyroid nodule is common in Bangladesh. Objectives: To validate the ultrasonography evaluation of solitary thyroid nodule comparing with histopathological diagnosis. Methodology: This cross sectional study enrolled 75 patients of age range between 14 to 72 years during July 2016 to June 2018 and the study was carried out in the department of Radiology & Imaging of Ultrasonography evaluation was finally compared with histopathological diagnosis which was considered as gold standard. Results: Among 75 patients are included in this study the age ranged between 14 to 72 years. Majority of the patients 37 (49.3%) were found between 31 to 40 years. 65 (86.3%) were female & 10 (13.3%) were male. All patients were presents with thyroid swelling. In USG findings Microcalcifications were present 9 (12%) in benign & 5(6.7%) in malignant cases. Presence of Halo were in all benign cases 14 (18.7%). Comet tail sign were in 5 (6.7%) in benign & 3 (4%) in malignant cases. Histological nodular goiter were 57 (76%), Follicular adenoma 8 (10.7%), Thyroditis 5 (6.7%) and Papillary carcinoma 4 (5.3%), Follicular Carcinoma 1 (1.3%). Conclusion: This cross sectional study was carried out with an aim to determine the usefulness of ultrasonogram diagnosis of solitary thyroid nodule compared with histopathology findings. As the validity test results are higher, it can be concluded that the ultrasonogram is a useful diagnostic modality in the evaluation of solitary thyroid nodule. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 76-84

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