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Guo X, Fan Q, Guo Y, Li X, Hu J, Wang Z, Wang J, Li K, Zhang N, Amin B, Zhu B. Clinical study on the necessity and feasibility of routine MRCP in patients with cholecystolithiasis before LC. BMC Gastroenterol 2024; 24:28. [PMID: 38195417 PMCID: PMC10777623 DOI: 10.1186/s12876-023-03117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND In the past quite a long time, intraoperative cholangiography(IOC)was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patients undergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. METHODS According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. RESULTS Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCP were higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in non-MRCP group (8.43%) was significantly higher (P < 0.05) than that in MRCP group (0%). There was no significant difference in hospital stay (P > 0.05), but there was significant difference in hospitalization expenses (P < 0.05) between the two groups. According to the stratification of gallbladder stone patients with CBDS, hospital stay and hospitalization expenses were compared, and there was no significant difference between the two groups (P > 0.05). CONCLUSIONS The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.
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Affiliation(s)
- Xu Guo
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Qing Fan
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Yiman Guo
- School of Clinical Medicine, Hebei University, Wusi East Road 180th, Lianchi District, Hebei Province, 071000, Baoding City, China
| | - Xinming Li
- Department of Urology, Fuyang People's Hospital, Anhui Medical University, Sanqing Road 501th, Ying Zhou District, 236012, Fuyang City, Anhui Province, China
| | - Jili Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, 450052, Zhengzhou City, Henan Province, China
| | - Zhuoyin Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Jing Wang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Kai Li
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Nengwei Zhang
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China
| | - Buhe Amin
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China.
| | - Bin Zhu
- Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Tieyi Road 10th, Yangfangdian Street, Haidian District, 100038, Beijing, China.
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Wilandika A, Gartika N, Nurfarida E. Early ambulation and dhikr complementary therapies effect on intestinal peristaltic in post-open cholecystectomy patients. Rev Bras Enferm 2023; 76Suppl 4:e20220636. [PMID: 38088708 PMCID: PMC10704669 DOI: 10.1590/0034-7167-2022-0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/22/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES to analyze and determine the effect of a combination intervention of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients. METHODS a pre-experimental design with one group pre and post-test design was used. The samples were 15 post-open cholecystectomy patients which were selected using the purposive sampling technique. The data were collected using the instrument observation sheet and analyzed using the Wilcoxon test. Early ambulation used standard operational procedure in the hospital and dhikr therapy was carried out at 2 hours post-operation for 10-15 minutes. RESULTS there was an effect of early ambulation and dhikr therapy on intestinal peristaltic recovery in post-open cholecystectomy patients with general anesthesia (Z=-3.442; p=0.001). CONCLUSIONS a combination of early ambulation and dhikr therapy can be recommended as interventions to improve intestinal peristaltic in a post-open cholecystectomy patient with general anesthesia.
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Affiliation(s)
| | - Nina Gartika
- Universitas Aisyiyah Bandung. Bandung, West Java, Indonesia
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Abbasnia F, Aghebati N, Miri HH, Etezadpour M. Effects of Patient Education and Distraction Approaches Using Virtual Reality on Pre-operative Anxiety and Post-operative Pain in Patients Undergoing Laparoscopic Cholecystectomy. Pain Manag Nurs 2023; 24:280-288. [PMID: 36658058 DOI: 10.1016/j.pmn.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fear of post-operative pain often contributes to pre-operative anxiety; accordingly, pain and anxiety are among the most common complications in patients undergoing laparoscopic cholecystectomy (LC). AIM The present study aimed to determine the effects of patient education and distraction using virtual reality (VR) on pre-operative anxiety and post-operative pain in patients undergoing LC. METHOD This randomized clinical trial included 150 patients in the surgery wards of educational hospitals in Mashhad, Iran, in 2020. The participants were randomly assigned to three groups of education, distraction, and control. The education and distraction groups watched two five-minute animations and three 360-degree images of nature using VR glasses 2 hours before and 4 hours after the surgery, respectively. On the other hand, the control group received routine care. Anxiety was measured using Spielberger's State Anxiety Inventory before and half an hour after the intervention. Moreover, the pain was measured using the visual analog scale and McGill Pain Questionnaire. RESULTS The results demonstrated a significant reduction in the two VR groups regarding the pre-operative anxiety mean scores, compared with the control group (p < .001). Furthermore, a significant reduction was observed in post-operative pain scores of patients in the two intervention groups compared with the control group (p = .001). CONCLUSIONS As evidenced by the results, both VR approaches of patient education and distraction equally decreased pre-operative anxiety and post-operative pain in patients undergoing LC.
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Affiliation(s)
- Fatemeh Abbasnia
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Aghebati
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamid Heidarian Miri
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Yayla A, Eskici İlgin V, Kılınç T, Karaman Özlü Z, Ejder Apay S. Nausea and Vomiting After Laparoscopic Cholecystectomy: Analysis of Predictive Factors. J Perianesth Nurs 2022; 37:834-841. [PMID: 35382962 DOI: 10.1016/j.jopan.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/02/2022] [Accepted: 01/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this study was to identify the factors predictive of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. DESIGN This is a descriptive, cross-sectional study. METHODS In total, 172 patients completed the study. "The Questionnaire Form," "Visual Analog Scale," "Nausea Scale," and "Anxiety Specific to Surgery Questionnaire" created by the researchers were used for data collection. FINDINGS At the second postoperative hour, 55.8% of the patients had nausea, 20.3% had vomiting and 75% had severe pain. The severity of nausea, vomiting, and pain decreased with time. Age, gender, smoking, motion sickness, postoperative pain, opioid use, preoperative fasting time, time of first postoperative fluid intake and preoperative anxiety score were found to be among the factors predictive of PONV (P < .05). CONCLUSIONS High rates of postoperative nausea and vomiting were recorded. The factors predictive of PONV can be evaluated in the preoperative period, and PONV can be controlled with early interventions and treatment of patients in the risk group.
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Affiliation(s)
- Ayşegül Yayla
- Department of Surgical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey.
| | - Vesile Eskici İlgin
- Department of Surgical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
| | - Tülay Kılınç
- Department of Surgical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
| | - Zeynep Karaman Özlü
- Department of Surgical Nursing, Faculty of Nursing, Anesthesiology Clinical Research Office, Atatürk University, Erzurum, Turkey
| | - Serap Ejder Apay
- Atatürk University Health Science Faculty, Department of Midwifery, Erzurum, Turkey
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Suragul W, Tantawanit A, Rungsakulkij N, Muangkaew P, Tangtawee P, Mingphrudhi S, Vassanasiri W, Lertsithichai P, Aeesoa S, Apinyachon W. OUP accepted manuscript. BJS Open 2022; 6:6594075. [PMID: 35639946 PMCID: PMC9154337 DOI: 10.1093/bjsopen/zrac066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/18/2022] [Accepted: 04/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Local anaesthetic infiltration is widely used to reduce pain after laparoscopic cholecystectomy (LC). This trial evaluated the effect of depth of local anaesthetic infiltration on postoperative pain reduction after LC. Methods Patients undergoing elective LC between March 2018 and February 2019 were randomized into no infiltration, subcutaneous infiltration, and rectus sheath infiltration using bupivacaine. The primary outcome was 24-h postoperative cumulative morphine use, and the secondary outcomes were mean 24-h Numerical Rating Scale (NRS) for pain, and nausea, and vomiting. Subgroups were compared and multivariable analyses were performed. Results Out of 170 eligible patients, 162 were selected and 150 patients were analysed: 48 in the no-infiltration group, 50 in the subcutaneous infiltration group, and 52 in the rectus sheath infiltration group. The groups had similar clinical features, although mean BMI was higher in the subcutaneous infiltration group (P = 0.001). The 24-h cumulative morphine use in the rectus sheath infiltration group was significantly lower than in the no-infiltration group (P = 0.043), but no difference was observed between the subcutaneous infiltration and no-infiltration groups (P = 0.999). One hour after surgery, the rectus sheath infiltration group had a significantly lower NRS score than the no-infiltration and subcutaneous infiltration groups respectively (P = 0.006 and P = 0.031); however, the score did not differ among the three groups at any of the time points from 2 h after the surgery. The incidence of nausea or vomiting was comparable among the three groups. Multivariable analysis documented that a lower dose of morphine use was associated with rectus sheath infiltration (P = 0.004) and diabetes (P = 0.001); whereas, increased morphine use was associate with age (P = 0.040) and a longer duration of surgery (P = 0.007). Conclusions Local anaesthetic infiltration into the rectus sheath reduced postoperative cumulative morphine use and the immediate NRS score in patients undergoing LC; however, the pain scores were comparable 2 h after surgery. Registration number TCTR20201103002 (http://www.thaiclinicaltrials.org).
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Affiliation(s)
- Wikran Suragul
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Apawee Tantawanit
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Paramin Muangkaew
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pongsatorn Tangtawee
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Somkit Mingphrudhi
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Watoo Vassanasiri
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Suraida Aeesoa
- Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Worapot Apinyachon
- Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence to: Worapot Apinyachon, Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand (e-mail: )
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Johansson E, Hultin M, Myrberg T, Walldén J. Early post-operative nausea and vomiting: A retrospective observational study of 2030 patients. Acta Anaesthesiol Scand 2021; 65:1229-1239. [PMID: 34086350 DOI: 10.1111/aas.13936] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/20/2021] [Accepted: 05/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The overall risk of post-operative nausea and vomiting (PONV) after general anaesthesia is reportedly 20%-40%. The first episode of PONV may occur early in the post-anaesthesia care unit (PACU) or later at the ward or after discharge at home in an ambulatory setting. This study aimed to investigate and describe the risk of early PONV in a PACU, and we hypothesised that patients and perioperative factors were associated with early PONV. METHODS This single-centre retrospective observational study was conducted in a Swedish county hospital from January to June 2017 and included adult patients who underwent surgical procedures under general anaesthesia. Perioperative data were obtained by reviewing the local registry for surgical procedures, medical records and anaesthesia and post-operative charts. Early PONV was defined as PONV occurring up to 4 hours post-operatively at the PACU. Any notification in the medical records, perioperative charts or the registry regarding nausea, vomiting or PONV treatment was regarded as PONV. Univariate and multivariate analyses were performed for factors associated with early PONV. RESULTS A total of 2030 patients were included in the study, of which 9.6% (n = 194) experienced early PONV. Factors associated with a high risk of early PONV were suboptimal PONV prophylaxis, need for opioids, female sex, body mass index >35 kg m-2 and major surgery and anaesthesia time ≥60 minutes. CONCLUSION We found that every 10th patient under general anaesthesia experienced early PONV. Suboptimal PONV prophylaxis and previously acknowledged risk factors for PONV were associated with early PONV.
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Affiliation(s)
- Emma Johansson
- Department of Surgical and Perioperative Sciences Anaesthesiology and Intensive Care Medicine (Sundsvall) Umeå University Umeå Sweden
| | - Magnus Hultin
- Department of Surgical and Perioperative Sciences Anaesthesiology and Intensive Care Medicine (Umeå) Umeå University Umeå Sweden
| | - Tomi Myrberg
- Department of Surgical and Perioperative Sciences Anaesthesiology and Intensive Care Medicine (Sunderbyn) Umeå University Umeå Sweden
| | - Jakob Walldén
- Department of Surgical and Perioperative Sciences Anaesthesiology and Intensive Care Medicine (Sundsvall) Umeå University Umeå Sweden
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