World Journal of Laparoscopic Surgery最新文献

{"title":"Laparoscopic Subtotal Cholecystectomy: Our Experience","authors":"R. Mishra, Martin C Obonna, G. Obonna","doi":"10.5005/jp-journals-10033-1462","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1462","url":null,"abstract":"A bstrAct Background: The gold standard for gallbladder (GB) surgery worldwide is laparoscopic cholecystectomy. At the same time, complications that may arise from performing cholecystectomy can be horrifying. This is because in some cases, the complex anatomy can predispose the patient to the dangerous arteriovenous and biliary injuries. A subtotal cholecystectomy (STC) can, thus, obviate these complications. Aim: To examine the clinical spectrum of STC and the postoperative turnout of this procedure. Materials and methods: Our health management information system was used to collate our 10-year data (January 2010–January 2020) from the secondary and tertiary health facilities owned by Ondo State of Nigeria. Information on patients’ biodata, indication for surgery, surgical approach, laboratory evaluation, and radiological assessment was entered into a spreadsheet and analyzed using Statistical Package for the Social Sciences (SPSS) version 20 (OBM Incorporation). STC occurs when there is a remnant of the GB after GB surgery exclusive of the cystic duct. Results: A total of 60 (15 % ) out of 400 patients underwent laparoscopic STC. Closely compacted, complexly crowded constituents and adhesions at the Calot’s triangle were the main indications for STC. Ten patients (16.7 % ) had bile leakage after surgery. There were no biliovascular injuries, and 1-month mortality was zero. There was no case of surgical site infection. Over a consistent follow-up of 1 year, clinical examination, liver function test, and ultrasonography revealed no abnormality in any of the patients. Conclusion: STC is a rescue mission during difficult GB surgery. Early consideration for STC before conversion to open surgery is more acceptable. Intraoperative injuries are obviated, and the postoperative outcomes are satisfactory.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49311813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial","authors":"Rk Mishra","doi":"10.5005/wjols-14-2-v","DOIUrl":"https://doi.org/10.5005/wjols-14-2-v","url":null,"abstract":"","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46023612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Management of Ovarian Dermoid Cyst in a 31-year-old Woman: A Case Report","authors":"C. Pramana","doi":"10.5005/jp-journals-10033-1456","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1456","url":null,"abstract":"Ovarian dermoid cysts, also known as mature teratomas, are one of the ovarian numbers that can develop into malignancy and are mostly found in women aged 20–40 years. Most cases of teratoma mature cystic were discovered accidentally through the imaging examination. We reported a 31-year-old woman with complaints of bleeding from the birth canal for 16 days and accompanied by sharp pain during menstruation. The general condition is good and other vital signs examined were within normal limits. Abdominal ultrasound examination showed a mass in the right adnexa with a size of 12 × 10 × 8 cm and there were longitudinal thin white lines. Laparoscopic right ovarian oophorectomy was performed. After removing the mass was opened and there was a lot of hair in it. There are no complications during surgery and after surgery. The results of the histopathological examination were by the dermoid cyst.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48270841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results Obtained with the Laparoscopic Approach to the Bile Duct for the Treatment of Choledocholithiasis in 101 Cases","authors":"B. Arnau, M. R. Blanco, Victor Molina Santos, Antonio Rabal Fueyo, Antonio Moral Duarte, S. Cabus","doi":"10.5005/jp-journals-10033-1447","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1447","url":null,"abstract":"Background: The optimal treatment for choledocholithiasis (CLT) is currently the subject of debate, as there is no clear evidence that a two-step (endoscopic plus surgical) approach is superior to a one-step surgical procedure. Materials and methods: We analyzed the results obtained from 101 consecutive patients diagnosed with CLT using magnetic resonance cholangiopancreatography (MRCP) or computed tomography (CT) scan undergoing cholecystectomy and laparoscopic exploration of the bile duct, carried out at our center between 2006 and 2019. In this analysis, special emphasis was made on the permanent resolution of the CLT and the associated complications. Results: The mean surgical time was 142 ± 36.7 minutes. In patients with a CLT diagnostic test more than 7 days previously, the presence of CLT was checked using intraoperative cholangiography (IOC), which was negative in 25 % of patients, while in the rest, a primary exploration was performed using a choledochoscope via choledochotomy in 82.2 % of patients and via the transcystic approach in two cases. A T-tube drain was inserted in 18.9 % of patients. The conversion rate was 0.9 % , due to a technical difficulty in removing the CLT in one patient. The laparoscopic approach treated the CLT permanently in 97 / 101 cases (96 % ), while four patients (3.9 % ) required postoperative endoscopic retrograde cholangiopancreatography (ERCP) due to residual cholelithiasis. A total of 15.8 % of patients experienced a postoperative biliary fistula, which was resolved using conservative management in 86.7 % of them, while two patients required surgical treatment and insertion of a percutaneous drain, respectively. The average postoperative stay duration was 6.5 ± 7.3 days. None of the patients showed signs of biliary stricture in the long-term postoperative follow-up. Conclusion: In our experience, the laparoscopic approach for one-step elective treatment of CLT is a safe option, with a very small number of complications and satisfactory short- and long-term results. Furthermore, despite preoperative identification of CLT, it helped to avoid unnecessary exploration of the bile duct in 25 % of patients.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46549341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Sonographic Imaging on Patients with Anterior Abdominal Wall Hernias to Prevent Reoperations","authors":"A. Enshaie, Saeed Kashefi, V. Aghamohammadi, Seyfollah Rezaie, Niloofar Afshari, K. Nasiri","doi":"10.5005/jp-journals-10033-1445","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1445","url":null,"abstract":"Background: Hernia is defined as an area of weakness or complete disruption of the body wall’s fibromuscular tissues. Structures arising from the cavity contained by the body wall can pass through, or herniate, through such a defect. The typical clinical finding is a bulged mass increasing in size when intra-abdominal pressure rises. The hernia is asymptomatic or may cause severe pain for patients. Arising of intra-abdominal pressure for each reason can generate anterior abdominal wall hernias; on the contrary, each synchronous surgically treatable intra-abdominal disease can be revealed with the same symptoms, and distinction of this disease prior to the surgery is important. Materials and methods: This study was conducted on 90 patients who were candidates for anterior abdominal wall herniorrhaphy. All patients were screened for the coexistence of intra-abdominal surgically treatable diseases using the abdominopelvic sonographic examination. According to our project, patients with a synchronous intra-abdominal illness were treated with single surgery for their hernia and surgically treatable disease. Other patients with the healthy sonographic report were only subject to herniorrhaphy. Results: The sonographic report was normal in 53 patients and abnormal (including cholelithiasis or any synchronous surgically treatable disease) in 37 patients. The study of the population using the Chi-square test to determine the need for further surgery (normal sonographic report rate) showed a statistical difference between hernia groups ( p = 0.001). In the umbilical hernia group, the need for further surgery is significantly lower than that in the other groups ( p < 0.001). Conclusions: The coexistence of intra-abdominal surgically treatable disease with anterior abdominal wall hernias and their possible recurrence due to the remaining of the intra-abdominal illness as a source for intra-abdominal cavity pressure convinced surgeons to carefully check patients for each surgically treatable intra-abdominal disease before surgery.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44744272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Laparoscopic-assisted Transversus Abdominis Plane Block during Elective Laparoscopic Cholecystectomy","authors":"A. Goel, R. Bansal, P. Garg, S. Kothari","doi":"10.5005/jp-journals-10033-1460","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1460","url":null,"abstract":"Background: In today’s era of minimally invasive surgery, early postoperative pain reduction, early recovery, and return to normal activities are also important aspects. This study has been designed to analyze and compare the effect of laparoscopically administered transversus abdominis plane (TAP) block with port-site infiltration of long-acting local anesthetic agent (0.25 % bupivacaine) in cases of elective laparoscopic cholecystectomy. Materials and methods: This is a comparative study carried out at St Joseph Hospital, Ghaziabad, from September 2019 to March 2020 on 154 patients who underwent standard four-port laparoscopic cholecystectomy. Seventy-seven patients in group I received TAP block with 0.25 % bupivacaine and seventy-seven patients in group II received 20 mL of 0.25 % bupivacaine infiltration over port sites, including 10 mL each at epigastric and umbilical port and 5 mL each at midclavicular line and anterior axillary line ports, respectively. Various parameters were assessed during the intraoperative and postoperative periods. The pain was analyzed using visual analog scoring (VAS) for the first 24 hours at an interval of 3, 6, 12, and 24 hours. A note was made of any additional analgesic requirement. Results: Postoperative pain at 3, 6, and 12 hours was significantly reduced in group I who received TAP block as compared to those who received port-site infiltration. Hospital stay duration was significantly shorter in group I. Conclusion: Laparoscopic-assisted TAP block significantly reduces early postoperative pain, shortens hospital stay after elective laparoscopic cholecystectomy, and is a safe and cost-effective method without any extra requirement of specialized equipment and skills.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47752351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoiding the Falciform Ligament Sign during the Intraoperative Cholangiogram","authors":"Saksham Gupta, S. Whitcher","doi":"10.5005/jp-journals-10033-1461","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1461","url":null,"abstract":"We have observed that the falciform ligament can appear prominently as a vertical lucent artifact making cholangiography difficult during laparoscopic cholecystectomy. Our suspicion is that this is due to the pneumoperitoneum, and once the pneumoperitoneum is released, this artifact disappears. We have presented images displaying this phenomenon that we feel would be useful for general surgeons operating on the gallbladder.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42406756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Predictors of Difficult Laparoscopic Cholecystectomy: AMU Scoring System","authors":"M. S. Akhtar, P. Alam, Y. Alvi, Isna Khan, Syed AA Rizvi, M. Raza","doi":"10.5005/jp-journals-10033-1454","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1454","url":null,"abstract":"bstrAct Introduction: With laparoscopy being the surgeon’s first choice even in difficult cholecystectomy, a need to objectively grade intraoperative difficulty during laparoscopic cholecystectomy (LC) is gaining popularity. The study was done to design a scoring system to predict the difficult outcome during intraoperative LC. Materials and methods: The study was done at the General Surgery Department in a tertiary level hospital among patients undergoing LC. The procedures that exceeded 70 minutes in duration and/or converted to open were considered the difficult LC. To develop the predictive score, an association of various factors with difficult cholecystectomy was identified by performing multiple logistic regression analysis, and receiver operating characteristic (ROC) curve was plotted to estimate the cutoff value for the scoring system. Results: We recruited 200 patients in this study, out of which 85 had difficult cholecystectomy procedures. Among all intraoperative predictors, adhesions, gallbladder (GB) condition, Calot’s triangle status and abnormality, and the presence of pericholecystic fluid were associated with a difficult LC. Based on the odds ratio, a new scoring system was designed with a score ranging from 0 to 25. The grading score was created as easy (0 – 5) and difficult (6 or above) based on the intraoperative factors. At a cutoff score of 6, this scoring system had a sensitivity and specificity of 87.1 and 88.7 % , respectively. Conclusion: This study demonstrates that an intraoperative scoring system can predict the difficult outcome of LC. This can help in minimizing the complication and conversion to open cholecystectomy, especially relevant for funds-limited settings like India.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47185417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between the Effect of Laparoscopic Sleeve Gastrectomy and Laparoscopic Mini-gastric Bypass on Type 2 Diabetes Mellitus in Obese Patients: A Prospective Study","authors":"Mohamed Elkerkary, H. Shaban, O. Adly, Mohamed KE Elhadary, Mohammad Farouk","doi":"10.5005/jp-journals-10033-1448","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1448","url":null,"abstract":"Background: One of the major global health burdens is type 2 diabetes mellitus (T2DM). Laparoscopic sleeve gastrectomy (LSG) has recently been shown to be effective and safe for T2DM management. Laparoscopic mini-gastric bypass (LMGB) was introduced as a simple (one anastomosis) operation combining both restrictive and malabsorptive functions thus suitable for obese patients with metabolic derangements like T2DM. This study aims to compare the effect of LSG and LMGB on T2DM in obese patients. Materials and methods: A cohort study was carried out on obese patients with T2DM submitted for LSG or LMGB in the department of surgery at Suez Canal university hospital and Suez Canal authority hospital, Egypt, from June 2018 to September 2020. The patients were followed up for 12 months. Results: A total of 20 patients were allocated to each group. The change in the mean body mass index (BMI) was significantly higher in the LSG, compared to the LMGB group ( p < 0.05). Both groups exhibited a significant reduction in the HbA1c at the end of follow-up 12 months after surgery; however, the reduction was significantly higher in the LMGB group ( p < 0.05).Among the LSG group, 75 % of the cases showed complete diabetic remission, 15 % showed partial remission, and 10 % showed improvement in their glycemic control at the end of follow-up. Among the LMGB group, 85 % of the cases showed complete diabetic remission and 10 % showed partial remission. The difference between the study groups was statistically significant. Conclusion: The study showed good improvement for T2DM and a great response in losing weight with a significant superiority of LMGB over the LSG.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44426799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Outcome of Laparoscopic vs Open Gastrectomy for Gastric Cancer: A Randomized Controlled Trial","authors":"M. Sayed, M. G. Taher, Salah I Mohamed, M. Hamad","doi":"10.5005/jp-journals-10033-1451","DOIUrl":"https://doi.org/10.5005/jp-journals-10033-1451","url":null,"abstract":"Background: Gastric cancer (GC) is a crucial cause of morbidity and mortality worldwide. In Egypt, GC ranked as the 12th most common cancer. During the last two decades, laparoscopic gastrectomy (LG) has proved to be popular and effective. This study aims to compare the short-term outcomes of LG vs open gastrectomy (OG) in resectable GC patients. Patients and methods: This is a randomized controlled trial, where patients presented to Assiut university hospital with resectable GC, in the period from January 2017 to December 2019, were randomly allocated to OG (group A) or LG (group B). Results: During the study period, 46 patients were randomized: 23 patients for OG and 23 for LG. Advanced cases after exploration were excluded from both the groups ended up with a total of 36 patients (20 for OG and 16 for LG). The mean follow-up time was 5 months ranging from 40 days to 10 months. There were no statistically significant differences between the two groups in the baseline clinicopathological data. The mean operative time was longer in LG (260.6 ± 46.7 vs 191.0 ± 24.7 minutes in OG) with a p -value <0.001. The postoperative hospital stay was more in OG compared to LG (8.0 ± 4.1 vs 6.9 ± 2.6 days, p -value = 0.361). Postoperative complications were more among OG (4/20) compared to (2/16) in LG ( p -value = 0.549). Just one mortality was reported in the OG. Conclusion: For GC cases, LG shows comparable outcomes to OG in short-term results, and it is a promising minimally invasive surgery in such cases.","PeriodicalId":38741,"journal":{"name":"World Journal of Laparoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44352367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}