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Cholecystectomy

Cholecystectomy is the surgical removal of the gallbladder, a common procedure used to treat gallbladder diseases such as gallstones, cholecystitis, and biliary dyskinesia.
The surgery typically involves making small incisions in the abdomen to access and remove the gallbladder.
Cholecystectomy can be performed using open or laparoscopic techniques, with the laparoscopic approach being the more common and less invasive method.
Optimal research and protocodls are key to improving outcomes and driving scientific breakthroughs in this field.

Most cited protocols related to «Cholecystectomy»

Over the 6‑month period covering April 2010 to September 2010, all patients admitted to one of our patient wards at the Division of General Surgery, Department of Surgery, Medical University of Vienna were included in this study.
The Division of General Surgery in our university hospital consists of the following teams and specializations: colorectal surgery, hepatobiliary surgery, endocrine surgery, upper gastrointestinal (GI) surgery (esophageal and stomach surgery), bariatric surgery, breast surgery, and pancreatic surgery.
The patient data were extracted by reviewing all discharge letters from that period taken from the digital archives.
Overall, 517 patients were admitted over this period, some repeatedly, leading to a total of 817 admissions. These 517 patients underwent 463 operations. The complications of these operations were then rated according to the Clavien-Dindo classification (Table 1). For easier use, the suffix “d” for permanent disability was not drawn upon.

Clavien-Dindo classification

GradeDefinition
Grade IAny deviation from the normal postoperative course without the need for pharmacological treatment, or surgical, endoscopic, and radiological interventions.Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics and electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside
Grade IIRequiring pharmacological treatment with drugs other than such allowed for grade I complications.Blood transfusions and total parenteral nutrition are also included
Grade IIIRequiring surgical, endoscopic, or radiological intervention
Grade IIIaIntervention not under general anesthesia
Grade IIIbIntervention under general anesthesia
Grade IVLife-threatening complication (including central nervous system complications) requiring IC/ICU management
Grade IVaSingle organ dysfunction (including dialysis)
Grade IVbMultiorgan dysfunction
Grade VDeath of a patient

According to Dindo et al. [6 (link)]

IC intermediate care, ICU intensive care unit

The operations were sorted according to the complexity ranking (eight groups) in the accounting system of the Austrian Chamber of Physicians (Table 2; [8 ]).

Operation groups (complexity according to the Austrian Chamber of Physicians)

Operation groupExamples
IAbscess incisions, secondary sutures, proctoscopy, skin biopsy
IIExcisions of atheromas, fibromas, lipomas, incisions of anal abscesses
IIIToe amputation, small lymph node extirpation, thoracic drainage, colonoscopy
IVTracheotomy, appendectomy, hernia operation, colostomy, gastrostomy, ERCP
VGastroenterostomy, interventions for recurrent hernia, Cimino fistula, radical varicose vein stripping
VIStrumectomy, cholecystectomy, splenectomy, hemicolectomy, reduction mammoplasty
VIIPartial pancreatectomy, subtotal colectomy, subsegmental and large liver resections
VIIIEsophageal resection, open surgery of aortic aneurysms, organ transplantation
Publication 2018
Amputation Antiemetics Antipyretics Anus Aortic Aneurysm Appendectomy Atheroma Bariatric Surgery Blood Transfusion Central Nervous System Cholecystectomy Colectomy Colostomy Dialysis Disabled Persons Diuretics Drainage Electrolytes Endocrine Surgical Procedures Fibroma Fingers Fistula Gastrointestinal Surgical Procedure Gastrostomy Hemicolectomy Hepatectomy Hernia Intensive Care Lipoma Lymph Node Excision Operative Surgical Procedures Organ Transplantation Pancreas Pancreatectomy Parenteral Nutrition, Total Patient Discharge Patients Pharmaceutical Preparations Pharmacotherapy Physicians Proctoscopy Skin Splenectomy Stomach Surgical Endoscopy Surgical Wound Sutures Therapeutics Therapy, Physical Thoracic Surgical Procedures Treatment Protocols Upper Gastrointestinal Tract Varices Wound Infection X-Rays, Diagnostic
We retrospectively analyzed 451 patients from six tertiary care centers in Japan between November 2005 and November 2011: Sapporo Medical University, Tokyo Medical University, Tokyo Women’s Medical University, Nagoya Daini Red Cross Hospital, Ogaki Municipal Hospital, and Fukuoka University School of Medicine. Consecutive patients who were operated on for cholecystectomy were included during the study period. The “gold standard” for acute cholecystitis in this study was pathological diagnosis using standard gross and histological criteria. We therefore confirmed the final diagnosis by pathological examination of excised gallbladders after operation. If the pathological findings were chronic cholecystitis or other, those cases were considered to be “negative.”
All 451 patients were evaluated using TG07 criteria. The validity of the diagnostic criteria of TG07 was investigated by analyzing their sensitivity and specificity. The severity grading system of TG07 was evaluated by determining the distribution of severity among these patients. Through these data, the Tokyo Guidelines Revision Committee members discussed the quality of diagnostic criteria and severity assessment of acute cholecystitis in TG07 to reassess TG and propose new guidelines.
The literature was selected as follows: using “Tokyo Guidelines” AND “acute cholecystitis[MeSH]”, only 3 items were selected in PubMed since the publication of TG07 (1 April 2007 – 31 March 2012). These articles were screened with “human” and “English”. However, using “acute cholecystitis[MeSH]” AND “prognosis[MeSH]”, a total of 119 items were selected in PubMed over the same length of time. From these articles, the prognostic factors of acute cholecystitis to be utilized for the revision of TG07 were screened by the Tokyo Guidelines Revision Committee members. In addition, the distribution of severity grading was aggregated from the literature which reported the data based on the severity assessment of TG07.
The Tokyo Guidelines Revision Committee discussed the modification of TG07 diagnostic criteria and severity assessment of acute cholecystitis by analyzing the results of the present study and integrating the literature evidence.
Publication 2012
Acute Cholecystitis Cholecystectomy Cholecystitis Committee Members Diagnosis Gallbladder Gold Homo sapiens Patient-Centered Care Patients Prognosis Prognostic Factors Woman
We constructed a sample consisting of patients who underwent 1 of 11 surgical procedures during the sample period: total knee arthroplasty (TKA), total hip arthroplasty (THA), laparoscopic cholecystectomy, open cholecystectomy, laparoscopic appendectomy, open appendectomy, cesarean delivery, FESS, cataract surgery, transurethral prostate resection (TURP), or simple mastectomy. We chose these procedures because they are commonly performed. In addition, with the exception of TKA and THA, these procedures are not indicated to relieve pain and are not thought to place patients at risk for long-term pain. We identified patients who underwent these procedures by identifying inpatient or outpatient claims with a CPT code for the given procedure (eTable 1 in the Supplement). We restricted our analysis to patients aged 18 to 64 years who were continuously enrolled for a period of at least 3 calendar years, encompassing the year before the procedure and the year after. For example, for patients who received their procedure in 2003, we required that the patient be continuously enrolled for at least the time period January 1, 2002, through December 31, 2004. In addition, we excluded patients who underwent 2 or more of the 11 studied surgical procedures. Using data from pharmacy claims, we further restricted our analysis to opioid-naive patients, defined as patients who did not fill a prescription for an opioid in the 12 months prior to their procedure. A flowchart outlining the construction of the sample is provided in the eFigure in the Supplement.
Publication 2016
Appendectomy Cataract Extraction Cesarean Section Cholecystectomy Cholecystectomy, Laparoscopic Dietary Supplements Inpatient Knee Replacement Arthroplasty Laparoscopy Operative Surgical Procedures Opioids Outpatients Pain Patients Simple Mastectomy Total Hip Arthroplasty Transurethral Resection of Prostate

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Publication 2019
Cholangiography Cholecystectomy Cholecystectomy, Laparoscopic Choledocholithiasis Duct, Bile Endoscopic Retrograde Cholangiopancreatography Patients

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Publication 2012
Aftercare Appendectomy Cholecystectomy Choledochoduodenostomy Duodenum Gastrostomy Head Heparin Human Body Intubation, Gastrointestinal Jejunostomy Liver Lovenox Medical Devices Operative Surgical Procedures Pancreas Pancreatectomy Pancreaticoduodenectomy Patients Peritoneal Cavity Portal Pressure Pressure Pylorus Reconstructive Surgical Procedures Roux-en-Y Anastomosis Spleen Splenic Artery Stomach Surgeons Tail Tissues Veins, Portal Veins, Splenic

Most recents protocols related to «Cholecystectomy»

This is a prospective observational study on 167 patients with hepatobiliary manifestations who underwent two-stage elective LRP with IPAA for UC from June 2013 to June 2018 at our universities’ hospitals. Inclusion criteria were all patients between 18 and 69 years; men and women with at least one hepatobiliary manifestation. In patients with UC, surgery was decided according to The European Crohn’s and Colitis Organisation guidelines on therapeutics in UC[11 (link)]. Exclusion criteria included: Alcohol abuse, severe heart failure or type II diabetes mellitus, complications or death related to LRP operation, liver toxicity of IBD-related medications, active or chronic viral hepatitis, hemochromatosis, Wilson's disease, drugs-induced steatosis (amiodarone or tamoxifen), morbid obesity or patients undergoing bariatric surgery, immunoglobulin G4-related cholangitis; human immunodeficiency virus/acquired immune deficiency syndrome; tuberculosis; secondary sclerosing cholangitis; cholangiocarcinoma; complications of advanced PSC (hepatic encephalopathy, portal hypertension, hepatorenal syndrome, or hepato-pulmonary syndrome; end-stage liver failure), hypercoagulability status (systemic lupus erythematosus, increased von Willebrand factor or increased homocysteine level), oral contraceptive pills, Grave's disease, dyslipidemia, and previous biliary tract surgery including cholecystectomy.
Publication 2023
167-A Abuse, Alcohol Acquired Immunodeficiency Syndrome Amiodarone Bariatric Surgery Biliary Tract Surgical Procedures Cholangiocarcinoma Cholangitis Cholecystectomy Colitis Congestive Heart Failure Contraceptives, Oral Crohn Disease Diabetes Mellitus, Non-Insulin-Dependent Dyslipidemias End Stage Liver Disease Europeans Factor VIII-Related Antigen Graves Disease Hemochromatosis Hepatic Encephalopathy Hepatitis, Chronic Hepatolenticular Degeneration Hepatopulmonary Syndrome Hepatorenal Syndrome HIV Homocysteine IgG4 Liver Lupus Erythematosus, Systemic Obesity, Morbid Patients Pharmaceutical Preparations Portal Hypertension Steatohepatitis Tamoxifen Therapeutics Thrombophilia Toxicity, Drug Tuberculosis Woman
The trial is designed as a randomized, controlled, single center no inferiority trial with two parallel groups and a primary endpoint of localization accuracy during laparoscopic colectomy, which will take place in the Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University, Shanghai, China (Fig. 1). The participants will be screened for inclusion and exclusion criteria (Table 1) by the reception oncologist. Eligible patients will be invited for study participation at their first visit at Department of Gastrointestinal Surgery. The doctor who sees the patient will give a formal and detailed description of the study and its procedures. Upon the acquisition of patient written informed consent form, patients will undergo assessment.

Key inclusion and exclusion criteria of the trial

Inclusion criteriaExclusion criteria

• Age from 18 to 80 years

• Large lateral spreading tumors that could not be treated endoscopically, malignant polyps treated endoscopically that required additional colorectal resection, and serosa-negative malignant colorectal tumors (≤ cT3)

• The tumor located in the colon, middle and high rectum (The lower edge of the tumor located above the peritoneal reflexes)

• No distant metastasis

• American Society of Anesthesiology score (ASA) class I-III

• Performance status of 0 or 1 on Eastern Cooperative Oncology Group scale (ECOG)

• Written informed consent

• BMI > 35 kg/m2

• Previous history of gastrointestinal surgery that altered the gastrointestinal anatomy.

• Pregnant or lactating women

• Severe mental disorder

• History of previous abdominal surgery (except cholecystectomy and appendectomy)

• Rejection of laparoscopic resection

• History of cerebrovascular accident within the past six months

• History of unstable angina or myocardial infarction within the past six months

• History of previous neoadjuvant chemotherapy or radiotherapy

• Comorbidity of emergent conditions like obstruction, bleeding or perforation.

• Needing simultaneous surgery for other diseases.

After completing an initial assessment and signing an informed consent form, participants will be randomized with 1:1 ratio into two groups: autologous blood marker group and intraoperative colonoscopy group. The data manager, who will not be involved in eligibility assessment and recruitment of patients, will perform the randomization with a list of randomly ordered treatment identifiers generated by a permuted block design using SAS (version 9.1; SAS Institute Inc.). Although it will not be feasible to blind the surgeons and participants, the researcher performing the statistical analyses will be blinded to the patient group allocation.
This protocol and the informed consent forms have been reviewed and approved by Shanghai East Hospital and Institute Ethics Review Committee. We will obtain a new approval from the Committee if any amendments are made to the protocol or the informed consent form that may have an impact on the conduct of the study or potential benefit of the patient. A signed consent must be obtained from every participant in the ancillary study, if the data collection/request is not covered in the original informed consent process for the main clinical trial. The study has been registered in Clinical-Trial.gov (NCT05597384).
Publication 2023
Abdomen Angina, Unstable Appendectomy Cerebrovascular Accident Cholecystectomy Colectomy Colon Colonoscopy Colorectal Neoplasms concomitant disease Eligibility Determination Gastrointestinal Surgical Procedure Laparoscopy Mental Disorders, Severe Myocardial Infarction Neoadjuvant Chemotherapy Neoplasm Metastasis Neoplasms Oncologists Operative Surgical Procedures Patients Peritoneum Physicians Polyps Radiotherapy Rectum Reflex Serous Membrane Surgeons Vision Woman
This retrospective cohort study enrolled patients who underwent laparoscopic surgery for cholecystolithiasis plus choledocholithiasis at the Department of Hepatobiliary Surgery of Tongling People’s Hospital from January 2017 to March 2021.
The inclusion criteria for the study include patients who had (1) a diagnosis of cholecystolithiasis plus choledocholithiasis by preoperative imaging examination and postoperative pathology and (2) who underwent LCBDPSENBD or LCBDTD or LCERCP surgery. The patients who underwent laparotomy underwent other surgeries (such as liver resection, appendectomy, etc.) simultaneously or with incomplete data were excluded.
European Society of Gastrointestinal Endoscopy (ESGE) suggests offering stone extraction to all patients with CBD stones. The European Society of Gastrointestinal Endoscopy recommends a convergent ERCP for cholecystectomy in patients with CBD stones. Intraoperative ERCP can be performed during laparoscopic cholecystectomy as a first-stage treatment for cholecystocholithiasis or after the failure of preoperative endoscopic attempts to remove CBDS. Guidelines recommend laparoscopic cholecystectomy within 2 weeks of ERCP in patients with CBD stones to reduce the rate of outcome and the risk of biliary event recurrence. In patients undergoing laparoscopic cholecystectomy, choledochoscope exploration of the CBD is a safe and effective technique for CBD stone clearance.22 (link) According to the guideline, we divided patients into 3 groups randomly.
This study was approved by the Ethics Committee of Tongling People’s Hospital (2021004). The requirement for patients’ informed consent was waived due to the retrospective nature of the study.
Publication 2023
Appendectomy Calculi Cholecystectomy Cholecystectomy, Laparoscopic Cholecystolithiasis Choledocholithiasis Diagnosis Endoscopic Retrograde Cholangiopancreatography Endoscopy Endoscopy, Gastrointestinal Ethics Committees, Clinical Europeans Hepatectomy Laparotomy Operative Surgical Procedures Patients Recurrence Surgical Procedures, Laparoscopic
This cohort study was determined to be exempt from review and informed consent by the institutional review board of the Mayo Clinic, Rochester, Minnesota, owing to the use of deidentified data. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.
Adult patients (ie, patients aged ≥18 years) who underwent 1 of 16 commonly scheduled general surgery operations (minimally invasive colectomy for cancer, minimally invasive colectomy for benign disease, lumpectomy for breast cancer, mastectomy for breast cancer, minimally invasive adrenalectomy, thyroid lobectomy, total thyroidectomy, parathyroidectomy, minimally invasive inguinal hernia repair, open inguinal hernia repair, minimally invasive ventral hernia repair, open umbilical hernia repair, minimally invasive sleeve gastrectomy, minimally invasive gastric bypass, minimally invasive cholecystectomy, and minimally invasive fundoplication) from January 1, 2016, to December 31, 2019 (before COVID-19), and January 1 to December 31, 2020 (during the COVID-19 pandemic), were identified in the ACS-NSQIP database using Current Procedural Terminology codes (eTable 1 in Supplement 1). These 16 procedures were selected as they represented the most frequently performed general surgery operations identified by the surgical specialty variable within the ACS-NSQIP database and consisted of a variety of procedures. To limit case-mix variation over time, each procedure group was limited to a consistent set of diagnosis codes specific to that procedure, based on codes from the International Classification of Diseases, Ninth Revision, Clinical Modification, or the International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (eTable 1 in Supplement 1). Patients with severe preoperative comorbidities that were likely to necessitate an inpatient stay (preoperative ventilator dependence, sepsis, septic shock, systemic inflammatory response syndrome, open and/or infected wound, acute renal failure, >4 U of red blood cell transfused within 72 hours prior to procedure, American Society of Anesthesiologists [ASA] class V, and disseminated cancer), and urgent or emergent operations were excluded from the analysis. Details regarding the number of hospitals participating in the ACS-NSQIP, the total number of cases submitted, the process for data collection, definitions of outcome variables, and procedures for ensuring the reliability of the data are described in the ACS-NSQIP Participant Use Data File user guide.10
Publication 2023
Adrenalectomy Adult Anesthesiologist Cholecystectomy Colectomy COVID 19 Diagnosis Dietary Supplements Erythrocytes Ethics Committees, Research Gastrectomy Gastric Bypass Hernia, Inguinal Herniorrhaphy Inpatient Kidney Failure, Acute Lumpectomy Malignant Neoplasm of Breast Malignant Neoplasms Mastectomy Nissen Operation Operative Surgical Procedures Parathyroidectomy Patients Septicemia Septic Shock Systemic Inflammatory Response Syndrome Thyroidectomy Thyroid Gland Umbilicus Ventral Hernia Wound Infection
The research team developed procedure-specific algorithms. At first, members of the research team met separately to develop the procedure-specific algorithms; for example, clinical researchers with an expertise in general surgery did not meet initially when developing the PSF in AIS algorithm, and vice versa. Both groups provided final recommendations regarding doses of opioid pills based on clinical considerations and notable risk factors for potential prescription opioid misuse. General surgeons, including both an attending and resident physician to account for different workflows, were consulted over a series of meetings to generate the initial algorithm for laparoscopic cholecystectomies. Once this initial algorithm was developed, it was shared with the paediatrics research team, feedback and recommendations were solicited, and a different, more complex algorithm was developed for AIS patients. The Paediatrics team opted to include a feature in the app to notify the provider that the patient would benefit from formal pain counselling in addition to a recommendation for the opioid prescription. This would occur through affirmative responses to questions such as ‘Is there opioid use within the household in which the patient resides?’ or ‘Has the patient taken any opioids that have not been prescribed to them for more than 5 days in the past 6 months?’, among others. We did not include this feature in the laparoscopic cholecystectomy algorithm due to concern that it may overcomplicate the app and be too time-consuming.
The two decision trees were reviewed by the full research team. Subsequent changes were made based on expert feedback. However, it was evident that the team needed to develop decision trees to be both procedure-specific and patient-specific. The procedures were intrinsically different, and they differed in terms of their length, and degree and duration of expected postoperative pain. Furthermore, adolescents were admitted with caregivers who needed to be included in the decision-making for pain treatment strategies, while adults having cholecystectomies were making decisions regarding pain treatments on discharge on their own.
The laparoscopic cholecystectomy algorithm (used in the General Surgery department) followed a more straightforward approach, with the final decision tree including seven questions with four possible recommendations, including zero need, low need (two pills), average need (five pills) and high need (ten pills) (table 1). The PSF in AIS algorithm (used in the Paediatrics department) was more complex to account for paediatric patients’ age, weight, previous opioid exposure/use and laminectomy levels included. The PSF in AIS algorithm involved 16 questions and 5 possible recommendations: zero need, low need (6–8 pills), low-average need (10–12 pills), average need (18 pills) and high need (24–26 pills) (table 2). All opioid pills were noted to be 5 mg hydrocodone/oxycodone or equivalent.
Publication 2023
Adolescent Adult Cholecystectomy Cholecystectomy, Laparoscopic Clinical Investigators Contraceptives, Oral Households Hydrocodone Laminectomy Management, Pain Opioids Oxycodone Pain Pain, Postoperative Patient Discharge Patients Physicians Prescription Opioid Misuse Surgeons

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More about "Cholecystectomy"

Cholecystectomy, also known as gallbladder removal, is a common surgical procedure used to treat various gallbladder conditions, such as gallstones (cholelithiasis), cholecystitis (inflammation of the gallbladder), and biliary dyskinesia (abnormal gallbladder function).
The surgery involves the removal of the gallbladder, a small, pear-shaped organ located under the liver that stores and concentrates bile, a digestive fluid.
Cholecystectomy can be performed using two main techniques: open surgery and laparoscopic surgery.
Open cholecystectomy involves making a larger incision in the abdomen to access and remove the gallbladder, while laparoscopic cholecystectomy, the more common and less invasive method, uses several small incisions and a tiny camera (laparoscope) to guide the surgeon during the procedure.
Optimal research and protocols are key to improving outcomes and driving scientific breakthroughs in the field of cholecystectomy.
Researchers can utilize various tools and technologies to enhance their studies, such as the SAS statistical software (version 9.4), the Da Vinci Firefly Surgical System for enhanced visualization during laparoscopic procedures, the QIAamp DNA Mini Kit for genetic analysis, the ABI Prism 7000 Sequence Detector for real-time PCR, and the SPSS statistical software (versions 22.0 and 25).
Additionally, researchers may work with biological materials like fetal bovine serum (FBS) and Ringerfundin solution, as well as employ common medical treatments like Penicillin.
By leveraging these resources and technologies, researchers can optimize their cholecystectomy studies and contribute to advancements in the field, leading to improved patient outcomes and better understanding of gallbladder-related diseases and their treatment.