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Laparoscopic management of remnant gall bladder with stones: Lessons from a tertiary care centre's experience

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Laparoscopic, Endoscopic and Robotic surgery 2024年第1期7卷 27-33页

作者： Gilbert Samuel Jebakumar Jeevanandham Muthiah Loganathan Jayapal R.Santhosh Kumar Siddhesh Tasgaonkar K.S.Santhosh Anand J.K.A.Jameel Sudeepta Kumar Swain K.J.Raghunath Prasanna Kumar Reddy Tirupporur Govindaswamy Balachandar Department of Surgical Gastroenterology Apollo HospitalsChennai 600006India Department of gen.ral surgery Apollo HospitalsChennai 600006India Department of minimal access surgery Apollo HospitalsChennai 600006India

Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone *** its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this *** objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant ***:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo Hospitals in South *** patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were *** following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative ***:In total,36 patients were included and *** majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 *** most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open *** fistula to the colon was observed in one *** was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients ***:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and *** who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain *** study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder

关键词： Remnant gall bladder Stump cholecystitis Subtotal cholecystectomy Laparoscopic completion cholecystectomy

Impact of liver metastasis on immunotherapy in gastric carcinoma

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World Journal of Gastrointestinal surgery 2024年第10期16卷 3084-3086页

作者： Mushtaq Chalkoo Mohd Yaqoob Bhat Yaser Hussain Wani Department of surgery Government Medical CollegeSrinagar 190014Jammu and KashmirIndia Department of gen.ral surgery Government Medical College SrinagarSrinagar 190010Jammu and KashmirIndia Post Graduate Department of minimal access and gen.ral surgery Government Medical College SrinagarSrinagar 190010Jammu and KashmīrIndia

The editorial discusses the impact of liver metastasis on immunotherapy efficacy in gastric cancer(GC)*** metastasis can hinder the effectiveness of immunotherapy by altering the immune microenvironment,leading to systemic loss of T-cells and reduced treatment *** suggest that liver meta-stases serve as a negative baseline factor for immunotherapy efficacy,resulting in poorer progression-free survival and objective response *** such as liver-mediated radiotherapy may help improve treatment outcomes by reshaping the liver’s immune microenvironment and reducing T-cell ***-ing the complex interplay between liver metastasis and immunotherapy response is crucial for optimising patient care in GC.

关键词： Immunotherapy Liver metastasis Immune tolerance Gastric carcinoma Hepatic Siphoning

International consensus guidelines on robotic pancreatic surgery in 2023

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Hepatobiliary surgery and Nutrition 2024年第1期13卷 89-104页

作者： Rong Liu Mohammed Abu Hilal Marc G.Besselink Thilo Hackert Chinnusamy Palanivelu Yupei Zhao Jin He Ugo Boggi Jin-Young Jang Fabrizio Panaro Brian K.P.Goh Mikhail Efanov Yuichi Nagakawa Hong-Jin Kim Xiaoyu Yin Zhiming Zhao Yi-Ming Shyr Shridhar Iyer Eli Kakiashvili Ho-Seong Han Jae Hoon Lee Roland Croner Marco Vito Marino Arun Prasad Wei Wang Songqing He Kehu Yang Qu Liu Zizheng Wang Mengyang Li Shuai Xu Kongyuan Wei Zhaoda Deng Yuze Jia Tess M.E.van Ramshorst Faculty of Hepatopancreatobiliary surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of surgery Poliambulanza Foundation HospitalBresciaItaly Department of surgery University Hospital Southampton NHS Foundation TrustSouthamptonUK Amsterdam UMC location University of AmsterdamDepartment of SurgeryAmsterdamThe Netherlands Cancer Center Amsterdam AmsterdamThe Netherlands Department of gen.ral Visceral and Thoracic SurgeryUniversity Hospital Hamburg-EppendorfHamburgGermany Department of minimal Invasive Hernia surgery GEM Hospital and Research CentreChennaiTamil NaduIndia Department of gen.ral surgery Peking Union Medical College Hospital BeijingBeijingChina Department of surgery Johns Hopkins University School of MedicineBaltimoreMDUSA Division of gen.ral and Transplant surgery University of PisaPisaItaly Department of surgery Seoul National University HospitalSeoul National University College of MedicineSeoulKorea Department of surgery/Division of HBP surgery&Transplantation University of MontpellierMontpellierFrance Department of Hepatopancreatobiliary and Transplant surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Department of Hepato-Pancreato-Biliary surgery Moscow Clinical Scientific CenterMoscowRussia Department of Gastrointestinal and Pediatric surgery Tokyo Medical UniversityShinjukuTokyoJapan Department of surgery Yeungnam University College of MedicineDaeguKorea Department of Pancreato-Biliary surgery The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina 18 Division of Hepatobiliary Pancreatic Surgery and Liver TransplantationNational University HospitalSingaporeSingapore Department of surgery Galilee Medical CenterNahariyaIsrael Department of surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-siKorea Division of Hepato-Biliary and Pancreatic surgery Department of SurgeryAsan Medical Cente

Background:With the rapid development of robotic surgery,especially for the abdominal surgery,robotic pancreatic surgery(RPS)has been applied increasingly around the ***,evidence-based guidelines regarding its application,safety,and efficacy are still *** harvest robust evidence and comprehensive clinical practice,this study aims to develop international guidelines on the use of ***:World Health Organization(WHO)Handbook for Guideline Development,GRADE Grid method,Delphi vote,and the AGREE-II instrument were used to establish the Guideline Steering Group,Guideline Development Group,and Guideline Secretary Group,formulate 19 clinical questions,develop the recommendations,and draft the *** online meetings were held on 04/12/2020,30/11/2021,and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved *** the experts focusing on minimally invasive surgery from America,Europe and Oceania made great contributions to this consensus ***:After a systematic literature review 176 studies were included,19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the ***:The international RPS guidelines can guide current practice for surgeons,patients,medical societies,hospital administrators,and related social *** randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.

关键词： Robotic surgery guidelines pancreatectomy pancreaticoduodenectomy distal pancreatectomy(DP)

Instrumental detection of cystic duct stones during laparoscopic cholecystectomy

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Hepatobiliary & Pancreatic Diseases International 2014年第2期13卷 215-218页

作者： Amir Kambal Tomos Richards Harsha Jayamanne Zeyed Sallami Ashraf Rasheed Taha Lazim Gwent Institute for minimal access surgery Royal Gwent Hospital

Residual cystic duct stones (CDSs) after cholecystectomy have been recognized as a cause of post cholecystectomy pain. This study was undertaken to determine the incidence of CDSs during laparoscopic cholecystectomy(LC). A cohort of 330 consecutive patients (80 males and 250females) undergoing LC between November 2006 and May2010 was studied. Their age ranged between 16 and 88 years(median 50, IQR: 36.62). The data were prospectively collected of preoperative liver function tests, imaging, the presence of intraoperative CDSs, and common bile duct stones at on-table cholangiogram. CDSs were detected intraoperatively in 64 of the 330 patients (19%). Ultrasound failed to detect CDSs in any of these cases. Deranged liver function tests were noted in 73% of the patients with CDSs and in 57% without CDSs Common bile duct stones were detected in 9% (29) of the 330patients. CDSs occur commonly at routine cholecystectomy, and preoperative investigations are not helpful in their diagnosis As CDSs may lead to postoperative morbidity, they should be actively sought out during surgery if present.

关键词： biliary tract diseases laparoscopic cholecystectomy complications cystic duct stones gallstone diseases

Single incision laparoscopic surgery

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World Journal of Gastroenterology 2010年第21期16卷 2705-2706页

作者： Arun Prasad Department of minimal access surgery Apollo HospitalNew Delhi 110044India

As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining *** are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of *** a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and *** port insertion and use of instruments by the "chop stick method" are recommended to successfully do the procedure as we have done in our so far small series of 40 cases.

关键词： Single incision laparoscopic surgery Cholecystectomy

Laparoscopic iliopubic tract repair for pediatric inguinal hernia has very low recurrence: an Indian experience

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World Journal of Pediatric surgery 2020年第3期3卷 5-10页

作者： Sunil Kumar Nayak Ramakrishnan Parthasarathi Raghavendra Gupta G H V Subbaiah Rajapandian Nalankilli Vaiyapurigoundar Palanisamy Chinnusamy Palanivelu minimal access surgery GEM Hospital and Research CentreCoimbatoreTamil NaduIndia

Background The aim of this study is to document results of laparoscopic iliopubic tract(IPT)repair for inguinal hernia in the pediatric age *** Hospital records of 190 children who underwent IPT repair between January 2015 and January 2020 were analyzed retrospectively for demographic details,variations between clinical,radiological and laparoscopic diagnosis,associated pathologies,operative time,hospital stay,postoperative complications and *** internal ring was narrowed by approximating IPT to conjoint tendon using 3-0 polypropylene continuous or interrupted *** In total,238 IPT repairs were done under gen.ral anesthesia in 190 children aged between 1 and 17 years.7.9%of children had phimosis,and three children had *** patients had undescended testis and another three IPT repairs were done in cases who presented with *** patent processus vaginalis(CPPV)was detected at the time of laparoscopy in 18.3%of *** far,166 children had been followed,and no recurrence was observed in any of these 96 of whom have completed more than 3 years after their ***,two patients developed hernia on the contralateral *** Laparoscopy is beneficial to pick up *** IPT repair for pediatric inguinal hernia is reproducible and safe with the least recurrence reported thus ***,further follow-up is ***,development of contralateral hernia needs to be investigated.

关键词： hernia Laparoscopic anesthesia

Intersphincteric resection and coloanal anastomosis in the treatment of distal rectal cancers

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Laparoscopic, Endoscopic and Robotic surgery 2023年第2期6卷 57-62页

作者： Shailesh P.Puntambekar Nikesh M.Gandhi Mohammed Azharuddin AAttar Suyog Bharambe Ravindra Sathe Mangesh Panse Mihir Chitale Kshitij Manerikar Sravya Inampudi Aishwarya Puntambekar Department of minimal access surgery Galaxy Care Laparoscopic InstitutePuneMaharashtra 411004India

Objective:In the evolving era of minimal access surgery,low rectal cancers still pose a challenge to laparoscopic or robotic ***,at our institute we intended to demonstrate the oncological efficacy of intersphincteric resection and coloanal anastomosis in the treatment of distal rectal cancers,performing the abdominal part of the procedure which includes rectal mobilization,***:From February 2017 to March 2021,125 patients who had undergone intersphincteric resection and coloanal anastomosis via the perineal approach at Galaxy Care Laparoscopic Institute,Pune,were included in this *** mobilization of the rectum was performed *** patients had a diversion ileostomy and a pelvic *** were followed-up for a period of 18 months *** on clinical and oncological outcomes were collected and *** pre-operative and post-operative Wexner incontinence scores were ***:The mean time taken for surgery was 181.57±30.00 *** mean blood loss was 119.76±42.53 *** patients(103,82.4%)had their tumour at a distance of 1e2 cm from the anal verge.A loco-regional recurrence rate of 12.8%(16/125)was noted in our *** the post-surgery Wexner score,74.4% of patients(93/125)had a score of 5 or less,depicting that three-quarters of the study population had satisfactory ***,81.6%of patients were satisfied with the functional results of ***:Intersphincteric resection and coloanal anastomosis,with a 12.8%recurrence rate,can now be considered an oncological and technically feasible procedure with sphincter salvage and good continence.

关键词： Intersphincteric resection Coloanal anastomosis Laparoscopy Continence

Cholecystoduodenocolic Fistula: An Unexpected Intraoperative Finding, a Surgical Challenge

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International Journal of Clinical Medicine 2016年第4期7卷 261-264页

作者： Gulzar Ahmad Bhat Rahul Jain Pawan Lal gen. & minimal access surgery Lok Nayak Hospital Maulana Azad Medical College New Delhi India

The bilioenteric fistulas, first described in 1890 by Courvoisier, are found in 0.15% - 8% of biliary tract operations. Combined fistulas involving the gallbladder, duodenum and colon are extremely rare. We presented a case of 38 year female who presented to our OPD with complaints of pain right upper abdomen for seven months in whom a cholecysto-duodenocolic fistula (Figure 1 & Figure 2) was found during surgery which was repaired primarily. Gallstone disease is a common problem in hepatobiliary system and may rarely present as cholecysto-enteric fistula. The most common type of biliary enteric fistula is Cholecystoduodenal fistula (70%). Cholecysto-duodeno-colic (CDC) fistula is a rare complication of cholelithiasis. The standard treatment of IBF is cholecystectomy and repair of the fistulous opening. Although very rare a cholecystoduodenocolic fistula should be kept as a possibility when there are adhesions between GB, duodenum and colon. Conversion to open surgery should be considered early when the anatomy is not clear to prevent iatrogen.c injury.

关键词： Fistula Cholecystectomy Cholecystoduodenocolic Fistula

Robotic assisted Roux-en-Y hepaticojejunostomy in a post-cholecystectomy type E2 bile duct injury

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World Journal of Gastroenterology 2015年第6期21卷 1703-1706页

作者： Arun Prasad Sudipto De Purak Mishra Abhishek Tiwari Department of minimal access and Robotic surgery Apollo Hospital

Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type *** has been performed laparoscopically with the advancement of laparoscopic ***,a telemanipulative robotic surgical system was introduced,providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of theoperative *** present a case of 36-year-old female patient who had undergone elective cholecystectomy2 mo ago for gall stones and had a common bile duct injury during *** the stricture was old and complete it could not be tackled *** did a laparoscopic assisted adhesiolysis followed by robotic Roux-en-Y *** intraoperative complications or technical problems were *** period was uneventful and she was discharged on the 4th postoperative *** followup,she is doing well without evidence of jaundice or *** is the first reported case of robotic hepaticojejunostomy following common bile duct *** hybrid technique gives the patient benefit of laparoscopic adhesiolysis and robotic suturing.

关键词： Hepaticojejunostomy Common bile duct Robotic surge