{"title":"Improvement effect of compound Ento-PB on oxazolone-induced ulcerative colitis in rats.","authors":"Zhi Fan, Jinhu Chen, Jia Wei, ZhiBin Yang, Huai Xiao, Heng Liu","doi":"10.1590/acb395524","DOIUrl":"10.1590/acb395524","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of the Chinese medicine compound Ento-PB on oxazolone (OXZ)-induced ulcerative colitis (UC) in rats.</p><p><strong>Methods: </strong>UC rats induced by OXZ were treated with Ento-PB. The damage to the colon was assessed using several measures, including the disease activity index (DAI), colon length, colon weight/length ratio, colonic mucosal damage index, and histological score. The levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-13 (IL-13), epidermal growth factor (EGF), inducible nitric oxide synthase, and total nitric oxide synthase (tNOS) in rat serum, as well as the levels of tumor necrosis factor-α (TNF-α) and myeloperoxidase (MPO) in rat colon tissue, were determined using enzyme-linked immunosorbent assay and conventional kits.</p><p><strong>Results: </strong>After being treated with Ento-PB, the DAI score and macroscopic lesion score of OXZ-induced UC rats were significantly reduced. Ento-PB prevented the shortening of rat colons, reduced the ratio of colon weight to length, and improved colon tissue lesions. Meanwhile, Ento-PB could significantly inhibit the activities of proinflammatory cytokines TNF-α, IL-13, and MPO, as well as tNOS and iNOS, while upregulating the expression of anti-inflammatory cytokines IL-4 and IL-10. Moreover, a significant increase in the expression level of EGF was observed in UC rats treated with Ento-PB, indicating that Ento-PB could enhance the repair of damaged intestinal epithelial tissue.</p><p><strong>Conclusions: </strong>Ento-PB demonstrates significant anti-UC activities in OXZ-induced UC rats by regulating the expression levels of inflammatory factors and promoting the repair of colon tissue. This study provides scientific evidence to support the further development of Ento-PB.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e395524"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gábor Martis, Renáta Laczik, Norbert Németh, Gabriella Martis, László Damjanovich
{"title":"Bilateral rectus muscle turning-over for complicated and eventrated abdominal wall hernias: results of a novel method.","authors":"Gábor Martis, Renáta Laczik, Norbert Németh, Gabriella Martis, László Damjanovich","doi":"10.1590/acb393624","DOIUrl":"10.1590/acb393624","url":null,"abstract":"<p><strong>Purpose: </strong>We present a technique for covering large midline loss of abdominal wall using a novel method by autologous tissues.</p><p><strong>Methods: </strong>Twenty-two patients (body mass index = 35,6 ± 6,9 kg/m2) were involved in the prospective cohort study. Acute and elective cases were included. The gap area was 450.1 ± 54 cm2. The average width of the midline gap was 16,3 ± 3,2 cm. The rectus muscles were mobilized from its posterior sheath. Both muscles were turned by180º medially, so that the complete abdominal wall gap could be covered without considerable tension. Changes in intra-abdominal pressure, quality of life and hernia recurrency were determined.</p><p><strong>Results: </strong>There was no significant increase in the intra-abdominal pressure. Wound infection and seroma occurred in four cases. Bleeding occurred in one case. Pre- and post-operative quality of life index significantly improved (23 ± 13 vs. 47 ± 6; p = 0,0013). One recurrent hernia was registered. The procedure could be performed safely and yielded excellent results. The method was applied in acute cases. The intact anatomical structure of rectus muscles was essential.</p><p><strong>Conclusions: </strong>The midline reconstruction with bilateral turned-over rectus muscles provided low tension abdominal wall status, and it did not require synthetic mesh implantation.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e393624"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gisely de Andrade Costa Pereira, André Luiz Oliveira Poleto, Aldo José Fontes-Pereira, Marco Antônio von Krüger, Wagner Coelho de Albuquerque Pereira
{"title":"Ultrasonic neuromodulation as a new therapy for spasticity in an animal model of spastic cerebral palsy.","authors":"Gisely de Andrade Costa Pereira, André Luiz Oliveira Poleto, Aldo José Fontes-Pereira, Marco Antônio von Krüger, Wagner Coelho de Albuquerque Pereira","doi":"10.1590/acb394924","DOIUrl":"10.1590/acb394924","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate a new therapeutic option for the spasticity using ultrasound neuromodulation in an animal model of spastic cerebral palsy.</p><p><strong>Methods: </strong>Thirty-two adult male Wistar rats were randomly distributed in: negative control (NC); positive control (PC); untreated model (UTM); and treated model (TM). Rats in the control groups received sham surgery, and rats in the model groups received the spastic cerebral palsy model surgery. The rats' motor functions were evaluated by the Rotarod and CatWalk tests before and after surgery. PC and TM groups underwent ultrasonic neuromodulation by a physiotherapeutic ultrasound (intensity 0.1 W/cm2, at 1 MHz) continuous mode for 5 seconds, for seven days.</p><p><strong>Results: </strong>Twelve rats showed a spastic pattern (UTM = 6 and TM = 6), motor limitations (UTM = 6 and TM = 6), and ten had difficulty feeding (UTM = 5 and TM = 5). One UTM group rat could not recover its preoperative latency time, while the other rats in the model groups did. The speed at which the limbs swung reduced after surgery and increased in subsequent assessments, demonstrating greater instability and a deficit in locomotion balance.</p><p><strong>Conclusions: </strong>Results were not yet sufficient to assert ultrasound neuromodulation as a possible therapy for spasticity in spastic cerebral palsy in the parameters used, and more studies are necessary.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e394924"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafaela Batista Coutinho, Wilza Arantes Ferreira Peres, Tatiana Pereira de Paula
{"title":"Association between preoperative fasting time and clinical outcomes in surgical patients in a private general hospital.","authors":"Rafaela Batista Coutinho, Wilza Arantes Ferreira Peres, Tatiana Pereira de Paula","doi":"10.1590/acb394524","DOIUrl":"10.1590/acb394524","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical patients are routinely subjected to long periods of fasting, a practice that can exacerbate the metabolic response to trauma and impair postoperative recovery. The aim of this study was to evaluate the association between preoperative fasting time and clinical outcomes in surgical patients.</p><p><strong>Methods: </strong>An observational, prospective study with a non-probabilistic sample that included patients of both sexes, aged over 18, undergoing elective surgeries. Data were extracted from electronic medical records, and a questionnaire was applied in 48 hours after surgery. Variables related to postoperative discomfort were assessed using an 11-point numeric rating scale.</p><p><strong>Results: </strong>The sample consisted of 372 patients, and the duration of the surgical event ranged from 30-680 minutes. The incidence of nausea (26.34%) was twice that of vomiting (13.17%) and showed an association with the surgical procedure's size (p = 0.018). A statistically significant difference was observed only between pain intensity and preoperative fasting times for liquids (p = 0.007) and postoperative fasting time (p = 0.08). The occurrence of postoperative complications showed no association with preoperative fasting time (p = 0.850).</p><p><strong>Conclusions: </strong>Although no association was observed between preoperative fasting time and surgical complications, it is noteworthy that both recommended and actual fasting time exceeded the proposed on clinical guidelines.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e394524"},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Protective function of albiflorin against ferroptosis in exhaustive exerciseinduced myocardial injury via the AKT/Nrf2/HO-1 signaling.","authors":"Zhuang Tian, Zhenyu Li","doi":"10.1590/acb393524","DOIUrl":"10.1590/acb393524","url":null,"abstract":"<p><strong>Purpose: </strong>It has been reported that exhaustive exercise (EE) causes myocyte injury, and eventually damages the function of the myocardia. Albiflorin (AF) has anti-inflammatory, antioxidant, and anti-apoptosis effects. In this study, we determined whether AF could mitigate the EE-induced myocardial injury and research the potential mechanisms.</p><p><strong>Methods: </strong>The rat model of EE was built by forced treadmill running method. Rats were intraperitoneally injected with AF before EE once daily for one week. The relative factors levels were examined by commercial kits. The apoptosis was appraised using a TdT-mediated dUTP nick end labeling assay kit. The ACSL4, GPX4, Nrf2, pAKT/AKT, and HO-1 contents were assessed by western blot.</p><p><strong>Results: </strong>AF lessened EE-induced cardiac myocytes ischemic/hypoxic injury and reduced the contents of myocardial injury biomarkers in the serum. AF lessened EE-induced cardiac myocyte apoptosis, inflammatory response, oxidative stress, and ferroptosis in myocardial tissues. However, the influences of AF were overturned by the co-treatment of AF and LY294002. AF activated the AKT/Nrf2/HO-1 signaling pathway in myocardial tissues in vivo.</p><p><strong>Conclusions: </strong>AF could curb cardiac myocytes ferroptosis, thus diminishing the EE-induced myocardial injury through activating the AKT/Nrf2/HO-1 cascade.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e393524"},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A neural cell automated analysis system based on pathological specimens in a gerbil brain ischemia model.","authors":"Eri Katsumata, Abhishek Kumar Ranjan, Yoshihiko Tashima, Takayuki Takahata, Toshiyuki Sato, Motoaki Kobayashi, Masami Ishii, Toyomi Takahashi, Asahi Oda, Momoko Hirano, Yoji Hakamata, Kazuhisa Sugai, Eiji Kobayashi","doi":"10.1590/acb394224","DOIUrl":"10.1590/acb394224","url":null,"abstract":"<p><strong>Purpose: </strong>Amid rising health awareness, natural products which has milder effects than medical drugs are becoming popular. However, only few systems can quantitatively assess their impact on living organisms. Therefore, we developed a deep-learning system to automate the counting of cells in a gerbil model, aiming to assess a natural product's effectiveness against ischemia.</p><p><strong>Methods: </strong>The image acquired from paraffin blocks containing gerbil brains was analyzed by a deep-learning model (fine-tuned Detectron2).</p><p><strong>Results: </strong>The counting system achieved a 79%-positive predictive value and 85%-sensitivity when visual judgment by an expert was used as ground truth.</p><p><strong>Conclusions: </strong>Our system evaluated hydrogen water's potential against ischemia and found it potentially useful, which is consistent with expert assessment. Due to natural product's milder effects, large data sets are needed for evaluation, making manual measurement labor-intensive. Hence, our system offers a promising new approach for evaluating natural products.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e394224"},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jannyely Moreira Neri, Paula Emília Apolônio Siqueira, Ana Luiza Cabral de Sá Leitão Oliveira, Renata Mendonça Araújo, Raimundo Fernandes de Araújo Júnior, Agnes Andrade Martins, Isabelle de Lima Marques, Rafaela Alcindo Silva, Aurigena Antunes de Araújo, Fabrício Gava Menezes
{"title":"Anticancer, anti-inflammatory and analgesic activities of aminoalcohol-based quinoxaline small molecules.","authors":"Jannyely Moreira Neri, Paula Emília Apolônio Siqueira, Ana Luiza Cabral de Sá Leitão Oliveira, Renata Mendonça Araújo, Raimundo Fernandes de Araújo Júnior, Agnes Andrade Martins, Isabelle de Lima Marques, Rafaela Alcindo Silva, Aurigena Antunes de Araújo, Fabrício Gava Menezes","doi":"10.1590/acb395124","DOIUrl":"10.1590/acb395124","url":null,"abstract":"<p><strong>Purpose: </strong>Bioactive molecules are relevant to fight cancer and associated conditions. Quinoxaline is a privileged N-heterocycle, notably as anticancer agents. Herein, we report the evaluation of the quinoxaline derivatives DEQX and OAQX as anticancer agents, as well as in function of their anti-inflammatory and analgesic activities.</p><p><strong>Methods: </strong>Quinoxalines were synthesized and tested as anticancer agents based on cell viability and Annexin V-FITC apoptosis. Anti-inflammatory activity was evaluated from mouse carrageenan peritonitis and levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-alfa for enzyme-linked immunosorbent assay. Hot-plate and acetic acid-induced writing test were employed to investigate analgesia.</p><p><strong>Results: </strong>Both reduced the Ht-29 cell viability in a dependent-concentration manner (p < 0.001). Total apoptosis was detected for cells treated with 12.5 and 25 µg/mL of both the compounds for 24 and 48 h (all doses, p < 0.0001). DEQX (all doses, p < 0.01) and OAQX (all doses, p < 0.001) acted in leukocyte migration and decreased the IL-1β and TNF-β levels (p < 0.05). DEQX (all doses, p < 0.05) and OAQX (5mg/kg, p < 0.001) showed peripheral analgesic effect.</p><p><strong>Conclusions: </strong>In-vitro and in-vivo results suggest that these quinoxalines are promising for application in pharmacological area due to their anticancer, anti-inflammatory, and peripheric analgesia.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e395124"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luis Otávio Amaral Duarte Pinto, Renata Cunha Silva, Helder Clay Fares Dos Santos Junior, Lívia Guerreiro de Barros Bentes, Mateus Itiro Tamazawskas Otake, Herick Pampolha Huet de Bacelar, Kátia Simone Kietzer
{"title":"Simulators in urology resident's training in retrograde intrarenal surgery.","authors":"Luis Otávio Amaral Duarte Pinto, Renata Cunha Silva, Helder Clay Fares Dos Santos Junior, Lívia Guerreiro de Barros Bentes, Mateus Itiro Tamazawskas Otake, Herick Pampolha Huet de Bacelar, Kátia Simone Kietzer","doi":"10.1590/acb394724","DOIUrl":"10.1590/acb394724","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of simulators on the training of urology residents in retrograde intrarenal surgery (RIRS).</p><p><strong>Methods: </strong>The study involved training eight urology residents, using two artificial simulators; one developed by the Universidade Estadual do Pará, using three-dimensional printing technology, and the other one patented by the medical equipment manufacturer Boston Scientific The qualification of residents took place through a training course, consisting of an adaptation phase (S0), followed by three training sessions, with weekly breaks between them (S1, S2 and S3). Study members should carry out a RIRS in a standardized way, with step-by-step supervision by the evaluator using a checklist. The participants' individual performance was verified through a theoretical assessment, before and after training (pre- and post-training), as well as by the score achieved in each session on a scale called global psychomotor skill score. In S3, residents performed an analysis of the performance and quality of the simulation, by completing the scale of student satisfaction and self confidence in learning (SSSCL).</p><p><strong>Results: </strong>At the end of the course, everyone was able to perform the procedure in accordance with the standard. The training provided a learning gain and a considerable improvement in skills and competencies in RIRS, with p < 0.05. SSSCL demonstrated positive feedback, with an overall approval rating of 96%.</p><p><strong>Conclusions: </strong>Artificial simulators proved to be excellent auxiliary tools in the training of urology residents in RIRS.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e394724"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Eduardo Braga Filho, Talita Dias da Silva, Claudia Joanete da Silva, Cleidivan Alves Dos Santos, Frank Menezes Rodrigues, Adriano Henrique Pereira Barbosa, Adriano Caixeta, Maria Cristina de Oliveira Izar, Bráulio Luna-Filho, Francisco Antonio Helfenstein Fonseca, Fernando Sabia Tallo, Leonardo Roever, Afonso Caricati-Neto, Francisco Sandro Menezes-Rodrigues
{"title":"Forty years of a Postgraduate Program in Cardiology at a Brazilian public university: indicators of its graduates.","authors":"Carlos Eduardo Braga Filho, Talita Dias da Silva, Claudia Joanete da Silva, Cleidivan Alves Dos Santos, Frank Menezes Rodrigues, Adriano Henrique Pereira Barbosa, Adriano Caixeta, Maria Cristina de Oliveira Izar, Bráulio Luna-Filho, Francisco Antonio Helfenstein Fonseca, Fernando Sabia Tallo, Leonardo Roever, Afonso Caricati-Neto, Francisco Sandro Menezes-Rodrigues","doi":"10.1590/acb394824","DOIUrl":"10.1590/acb394824","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the profile of graduates of the Postgraduate Program (PGP) in Cardiology of a public federal university, according to sociodemographic factors and professional trajectory.</p><p><strong>Methods: </strong>The variables were collected from databases from the observed institution and digital platforms. The analysis of differences between the various levels of degrees was carried out in three cohorts: the entire historical series (graduates from 1978-2021), the first 20 years (1978-1997) and the second 20 years (1998-2018).</p><p><strong>Results: </strong>The results demonstrated that most students from the PGP completed a PhD and are men over 30 years old, they came from public universities and the Southeast region. In the first 20 years, significant differences were observed in the distribution of masters and doctors working professionally at the institution analyzed, as well as in the age of the students. In the 20 years of the second half, there were differences between masters and PhD working professionally in the institution itself, as they came from private universities, they are women and PhD.</p><p><strong>Conclusions: </strong>The changes in the profile of masters and PhD that graduated from this PGP in cardiology reflect transformations that occurred in the job market and academy over the decades.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e394824"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcelo Augusto Fontenelle Ribeiro Junior, Roberto Rizzi, Sariya Khan, Maryam Makki, Shahin Mohseni
{"title":"Shoeshine maneuver for cystic duct dissection: a simple technique to make Calot-triangle dissection smooth.","authors":"Marcelo Augusto Fontenelle Ribeiro Junior, Roberto Rizzi, Sariya Khan, Maryam Makki, Shahin Mohseni","doi":"10.1590/acb395224","DOIUrl":"10.1590/acb395224","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic cholecystectomy, introduced in 1985 by Prof. Dr. Erich Mühe, has become the gold standard for treating chronic symptomatic calculous cholecystopathy and acute cholecystitis, with an estimated 750,000 procedures performed annually in the United States of America. The risk of iatrogenic bile duct injury persists, ranging from 0.2 to 1.3%. Risk factors include male gender, obesity, acute cholecystitis, previous hepatobiliary surgery, and anatomical variations in Calot's triangle. Strategies to mitigate bile duct injury include the Critical View of Safety and fundus-first dissection, along with intraoperative cholangiography and alternative approaches like subtotal cholecystectomy.</p><p><strong>Methods: </strong>This paper introduces the shoeshine technique, a maneuver designed to achieve atraumatic exposure of anatomical structures, local hemostatic control, and ease of infundibulum mobilization. This technique involves the use of a blunt dissection tool and gauze to create traction and enhance visibility in Calot's triangle, particularly beneficial in cases of severe inflammation. Steps include using the critical view of safety and Rouviere's sulcus line for orientation, followed by careful dissection and traction with gauze to maintain stability and reduce the risk of instrument slippage.</p><p><strong>Results: </strong>The technique, routinely used by the authors in over 2000 cases, has shown to enhance patient safety and reduce bile duct injury risks.</p><p><strong>Conclusion: </strong>The shoeshine technique represents a simple and easy way to apply maneuver that can help surgeon during laparoscopic cholecystectomies exposing the hepatocystic area and promote blunt dissection.</p>","PeriodicalId":93850,"journal":{"name":"Acta cirurgica brasileira","volume":"39 ","pages":"e395224"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}