Effect Of Laparoscopic Cholecystectomy Research Articles

Effect of laparoscopic cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in post menopausal women

Background Laparoscopic cholecystectomy (LC) is the gold standard management for benign gallbladder diseases. It has been observed that there is alteration in vitamin D levels and bone mineral density after cholecystectomy due to altered enterohepatic circulation. With increase in average age expectancy of the population, low levels of vitamin D levels and osteoporosis after cholecystectomies might cause increased health care burden. Methods A prospective observational study was planned between 1 January 2022 and 30 June 2023 in the Department of General Surgery at PGIMER Chandigarh, a tertiary care hospital in north India. One hundred and three post-menopausal women who underwent LC and met the inclusion and exclusion criteria were included in the study. All participants underwent estimation of vitamin D and bone mineral density preoperatively and third-post operative month (POM). Results The mean age of the patients was 58.46 ± 7.44. Pain abdomen was present in 68(66%) patients, 18 had epigastric discomfort and 17 had dyspepsia. The mean levels of vitamin D decreased from 21.92 at the baseline to 20.12 at third POM (p < .001). There was a significant change in t score Femoral Neck (−1.12 vs −1.15, p < .001) and Lumbar spine L1–L4 − 1.98 vs −1.98 (p = .033). z-scores of the femoral neck were −0.34 vs −0.54 (p < .001) and of lumbar spine L1–L4 were −0.95 vs 1.02 (p < .001). The decrease in fracture risk for the femoral neck (p = .344) and the lumbar spine (p = .223) was not statistically significant. Conclusion There is a significant decrease in vitamin D and BMD levels after LC in post-menopausal females.

Retracted: Effectiveness of Laparoscopic Cholecystectomy in Patients with Gallbladder Stones with Chronic Cholecystitis.

[This retracts the article DOI: 10.1155/2022/1434410.].

Safety and Effectiveness of Laparoscopic Cholecystectomy in Acute Cholecystitis Patients who are 80 Years of Age or Older

Safety and Effectiveness of Laparoscopic Cholecystectomy in Acute Cholecystitis Patients who are 80 Years of Age or Older

Associations among Lipid Profile, Mucin1 and Cholesterol Ester Transfer Protein Status in Bangladeshi Patients with Cholelithiasis and Effects of Laparoscopic Cholecystectomy on Them

Associations among Lipid Profile, Mucin1 and Cholesterol Ester Transfer Protein Status in Bangladeshi Patients with Cholelithiasis and Effects of Laparoscopic Cholecystectomy on Them

The effect of laparoscopic cholecystectomy on lipid profile

Background: Gallstone disease (GSD) is one of the most common surgical gastrointestinal diseases. Cholesterol is one of the constituents of gallstones. Hyperlipidemia and GSD are often linked to cholesterol in pathophysiology, and cholecystectomy is associated with hepatobiliary circulation affecting fat absorption. The aim of the study is to assess the lipid profile (LP) changes after laparoscopic cholecystectomy (LC). Methods: Prospective cohort study that included 200 patients with documented GSD and baseline measurement of LP, followed by LC for half of them, and two follow-up measurements of LP after 2 weeks and 1 month. Comparison of the LP between the two groups to estimate the difference that occur due to LC, after that, comparison of the two follow-up measurements with baseline to estimate the effect of these changes with time. Results: Total serum cholesterol (TC) and triglyceride level (TG) were significantly lower from control 1 month after surgery; on pairwise analysis, TG level was lower than baseline on both 2-week and 1-month follow-up measurements. High-density lipoprotein (HDL) was higher than the control after 1 month, on pairwise analysis at 2 weeks, no difference from baseline was found, and a significant difference was found after 1 month. Both low-density lipoprotein (LDL) and very LDL (VLDL) were not different from the control. Conclusion: LC is associated with a reduction of the serum level of both TC and TG and an increase serum level of HDL after 1 month of follow-up.

An observational study on the effect of laparoscopic cholecystectomy over pulmonary function test

An observational study on the effect of laparoscopic cholecystectomy over pulmonary function test

Associations among Lipoprotein (a) and Apolipoproteins (A1, B100, E) Status in Bangladeshi Patients with Cholelithiasis and Effects of Laparoscopic Cholecystectomy on the Status

Cholelithiasis i.e. gallstone disease (GD) is one of the common gastrointestinal disorders prevalent in about 10-15% of adults in the developing countries. Cholecystectomy, i.e. surgical removal of the gallbladder and gallstones, is the treatment of choice currently. Studies over many years ago showed that more than 50% of patients with gallstone would have lipid disorder. The disease mechanism i.e. pathogenesis of cholesterol gallstone is widely accepted as an altered lipid metabolism, because of which there is a relative increase in the cholesterol levels compared to other lipids secreted by the liver into the bile [1-3]. Association between gallstones and altered lipid profile and hypomotility of the gallbladder have been reported in some studies [4-7].

Analysis of Clinical Effect of Laparoscopic Cholecystectomy and Open Cholecystectomy in the Treatment of Elderly Patients with Acute Cholecystitis

Analysis of Clinical Effect of Laparoscopic Cholecystectomy and Open Cholecystectomy in the Treatment of Elderly Patients with Acute Cholecystitis

Comparative Study between IV Paracetamol and IM Pethidine for Post Operative Analgesia in Laparoscopic Cholecystectomy

Background: Effective analgesia is important after laparoscopic cholecystectomy. Paracetamol have been used extensively as alternatives, and it seems that they are more effective for mild to moderate pain control postoperatively. As laparoscopic Cholecystectomy poses moderate pain, in this study we compare the quality of analgesia and side effects of paracetamol versus pethidine for post-operative analgesia after laparoscopic cholecystectomy.&#x0D; Objectives: This study was designed to observe the effect of I.V. paracetamol and I.M. pethidine for analgesic efficacy in post-operative analgesia with their side effects in laparoscopic cholecystectomy. Material and method: Sixty (60) patients were selected in the pre anaesthetic check up room whose were going to be operated for laparoscopic cholecystectomy. Each patient in group A received intravenous paracetamol (1g/100ml)15mg/kg over 15minutes and group B received intramuscular pethidine (100mg)- 2mg/kg postoperatively.&#x0D; Results: In group A that was paracetamol group and group B that was pethidine group the visual analogue scale (VAS) almost similar but total analgesic consumption in pethidine group were slightly higher than paracetamol group and the respiratory rate were significantly lower in pethidine group.&#x0D; Conclusion: Our results indicate that IV paracetamol 15mg / kg has better analgesic potency and less side effects than 2 mg / kg IM pethidine for postoperative analgesia after laparoscopic cholecystectomy.&#x0D; Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 46-53

Effect of Laparoscopic Cholecystectomy in Alleviating Dyspeptic Symptoms in Patients with Cholelithiasis

Objective: To compare the change in preoperative and postoperative dyspeptic symptoms. Introduction: In the era of increasing prevalence of gall stones due to more frequent incidental detection radiologically, it is the need of the hour that we assess the benefit of these increasing cholecystectomies with regard to dyspeptic symptoms. Till now there is not enough evidence on the basis of which we can determine whether laparoscopic cholecystectomy can resolve the dyspeptic symptoms in patients of gall stones. There is a need to establish a guideline to operate in view of alleviating dyspeptic symptoms. Methodology: A total of 308 (M:F=2:3) patients were evaluated for dyspeptic symptoms using the Glasgow dyspepsia severity score (GDSS). They were followed up after 1 month, 6 months. Disease distribution and change in GDSS scores were analysed. Results: The mean age was 47.2 ± 15.42 years. Preoperatively mean GDSS was 11.49 ± 2.11. One month post surgery 82% had a GDSS around 2.95. 12% had a significant drop in GDSS at the end of 6 months (p<0.001). 3.89% had a GDSS of more than 10 which indicated persistentdyspepsia. 3 patients 0.97% had subsequent worsening of GDSS. Conclusion: Most symptomatic patients undergoing laparoscopic cholecystectomy are objectively relieved of dyspeptic symptoms. Very few patients have persistent symptoms even after 6 months. Patients tend to associate relief of dyspepsia with successful outcome of surgery. It is extremely essential that patients be counselled in detail about the possibility of persistence of dyspeptic symptoms which may in-fact be functional/inorganic.

Effect of laparoscopic cholecystectomy on liver enzymes in Arabian goats

Effect of laparoscopic cholecystectomy on liver enzymes in Arabian goats

Clinical efficacy and safety analysis of laparoscopic cholecystectomy in patients with chronic cholecystitis and cholecystolithiasis

Objective To discuss the effect of laparoscopic cholecystectomy open cholecystectomy on liver function, inflammatory factors and immunoglobulin in patients with chronic cholecystitis and cholecystolithiasis. Methods One hundred and five cases of chronic cholecystitis and cholecystolithiasis patients in the First Hospital of Danjiangkou City were selected form May 2015 to May 2017 by taking a retrospective analysis, and divided into experimental group (treated with laparoscopic cholecystectomy, n=52) and control group (treated with traditional open cholecystectomy, n=53) according to the different ways of treatment, recorded and compared the indicators of the operation process, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), gamma glutamyl transpeptidase (GGT), tumor necrosis factor-ɑ(TNF-α), interleukin-6(IL-6), interleukin-8 (IL-8), C reactive protein(CRP), IgA, IgG, IgM. The measurement data were expressed by (±s), and the t test was used comparison between groups, and the χ2 test was used comparison between enumeration data, the comparison of the incidence of postoperative complications between the two groups was used the rank sum test, repeated measurement data using repeated measurement variance analysis. Results The operation time, intraoperative blood loss, postoperative anal exhaust time, first defecation time after operation, hospitalization time and hospitalization costs of experimental group were (73.71±11.62) minutes, (60.73±6.88) ml, (24.38±3.72) hours, (37.21±2.79) hours, (5.68±1.78) days, (6 600±1 600) yuan respectively, the control group were (118.48±25.52) minutes, (121.24±13.29) ml, (32.77±4.46) hours, (56.85±5.81) hours, (9.29±2.89) days, (4 900±1 100) yuan respectively, which were statistically significant(the values of t were 3.584, 4.183, 3.397, 3.245, 3.489, 2.938 respectively, all P 0.05). The immunoglobulin indexes IgA, IgG, IgM in the control group were significantly lower than preoperative all P<0.05, the 1, 3, 5 days IgA, IgG, IgM of the control group after operation were significantly lower than the experimental group (all P<0.05). The incidence of operative complications of experimental group 5.77%(3/52) was significantly lower than the control group 15.09%(8/53), which was statistical difference (Z=5.118, P=0.000). Conclusion The therapeutic effect of Laparoscopic cholecystectomy on chronic cholecystitis and cholecystolithiasis is reliable, small trauma and short hospitalization time, although patients with postoperative liver function increase significantly but can be quickly restored, the level of inflammatory factors in the patients is significantly improved, and there is little effect on the immune function, and the incidence of postoperative complications is low, so it is worth popularizing in clinical practice. Key words: Cholecystectomy, laparoscopic; Cholecystitis; Immunoglobulins; Liver function; Inflammatory factors

Effects of Laparoscopic Cholecystectomy on Mucin1 and Cholesterol Ester Transfer Protein Status in Bangladeshi patients with Cholelithiasis

Objective: Although it was reported that cholecystectomy had profound impact on lipid profile and lipoprotein (a) status, no studies were reported on Mucin1 and cholesterol ester transfer protein (CETP) in Bangladeshi patients with cholelithiasis i.e. gallstone disease (GD). The present study was done about effects of laparoscopic cholecystectomy on Mucin1 and CETP status in Bangladeshi patients with cholelithiasis.Patients & Methods: Forty-four adult GD patients with cholelithiasis and 30 normal controls (NC) subjects were included in the study. The blood was taken from fasting patients before cholecystectomy (Serum-I°), gall bladder bile during cholecystectomy (Bile-I°) and blood again after 2-3 months at follow-up (Serum-II°) and from fasting NC subjects. Mucin1 and CETP levels were quantified in serum and bile by enzyme immunoassay (EIA) method using commercially available research kits. The results were compared by appropriate statistical tests using SPSS program.Results: Serum levels of both Mucin1 and CETP were increased in Pt-I°(S) compared to NC-I°(S) which were reduced after cholecystectomy in Pts-II°(S). However, serum CETP mean level in Pts-I°(S) was not significantly higher than NC-I°(S).The Mucin1 and CETP levels in patients bile, i.e. Pt-I°(B), were lower compared to serum levels before, Pt-I°(S), and after, (Pt-II°(S), cholecystectomy [Mucin1 (ng/ml): Pts-I°(S): 10.77 ± 2.93, Pts-I°(B): 1.29 ± 1.21, Pts II°(S): 6.67 ± 2.03, NCs(I°): 4.63 ± 0.53; CETP (μg/ml): Pts-I°(S): 11.47 ± 5.04, Pts-I°(B): 1.16 ± 1.19, Pts-II°(S): 9.41 ± 2.42, NCs (I°): 9.57 ± 3.63] . A significantly large proportion of patients had higher levels of Mucin1, but large number of patients had CETP levels within the normal range in Pt-I°(S). Interestingly, this was changed after cholecystectomy that significant proportion of patients had higher CETP levels in Pt-II°(S).Conclusions: Alterations in serum Mucin1 and CETP status were significant but complex and laparoscopic cholecystectomy had significant impact indicating an important function of gallbladder relevant to their metabolism. Further studies are needed on prevalence and frequency of metabolic syndrome, insulin resistance, cytokines and other relevant parameters in Bangladeshi patients with GD i.e. cholelithiasis.

Influence of different operation opportunity on clinical effects of laparoscopic cholecystectomy in the treatment of patients with acute gallstone pancreatitis

Objective To evaluate the influence different of operation opportunity on clinical effects of laparoscopic cholecystectomy in the treatment of patients with acute gallstone pancreatitis. Methods A retrospective analysis was made on 93 patients with acute gallstone pancreatitis, laparoscopic cholecystectomy was performed in all patients.And the patients were divided into research group(early: within 48 h) and control group(delay: over 8 to 12 weeks) by operation opportunity.The operation index, biochemical index, quality of life, recurrence and complication occurrence between the two group were compared. Results There were no significant differences in the amount of blood loss and operation time between the two groups (t=0.332, 0.486, all P>0.05). The hospital stay of the research group was lower than that of the control group[(11.43±2.65)d vs.(20.51±3.42)d], the difference was statistically significant (t=14.245, P 0.05). The life quality of the two groups were greatly improved after treatment, and had significant difference compared with before treatment (t=5.017, 7.028, 6.124, 3.095, 6.023, 6.995, 6.184, 3.128, all P 0.05). Conclusion Early laparoscopic cholecystectomy can shorten the length of stay in patients with acute gallstone pancreatitis , and with good clinical effects and safety. Key words: Cholecystolithiasis; Panceratitis; Cholecystectomy, laparoscopic

Clinical observation on prevention of bile duct injury during laparoscopic cholecystectomy: a report of 65 cases

Objective To investigate the clinical effect of laparoscopic cholecystectomy in prevention of bile duct injury during operation. Methods From December 2014 to December 2015, 39 cases of laparoscopic cholecystectomy were selected as the control group.From January 2016 to January 2017, 26 patients with acute cholecystitis were selected as the observation group.The two groups were treated with gallbladder excision operation.The causes of bile duct injury in control group were analyzed and developed targeted preventive measures.and the preventive measures were implemented in the observation group.The incidence of bile duct injury, hospitalization time, operation time were observed in the two groups. Results The observation group had no bile duct injury, the incidence rate of bile duct injury in the control group was 7.69%, the difference between the two groups was significant (χ2=3.90, P<0.05). The operation time, hospitalization time of the observation group were (68.91±3.44)min, (4.65±1.66)d, which were less than those of the control group (t=9.59, 2.03, all P<0.05). Conclusion For patients with laparoscopic cholecystectomy, the implementation of effective measures have better effect in prevention of bile duct injury. Key words: Biliary tract; Cholecystectomy, laparoscopic

Effects of Laparoscopic Cholecystectomy on Intraocular Pressure

Purpose: To evaluate the effects of laparoscopic cholecystectomy in patients with gall stones under general anesthesia using carbon dioxide (CO2) insufflations on the intraocular pressure (IOP). Methods: The study was an observational case series, involved 24 non-glaucomatous patients with gall stones who underwent laparoscopic cholecystectomy surgery under general anesthesia using (CO2) insufflations in the period from January 2016 to April 2016 in Zagazig University Hospitals. IOP was measured preoperatively, intra-operatively and shortly postoperatively. Interpretation of the results was performed. Results: The study revealed that IOP was elevated significantly during laparoscopic cholecystectomy surgery (P < 0.001), as the mean preoperative IOP was (15.21 ± 1.61 mmHg) compared to intra-operative (24.55 ± 6.28 mmHg) and nearly returned to the normal level after 8 hours postoperatively (16.13 ± 2.44 mmHg). Conclusion: Laparoscopic cholecystectomy surgery elevated IOP significantly which is not favorable for glaucoma or ocular hypertension patients, especially for the old.

Cost-Utility Analysis of Laparoscopic Cholecystectomy and Open Cholecystectomy in Kashani Hospital, Shahr-e-Kord, Iran

Background: A cost-effectiveness analysis is used to evaluate and compare the cost versus the benefits of different treatment modalities. The clinical effectiveness of laparoscopic cholecystectomy has been well documented. To our knowledge, there was no published data on the cost-utility of laparoscopic cholecystectomy in Iran. Objectives: This study aimed to compare the cost-utility of the two surgical methods for removing gallstones: open cholecystectomy and laparoscopic cholecystectomy. Patients and Methods: In this comparative cross-sectional analysis, we investigated the data of patients who had undergone laparoscopic and open cholecystectomy operations in Kashani hospital, Iran, between 2012 and 2014. Using the available samples, two groups of 30 patients were randomly selected. SF-36 was used to assess the quality of life (QoL) of patients 30 to 35 days after operation, and quality-adjusted life years (QALYs) were calculated by multiplying the SF-36 score by healthy years of life. An activity-based costing method was used to determine the costs of the operations. The cost-effectiveness ratio (CER) was calculated by dividing the costs of each method by the gained QALY. To determine the difference between the two surgical methods, we used independent-samples t test. Results: The data of 60 patients, 40 men and 20 women, with the mean age of 54.30 ± 16.44 in the laparoscopic group and 51.77 ± 18.41 in the open cholecystectomy group were analyzed. The mean cost of surgery was lower in the laparoscopy group (2259 ± 895 USD) than in the laparotomy group (2972 ± 907.9 USD) (P = 0.003). The mean SF-36 score was higher in the laparoscopic group (65.98 ± 9.22) than in the open cholecystectomy group (58.03 ± 11.30) (P < 0.004). The cost of gaining QALY was also significantly lower in the laparoscopic group. The mean of the gained QALY index was 1.79 ± 0.29 and 1.14 ± 0.41 for the laparoscopic and open surgeries, respectively (P < 0.001). The incremental CER was 1067 USD for each QALY for the laparoscopic group in comparison to the value of open cholecystectomy. Conclusions: Laparoscopic cholecystectomy was more cost-effective than open cholecystectomy and is therefore preferred and recommended in patients with gallstones.

Effect of laparoscopic cholecystectomy on aminotransferase levels in patients with hyperlipidemia

Effect of laparoscopic cholecystectomy on aminotransferase levels in patients with hyperlipidemia

Lipoprotein (a) Status and Effect of Laparoscopic Cholecystectomy on it in Bangladeshi Patients with Cholelithiasis

Objective: Although it was reported that cholecystectomy had complex impact on lipid profile in cholelithiasis, lipoprotein (a) [Lp(a)] was not studied. The present study was therefore conducted on serum Lp(a) status in Bangladeshi patients with cholelithiasis and effect of cholecystectomy on it. Patients and Methods: Adult patients (n=44) with cholelithiasis and 30 normal controls (NC) were included in the study. The blood sample was taken from fasting patients before cholecystectomy (Serum-I0), gall bladder bile sample during cholecystectomy (Bile-I0) and blood sample again after 2-3 months at follow-up (Serum-II0) and from fasting NC subjects. Lp(a) level was quantitated in serum and bile by immunoturbidimetric method using commercially available research kit. The results were compared statistically by ANOVA, Student’s t-test and Chisquared test using SPSS programme. Results: The Lp(a) status (mg/dl, Mean ± SD) in controls and patients and their statistical analysis revealed that Lp(a) was much higher in patients compared to controls (NC: 29.07 ± 14.1, Patients Serum-I0: 290.84 ± 110.93, Patients Bile-I0 : 37.12 ± 28.61, Patients Serum-II0: 203.70 ± 90.13) (P<0.001). Lp(a) was lowered after cholecystectomy, but remained elevated in patients Serum-II0 compared to NC significantly (P<0.001). No significant difference was observed for Lp(a) levels between NC and patients Bile-I0 (P=0.173). The proportions of patients for Serum-I0, Bile-I0 and Serum-II0 with Lp(a) levels above and within normal limits and their statistical analyses showed significant associations (P<0.001). Conclusions: Cholelithiasis had complex impact on Lp(a) status indicating a special function of gall bladder relevant to its metabolism. Further studies are warranted.

Oral Clonidine in reduction of postoperative nausea and vomiting after laparoscopic cholecystectomy: A double blinded placebo controlled trial

Background: The common adverse effects of laparoscopic cholecystectomy include nausea and vomiting. Surgical pneumoperitoneum can stimulate vagal response and induce the release of various emetogenic substances such as 5-hydroxytryptamine and acetylcholine. We hypothesized that oral Clonidine administered preoperatively reduces the post operative nausea and vomiting following laparoscopic cholecystectomy.Methodology: In a randomized, double-blinded placebo controlled study, seventy patients undergoing laparoscopic cholecystectomy were assigned to receive either oral Pyridoxine (placebo) or oral Clonidine 200?g 20-30 minutes before conduction of general anaesthesia. We assessed post operative nausea and vomiting and compared its incidence following laparoscopic cholecystectomy with prophylactic use of oral Clonidine or placebo. We also found out the requirements of rescue antiemetic medication (Ondansetron and Promethazine) for post operative nausea and vomiting after prophylactic use of oral Clonidine or Placebo.Results: Three patients in Clonidine group and 12 patients in Placebo group vomited in first two hours. Likewise, 11 and 22 patients vomited in Clonidine and Placebo group over 24 hours respectively. In group Clonidine, 18 patients had nausea in first two hours and 20 patients had nausea over 24 hours. In group Placebo, 33 patients developed nausea in first two hours and over 24 hours. Ten patients in Clonidine group and 19 patients in Placebo group required Ondansetron as rescue antiemetics over 24 hours.Conclusion: Oral Clonidine given pre-operative to patients undergoing laparoscopic cholecystectomy decrease the incidence of post operative nausea and vomiting.Journal of Society of Anesthesiologists 2014 1(2): 76-79