Pub Date : 2024-11-01DOI: 10.1016/j.ciresp.2024.06.010
Rocío Pérez Quintero , Marcos Bruna Esteban , Antonio José Serrano López
In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications. Because of this, research and the creation of predictive models that identify patients at high risk of developing complications are mandatory in order to obtain an early diagnosis.
The PROFUGO study (PRedictivO Model for Early Diagnosis of anastomotic LEAK after esophagectomy and gastrectomy) is proposed as a prospective and multicenter national study that aims to develop, with the help of artificial intelligence methods, a predictive model that allows for the identification of high-risk cases of anastomotic leakage and/or major complications by analyzing different clinical and analytical variables collected during the postoperative period of patients undergoing esophagectomy or gastrectomy.
{"title":"Protocolo del estudio PROFUGO: Modelo PRedictivO para el Diagnóstico Precoz de la FUGa anastomótica tras esofaguectomía y gastrectomía","authors":"Rocío Pérez Quintero , Marcos Bruna Esteban , Antonio José Serrano López","doi":"10.1016/j.ciresp.2024.06.010","DOIUrl":"10.1016/j.ciresp.2024.06.010","url":null,"abstract":"<div><div>In esophagogastric surgery, the appearance of an anastomotic leak is the most feared complication. Early diagnosis is important for optimal management and successful resolution. For this reason, different studies have investigated the value of the use of markers to predict possible postoperative complications. Because of this, research and the creation of predictive models that identify patients at high risk of developing complications are mandatory in order to obtain an early diagnosis.</div><div>The PROFUGO study (PRedictivO Model for Early Diagnosis of anastomotic LEAK after esophagectomy and gastrectomy) is proposed as a prospective and multicenter national study that aims to develop, with the help of artificial intelligence methods, a predictive model that allows for the identification of high-risk cases of anastomotic leakage and/or major complications by analyzing different clinical and analytical variables collected during the postoperative period of patients undergoing esophagectomy or gastrectomy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 11","pages":"Pages 624-629"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.ciresp.2024.05.011
David Hernández-Bermejo , Celia García-Vega , Juan Jesús Rubio-García , Celia Villodre-Tudela , Silvia Carbonell-Morote , José Manuel Ramia
Introduction
Cholelithiasis is the most common hospital diagnosis of the digestive system, and its treatment, if symptomatic, is laparoscopic cholecystectomy. There is a growing need for comprehensive determination of postoperative outcomes and the efficiency of healthcare facilities. The “textbook outcome”(TO) indicates the quality of care commonly used in oncological procedures, obtained by adding several postoperative parameters, which informs whether a perfect result has been obtained. The main objective of this study is to determine the TO for cholecystectomy and to see the factors that influence its achievement.
Methods
Retrospective observational unicentric cohort study on patients who underwent cholecystectomy between 2018-2020. We defined TO as those patients who met the following premises: Clavien-Dindo complications < III, postsurgical stay less than the 75th percentile (<3 days), and no readmissions or mortality in the first ninety days. Perioperative characteristics were analyzed, and the patients were divided into two groups according to whether or not they achieved TO. We defined criteria for difficult cholecystectomy according to the operative report.
Results
The percentage of TO was 72% (342/475) (82.6% in elective surgery and 60.5% in urgent surgery). The univariate analysis showed that the following factors are associated with achieving TO: female sex, age < 63 years, ASA risk < III, elective surgery, laparoscopic approach, and not difficult cholecystectomy. After multivariate analysis, ASA< III (OR 2.39 CI95% 1.37-4.16), elective surgery (OR 2.77 CI95% 1.64-4.67), laparoscopic approach (OR 5.71 CI95% 2.89-11.30) and not to be difficult cholecystectomy (OR 0.42 CI95% 0.259-0.71) remained statistically significant.
Conclusions
The TO is a healthcare quality tool that is simple to perform, easily interpretable, and helpful for evaluating quality in healthcare and comparing centers. It applies not only to oncological procedures but also to cholecystectomy.
{"title":"Textbook outcome en colecistectomía. ¿Es útil esta herramienta en una intervención con baja tasa de morbilidad?","authors":"David Hernández-Bermejo , Celia García-Vega , Juan Jesús Rubio-García , Celia Villodre-Tudela , Silvia Carbonell-Morote , José Manuel Ramia","doi":"10.1016/j.ciresp.2024.05.011","DOIUrl":"10.1016/j.ciresp.2024.05.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Cholelithiasis is the most common hospital diagnosis of the digestive system, and its treatment, if symptomatic, is laparoscopic cholecystectomy. There is a growing need for comprehensive determination of postoperative outcomes and the efficiency of healthcare facilities. The “textbook outcome”(TO) indicates the quality of care commonly used in oncological procedures, obtained by adding several postoperative parameters, which informs whether a perfect result has been obtained. The main objective of this study is to determine the TO for cholecystectomy and to see the factors that influence its achievement.</div></div><div><h3>Methods</h3><div>Retrospective observational unicentric cohort study on patients who underwent cholecystectomy between 2018-2020. We defined TO as those patients who met the following premises: Clavien-Dindo complications <<!--> <!-->III, postsurgical stay less than the 75th percentile (<3 days), and no readmissions or mortality in the first ninety days. Perioperative characteristics were analyzed, and the patients were divided into two groups according to whether or not they achieved TO. We defined criteria for difficult cholecystectomy according to the operative report.</div></div><div><h3>Results</h3><div>The percentage of TO was 72% (342/475) (82.6% in elective surgery and 60.5% in urgent surgery). The univariate analysis showed that the following factors are associated with achieving TO: female sex, age <<!--> <!-->63 years, ASA risk <<!--> <!-->III, elective surgery, laparoscopic approach, and not difficult cholecystectomy. After multivariate analysis<del>,</del> ASA<<!--> <!-->III (OR 2.39 CI95% 1.37-4.16), elective surgery (OR 2.77 CI95% 1.64-4.67), laparoscopic approach (OR 5.71 CI95% 2.89-11.30) and not to be difficult cholecystectomy (OR 0.42 CI95% 0.259-0.71) remained statistically significant.</div></div><div><h3>Conclusions</h3><div>The TO is a healthcare quality tool that is simple to perform, easily interpretable, and helpful for evaluating quality in healthcare and comparing centers. It applies not only to oncological procedures but also to cholecystectomy.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 11","pages":"Pages 582-589"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.ciresp.2024.05.016
Andrea Norte, Carmen Martínez, Ana Pasalodos, Ivette Tort, Anna Sánchez, Pilar Hernández, Jesús Bollo, Eduard Maria Targarona
Aim
To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach.
Methods
We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission.
Results
Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57–113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5–7). Readmission was needed in 6.8% (n = 7) of patients.
Conclusion
A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.
{"title":"Impact of the laparoscopic approach, early closure and preoperative stimulation on outcomes of ileostomy closure after rectal resection","authors":"Andrea Norte, Carmen Martínez, Ana Pasalodos, Ivette Tort, Anna Sánchez, Pilar Hernández, Jesús Bollo, Eduard Maria Targarona","doi":"10.1016/j.ciresp.2024.05.016","DOIUrl":"10.1016/j.ciresp.2024.05.016","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach.</div></div><div><h3>Methods</h3><div>We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission.</div></div><div><h3>Results</h3><div>Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57–113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5–7). Readmission was needed in 6.8% (n = 7) of patients.</div></div><div><h3>Conclusion</h3><div>A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 11","pages":"Pages 590-598"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.ciresp.2024.06.009
Ana Belén Martín Arnau , Antonio Molera Espelt , Jordi Villaba Auñon , Santiago Sánchez-Cabús
The treatment of lithiasis in patients with biliodigestive bypass can be controversial. The combination of percutaneous access together with cholangioscopy is an alternative to surgical treatment for the management of this pathology.In recent years, the appearance of smaller and more flexible fiber-optic cholangioscopes as well as the possibility to perform lithotripsy have changed the treatment of this pathology, providing good results. After our experience, we believe that cholangioscopy assisted by a percutaneous approach is a safe technique, with few complications and early recovery for patients in whom it is not possible to perform endoscopic management.
{"title":"Colangioscopia asistida mediante abordaje transparietohepático en el manejo de las hepatolitiasis","authors":"Ana Belén Martín Arnau , Antonio Molera Espelt , Jordi Villaba Auñon , Santiago Sánchez-Cabús","doi":"10.1016/j.ciresp.2024.06.009","DOIUrl":"10.1016/j.ciresp.2024.06.009","url":null,"abstract":"<div><div>The treatment of lithiasis in patients with biliodigestive bypass can be controversial. The combination of percutaneous access together with cholangioscopy is an alternative to surgical treatment for the management of this pathology.In recent years, the appearance of smaller and more flexible fiber-optic cholangioscopes as well as the possibility to perform lithotripsy have changed the treatment of this pathology, providing good results. After our experience, we believe that cholangioscopy assisted by a percutaneous approach is a safe technique, with few complications and early recovery for patients in whom it is not possible to perform endoscopic management.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 11","pages":"Pages 599-604"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ciresp.2024.01.007
Wei Yang , Chendong He
{"title":"Multifocal small bowel adenocarcinoma with liver metastasis based on a 16-year history of Crohn’s disease","authors":"Wei Yang , Chendong He","doi":"10.1016/j.ciresp.2024.01.007","DOIUrl":"10.1016/j.ciresp.2024.01.007","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 10","pages":"Page 564"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ciresp.2024.07.008
Olga Dobato Portoles , Daniel Aparicio Lopez , Reyes Ibañez Carreras , Elena Aguirre Ortega , Beatriz Eizaguirre Zarza , Carmen García Mur , Aurora Carrasquer Puyal , María Pilar Cebollero Benito , Laura Isabel Comín Novella , Marta Allue Cabañuz , Fernando Martinez Ubieto , Ramón Sousa Domínguez , Javier Torcal Aznar , Carmen Casamayor Franco
Introduction
Male breast cancer accounts for 1% of all breast cancers. Its low frequency leads to a lack of awareness, resulting in significant diagnostic delays. Additionally, this limits the available evidence, which primarily uses diagnostic-therapeutic algorithms based on women.
Methods
A multicenter, observational, descriptive, retrospective study was conducted in the autonomous community of Aragon, Spain, from 1995 to 2022 including men with a pathological diagnosis of breast cancer. The prevalence, clinical presentation, pathological characteristics and prognosis of this pathology in men were analyzed.
Results
A total of 148 patients were included, one of the largest series available, with a prevalence of 1%. The most common clinical presentation was a palpable retroareolar mass. Invasive ductal carcinoma was the most frequent type (88.89%), and luminal B was the predominant subtype (47.76%). Surgery was the most utilized treatment; mastectomy was performed in 90.34% and AL in 46.89%. At diagnosis, 52.46% had extramammary involvement. The recurrence rate was 24.1%, and the mortality attributed to the disease was 14.6%.
Conclusions
There is a high rate of metastatic involvement at diagnosis, a high percentage of mutilating surgeries, and a high number of recurrences compared to available studies on males. Additionally, a worse prognosis is observed compared to breast cancer in women, despite these tumors having a less aggressive molecular subtype. These findings highlight the importance of conducting studies focused on men to develop specific protocols.
{"title":"Cáncer de mama en el varón: estudio multicéntrico en Aragón durante 27 años","authors":"Olga Dobato Portoles , Daniel Aparicio Lopez , Reyes Ibañez Carreras , Elena Aguirre Ortega , Beatriz Eizaguirre Zarza , Carmen García Mur , Aurora Carrasquer Puyal , María Pilar Cebollero Benito , Laura Isabel Comín Novella , Marta Allue Cabañuz , Fernando Martinez Ubieto , Ramón Sousa Domínguez , Javier Torcal Aznar , Carmen Casamayor Franco","doi":"10.1016/j.ciresp.2024.07.008","DOIUrl":"10.1016/j.ciresp.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Male breast cancer accounts for 1% of all breast cancers. Its low frequency leads to a lack of awareness, resulting in significant diagnostic delays. Additionally, this limits the available evidence, which primarily uses diagnostic-therapeutic algorithms based on women.</div></div><div><h3>Methods</h3><div>A multicenter, observational, descriptive, retrospective study was conducted in the autonomous community of Aragon, Spain, from 1995 to 2022 including men with a pathological diagnosis of breast cancer. The prevalence, clinical presentation, pathological characteristics and prognosis of this pathology in men were analyzed.</div></div><div><h3>Results</h3><div>A total of 148 patients were included, one of the largest series available, with a prevalence of 1%. The most common clinical presentation was a palpable retroareolar mass. Invasive ductal carcinoma was the most frequent type (88.89%), and luminal B was the predominant subtype (47.76%). Surgery was the most utilized treatment; mastectomy was performed in 90.34% and AL in 46.89%. At diagnosis, 52.46% had extramammary involvement. The recurrence rate was 24.1%, and the mortality attributed to the disease was 14.6%.</div></div><div><h3>Conclusions</h3><div>There is a high rate of metastatic involvement at diagnosis, a high percentage of mutilating surgeries, and a high number of recurrences compared to available studies on males. Additionally, a worse prognosis is observed compared to breast cancer in women, despite these tumors having a less aggressive molecular subtype. These findings highlight the importance of conducting studies focused on men to develop specific protocols.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 10","pages":"Pages 524-532"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ciresp.2023.11.005
{"title":"Xenotrasplante hepático. Momento de dar el salto a la clínica","authors":"","doi":"10.1016/j.ciresp.2023.11.005","DOIUrl":"10.1016/j.ciresp.2023.11.005","url":null,"abstract":"","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 10","pages":"Pages 513-514"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141277709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ciresp.2024.06.005
José Ceballos Esparragón , Javier Dagnesses Fonseca , Jordi Marín García , Patrizio Petrone
Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024. Computed tomography is the gold-standard imaging test for diagnosis. Open surgery is generally the preferred approach, particularly in emergencies. Acute TAWH can be treated by primary suture or mesh repair, depending on local conditions, while late cases usually require mesh.
{"title":"Hernias abdominales secundarias a traumatismo no penetrante. Una revisión sistemática","authors":"José Ceballos Esparragón , Javier Dagnesses Fonseca , Jordi Marín García , Patrizio Petrone","doi":"10.1016/j.ciresp.2024.06.005","DOIUrl":"10.1016/j.ciresp.2024.06.005","url":null,"abstract":"<div><div>Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024. Computed tomography is the gold-standard imaging test for diagnosis. Open surgery is generally the preferred approach, particularly in emergencies. Acute TAWH can be treated by primary suture or mesh repair, depending on local conditions, while late cases usually require mesh.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 10","pages":"Pages 515-523"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ciresp.2024.07.010
Maria Luisa Galaviz-Sosa , Eric Herrero Fonollosa , María Isabel García-Domingo , Judith Camps Lasa , María Galofré Recasens , Melissa Arias Aviles , Esteban Cugat Andorrà
Background
This study aims to compare the visualization of the cystic duct-common bile duct junction with indocyanine green (ICG) among 3 groups of patients divided according to the difficulty of elective laparoscopic cholecystectomy.
Methods
Conducted at a single center, this non-randomized, prospective, observational study encompassed 168 patients who underwent elective laparoscopic cholecystectomy and were assessed with a preoperative risk score to predict difficult cholecystectomies, including clinical factors and radiological findings. Three groups were identified: low, moderate, and high risk. A dose of 0.25 mg of IV ICG was administered during anesthesia induction and the different objectives were evaluated.
Results
The visualization of the cystic duct-common bile duct junction was achieved in 28 (100%), 113 (91.1%), and 10 (63%) patients in the low, moderate, and high-risk groups, respectively. The high-risk group had longer total operative time, higher conversion, more complications and longer hospital stay. In the surgeon's subjective assessment, ICG was considered useful in 36% of the low-risk group, 58% in the moderate-risk group, and 69% in the high-risk group. Additionally, there were no cases where ICG modified the surgeon's surgical approach in the low-risk group, compared to 11% in the moderate-risk group and 25% in the high-risk group (p < 0.01).
Conclusions
The results of this study confirm that in the case of difficult cholecystectomies, the visualization of the cystic duct-common bile duct junction is achieved in 63% of cases and prompts a modification of the surgical procedure in one out of four patients.
{"title":"Verde de indocianina en la colecistectomía laparoscópica: utilidad y correlación con un score preoperatorio de riesgo","authors":"Maria Luisa Galaviz-Sosa , Eric Herrero Fonollosa , María Isabel García-Domingo , Judith Camps Lasa , María Galofré Recasens , Melissa Arias Aviles , Esteban Cugat Andorrà","doi":"10.1016/j.ciresp.2024.07.010","DOIUrl":"10.1016/j.ciresp.2024.07.010","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to compare the visualization of the cystic duct-common bile duct junction with indocyanine green (ICG) among 3 groups of patients divided according to the difficulty of elective laparoscopic cholecystectomy.</div></div><div><h3>Methods</h3><div>Conducted at a single center, this non-randomized, prospective, observational study encompassed 168 patients who underwent elective laparoscopic cholecystectomy and were assessed with a preoperative risk score to predict difficult cholecystectomies, including clinical factors and radiological findings. Three groups were identified: low, moderate, and high risk. A dose of 0.25<!--> <!-->mg of IV ICG was administered during anesthesia induction and the different objectives were evaluated.</div></div><div><h3>Results</h3><div>The visualization of the cystic duct-common bile duct junction was achieved in 28 (100%), 113 (91.1%), and 10 (63%) patients in the low, moderate, and high-risk groups, respectively. The high-risk group had longer total operative time, higher conversion, more complications and longer hospital stay. In the surgeon's subjective assessment, ICG was considered useful in 36% of the low-risk group, 58% in the moderate-risk group, and 69% in the high-risk group. Additionally, there were no cases where ICG modified the surgeon's surgical approach in the low-risk group, compared to 11% in the moderate-risk group and 25% in the high-risk group (p<!--> <!--><<!--> <!-->0.01).</div></div><div><h3>Conclusions</h3><div>The results of this study confirm that in the case of difficult cholecystectomies, the visualization of the cystic duct-common bile duct junction is achieved in 63% of cases and prompts a modification of the surgical procedure in one out of four patients.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"102 10","pages":"Pages 533-539"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号