Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between April 1989 and November 1991, 500 consecutive patients (393 women and 107 men, aged 17 to 87 years) underwent laparoscopic cholecystectomy at our institution. The most common indication for surgery was chronic calculous cholecystitis. Twelve (2.4%) patients underwent emergency surgery, and the rest had elective operations. The average operative time was 36 minutes. In all but 72 cases, dissection was performed with a laser. In 4 instances (0.08%), the laparoscopic procedure was converted to an open cholecystectomy because acute cholecystitis made the gallbladder hard to grasp (2 cases) or faulty insufflation equipment afforded poor visualization of the operative field (2 cases). Three patients (0.06%) underwent reoperation for posterior cystic artery bleeding, cystic duct leakage, and common-bile-duct injury (1 case each). Minor complaints during the immediate postoperative period included nausea and shoulder pain. Patients were discharged from the hospital an average of 20 hours after surgery and resumed full activity within 3 to 8 days.
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PMID:Laparoscopic cholecystectomy: experience in 500 consecutive cases. 817 50

Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in the abdomen. Intraperitoneal local anesthesia (IPLA) reduces pain after LC. Acute cholecystitis-associated inflammation, increased gallbladder wall thickness, dissection difficulties, and a longer operative time are several reasons for assuming a benefit in pain scores in urgent LC with IPLA application. The aim was to determine the postoperative analgesic efficacy of high-volume, low-dose intraperitoneal bupivacaine in urgent LC. Materials and Methods. Fifty-seven patients who were American Society of Anesthesiologists physical status I or II were randomly assigned to receive either normal saline (control group) or intraperitoneal bupivacaine (test group) at the beginning or end of urgent LC. The primary outcome was the postoperative pain score of the Visual Analogue Scale (VAS). The secondary outcomes included Visual Rating Prince Henry Scale (VRS), patient satisfaction, and analgesic consumption. Results. Postoperative VAS scores at the first and fourth hours were significantly lower in the test group than in the control group (P < .001). Postoperative VRS scores at the first, fourth, and eighth hours were significantly lower in the test group than in the control group (P < .001, P = .002, P = .004, respectively). Analgesic use was significantly higher in the control group at the first postoperative hour (P < .001). Shoulder pain was significantly lower, and patient satisfaction was significantly higher in the test group relative to the control group (both P < .001). Conclusion. High-volume, low-concentration intraperitoneal bupivacaine resulted in better postoperative pain control and reduced incidence of shoulder pain and analgesic consumption in urgent LC.
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PMID:High-Volume, Low-Concentration Intraperitoneal Bupivacaine Study in Emergency Laparoscopic Cholecystectomy: A Double-Blinded, Prospective Randomized Clinical Trial. 3224 64