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Diagnósticos de enfermagem de pacientes em período pós-operatório imediato de cirurgia de colecistectomia laparoscópica; Nursing diagnoses for patients in the immediate post-operative period after laparoscopic cholecystectomy

Dalri, Cristina Camargo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 27/06/2005 PT
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66.74%
Esse estudo teve como objetivos identificar os diagnósticos de enfermagem presentes em pacientes em pós-operatório imediato de colecistectomia, submetidos à anestesia geral com base na Taxonomia II da North American Nursing Diagnoses Association (NANDA) e no Modelo Conceitual de Horta; analisar os diagnósticos de enfermagem presentes nesses pacientes em relação aos fatores relacionados, características definidoras e fatores de risco e em relação ao seu estabelecimento e resolução no pós-operatório imediato; dentre os pacientes estudados que apresentaram o Diagnóstico de Enfermagem de Dor aguda, identificar as manifestações de dor apresentadas no pós-operatório imediato e compará-las com as características definidoras apresentadas pela NANDA e por outras literaturas. Para a etapa de coleta de dados, foi elaborado e validado um instrumento de coleta de dados com base no Modelo Conceitual de Wanda Horta. Foram avaliados 15 pacientes adultos no período pós-operatório imediato de colecistectomia laparoscópica, durante o período de setembro de 2004 a janeiro de 2005, no Centro de Recuperação Pós-anestésica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. Para o estabelecimento dos diagnósticos de enfermagem...

O valor da biópsia do fígado na doença hepática gordurosa não alcoólica em pacientes com colelitíase submetidos à colecistectomia laparoscópica; The importance of liver biopsy in non-alcoholic fatty liver disease in patients with cholelithiasis submitted to laparoscopic cholecystectomy

Pinto, Monica Madeira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 07/04/2011 PT
Relevância na Pesquisa
66.97%
A colelitíase é uma doença frequente na população geral. Um dos seus fatores de risco é a diabetes melitus tipo 2, relacionada à anormalidades metabólicas associadas a sobrepeso, obesidade, resistência à insulina, hipertrigliceridemia e hábitos dietéticos. Fatores de risco semelhantes são encontrados na doença hepática gordurosa não alcoólica (DHGNA). A DHGNA engloba um espectro de condições patológicas que pode evoluir da esteatose, para esteato-hepatite (EHNA), fibrose, cirrose e neoplasia hepática. A distinção entre esteatose e EHNA é de grande relevância na prática clínica, em virtude de a primeira ser uma condição benigna e reversível, enquanto que a segunda apresenta potencial evolutivo para cirrose e carcinoma hepatocelular. Somente a biópsia hepática pode classificar e estadiar a DHGNA. A DHGNA e a colelitíase têm similaridade quanto à patogênese e aos fatores de risco, o que nos motivou a realizar este estudo. Os objetivos do trabalho foram: a) Definir a frequência da esteatose hepática e da EHNA em pacientes com colelitíase submetidos à colecistectomia laparoscópica. b) Avaliar as alterações histopatológicas da DHGNA nos pacientes com colelitíase. c) Avaliar a acurácia dos exames de imagem-ultrassonografia abdominal (US) e tomografia computadorizada (TC) no diagnóstico da DHGNA. d) Relacionar aspectos clínicos...

Complicações e desconfortos em colecistectomias videolaparoscópicas: relação com as variáveis pré-operatórias e intraoperatórias; Discomforts and complications in laparoscopic cholecystectomy: relationship with preoperative variables and intraoperative

Fernandes, Carolina Nóvoa
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 26/11/2013 PT
Relevância na Pesquisa
66.88%
Introdução: A colelitíase é uma das afecções do sistema digestório mais frequente, acometendo 20% da população adulta. Atualmente, a colecistectomia videolaparoscópica (CVL) é o tratamento de escolha nas doenças benignas da vesícula biliar, inclusive, na colecistite aguda. Entretanto, independente dos benefícios indiscutíveis da cirurgia minimalmente invasiva, esse procedimento não exclui a possibilidade de complicações ou desconfortos ao paciente no pós-operatório. Objetivo: Identificar a relação entre as variáveis pré e intra-operatórias e as ocorrências de complicações e desconfortos pós-operatórios em pacientes submetidos à CVL. Casuística e método: Trata-se de um estudo retrospectivo, do tipo descritivo, exploratório, de nível I e com abordagem quantitativa. A amostra do estudo foi composta por 495 prontuários de pacientes submetidos à CVL, em caráter eletivo no Hospital Estadual de Diadema, no período entre janeiro de 2009 e agosto de 2012. Os dados foram obtidos com base no preenchimento de um instrumento semiestruturado, contendo: dados demográficos, variáveis clínicas do pré, intra e pós-operatórias. O estudo estatístico foi realizado no sistema SPSS 15.0, sendo adotado o nível de significância de 5%. Resultados: Na amostra estudada houve: predominância do feminino (89...

Randomized, controlled trial comparing the effects of anesthesia with propofol, isoflurane, desflurane and sevoflurane on pain after laparoscopic cholecystectomy

Ortiz,Jaime; Chang,Lee C.; Tolpin,Daniel A.; Minard,Charles G.; Scott,Bradford G.; Rivers,Jose M.
Fonte: Sociedade Brasileira de Anestesiologia Publicador: Sociedade Brasileira de Anestesiologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
66.95%
Background: Pain is the primary complaint and the main reason for prolonged recovery after laparoscopic cholecystectomy. The authors hypothesized that patients undergoing laparoscopic cholecystectomy will have less pain four hours after surgery when receiving maintenance of anesthesia with propofol when compared to isoflurane, desflurane, or sevoflurane. Methods: In this prospective, randomized trial, 80 patients scheduled for laparoscopic cholecystectomy were assigned to propofol, isoflurane, desflurane, or sevoflurane for the maintenance of anesthesia. Our primary outcome was pain measured on the numeric analog scale four hours after surgery. We also recorded intraoperative use of opioids as well as analgesic consumption during the first 24 h after surgery. Results: There was no statistically significant difference in pain scores four hours after surgery (p = 0.72). There were also no statistically significant differences in pain scores between treatment groups during the 24 h after surgery (p = 0.45). Intraoperative use of fentanyl and morphine did not vary significantly among the groups (p = 0.21 and 0.24, respectively). There were no differences in total morphine and hydrocodone/APAP use during the first 24 h (p = 0.61 and 0.53...

Elimination of biliary stones through the urinary tract: a complication of the laparoscopic cholecystectomy

Castro,Maurício Gustavo Bravim de; Alves,Antônio Sérgio; Oliveira,Cláudio Almeida de; Vieira Júnior,Álvaro; Vianna,José Luiz Campello de Mello; Costa,Renato Freitas Carvalho
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/1999 EN
Relevância na Pesquisa
66.84%
The introduction and popularization of laparoscopic cholecystectomy has been accompanied with a considerable increase in perforation of gallbladder during this procedure (10%--32%), with the occurrence of intraperitoneal bile spillage and the consequent increase in the incidence of lost gallstones (0.2%--20%). Recently the complications associated with these stones have been documented in the literature. We report a rare complication occurring in an 81-year-old woman who underwent laparoscopic cholecystectomy and developed cutaneous fistula to the umbilicus and elimination of biliary stones through the urinary tract. During the cholecystectomy, the gall bladder was perforated, and bile and gallstones were spilled into the peritoneal cavity. Two months after the initial procedure there was exteriorization of fistula through the umbilicus, with intermittent elimination of biliary stones. After eleven months, acute urinary retention occurred due to biliary stones in the bladder, which were removed by cystoscopy. We conclude that efforts should be concentrated on avoiding the spillage of stones during the surgery, and that no rules exist for indicating a laparotomy simply to retrieve these lost gallstones.

Migração de clipe metálico para úlcera duodenal após colecistectomia videolaparoscópica: Ligaclip migration into a duodenal ulcer following laparoscopic cholecystectomy

Reis,Luciano Dias de Oliveira; Coelho,Júlio Cezar Uili; Cardoso Filho,Celso Augusto Milani
Fonte: Colégio Brasileiro de Cirurgiões Publicador: Colégio Brasileiro de Cirurgiões
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2002 PT
Relevância na Pesquisa
66.67%
We report a rare cause of pyloric stenosis caused by migration of surgical clips into a duodenal ulcer following laparoscopic cholecystectomy. Even after endoscopic removal of the clips the inflammatory reaction during the healing process caused a stenosis of the pylorus that eventually required a truncal vagotomy and gastroenterostomy.

Simplified laparoscopic cholecystectomy with two incisions

ABAID,Rafael Antoniazzi; CECCONELLO,Ivan; ZILBERSTEIN,Bruno
Fonte: Colégio Brasileiro de Cirurgia Digestiva Publicador: Colégio Brasileiro de Cirurgia Digestiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
56.88%
BACKGROUND: Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. AIM: To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. TECHNIQUE: In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. CONCLUSION: Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result.

Comparative analysis of iatrogenic injury of biliary tract in laparotomic and laparoscopic cholecystectomy

FORTUNATO,André Augusto; GENTILE,João Kleber de Almeida; CAETANO,Diogo Peral; GOMES,Marcus Aurélio Zaia; BASSI,Marco Antônio
Fonte: Colégio Brasileiro de Cirurgia Digestiva Publicador: Colégio Brasileiro de Cirurgia Digestiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 EN
Relevância na Pesquisa
57.03%
BACKGROUND: Iatrogenic injury to the bile ducts is the most feared complication of cholecystectomy and several are the possibilities to occur. AIM: To compare the cases of iatrogenic lesions of the biliary tract occurring in conventional and laparoscopic cholecystectomy, assessing the likely causal factors, complications and postoperative follow-up. METHODS: Retrospective cohort study with analysis of records of patients undergoing conventional and laparoscopic cholecystectomy. All the patients were analyzed in two years. The only criterion for inclusion was to be operative bile duct injury, regardless of location or time of diagnosis. There were no exclusion criteria. Epidemiological data of patients, time of diagnosis of the lesion and its location were analyzed. RESULTS: Total of 515 patients with gallstones was operated, 320 (62.1 %) by laparotomy cholecystectomy and 195 by laparoscopic approach. The age of patients with bile duct injury ranged from 29-70 years. Among those who underwent laparotomy cholecystectomy...

The effect of laparoscopic cholecystectomy on biliary reflux

Maddern, G.; Baxter, P.
Fonte: BLACKWELL SCIENCE Publicador: BLACKWELL SCIENCE
Tipo: Artigo de Revista Científica
Publicado em //1997 EN
Relevância na Pesquisa
57.05%
BACKGROUND: The present study evaluates the effect of laparoscopic cholecystectomy on biliary reflux in patients with cholelithiasis. METHODS: All patients over 18 years of age awaiting elective cholecystectomy for gallstone disease in one of two teaching hospitals were contacted by telephone, and those who gave informed consent were entered in the study. A total of 66 patients (43 females and 23 males) underwent milk 99mTc DIDA scans. Elective laparoscopic cholecystectomy was perfomed after a median of 28.5 days (range: 8-588 days) and patients were re-investigated with a milk 99mTc DIDA scan at a median time of 50 days (range: 18-370 days) postoperatively. Scans were carried out in the Nuclear Medicine Department of the Royal Adelaide Hospital. RESULTS: All but two patients had a functioning gall-bladder on milk 99mTc N-2, 6-dimethylphenyl-carbamoylmethyl iminodiacetic acid scanning prior to cholecystectomy. One of these patients was found to have a gall-bladder carcinoma at cholecystectomy. Fifty-seven of the 66 patients had a successful laparoscopic cholecystectomy (nine open cholecystectomies). Nineteen patients experienced gastroduodenal reflux into the stomach prior to cholecystectomy and 23 patients experienced it postoperatively. There was no significant difference in gastroduodenal reflux in both the open and laparoscopic groups. CONCLUSION: The present study demonstrated that laparoscopic cholecystectomy did not significantly alter gastroduodenal reflux.; Maddern...

Prospective audit of laparoscopic cholecystectomy experience at a secondary referral centre in South Australia

Tan, Jeremy T. H.; Suyapto, Dion Royce; Neo, Eu Ling; Leong, Paul S. K.
Fonte: Blackwell Publishing Publicador: Blackwell Publishing
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
67.02%
Background: Laparoscopic cholecystectomy is now the gold standard procedure for symptomatic gallstone disease. Nevertheless, there are still several controversies such as the need for routine intraoperative cholangiogram (IOC), the indications for and results of early laparoscopic cholecystectomy in the setting of acute cholecystitis and the use of endoscopic retrograde cholangiopancreatography versus laparoscopic common bile duct (CBD) exploration for intraoperatively detected choledocholithiasis. The aim of this study was to investigate some of these controversies. Methods: All laparoscopic cholecystectomies carried out at our institution, a secondary referral centre in Adelaide, South Australia, over a 9-month period were prospectively audited. Data were collected regarding indications for surgery, rate of conversion to open operation, use of IOC, rate of choledocholithiasis and complication rate. Results: There were 202 patients, of whom 152 were women and 50 men. Age range was 15–83 years. Sixty-one per cent of emergency operations were for acute cholecystitis. The conversion rate for emergency operations was 20.6% and for elective procedures was 4.2% (P = 0.003).One hundred and eighty-four patients had an IOC performed. Twelve of these patients had choledocholithiasis. Six of these 12 patients had both normal preoperative ultrasound and liver function tests. Four of the patients went on to postoperative endoscopic retrograde cholangiopancreatography...

Opioid-free total intravenous anesthesia with propofol, dexmedetomidine and lidocaine infusions for laparoscopic cholecystectomy: a prospective, randomized, double-blinded study

Bakan,Mefkur; Umutoglu,Tarik; Topuz,Ufuk; Uysal,Harun; Bayram,Mehmet; Kadioglu,Huseyin; Salihoglu,Ziya
Fonte: Sociedade Brasileira de Anestesiologia Publicador: Sociedade Brasileira de Anestesiologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
Relevância na Pesquisa
66.88%
BACKGROUND AND OBJECTIVES: Intraoperative use of opioids may be associated with postoperative hyperalgesia and increased analgesic consumption. Side effects due to perioperative use of opioids, such as postoperative nausea and vomiting may delay discharge. We hypothesized that total intravenous anesthesia consisting of lidocaine and dexmedetomidine as an opioid substitute may be an alternative technique for laparoscopic cholecystectomy and would be associated with lower fentanyl requirements in the postoperative period and less incidence of postoperative nausea and vomiting. METHODS: 80 Anesthesiologists I-II adults were scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated into two groups to have either opioid-free anesthesia with dexmedetomidine, lidocaine, and propofol infusions (Group DL) or opioid-based anesthesia with remifentanil, and propofol infusions (Group RF). All patients received a standard multimodal analgesia regimen. A patient controlled analgesia device was set to deliver IV fentanyl for 6 h after surgery. The primary outcome variable was postoperative fentanyl consumption. RESULTS: Fentanyl consumption at postoperative 2nd hour was statistically significantly less in Group DL, compared with Group RF...

Syndrome of inappropriate antidiuretic hormone secretion related to Guillain-Barré syndrome after laparoscopic cholecystectomy

Çakirgöz,Mensure Yilmaz; Duran,Esra; Topuz,Cem; Kara,Deniz; Turgut,Namigar; Türkmen,Ülkü Aygen; Turanç,Bülent; Dolap,Mustafa Önder; Hanci,Volkan
Fonte: Sociedade Brasileira de Anestesiologia Publicador: Sociedade Brasileira de Anestesiologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
66.67%
Background and objectives: Guillain-Barré Syndrome is one of the most common causes of acute polyneuropathy in adults. Recently, the occurrence of Guillain-Barré Syndrome after major and minor surgical operations has been increasingly debated. In Guillain-Barré syndrome, syndrome of inappropriate antidiuretic hormone secretion and dysautonomy are generally observed after maximal motor deficit. Case report: A 44-year-old male patient underwent a laparoscopic cholecystectomy for acute cholecystitis. After the development of a severe headache, nausea, diplopia, and attacks of hypertension in the early postoperative period, a computer tomography of the brain was normal. Laboratory tests revealed hyponatremia linked to syndrome of inappropriate antidiuretic hormone secretion, the patient's fluids were restricted, and furosemide and 3% NaCl treatment was initiated. On the second day postoperative, the patient developed numbness moving upward from the hands and feet, loss of strength, difficulty swallowing and respiratory distress. Guillain-Barré syndrome was suspected, and the patient was moved to intensive care. Cerebrospinal fluid examination showed 320 mg/dL protein, and acute motor-sensorial axonal neuropathy was identified by electromyelography. Guillain-Barré syndrome was diagnosed...

What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations

Genc,Volkan; Sulaimanov,Marlen; Cipe,Gokhan; Basceken,Salim Ilksen; Erverdi,Nezih; Gurel,Mehmet; Aras,Nusret; Hazinedaroglu,Selcuk M
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 EN
Relevância na Pesquisa
56.96%
OBJECTIVE: Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy is still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decided to review the rate and causes of conversion from laparoscopic to open cholecystectomy. METHOD: This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from May 1999 to June 2010. The exclusion criteria were malignancy and/or existence of gallbladder polyps detected pathologically. Patient demographics, indications for cholecystectomy, concomitant diseases, and histories of previous abdominal surgery were collected. The rate of conversion to open cholecystectomy, the underlying reasons for conversion, and postoperative complications were also analyzed. RESULTS: Of 5382 patients for whom LC was attempted, 5164 were included this study. The overall rate of conversion to open cholecystectomy was 3.16% (163 patients). There were 84 male and 79 female patients; the mean age was 52.04 years (range: 26-85). The conversion rates in male and female patients were 5.6% and 2.2%...

Laparoscopic cholecystectomy versus minilaparotomy in cholelithiasis: systematic review and meta-analysis

CASTRO,Paula Marcela Vilela; AKERMAN,Denise; MUNHOZ,Carolina Brito; SACRAMENTO,Iara do; MAZZURANA,Mônica; Alvarez,Guines Antunes
Fonte: Colégio Brasileiro de Cirurgia Digestiva Publicador: Colégio Brasileiro de Cirurgia Digestiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
56.96%
INTRODUCTION: A introdução da técnica laparoscópica em 1985 foi um fator importante na colecistectomia por representar técnica menos invasiva, resultado estético melhor e menor risco cirúrgico comparado ao procedimento laparotômico. AIM: To compare laparoscopic and minilaparotomy cholecystectomy in the treatment of cholelithiasis. METHODS: A systematic review of randomized clinical trials, which included studies from four databases (Medline, Embase, Cochrane and Lilacs) was performed. The keywords used were "Cholecystectomy", "Cholecystectomy, Laparoscopic" and "Laparotomy". The methodological quality of primary studies was assessed by the Grade system. RESULTS: Ten randomized controlled trials were included, totaling 2043 patients, 1020 in Laparoscopy group and 1023 in Minilaparotomy group. Laparoscopic cholecystectomy dispensed shorter length of hospital stay (p<0.00001) and return to work activities (p<0.00001) compared to minilaparotomy...

What necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations

Genc, Volkan; Sulaimanov, Marlen; Cipe, Gokhan; Basceken, Salim Ilksen; Erverdi, Nezih; Gurel, Mehmet; Aras, Nusret; Hazinedaroglu, Selcuk M
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2011 ENG
Relevância na Pesquisa
56.96%
OBJECTIVE: Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy is still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decided to review the rate and causes of conversion from laparoscopic to open cholecystectomy. METHOD: This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from May 1999 to June 2010. The exclusion criteria were malignancy and/or existence of gallbladder polyps detected pathologically. Patient demographics, indications for cholecystectomy, concomitant diseases, and histories of previous abdominal surgery were collected. The rate of conversion to open cholecystectomy, the underlying reasons for conversion, and postoperative complications were also analyzed. RESULTS: Of 5382 patients for whom LC was attempted, 5164 were included this study. The overall rate of conversion to open cholecystectomy was 3.16% (163 patients). There were 84 male and 79 female patients; the mean age was 52.04 years (range: 26-85). The conversion rates in male and female patients were 5.6% and 2.2%...

Outpatient laparoscopic cholecystectomy: A new gold standard for cholecystectomy?

Bueno Lledó,J.; Planells Roig,M.; Arnau Bertomeu,C.; Sanahuja Santafé,A.; Oviedo Bravo,M.; García Espinosa,R.; Martí Obiol,R.; Espí Salinas,A.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2006 ENG
Relevância na Pesquisa
66.78%
Objective: to contribute our experience for five years in the implemetation of outpatient laparoscopic cholecystectomy (LC). Patients: between January 1999 and March 2004 we performed 504 outpatient LCs. We applied both exclusion and inclusion criteria, an anesthetic and surgical protocol, and discharge-specific criteria. Postoperative management in "fast track" regime. Postoperative period controlled by protocol, including phone calls after cholecystectomy. Results: the ambulatory percentage in the global series was 88.8%, and mean hospital stay was 6.1 hours. Fifty-one patients required overnight stays (10.1%), most of them for "social" causes. Five patients required admission (between 24 and 48 hours) for different causes (conversion to laparotomy, intraoperative neumothorax, and postoperative medical complications). Six patients (1.1%) were readmitted, and we observed 11.6% postoperative complications in the global series, with abdominal parietal pain being most frequent. Phone localization by 22.00 p.m. in the same day of surgery was 100% complete for outpatient cases. Postoperative surveillance within the first month after surgery was completed in 93.9%, and within th first year in 86.7% of patients. Conclusions: outpatient LC is safe and feasible...

Laparoscopic cholecystectomy in patients over 70 years of age: review of 176 cases

Pérez Lara,F. J.; Luna Díaz,R. de; Moreno Ruiz,J.; Suescun García,R.; Rey Moreno,A. del; Hernández Carmona,J.; Oliva Muñoz,H.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2006 ENG
Relevância na Pesquisa
66.84%
Introduction: we assessed the results of laparoscopic cholecystectomy in 176 patients over the age of 70 years. Patients and methods: the study included all patients older than 70 years of age who underwent laparoscopic surgery cholelithiasis during the previous ten years. Variables studied included age, sex, type of operation (programmed/emergency), comorbidity, anesthetic risk, intraoperative cholangiography, conversion to open surgery, number of trocars, reoperation, residual choledocholithiasis, postoperative hospital stay, morbidity and mortality. Results: the study included 176 patients (23.29% men and 76.71% women). The mean age was 74.86 years. The mean hospital stay was 1.27 days, with 16.98% morbidity and 0.56% mortality. Conclusions: laparoscopic cholecystectomy is a safe procedure in older patients. It results in faster recovery, a shorter postoperative stay and lower rates of morbidity and mortality than open bile duct surgery.

Quality of life (GIQLI) and laparoscopic cholecystectomy usefulness in patients with gallbladder dysfunction or chronic non-lithiasic biliary pain (chronic acalculous cholecystitis)

Planells Roig,M.; Bueno Lledó,J.; Sanahuja Santafé,A.; García Espinosa,R.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/07/2004 ENG
Relevância na Pesquisa
66.78%
Objective: the aim of this study was to evaluate the incidence, clinical features and role of laparoscopic cholecystectomy (LC) in patients with chronic acalculous cholecystitis (CAC) in comparison with a control group of patients who underwent cholecystectomy for chronic calculous cholecystitis (CCC). Material and methods: prospective evaluation of 34 patients with CAC in contrast with 297 patients with CCC. Outcome measures: clinical presentation, quality of life using the Gastrointestinal Quality of Life Index (GIQLI), usefulness derived from the therapeutic procedure as measured in quality of life units by GIQLI, and clinical efficacy at one year of follow-up. Results: the incidence of complicated biliary disease was higher in CAC (27%), in comparison with CCC (13.8%). The histological study of the excised gallbladder revealed a higher incidence of cholesterolosis associated with chronic cholecystitis in the CAC group (64.9%). GIQLI showed significant differences between preoperative and postoperative measurements in both groups. The associated usefulness of LC was similar in both groups (73 versus 67.3 per cent), confirming an important increase in quality of life for both categories. Conclusions: the incidence of CAC is 11 per cent with a high association with cholesterolosis. Quality of life and LC usefulness are similar to those of patients with CCC. Due to the fact that cholecistogammagraphy is a technique not available in daily clinical practice...

Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit?

Martínez Vieira,A.; Docobo Durántez,F.; Mena Robles,J.; Durán Ferreras,I.; Vázquez Monchul,J.; López Bernal,F.; Romero Vargas,E.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/07/2004 ENG
Relevância na Pesquisa
66.88%
Objective: analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance. Patients and method: eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service) from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients. Results: group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017), inability to tolerate oral diet (p = 0.002), and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003). Conclusions: outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.

Results of laparoscopic cholecystectomy in a third-level university hospital after 17 years of experience

Priego,P.; Ramiro,C.; Molina,J. M.; Rodríguez Velasco,G.; Lobo,E.; Galindo,J.; Fresneda,V.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/01/2009 ENG
Relevância na Pesquisa
66.79%
Objective: the aim of the study is to determine the results obtained with laparoscopic cholecystectomy at Ramón y Cajal Hospital after 17 years of experience, comparing current results with those at the beginning of the experience. Material and methods: between 1991 and December 2007, 3,933 laparoscopic cholecystectomies were performed at the "Ramón y Cajal Hospital"; 1,849 patients were operated on between 1991 and 2000, and 2,084 between 2001 and 2007. Patients studied included 69.8% of women and 30.2% of men, with a mean age of 56.95 years (range 9-94 years). In all, 54.68% of patients had a concomitant disease before surgery (hypertension, diabetes, ischemic heart disease, respiratory disease...). Surgery was performed by a staff surgeon for 58.04% of cases, and by a resident in the remaining 41.96%. Surgical indications were cholelithiasis in 75.5%, pancreatitis in 13.3%, cholecystitis in 6.3%, choledocholithiasis in 3.05%, and others in 1.2% of cases. Results: mean hospital stay was 3.06 days. Conversion to open surgery was required for 8.3% of cases (331 patients). The major surgical complication rate was 2.34%, with the most frequent being hemoperitoneum (1%). Common bile duct injury occurred in thirteen cases (0.3%), 51 patients (1.3%) were soon re-operated...