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Research on the prognostic value of adjusting intraperitoneal threedimensional quality evaluation mode in laparoscopic cholecystectomy patients

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1078-1086页

作者： Yuan Zhou Zhan-Qing Chen Operating Room Lianyungang Hospital of Traditional Chinese MedicineLianyungang 222000Jiangsu ProvinceChina Operating Room The Second People's Hospital of Lianyungang Affiliated to Kangda College of Nanjing Medical UniversityLianyungang 222000Jiangsu ProvinceChina

BACKGROUND Benign gallbladder diseases have become a high-prevalence condition not only in China but also *** main types of benign gallbladder diseases include gallbladder polyps,acute and chronic cholecystitis,and gallstones,with gallstones being the most common,accounting for over 70%of *** the mortality rate of benign gallbladder diseases is low,they carry obvious potential *** have shown that an increased incidence of benign gallbladder diseases can increase the risk of cardiovascular diseases and gallbladder cancer,resulting in a substantial disease burden on patients and their *** To assess the medical utility of the Configuration-Procedure-Consequence(CPC)three-dimensional quality evaluation model in modulating the prognosis of laparoscopic cholecystectomy *** A total of 98 patients who underwent laparoscopic cholecystectomy in our hospital from February 2020 to January 2022 were selected as the *** to the random number table method,they were divided into a study group and a control group,with 49 patients in each *** control group received routine perioperative care,while the study group had the addition of the CPC three-dimensional quality *** postoperative recovery-related indicators(time to first flatus,time to oral intake,time to ambulation,hospital stay),stress indicators(cortisol and adrenaline levels),distinctions in anxiety and RESULTS The time to first flatus,time to oral intake,time to ambulation,and hospital stay of the study group patients were obviously lower than those of the control group patients,with statistical significance(P0.05).However,on the 3rd day after surgery,the cortisol and adrenaline leve

关键词： Configuration-Procedure-Consequence Three-dimensional quality evaluation laparoscopic cholecystectomy Recovery process Anxiety and depression Complications

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Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1700-1708页

作者： Hong-Dan Liu Qi Zhang Wen-Si Xu Shuang Jin Department of Gastroenterology The Third Affiliated Hospital of Qiqihar Medical UniversityQiqihar 161000Heilongjiang ProvinceChina

BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is *** To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical ***-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two *** Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST *** hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically *** serious complications occurred in either *** 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.

关键词： Gallbladder stone Common bile duct stone Endoscopic papillary balloon dilation laparoscopic cholecystectomy Endoscopic sphincterotomy

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Evaluating effectiveness and safety of combined percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy in acute cholecystitis patients:Meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1407-1419页

作者： Yu Li Wei-Ke Xiao Xiao-Jun Li Hui-Yuan Dong Department of General Surgery No.942 Hospital of PLAYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Acute cholecystitis(AC)is a common disease in general *** cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating *** low-risk patients without complications,LC is the recommended treatment plan,but there is still controversy regarding the treatment strategy for moderate AC patients,which relies more on the surgeon's experience and the medical platform of the visiting *** transhepatic gallbladder puncture drainage(PTGBD)can effectively alleviate gallbladder inflammation,reduce gallbladder wall edema and adhesion around the gallbladder,and create a"time window"for elective *** To compare the clinical efficacy and safety of LC or PTGBD combined with LC for treating AC patients,providing a theoretical basis for choosing reasonable surgical methods for AC *** In this study,we conducted a clinical investigation regarding the combined use of PTGBD tubes for the treatment of gastric cancer patients with *** performed searches in the following databases:PubMed,Web of Science,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and Wanfang *** search encompassed literature published from the inception of these databases to the ***,relevant data were extracted,and a meta-analysis was conducted using RevMan 5.3 *** A comprehensive analysis was conducted,encompassing 24 studies involving a total of 2564 *** patients were categorized into two groups:1371 in the LC group and 1193 in the PTGBD+LC *** outcomes of the meta-analysis revealed noteworthy disparities between the PTGBD+LC group and the LC group in multiple dimensions:(1)Operative time:Mean difference(MD)=17.51,95%CI:9.53-25.49,P<0.01;(2)Conversion to open surgery rate:Odds ratio(OR)=2.95,95%CI:1.90-4.58,P<0.01;(3)Intraoperative bleeding loss:MD=32.27,95%CI:23.03-41.50,P<0.01;(4)Postoperative hospital stay:MD=1.44,95%CI:0.14-2.73,P=0.03;(5)Overall posto

关键词： Acute cholecystitis laparoscopic cholecystectomy Percutaneous transhepatic gallbladder drainage Metaanalysis Efficacy

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Clinical efficacy of laparoscopic cholecystectomy plus cholangioscopy for the treatment of cholecystolithiasis combined with choledocholithiasis

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2080-2087页

作者： Chao-Hui Liu Zhi-Wei Chen Zhe Yu Hong-Yu Liu Jian-Sheng Pan Shuang-Shuang Qiu Department of General Surgery The Affiliated Haixia Hospital of Huaqiao University(910th Hospital of Joint Logistic Support Force)Quanzhou 362000Fujian ProvinceChina Department of General Surgery Anxi Hospital of Traditional Chinese MedicineQuanzhou 362499Fujian ProvinceChina

BACKGROUND Currently,endoscopic retrograde cholangiopancreatography(ERCP)plus laparoscopic cholecystectomy(LC)is the main treatment for cholecystolithiasis combined with ***,the treatment is unsatisfactory,and the development of better therapies is *** To determine the clinical efficacy of LC plus cholangioscopy for cholecystolithiasis combined with *** Patients(n=243)with cholecystolithiasis and choledocholithiasis admitted to The Affiliated Haixia Hospital of Huaqiao University(910th Hospital of Joint Logistic Support Force)between January 2019 and December 2023 were included in the study;111 patients(control group)underwent ERCP+LC and 132 patients(observation group)underwent LC+laparoscopic common bile duct exploration(LCBDE).Surgical success rates,residual stone rates,complications(pancreatitis,hyperamylasemia,biliary tract infection,and bile leakage),surgical indicators[intraoperative blood loss(IBL)and operation time(OT)],recovery indices(postoperative exhaust/defecation time and hospital stay),and serum inflammatory markers[C-reactive protein(CRP)],tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were *** No significant differences in surgical success rates and residual stone rates were detected between the observation and control ***,the complication rate,IBL,OT,postoperative exhaust/defecation time,and hospital stays were significantly reduced in the observation group compared with the control ***,CRP,TNF-α,and IL-6 Levels after treatment were reduced in the observation group compared with the levels in the control *** These results indicate that LC+LCBDE is safer than ERCP+LC for the treatment of cholecystolithiasis combined with *** surgical risks and postoperative complications were lower in the observation group compared with the control ***,patients may recover quickly with less inflammation after LCBDE.

关键词： laparoscopic common bile duct exploration Endoscopic retrograde cholangiopancreatography laparoscopic cholecystectomy Cholecystolithiasis Choledocholithiasis Clinical efficacy

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Efficacy of laparoscopic cholecystectomy in Treating Patients with Gallstones and Its Effect on Interleukin-6 and Tumor Necrosis Factor-α Levels

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Journal of Clinical and Nursing Research 2024年第6期8卷 300-304页

作者： Zhaowei Wang Chongran Xu Suzhou Science&Technology Town Hospital Suzhou 215000Jiangsu ProvinceChina Suzhou 100 Hospital SuzhouSuzhou 215000Jiangsu ProvinceChina

Objective:To investigate the efficacy of laparoscopic cholecystectomy in the treatment of patients with gallstones and its effect on the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-a).Methods:A total of 82 patients with gallstones admitted from July 2020 to July 2023 were recruited and allocated into control and observation groups using the random number table method,with 41 cases in each *** patients were treated with laparoscopic cholecystectomy,with the anterior triangle anatomical approach to the gallbladder in the control group and the posterior triangle anatomical approach to the gallbladder in the observation *** treatment effect and inflammatory factor levels of both groups were observed and ***:When comparing the clinical outcomes of both patient groups,the key parameters evaluated included time to mobilization,duration of surgery,extubation time,and intraoperative *** observation group exhibited a significant advantage in these parameters compared to the control group(Plaparoscopic cholecystectomy for gallstones can benefit from the implementation of the posterior triangular anatomical approach to the gallbladder,which not only enhances therapeutic efficacy but also offers significant advantages in reducing levels of IL-6,TNF-α,and ***,it is recommended for the widespread adoption of this treatment approach in clinical practice.

关键词： laparoscopic cholecystectomy Gallstones Efficacy Interleukin-6 Tumor necrosis factor-α

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laparoscopic cholecystectomy based on Laennec approach via the cystic plate with lymphadenectomy in Calot's triangle for gallbladder neoplasms:Initial experience and technical details

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iLIVER 2023年第4期2卷 202-207页

作者： Bin Ouyang Laizhu Zhang Yajuan Cao Zhongjie Xing Jin Peng Yang Yue Decai Yu Nanjing Central Hospital Nanjing 210008China The Affiliated Drum Tower Hospital Nanjing University Medical SchoolNanjing 210008China

Background:It is still challenging to define the exact stage of early gallbladder carcinoma with preoperative ***,subserous gallbladder is dissected for the potential early gallbladder carcinoma,which may cause incomplete tumor resection or tumor spread especially for the patients with T2 ***,we reported our experience and safety of Laennec approach via the cystic plate to dissect the whole gallbladder with lymphadenectomy in Calot's triangle for accurate diagnosis and stage in gallbladder ***:The anatomical gap between Laennec capsule and the cystic plate serves as the landmark to dissect the whole gallbladder through Laennec *** cholecystectomy based on Laennec approach via the cystic plate,together with lymphadenectomy in Calot's triangle,was performed in 17 patients with gallbladder ***:All patients had less intraoperative bleeding,no gallbladder breakage,no bile leakage,and accurate intraoperative rapid pathological staging under the corresponding *** duration of surgery was comparable to that of traditional laparoscopic ***:laparoscopic cholecystectomy based on Laennec approach via the cystic plate,together with lymphadenectomy in Calot's triangular is safe for gallbladder *** the future,the prospective clinical trial is going on to confirm the feasibility and effectiveness of this approach.

关键词： Laennec approach Cystic plate laparoscopic cholecystectomy Gallbladder neoplasms Patient safety

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Clinical observation of laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography or common bile duct lithotripsy

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World Journal of Clinical Cases 2022年第30期10卷 10931-10938页

作者： Hong Niu Fei Liu Yi-Bo Tian Department of Gastroenterology Jincheng General HospitalJincheng 048000Shanxi ProvinceChina Department of General Surgery Jincheng General HospitalJincheng 048000Shanxi ProvinceChina Department of Emergency Jincheng General HospitalJincheng 048000Shanxi ProvinceChina

BACKGROUND The incidence of common bile duct(CBD) stones accounts for approximately 10%–15% of all CBD *** 8%–20% of these patients also have gallstones with heterogenous signs and *** To investigate the clinical effects of laparoscopic cholecystectomy(LC) combined with endoscopic retrograde cholangiopancreatography(ERCP) and LC with CBD excision and stone extraction in one-stage suture(LBEPS) for the treatment of gallbladder and CBD *** Ninety-four patients with gallbladder and CBD stones were selected from our hospital from January 2018 to June *** were randomly divided into study and control groups with 47 patients *** study group underwent LC with ERCP,and the control group underwent LC with ***,recovery time of gastrointestinal function,complication rates,liver function indexes,and stress response indexes were measured pre-and postoperatively in both the *** The durations of treatment and hospital stay were shorter in the study group than in the control *** was no significant difference between the one-time stone removal rate between the study and control *** time to anal evacuation,resumption of oral feeding,time to bowel sound recovery,and time to defecation were shorter in the study group than in the control *** preoperative serum direct bilirubin(DBIL),total bilirubin(TBIL),and alanine aminotransferase(ALT) levels were insignificantly higher in the study group than that in the control group.A day after surgery,the postoperative serum DBIL,TBIL,and ALT levels were lower than their preoperative levels in both groups,and of the two groups,the levels were lower in the study *** the preoperative serum adrenocorticotrophic(ACTH),cortisol(COR),epinephrine(A),and norepinephrine(NE) levels were higher in the study group than that in the control group,these differences were not significant(P > 0.05).The serum ACTH,COR,A,and NE levels in both groups decreased one day

关键词： laparoscopic cholecystectomy Endoscopic retrograde cholangiopancreatography Choledochotomy with one-stage suture Gallbladder stones Common bile duct stones

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Real-Time laparoscopic cholecystectomy Simulation Using a Particle-Based Physical System

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Complex System Modeling and Simulation 2022年第2期2卷 186-196页

作者： Hongyu Wu Fan Ye Yang Gao Yu Cong Aimin Hao State Key Laboratory of Virtual Reality Technology and Systems Beijing Advanced Innovation Center for Biomedical EngineeringBeihang UniversityBeijing 100191China Research Unit of Virtual Human and Virtual Surgery(2019RU004) Chinese Academy of Medical SciencesBeijing 100730China Beijing UniDraw Virtual Reality Technology Research Institute Co. LtdBeijing 101300China

laparoscopic cholecystectomy is used to treat cholecystitis and *** the high risk of the surgery prevents novice doctors from practicing it on real patients,VR-based surgical simulation has been developed to simulate surgical procedures to train surgeons without patients,cadavers,or *** this study,we propose a real-time system designed to provide plausible visual and tactile simulation of the main surgical *** achieve this,the physical properties of organs are modeled by particles,and cluster-based shape matching is used to simulate soft *** haptic interaction between tools and soft tissue is modeled as a collision between a capsule and ***-based haptic rendering is used to generate feedback force and the non-penetrating position of the virtual *** proposed system can simulate the major steps of laparoscopic cholecystectomy,such as the anatomy of Calot’s triangle,clipping of the cystic duct and biliary artery,disjunction of the cystic duct and biliary artery,and separation of the gallbladder *** experimental results show that haptic rendering can be performed at a high frequency(>900 Hz),whereas mesh skinning and graphics rendering can be performed at 60 frames per second(fps).

关键词： virtual surgery laparoscopic cholecystectomy position-based dynamics

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Vascular injury during laparoscopic cholecystectomy:An oftenoverlooked complication

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World Journal of Gastrointestinal Surgery 2023年第3期15卷 338-345页

作者： Antonio Pesce Nicolò Fabbri Carlo Vittorio Feo Department of Surgery University of FerraraAzienda USL of FerraraAzienda USL of FerraraLagosanto 44023FerraraItaly

laparoscopic cholecystectomy is one of the most frequently performed procedures in gastrointestinal surgery *** complications due to vascular injuries represent an important cause of morbidity and mortality,especially when facing major bleeding during laparoscopy,where bleeding control can be technically challenging in inexperienced ***,the reported incidence rate of conversion to open surgery due to vascular lesions is approximately 0%-1.9%,with a mortality rate of approximately 0.02%.The primary aim of this article was to perform an up-to-date overview regarding the incidence and surgical management of vascular injuries during laparoscopic cholecystectomy according to the available scientific evidence.

关键词： laparoscopic cholecystectomy Vascular injury Vascular anomalies Surgical management Specialized hepatobiliary centers

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laparoscopic cholecystectomy for gangrenous cholecystitis in around nineties: Two case reports

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World Journal of Clinical Cases 2021年第14期9卷 3424-3431页

作者： Hiroyuki Inoue Toshiya Ochiai Hidemasa Kubo Yusuke Yamamoto Ryo Morimura Hisashi Ikoma Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectual University of MedicineKyoto 6028566Japan Department of Surgery North Medical Center Kyoto Prefectural University of MedicineKyoto 6292261Japan Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of MedicineKyoto 6028566Japan

BACKGROUND Gangrenous cholecystitis is a form of acute cholecystitis which involves gangrenous alterations in the gallbladder wall and it often follows an acute and serious *** herein report on two cases of very elderly people diagnosed early with gangrenous cholecystitis,who safely underwent laparoscopic cholecystectomy(LC)and both demonstrated a good *** SUMMARY Case 1:An 89-year-old *** underwent abdominal contrast-enhanced computed tomography(CECT)due to abdominal pain and *** gallbladder wall indicated the absence of contrast enhancement,thus leading to diagnosis of gangrenous cholecystitis and she therefore underwent *** her gallbladder demonstrated diffuse necrosis and it was also partly perforated,she was able to be discharged without any serious *** 2:A 91-year-old *** made an emergency visit with a chief complaint of abdominal *** CECT revealed swelling of the gallbladder and an ambiguous continuity of the gallbladder *** was diagnosed with gangrenous cholecystitis and underwent *** gallbladder had swelling and diffuse *** her preoperative blood culture was positive,she showed a good outcome following *** Although a definite diagnosis of gangrenous cholecystitis is difficult to make prior to surgery,if an early diagnosis can be made and appropriate treatment can be carried out,then even very elderly individuals may be discharged without major complications.

关键词： Gangrenous cholecystitis laparoscopic cholecystectomy Elderly people Critical view of safety Tokyo guidelines 2018 Case report

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