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Cholecystectomy

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The SAGES Manual of Acute Care Surgery
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Abstract

Gallbladder disease is a common cause of hospital admissions, and its evaluation and treatment is a frequent occurrence for the acute care surgeon. Understanding gallbladder disease and gallstone sequelae will assist in the clinical management of these patients. This chapter will cover the common clinical presentations of these patients, common indications for cholecystectomy and its proper technique, and postoperative complications.

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References

  1. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep. 2005;7(2):132–40.

    Article  Google Scholar 

  2. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172–87.

    Article  Google Scholar 

  3. Behari A, Kapoor VK. Asymptomatic gallstones (AsGS) – To treat or not to? Indian J Surg. 2012;74(1):4–12.

    Article  Google Scholar 

  4. Lamberts MP. Indications of cholecystectomy in gallstone disease. Curr Opin Gastroenterol. 2018;34(2):97–102.

    Article  Google Scholar 

  5. Ikard RW. Gallstones, cholecystitis and diabetes. Surg Gynecol Obstet. 1990;171(6):528–32.

    CAS  PubMed  Google Scholar 

  6. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci. 2007;52(5):1313–25.

    Article  Google Scholar 

  7. Gurusamy KS, Koti R, Fusai G, Davidson BR. Early versus delayed laparoscopic cholecystectomy for uncomplicated biliary colic. Cochrane Database Syst Rev. 2013;(6):CD007196.

    Google Scholar 

  8. Canfield AJ, Hetz SP, Schriver JP, Servis HT, Hovenga TL, Cirangle PT, et al. Biliary dyskinesia: a study of more than 200 patients and review of the literature. J Gastrointest Surg. 1998;2(5):443–8.

    Article  CAS  Google Scholar 

  9. Veenstra BR, Deal RA, Redondo RE, Daly SC, Najman J, Myers JA, et al. Long-term efficacy of laparoscopic cholecystectomy for the treatment of biliary dyskinesia. Am J Surg. 2014;207(3):366–70; discussion 9–70.

    Article  Google Scholar 

  10. Whipple AO. Surgical criteria for cholecystectomy. Bull N Y Acad Med. 1926;2(6):302–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):41–54.

    Article  Google Scholar 

  12. Attasaranya S, Fogel EL, Lehman GA. Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Med Clin North Am. 2008;92(4):925–60.. x

    Article  Google Scholar 

  13. da Costa DW, Bouwense SA, Schepers NJ, Besselink MG, van Santvoort HC, van Brunschot S, et al. Same-admission versus interval cholecystectomy for mild gallstone pancreatitis (PONCHO): a multicentre randomised controlled trial. Lancet. 2015;386(10000):1261–8.

    Article  Google Scholar 

  14. Gurusamy KS, Davidson C, Gluud C, Davidson BR. Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev. 2013;(6):CD005440.

    Google Scholar 

  15. Wilkins T, Agabin E, Varghese J, Talukder A. Gallbladder dysfunction: cholecystitis, Choledocholithiasis, cholangitis, and biliary dyskinesia. Prim Care. 2017;44(4):575–97.

    Article  Google Scholar 

  16. American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Anderson MA, Appalaneni V, Ben-Menachem T, Decker GA, Early DS, et al. The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia. Gastrointest Endosc. 2013;77(2):167–74.

    Article  Google Scholar 

  17. Sharon Weber BY, Fong Y. Biliary neoplasms. In: Mullholland M, editor. Greenfield’s surgery: scientific principles and practice, vol. 2. 5th ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.

    Google Scholar 

  18. Franquet T, Montes M, Ruiz de Azua Y, Jimenez FJ, Cozcolluela R. Primary gallbladder carcinoma: imaging findings in 50 patients with pathologic correlation. Gastrointest Radiol. 1991;16(2):143–8.

    Article  CAS  Google Scholar 

  19. Pineda O, Maydon HG, Amado M, Sepulveda EM, Guilbert L, Espinosa O, et al. A prospective study of the conservative management of asymptomatic preoperative and postoperative gallbladder disease in bariatric surgery. Obes Surg. 2017;27(1):148–53.

    Article  Google Scholar 

  20. Muroni M, Loi V, Lionnet F, Girot R, Houry S. Prophylactic laparoscopic cholecystectomy in adult sickle cell disease patients with cholelithiasis: a prospective cohort study. Int J Surg. 2015;22:62–6.

    Article  Google Scholar 

  21. Tulchinsky M, Colletti PM, Allen TW. Hepatobiliary scintigraphy in acute cholecystitis. Semin Nucl Med. 2012;42(2):84–100.

    Article  Google Scholar 

  22. Shakespear JS, Shaaban AM, Rezvani M. CT findings of acute cholecystitis and its complications. AJR Am J Roentgenol. 2010;194(6):1523–9.

    Article  Google Scholar 

  23. Rodriguez LE, Santaliz-Ruiz LE, De La Torre-Bisot G, Gonzalez G, Serpa MA, Sanchez-Gaetan F, et al. Clinical implications of hepatobiliary scintigraphy and ultrasound in the diagnosis of acute cholecystitis. Int J Surg. 2016;35:196–200.

    Article  Google Scholar 

  24. Richardson WS, Hamad GG, Stefanidis D, Committee SG. SAGES VTE prophylaxis for laparoscopic surgery guidelines: an update. Surg Endosc. 2017;31(2):501–3.

    Article  Google Scholar 

  25. Ahmad G, Gent D, Henderson D, O’Flynn H, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2015;(8):CD006583.

    Google Scholar 

  26. Siddiqui NA, Azami R, Murtaza G, Nasim S. Postoperative port-site pain after gall bladder retrieval from epigastric vs. umbilical port in laparoscopic cholecystectomy: a randomized controlled trial. Int J Surg. 2012;10(4):213–6.

    Article  Google Scholar 

  27. Memon JM, Memon MR, Arija D, Bozdar AG, Talpur MM. Retrieval of gallbladder through epigastric port as compared to umbilical port after laparoscopic cholecystectomy. Pak J Pharm Sci. 2014;27(6 Spec No.):2165–8.

    Google Scholar 

  28. Kaya C, Bozkurt E, Yazici P. The impact of gallbladder retrieval from an epigastric vs. umbilical port on trocar-site complications A prospective randomized study. Ann Ital Chir. 2017;88:326–9.

    PubMed  Google Scholar 

  29. Strasberg SM, Brunt LM. The critical view of safety: why it is not the only method of ductal identification within the standard of care in laparoscopic cholecystectomy. Ann Surg. 2017;265(3):464–5.

    Article  Google Scholar 

  30. Kelly MD. Laparoscopic retrograde (fundus first) cholecystectomy. BMC Surg. 2009;9:19.

    Article  Google Scholar 

  31. Ota A, Kano N, Kusanagi H, Yamada S, Garg A. Techniques for difficult cases of laparoscopic cholecystectomy. J Hepato-Biliary-Pancreat Surg. 2003;10(2):172–5.

    Article  Google Scholar 

  32. Elshaer M, Gravante G, Thomas K, Sorge R, Al-Hamali S, Ebdewi H. Subtotal cholecystectomy for “difficult gallbladders”: systematic review and meta-analysis. JAMA Surg. 2015;150(2):159–68.

    Article  Google Scholar 

  33. Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ. Subtotal cholecystectomy-“fenestrating” vs “reconstituting” subtypes and the prevention of bile duct injury: definition of the optimal procedure in difficult operative conditions. J Am Coll Surg. 2016;222(1):89–96.

    Article  Google Scholar 

  34. Sheffield KM, Riall TS, Han Y, Kuo YF, Townsend CM Jr, Goodwin JS. Association between cholecystectomy with vs without intraoperative cholangiography and risk of common duct injury. JAMA. 2013;310(8):812–20.

    Article  CAS  Google Scholar 

  35. Stewart L. Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 2014;94(2):297–310.

    Article  Google Scholar 

  36. Mazer LM, Tapper EB, Sarmiento JM. Non-operative management of right posterior sectoral duct injury following laparoscopic cholecystectomy. J Gastrointest Surg. 2011;15(7):1237–42.

    Article  Google Scholar 

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Mazer, L., Brill, E. (2020). Cholecystectomy. In: Renton, D., Lim, R., Gallo, A., Sinha, P. (eds) The SAGES Manual of Acute Care Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-21959-8_3

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  • DOI: https://doi.org/10.1007/978-3-030-21959-8_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21958-1

  • Online ISBN: 978-3-030-21959-8

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