Cholecystectomy - Knowledge (XXG)

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issues such as adherent bowel or colon, inability to properly identify anatomical planes from previously formed scar-tissue. If there is an inability to safely isolate the structures needed to isolate for cholecystectomy (the cystic duct and the cystic artery) for whatever reason (many times patients have part of the small bowel or colon stuck to the gallbladder, which make it dangerous to pull off without making an accidental hole in the small bowel), the surgical team may elect to do a subtotal cholecystectomy; either a fenestrated or reconstituting type. Essentially, only part of the gallbladder is removed and a drain is left in place for several days. Complications include continued output from drain, which may result in the need for ERCP stent placement to stop drainage.

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long thin tube with a camera on the end, is passed through the mouth and down the esophagus. The doctor advances the camera through the stomach and into the first part of the small intestine to reach the opening of the bile duct. The doctor can inject a special, radiopaque dye through the endoscope into the bile duct to see stones or other blockages on x-ray. ERCP does not require general anaesthesia and can be done outside of the operating room. While ERCP can be used to remove a specific stone that is causing a blockage to allow drainage, it cannot remove all stones in the gallbladder. Thus, it is not considered a definitive treatment and people with recurrent complications from stones will still likely need a cholecystectomy.

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duct stones discovered during laparoscopic cholecystectomy. This technique was first described in 1993 by Deslandres et al. and has, in several studies, been shown to have a high rate of CBD stones clearance and a reduced number of complications, particularly post-ERCP pancreatitis, in comparison with conventional ERCP. This is probably due to the facilitated access to the common bile duct with a lesser degree of manipulation and trauma to the papilla Vateri. In a study by Swahn et al. the rendezvous method was shown to reduce the risk of PEP from 3.6 to 2.2% compared with conventional biliary cannulation. The success rate of passing the transcystic guidewire into the duodenum has been reported to be over 80%.

622: 614: 3488: 1251: 272:, is moderate to severe, and goes away on its own after a few hours when the stone dislodges. Biliary colic usually occurs after meals when the gallbladder contracts to push bile out into the digestive tract. After a first attack of biliary colic, more than 90% of people will have a repeat attack in the next 10 years. Repeated attacks of biliary colic are the most common reason for removing the gallbladder, and lead to about 300,000 cholecystectomies in the US each year. 882:(PGB), a condition where the gallbladder wall shows calcification on imaging tests, was previously considered a reason to remove the gallbladder because it was thought that people with this condition had a high risk of developing gallbladder cancer. However, recent studies have shown that there is no strong association between gallbladder cancer and porcelain gallbladder, and that PGB alone is not a strong enough indication for a prophylactic cholecystectomy. 1036:

strong resistance by the German surgical establishment and he had difficulty communicating it in English. It was consequently ignored. Mühe's work was further disparaged in 1987, when he was charged with manslaughter for a postoperative patient death that was mistakenly attributed to his innovative technique. He was exonerated in 1990 after further investigation. His pioneering work was eventually recognized by the German Surgical Society Congress in 1992.

928: 601: 1009:, or gallstone removal. Langenbuch's rationale for developing the new technique stemmed from 17th century studies in dogs that demonstrated the gallbladder to be nonessential and medical opinion among his colleagues that gallstones formed in the gallbladder. Although the technique was initially controversial, cholecystectomy became established as a lower mortality procedure than cholecystostomy by the 20th century. 432:. Complications from a bile leak can follow a person for years and can lead to death. Bile leak should always be considered in any patient who is not recovering as expected after cholecystectomy. Most bile injuries require repair by a surgeon with special training in biliary reconstruction. If biliary injuries are properly treated and repaired, more than 90% of patients can have a long-term successful recovery. 417:, or damage to the bile ducts. Laparoscopic cholecystectomy has a higher risk of bile duct injury than the open approach, with injury to bile ducts occurring in 0.3% to 0.5% of laparoscopic cases and 0.1% to 0.2% of open cases. In laparoscopic cholecystectomy, approximately 25–30% of biliary injuries are identified during the operation; the rest become apparent in the early post-operative period. 223: 728:) is an experimental technique where the laparoscope is inserted through natural orifices and internal incisions, rather than skin incisions, to access to the abdominal cavity. This offers the potential to eliminate visible scars. Since 2007, cholecystectomy by NOTES has been performed anecdotally via transgastric and transvaginal routes. As of 2009 the risk of 991: 347:. The common bile duct drains the liver and pancreas, and a blockage there can lead to inflammation and infection in both the pancreas and biliary system. While cholecystectomy is not usually the immediate treatment choice for either of these conditions, it is often recommended to prevent repeat episodes from additional gallstones getting stuck. 712:, instead of the 3-4 four small different incisions used in standard laparoscopy. There appears to be a cosmetic benefit over conventional four-hole laparoscopic cholecystectomy, and no advantage in postoperative pain and hospital stay compared with standard laparoscopic procedures. There is no scientific consensus regarding risk for 960:

complications from surgery under general anaesthesia, such as elderly people and those with co-existing illnesses. Draining pus and infected material through the tube reduces inflammation in and around the gallbladder. It can be a lifesaving procedure, without requiring that the person undergo emergency surgery.

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Rábago LR, Vicente C, Soler F, Delgado M, Moral I, Guerra I, Castro JL, Quintanilla E, Romeo J, Llorente R, Vázquez Echarri J, Martínez-Veiga JL, Gea F (August 2006). "Two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) compared with single-stage treatment with

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is the drainage of the gallbladder via insertion of a small tube through the abdominal wall. This is usually done using guidance from imaging scans to find the right place to insert the tube. Cholecystostomy can be used for people who need immediate drainage of the gallbladder but have a high risk of

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Conservative management for biliary colic involves a "watch and wait" approach—treating symptoms as-needed with oral medications. Experts agree that this is the preferred treatment for people with gallstones but no symptoms. Conservative management may also be appropriate for people with mild biliary

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It is generally safe for pregnant women to undergo laparoscopic cholecystectomy during any trimester of pregnancy. Early elective surgery is recommended for women with symptomatic gallstones to decrease the risk of spontaneous abortion and pre-term delivery. Without cholecystectomy, more than half of

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After surgery, most patients are admitted to the hospital for routine monitoring. For uncomplicated laparoscopic cholecystectomies, people may be discharged on the day of surgery after adequate control of pain and nausea. Patients who were high-risk, those who required emergency surgery, and/or those

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The 1-week-old incisions of a post-operative laparoscopic cholecystectomy as indicated by red arrows. The 3 abdominal incisions are approximately 6mm, while the fourth incision near the umbilicus is 18mm, each closed with dissolvable sutures. Minor inflammation can be seen surrounding each site due

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All surgery carries risk of serious complications including damage to nearby structures, bleeding, infection, or even death. The operative death rate in cholecystectomy is about 0.1% in people under age 50 and about 0.5% in people over age 50. The greatest risk of death comes from co-existing illness

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Tzovaras G, Baloyiannis I, Zachari E, Symeonidis D, Zacharoulis D, Kapsoritakis A, Paroutoglou G, Potamianos S (March 2012). "Laparoendoscopic rendezvous versus preoperative ERCP and laparoscopic cholecystectomy for the management of cholecysto-choledocholithiasis: interim analysis of a controlled

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procedure that can remove gallstones or prevent blockages by widening parts of the bile duct where gallstones frequently get stuck. ERCP is often used to retrieve stones stuck in the common bile duct in patients with gallstone pancreatitis or cholangitis. In this procedure, an endoscope, or small,

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In recent years the LERV technique, in which access to the common bile duct by ERCP is facilitated by an antegrade guidewire, which is intraoperatively introduced during fluoroscopy and is advanced through the cystic duct to the duodenum, has been established as an alternative to treat common bile

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For some people, drainage with cholecystostomy is enough and they do not need to have the gallbladder removed later. For others, percutaneous cholecystostomy allows them to improve enough in the short term that they can get surgery at a later time. There is no clear evidence one way or another to

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in 1980. He subsequently designed an optical laparoscope with a working channel large enough to fit a distended gallbladder. Mühe presented his technique to the Congress of the German Surgical Society in 1986, claiming reduced postoperative pain and shorter hospitalization. His work was met with

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Abdomen of a 45-year-old male approximately one month after a laparoscopic cholecystectomy. Surgical incision points are highlighted; the point at top right is barely visible. The gall bladder was removed via the incision at the navel. There is a fourth incision (not shown) on the person's right

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Intra-operative decisions, with patient safety at the forefront, sometimes call for, what is known in surgical education as, "bail-out" procedures. This is usually due to the surgical team making a clinical decision in the operating room to not proceed with the intended cholecystectomy, due to

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of the gallbladder caused by interruption in the normal flow of bile, is another reason for cholecystectomy. It is the most common complication of gallstones; 90–95% of acute cholecystitis is caused by gallstones blocking drainage of the gallbladder. If the blockage is incomplete and the stone

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concluded that cholecystecomy has no effect on the risk of colorectal cancer overall, but does have a harmful effect on the risk of right-sided colon cancer. A nationwide cohort study in Korea reported a significantly increased total cancer risk, including increased risk of several different

253:) done for some other reason. The traditional risk factors for gallstones are the four “F's: female, fat, forty, and fertile. Of the more than 20 million people in the US with gallstones, only about 30% will eventually require cholecystectomy to relieve symptoms (pain) or treat complications. 780:

After removal, the gallbladder should be sent for pathological examination to confirm the diagnosis and look for any incidental cancer. Incidental cancer of the gallbladder is found in approximately 1% of cholecystectomies. If cancer is present in the gallbladder, it is usually necessary to

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There are no specific contraindications for cholecystectomy, and in general it is considered a low-risk surgery. However, anyone who cannot tolerate surgery under general anesthesia should not undergo cholecystectomy. People can be split into high and low risk groups using a tool such as the

1043:. His technique was rapidly adopted and improved in France. It was subsequently introduced to the rest of the world over the next three years. Driven by popularity among patients, the laparoscopic technique became preferred over open surgery and noninvasive treatments for gallstones. 744:. Open cholecystectomy is often done if difficulties arise during a laparoscopic cholecystectomy, for example, the patient has unusual anatomy, the surgeon cannot see well enough through the camera, or the patient is found to have cancer. It can also be done if the patient has severe 910:

Conservative management for acute cholecystitis involves treating the infection without surgery. It is usually only considered in patients at very high risk for surgery or other interventions listed below. It consists of treatment with intravenous antibiotics and fluids.

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Experts agree that many biliary injuries in laparoscopic cases are caused by difficulties seeing and identifying the anatomy clearly. If the surgeon has problems identifying anatomical structures, they might need to convert from laparoscopic to open cholecystectomy.

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CBDS are found in 10–15% of patients during cholecystectomy when intraoperative cholangiography (IOC) is routinely performed. There are several strategies to manage choledocholithiasis but the optimal method as well as the timing of treatment is still under debate.

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Tommasi C, Bencini L, Bernini M, Naspetti R, Cavallina G, Manetti R, Talamucci L, Farsi M (May 2013). "Routine use of simultaneous laparoendoscopic approach in patients with confirmed gallbladder and bile duct stones: fit for laparoscopy fit for "rendezvous"".

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Möller M, Gustafsson U, Rasmussen F, Persson G, Thorell A (October 2014). "Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks)".

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Leakage from the stump of the cystic duct is a complication that is more common with the laparoscopic approach than the open approach but is still rare, occurring in less than 1% of procedures; it is treated by drainage followed by insertion of a bile duct

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Agresta F, Campanile FC, Vettoretto N, Silecchia G, Bergamini C, Maida P, Lombari P, Narilli P, Marchi D, Carrara A, Esposito MG, Fiume S, Miranda G, Barlera S, Davoli M (May 2015). "Laparoscopic cholecystectomy: consensus conference-based guidelines".

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Yamashita Y, Takada T, Kawarada Y, Nimura Y, Hirota M, Miura F, Mayumi T, Yoshida M, Strasberg S, Pitt HA, de Santibanes E, Belghiti J, Büchler MW, Gouma DJ, Fan ST, Hilvano SC, Lau JW, Kim SW, Belli G, Windsor JA, Liau KH, Sachakul V (January 2007).

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between adults, a cholecystectomy is performed in the donor because the gallbladder interferes with removal of the right (lateral) lobe of the liver and to prevent the formation of gallstones in the recipient. The gallbladder is not removed in

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on physical exam – meaning that when a doctor asks the patient to take a deep breath and then pushes down on the upper right side of their abdomen, the patient stops their inhalation due to pain from the pressure on their inflamed gallbladder.

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cholecystitis. It usually develops in people who have abnormal bile drainage secondary to a serious illness, such as people with multi-organ failure, serious trauma, recent major surgery, or following a long stay in the intensive care unit.

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cholecystectomy uses several (usually 4) small incisions in the abdomen to allow the insertion of operating ports, small cylindrical tubes approximately 5 to 10 mm in diameter, through which surgical instruments are placed into the

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is given to prevent deep vein thrombosis. Use of prophylactic antibiotics is controversial; however, a dose may be given prior to surgery to prevent infection in certain people at high risk. Gas may be removed from the stomach with an

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Kimura Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Windsor JA, Mayumi T, Yoshida M, Miura F, Higuchi R, Gabata T, Hata J, Gomi H, Dervenis C, Lau WY, Belli G, Kim MH, Hilvano SC, Yamashita Y (January 2013).

680:, an instrument with a video camera and light source at the end, illuminates the abdominal cavity and sends a magnified image from inside the abdomen to a video screen, giving the surgeon a clear view of the organs and tissues. The 867:

such women will have recurrent symptoms during their pregnancy, and nearly one in four will develop a complication, such as acute cholecystitis, that requires urgent surgery. Acute cholecystitis is the second most common cause of

388:. In this system, people who are ASA categories III, IV, and V are considered high risk for cholecystectomy. Typically this includes very elderly people and people with co-existing illness, such as end-stage liver disease with 323:

People with repeat episodes of acute cholecystitis can develop chronic cholecystitis from changes in the normal anatomy of the gallbladder. This can also be an indication for cholecystectomy if the person has ongoing pain.

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As of 2008, 90% of cholecystectomies in the United States were done laparoscopically. Laparoscopic surgery is thought to have fewer complications, shorter hospital stay, and quicker recovery than open cholecystectomy.

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Ingraham AM, Cohen ME, Ko CY, Hall BL (August 2010). "A current profile and assessment of north American cholecystectomy: results from the American college of surgeons national surgical quality improvement program".

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Chamberlain RS, Sakpal SV (September 2009). "A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy".

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Siiki A, Rinta-Kiikka I, Sand J, Laukkarinen J (May 2015). "Biodegradable biliary stent in the endoscopic treatment of cystic duct leak after cholecystectomy: the first case report and review of literature".

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Deslandres E, Gagner M, Pomp A, Rheault M, Leduc R, Clermont R, Gratton J, Bernard EJ (1993). "Intraoperative endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy".

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Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR (2007).

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Swahn F, Nilsson M, Arnelo U, Löhr M, Persson G, Enochsson L (April 2013). "Rendezvous cannulation technique reduces post-ERCP pancreatitis: a prospective nationwide study of 12,718 ERCP procedures".

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Schafer M, Suter C, Klaiber C, et al. (Apr 1998). "Spilled gallstones after laparoscopic cholecystectomy. A relevant problem? A retrospective analysis of 10,174 laparoscopic cholecystectomies".

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Another complication singular to the laparoscopic procedure is the phenomenon of the "spilled gallstone" which complicates 0.08–0.3% of cases. Here a stone escapes the resected gallbladder into the

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and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. Cholecystectomy can be performed either

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Abbasoğlu O, Tekant Y, Alper A, Aydın Ü, Balık A, Bostancı B, Coker A, Doğanay M, Gündoğdu H, Hamaloğlu E, Kapan M, Karademir S, Karayalçın K, Kılıçturgay S, Şare M, Tümer AR, Yağcı G (2016).

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In open cholecystectomy, a surgical incision of around 8 to 12 cm is made below the edge of the right rib cage and the gallbladder is removed through this large opening, typically using

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The procedure does come with significant risks and complications—in one retrospective study of patients who received percutaneous cholecystostomy for acute cholecystitis, 44% developed

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Gallstones are very common but 50–80% of people with gallstones are asymptomatic and do not need surgery; their stones are noticed incidentally on imaging tests of the abdomen (such as

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Damage to the bile ducts is very serious because it causes leakage of bile into the abdomen. Signs and symptoms of a bile leak include abdominal pain, tenderness, fever and signs of

358:(also called carcinoma of the gallbladder) is a rare indication for cholecystectomy. In cases where cancer is suspected, the open technique for cholecystectomy is usually performed. 1068:

Laparoscopic cholecystectomy can be a challenging procedure and surgeons must be trained with advanced laparoscopic skills to complete the operation with safety and effectiveness.

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and routine use deemed to decrease risk of injury and morbidity following unaddressed injury while only increasing cancer rates due to radiation exposure by a lesser fraction.

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passes quickly, the person experiences biliary colic. If the gallbladder is completely blocked and remains so for a prolonged period, the person develops acute cholecystitis.

814:. Symptoms are typically similar to the pain and discomfort of biliary colic with persistent pain in the upper right abdomen and commonly include gastrointestinal distress ( 198:

The surgery is usually successful in relieving symptoms, but up to 10 percent of people may continue to experience similar symptoms after cholecystectomy, a condition called

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Injury of the bile ducts can be prevented and treated by routinely using X-ray investigation of the bile ducts (intraoperative cholangiography (IOC)). This method was

725: 4323: 940: 268:, occurs when a gallstone temporarily blocks the bile duct that drains the gallbladder. Typically, pain from biliary colic is felt in the right upper part of the 4284: 3453:

Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, Leandro G, Montori G, Ceresoli M, Corbella D, Sartelli M, Sugrue M, Ansaloni L (June 2015).

2152:"Need brooks no delay. Peritoneo-cutaneous fistula formation secondary to gallstone dropped at laparoscopic cholecystectomy 20 years previously: a case report" 4349: 2966:"Laparoscopic subtotal cholecystectomy: a classification, which encompasses the variants, technical modalities, and extent of resection of the gallbladder" 4588: 2559:

Sanabria A, Dominguez LC, Valdivieso E, Gomez G (December 2010). "Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy".

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There are several alternatives to cholecystectomy for people who do not want surgery, or in whom the benefits of surgery would not outweigh the risks.

841:. Most cases resolve within weeks or a few months, though in rare cases the condition can last for years. It can be controlled with medication such as 4354: 3644: 385: 3587: 4090: 3120:

Gurusamy KS, Rossi M, Davidson BR (August 2013). "Percutaneous cholecystostomy for high-risk surgical patients with acute calculous cholecystitis".

837:, the portion of the intestine where these salts are normally reabsorbed, becomes overwhelmed, does not absorb everything, and the person develops 4247: 1315: 807:

In 95% of people undergoing cholecystectomy as treatment for simple biliary colic, removing the gallbladder completely resolves their symptoms.

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lower flank, used for draining. All incisions have healed well and the most visible remaining effect of surgery is from the pre-operative

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if it is not identified and removed. Some reports exist of spilled stones lying unnoticed for up to 20 years before eventually causing an

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In a study of Medicaid-covered and uninsured U.S. hospital stays in 2012, cholecystectomy was the most common operating room procedure.

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In ERCP, the endoscope enters through the mouth and passes through the stomach and start of the small intestine to reach the bile ducts.

900: 4289: 1975:"Outcome trends and safety measures after 30 years of laparoscopic cholecystectomy: a systematic review and pooled data analysis" 367: 339:

are rarer and more serious complications from gallstone disease. Both can occur if gallstones leave the gallbladder, pass through the

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A systematic review and meta analysis of eighteen studies on the association between cholecystectomy and the risk of development of

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Lirici MM, Tierno SM, Ponzano C (October 2016). "Single-incision laparoscopic cholecystectomy: does it work? A systematic review".

613: 1787: 1266:"Right hepatectomy due to portal vein thrombosis in vasculobiliary injury following laparoscopic cholecystectomy: a case report" 4080: 3787: 3738: 291:

Pain in cholecystitis is similar to that of biliary colic, but lasts longer than six hours and occurs together with signs of

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Gallstone Disease: Diagnosis and Management of Cholelithiasis, Cholecystitis and Choledocholithiasis. Clinical Guideline 188

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Pucher PH, Brunt LM, Davies N, Linsk A, Munshi A, Rodriguez HA, Fingerhut A, Fanelli RD, Asbun H, Aggarwal R (March 2018).

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indicate that surgical removal after cholecystostomy is best for high-risk surgical patients with acute cholecystitis.

967:(one or more stones stuck in the common bile duct), 27% had tube dislodgment, and 23% developed postoperative abscess. 4344: 4179: 1853:"Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement" 1316:"The National Institutes of Health (NIH) Consensus Development Program: Gallstones and Laparoscopic Cholecystectomy" 582:

Peroperative Endoscopic Retrograde Cholangio-Pancreaticography (ERCP)/ Laparo-endoscopic rendezvous (LERV) technique

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are the most common reasons for removal of the gallbladder. The gallbladder can also be removed in order to treat

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cholecystectomy had replaced open cholecystectomy as the first-choice of treatment for people with uncomplicated

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with clips and cut in order to remove the gallbladder. The gallbladder is then removed through one of the ports.

4534: 4389: 4047: 3728: 3670: 3066:"Increased Risk of Cancer after Cholecystectomy: A Nationwide Cohort Study in Korea including 123,295 Patients" 708:) or laparoendoscopic single site surgery (LESS) is a technique in which a single incision is made through the 315:

Five to ten percent of acute cholecystitis occurs in people without gallstones, and for this reason, is called

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A review of safety data in laparoscopic cholecystectomy found the following complications to be most common:

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Swahn F, Regnér S, Enochsson L, Lundell L, Permert J, Nilsson M, Thorlacius H, Arnelo U (September 2013).

1769: 964: 653: 561: 1704:"Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines" 4488: 4418: 4274: 3868: 3829: 879: 757: 648: 332: 4557: 3180:"High rate of common bile duct stones and postoperative abscess following percutaneous cholecystostomy" 1903:

Stewart L (April 2014). "Iatrogenic biliary injuries: identification, classification, and management".

1021: 825:. The cause is unclear, but is presumed to be due to disturbances in the biliary system that speed up 3455:"Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis" 2369:"Endoscopic retrograde cholangiopancreatography with rendezvous cannulation reduces pancreatic injury" 1323: 1024:. Mühe was inspired to develop a technique for laparoscopic cholecystectomy by the first laparoscopic 4085: 2296:

intraoperative ERCP for patients with symptomatic cholelithiasis with possible choledocholithiasis".

1062: 1047: 644: 640: 538: 429: 4460: 4384: 4279: 4184: 4159: 4075: 4070: 4014: 3809: 1822: 765: 689: 389: 3385:"Erich Mühe and the rejection of laparoscopic cholecystectomy (1985): a surgeon ahead of his time" 1496: 3954: 3797: 2946: 2897: 2796: 2622: 2083: 1421: 790:

undergoing open cholecystectomy usually need to stay in the hospital several days after surgery.

542: 355: 246: 239: 235: 1751: 1150:"Characteristics of Operating Room Procedures in U.S. Hospitals, 2011 – Statistical Brief #170" 44:

A US Navy general surgeon and an operating room nurse performing a laparoscopic cholecystectomy

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re-operate to remove parts of the liver and lymph nodes and test them for additional cancer.

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Mulita, Francesk; Benetatos, Nikolaos; Maroulis, Ioannis; Germanos, Stylianos (2021-01-18).

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Brunicardi FC, Andersen DK, Dunn DL, Hunter JG, Matthews JB, Pollock RE, Billiar TR (2014).

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on July 15, 1882. Before this, surgical therapy for symptomatic gallstones was limited to

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Mulholland MW, Lillemoe KD, Doherty GM, Upchurch GR, Alam HB, Pawlik TM (December 2016).

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Jadrijevic, S; Sef, D; Kocman, B; Mrzljak, A; Matasic, H; Skegro, D (7 December 2014).

842: 741: 657: 414: 203: 2696: 2345: 2201:"Iatrogenic biliary injuries during laparoscopic cholecystectomy. A continuing threat" 455:

Rates of complications other than bile duct injury after laparoscopic cholecystectomy

4582: 4478: 4207: 4137: 3873: 3708: 3610: 2933: 2916: 2595:"SAGES guidelines for the clinical application of laparoscopic biliary tract surgery" 2103:"Spilled gall stones during laparoscopic cholecystectomy: a review of the literature" 1055: 1017: 868: 745: 685: 280: 261: 3505:. Agresta, Ferdinando, Campanile, Fabio Cesare, Vettoretto, Nereo. Cham : Springer. 2950: 2626: 1425: 4455: 4269: 4164: 4149: 4004: 3129: 2901: 2800: 2568: 1040: 1029: 1025: 606: 393: 336: 304: 284: 3151: 2087: 2432: 1950:

Swedish Agency for Health Technology Assessment and Assessment of Social Services

1456: 146: 4445: 4301: 4264: 4132: 4127: 4112: 3976: 3863: 3846: 3824: 3814: 3718: 681: 677: 668: 340: 188: 180: 3471: 3454: 3344:"Twenty years of laparoscopic cholecystectomy: Philippe Mouret--March 17, 1987" 2217: 2200: 1752:"What to expect after your liver transplant | Nebraska Medicine Omaha, NE" 1234: 1217: 1119: 979:

About 600,000 people receive a cholecystectomy in the United States each year.

537:

The same study found the prevalence of bowel injury, sepsis, pancreatitis, and

222: 206:, wound infection, bleeding, vasculobiliary injury, retained gallstones, liver 4508: 4450: 4427: 4194: 4062: 3841: 3819: 2885: 2784: 2736: 2668: 2610: 2503: 2273: 1990: 1916: 1719: 1672: 1655: 1518: 1409: 1353:

Sabiston textbook of surgery: the biological basis of modern surgical practice

990: 231: 3520: 3195: 2981: 2819:"New minimally invasive approaches for cholecystectomy: Review of literature" 2385: 1607: 1370: 1195: 1039:

Philippe Mouret performed laparoscopic cholecystectomy on March 17, 1987, in

4305: 4108: 4019: 4009: 3966: 3896: 3700: 3551: 2835: 2118: 1282: 1051: 1032: 944: 830: 815: 769: 761: 372: 292: 265: 184: 3569: 3480: 3410: 3369: 3313: 3240: 3213: 3137: 3099: 3050: 2999: 2942: 2893: 2854: 2792: 2754: 2721:"Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines" 2704: 2618: 2576: 2511: 2475: 2440: 2404: 2317: 2281: 2226: 2185: 2136: 2044: 2008: 1924: 1886: 1737: 1681: 1571: 1474: 1417: 1301: 1243: 1135: 1020:

performed the first laparoscopic cholecystectomy on September 12, 1985, in

810:

Up to 10% of people who undergo cholecystectomy develop a condition called

2353: 2309: 2167: 2079: 2071: 2036: 1868: 1001:

performed the first successful cholecystectomy at the Lazarus hospital in

4376: 4117: 3031: 2467: 838: 822: 627: 211: 3501:

Agresta, Ferdinando; Campanile, Fabio Cesare; Vettoretto, Nereo (2014).

899:

colic, as the pain from colic can be managed with pain medications like

424:

several days following surgery, or through laboratory studies as rising

3753: 1118:

Abraham S, Rivero HG, Erlikh IV, Griffith LF, Kondamudi VK (May 2014).

994:

Carl Langenbuch performed the first successful cholecystectomy in 1882.

749: 565: 557: 269: 250: 207: 3081: 2025:

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

166: 4470: 4034: 3227:

Lopez-Gonzalez L, Pickens GT, Washington R, Weiss AJ (October 2014).

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Choi YJ, Jin EH, Lim JH, Shin CM, Kim N, Han K, Lee DH (May 2022).

4239: 3235:(183). Rockville, MD: Agency for Healthcare Research and Quality. 3229:"Characteristics of Medicaid and Uninsured Hospitalizations, 2012" 989: 926: 918: 834: 709: 620: 612: 599: 550: 296: 221: 2241: 2593:

Overby DW, Apelgren KN, Richardson W, Fanelli R (October 2010).

375:

transplantations as the left lobe of the liver is used instead.

3633: 3342:

Polychronidis A, Laftsidis P, Bounovas A, Simopoulos C (2008).

2242:"Årsrapport för Svenskt Kvalitetsregister för gallstenskirurgi" 2101:

Satesh-Kumar T, Saklani A, Vinayagam R, Blackett R (Feb 2004).

2653:. Yeo, Charles J. (8th ed.). Philadelphia, PA: Elsevier. 307:. People with cholecystitis will also usually have a positive 3265:(5th ed.). Philadelphia: Elsevier Saunders. p. 6. 3263:

Blumgart's surgery of the liver, biliary tract, and pancreas

2817:

Gaillard M, Tranchart H, Lainas P, Dagher I (October 2015).

1566:. National Institute for Health and Care Excellence (NICE). 1351:

Townsend CM, Evers BM, Mattox KL, Beauchamp RD (June 2016).

3429:"The first Lap Chole in Europe: A 'Criminal' Is Vindicated" 716:

with SILS versus traditional laparoscopic cholecystectomy.

103: 97: 88: 70: 1178:

Greenfield's surgery: scientific principles & practice

64: 617:

Steps of a cholecystectomy, as seen through a laparoscope

76: 2199:

Malik AM, Laghari AA, Talpur AH, Khan A (October 2008).

3178:

Furtado R, Le Page P, Dunn G, Falk GL (February 2016).

1562:

Internal Clinical Guidelines Team (UK) (October 2014).

396:. Alternatives to surgery are briefly mentioned below. 183:. Cholecystectomy is a common treatment of symptomatic 2970:

The Annals of the Royal College of Surgeons of England

1355:(20th ed.). Philadelphia, PA: Elsevier Saunders. 3503:

Laparoscopic Cholecystectomy: an Evidence-based Guide

91: 79: 73: 61: 58: 2240:

Persson G, Enochsson L, Sandblom G (8 August 2017).

1583: 1581: 1061:

By 2014 laparoscopic cholecystectomy had become the

94: 85: 67: 4533: 4501: 4469: 4426: 4417: 4375: 4300: 4238: 4229: 4193: 4099: 4061: 4033: 3995: 3935: 3926: 3887: 3752: 3695: 3686: 3677: 3588:"Operation Brochures for Patients: Cholecystectomy" 1942:"Intraoperative cholangiography in cholecystectomy" 1120:"Surgical and nonsurgical management of gallstones" 153: 139: 127: 115: 100: 82: 49: 32: 3184:Annals of the Royal College of Surgeons of England 1632:(24th ed.). Philadelphia: Elsevier Saunders. 1490: 1488: 1486: 1484: 821:Some people following cholecystectomy may develop 2644: 2642: 2640: 2638: 2636: 1846: 1844: 1842: 1823:"Treatment of Gallstones and Gallbladder Disease" 853:specific types of cancer, after cholecystectomy. 724:Natural orifice transluminal endoscopic surgery ( 3337: 3335: 3333: 3331: 3329: 3327: 3325: 3323: 3115: 3113: 3111: 3109: 1770:"Living Donor Liver Transplant | Baltimore" 3173: 3171: 1898: 1896: 1390: 1388: 1386: 1384: 1382: 1380: 2866: 2864: 1968: 1966: 1623: 1621: 1619: 1617: 1346: 1344: 1342: 1340: 1180:(6th ed.). Philadelphia: Wolters Kluwer. 941:endoscopic retrograde cholangiopancreatography 4285:Transjugular intrahepatic portosystemic shunt 3645: 3261:Jarnagin WR, Belghiti J, Blumgart LH (2012). 3013:Mu L, Li W, Ren W, Hu D, Song Y (June 2023). 2766: 2764: 2651:Shackelford's surgery of the alimentary tract 1660:Journal of Hepato-Biliary-Pancreatic Sciences 1171: 1169: 1065:for the treatment of symptomatic gallstones. 413:A serious complication of cholecystectomy is 8: 2725:Journal of Hepato-Biliary-Pancreatic Surgery 1708:Journal of Hepato-Biliary-Pancreatic Surgery 1697: 1695: 1693: 1691: 1211: 1209: 1207: 1205: 660:may be used to empty the patient's bladder. 3256: 3254: 3252: 3250: 3122:The Cochrane Database of Systematic Reviews 2812: 2810: 2685:Journal of the American College of Surgeons 2561:The Cochrane Database of Systematic Reviews 2529: 2527: 2525: 2523: 2521: 1827:Society for Surgery of the Alimentary Tract 202:. Complications of cholecystectomy include 4423: 4235: 3932: 3692: 3683: 3652: 3638: 3630: 1808:. Johns Hopkins Medical. 19 November 2019. 1501:CURRENT Diagnosis & Treatment: Surgery 38: 3559: 3470: 3400: 3359: 3303: 3203: 3089: 3040: 3030: 2989: 2932: 2844: 2834: 2823:World Journal of Gastrointestinal Surgery 2744: 2588: 2586: 2394: 2384: 2216: 2175: 2126: 1998: 1876: 1727: 1671: 1464: 1291: 1281: 1233: 1216:Jaunoo SS, Mohandas S, Almond LM (2010). 1113: 1111: 1109: 1107: 1105: 1103: 386:ASA physical status classification system 4091:Transanal hemorrhoidal dearterialization 3288:"The first laparoscopic cholecystectomy" 3152:"ERCP: MedlinePlus Medical Encyclopedia" 2921:The American Journal of Gastroenterology 2538:(10th ed.). McGraw-Hill Education. 1788:"Liver Donors FAQ: The Donation Surgery" 1503:(14th ed.). McGraw-Hill Education. 626:to skin irritation caused by removal of 453: 4248:Artificial extracorporeal liver support 1817: 1815: 1099: 494:Retained stone in the common bile duct 3422: 3420: 871:in pregnant women after appendectomy. 704:Single incision laparoscopic surgery ( 328:Cholangitis and gallstone pancreatitis 29: 1936: 1934: 1905:The Surgical Clinics of North America 7: 3803:Vertical banded gastroplasty surgery 1218:"Postcholecystectomy syndrome (PCS)" 3852:Percutaneous endoscopic gastrostomy 3660:Tests and procedures involving the 2874:Journal of Gastrointestinal Surgery 688:are identified and dissected, then 405:like cardiac or pulmonary disease. 162: 27:Surgical removal of the gallbladder 4290:Distal splenorenal shunt procedure 572:Conversion to open cholecystectomy 394:whose blood does not clot properly 368:living donor liver transplantation 25: 4589:Accessory digestive gland surgery 2697:10.1016/j.jamcollsurg.2010.04.003 2150:Nugent L, Chandran P (Feb 2018). 1441:"Risk Factors for Cholelithiasis" 1439:Pak, M; Lindseth, G (July 2016). 230:Pain and complications caused by 3486: 3459:International Journal of Surgery 2934:10.1111/j.1572-0241.2001.03597.x 2536:Schwartz's principles of surgery 2205:International Journal of Surgery 2156:Journal of Surgical Case Reports 1398:Langenbeck's Archives of Surgery 1249: 1222:International Journal of Surgery 54: 4081:Lateral internal sphincterotomy 2917:"Incidental gallbladder cancer" 1539:. November 2013. Archived from 1270:Journal of Medical Case Reports 305:elevated white blood cell count 179:is the surgical removal of the 3788:Endoscopic sleeve gastroplasty 3739:Functional Lumen Imaging Probe 3130:10.1002/14651858.CD007088.pub2 2569:10.1002/14651858.CD005265.pub2 1592:. Philadelphia, PA: Elsevier. 214:(narrowing) of the bile duct. 1: 4170:Lower gastrointestinal series 3914:Upper gastrointestinal series 2346:10.1016/s0016-5107(93)70011-5 1590:Essential surgical procedures 748:, emphysematous gallbladder, 4436:Diagnostic peritoneal lavage 4155:Double-contrast barium enema 3982:Partial ileal bypass surgery 3859:Esophagogastric dissociation 3592:American College of Surgeons 2964:Lunevicius, R (April 2020). 2433:10.1097/SLA.0b013e3182456ec0 1457:10.1097/SGA.0000000000000235 812:postcholecystectomy syndrome 720:Natural orifice transluminal 664:Laparoscopic cholecystectomy 200:postcholecystectomy syndrome 18:Laparoscopic cholecystectomy 4594:Surgical removal procedures 4253:Bioartificial liver devices 4180:Transrectal ultrasonography 1588:Velasco JM (October 2015). 4610: 4175:Small-bowel follow-through 4043:Abdominoperineal resection 3902:Esophagogastroduodenoscopy 3472:10.1016/j.ijsu.2015.04.083 2218:10.1016/j.ijsu.2008.07.005 1235:10.1016/j.ijsu.2009.10.008 4535:Clinical prediction rules 4441:Intraperitoneal injection 4145:Abdominal ultrasonography 4053:Total mesorectal excision 3972:Intestine transplantation 3762:Sengstaken–Blakemore tube 3744:High resolution manometry 3734:Esophageal motility study 3668: 2886:10.1007/s11605-009-0902-y 2785:10.1007/s00464-016-4757-5 2737:10.1007/s00534-006-1161-x 2611:10.1007/s00464-010-1268-7 2504:10.1007/s00268-013-1962-4 2274:10.1001/jamasurg.2014.249 1991:10.1007/s00464-017-5974-2 1917:10.1016/j.suc.2014.01.008 1720:10.1007/s00534-006-1152-y 1673:10.1007/s00534-012-0564-0 1410:10.1007/s00423-015-1300-4 1124:American Family Physician 1078:List of surgeries by type 785:Post-operative management 635:Pre-operative preparation 545:to be around 0.15% each. 163: 37: 4390:Pancreas transplantation 4048:Lower anterior resection 3729:Esophageal pH monitoring 3671:Digestive system surgery 3536:"Enlarged cystic artery" 3427:Stern V (10 June 2013). 3196:10.1308/rcsann.2016.0004 2982:10.1308/rcsann.2020.0007 2915:Kapoor VK (March 2001). 2649:Yeo, Charles J. (2018). 2386:10.3748/wjg.v19.i36.6026 1792:ucsfbenioffchildrens.org 1630:Goldman's Cecil Medicine 1445:Gastroenterology Nursing 794:Subtotal Cholecystectomy 518:Intra-abdominal abscess 4484:Inguinal hernia surgery 4400:Pancreaticoduodenectomy 3783:Adjustable gastric band 3724:Impedance–pH monitoring 3552:10.1136/bcr-2020-240056 2836:10.4240/wjgs.v7.i10.243 2119:10.1136/pmj.2003.006023 1499:. In Doherty GM (ed.). 1283:10.1186/1752-1947-8-412 1088:Waltman Walter syndrome 894:Conservative management 886:Alternatives to surgery 343:, and get stuck in the 4514:Exploratory laparotomy 4329:Hepatoportoenterostomy 3793:Gastric bypass surgery 3662:human digestive system 3233:HCUP Statistical Brief 1857:Ulusal Cerrahi Dergisi 1013:Laparoscopic technique 995: 936: 924: 649:Prophylactic treatment 647:are usually obtained. 631: 618: 610: 560:where it can become a 337:gallstone pancreatitis 227: 4489:Femoral hernia repair 4275:Liver transplantation 3869:Nissen fundoplication 3611:"Gallbladder removal" 2373:World J Gastroenterol 2310:10.1055/s-2006-944617 2072:10.1007/s004649900659 2037:10.1089/lap.2015.0068 1869:10.5152/UCD.2016.3683 993: 930: 922: 880:Porcelain gallbladder 875:Porcelain gallbladder 730:gastrointestinal leak 624: 616: 603: 362:Liver transplantation 225: 4086:Rubber band ligation 4025:Hartmann's operation 3433:General Surgery News 3383:Litynski GS (1998). 3032:10.21037/tcr-22-2049 2468:10.1038/ajg.2012.470 1154:www.hcup-us.ahrq.gov 736:Open cholecystectomy 645:liver function tests 641:complete blood count 539:deep vein thrombosis 430:alkaline phosphatase 264:, or pain caused by 195:surgical technique. 4461:Peritoneal dialysis 4280:Portal hypertension 4185:Virtual colonoscopy 4160:Endoanal ultrasound 4076:Anorectal manometry 4071:Anal sphincterotomy 4015:Colonic polypectomy 3810:Collis gastroplasty 3286:Reynolds W (2001). 2419:randomized trial". 2334:Gastrointest Endosc 2168:10.1093/jscr/rjy013 1756:www.nebraskamed.com 1495:Doherty GM (2015). 1056:acute cholecystitis 965:choledocholithiasis 903:(ex: ketorolac) or 803:Long-term prognosis 766:portal hypertension 752:of gallbladder and 562:focus for infection 456: 447:Other complications 390:portal hypertension 276:Acute cholecystitis 226:Gallbladder anatomy 3955:Jejunoileal bypass 3798:Sleeve gastrectomy 2773:Surgical Endoscopy 2599:Surgical Endoscopy 2456:Am J Gastroenterol 1979:Surgical Endoscopy 1628:Goldman L (2011). 1022:Böblingen, Germany 996: 937: 925: 639:Before surgery, a 632: 619: 611: 543:pulmonary embolism 454: 356:Gallbladder cancer 351:Gallbladder cancer 240:gallbladder cancer 236:biliary dyskinesia 228: 4576: 4575: 4521:Rapid urease test 4497: 4496: 4413: 4412: 4405:Puestow procedure 4367:Cholescintigraphy 4225: 4224: 4221: 4220: 4213:Stool guaiac test 4123:Capsule endoscopy 3945:Bariatric surgery 3922: 3921: 3837:Gastroenterostomy 3778:Bariatric surgery 3617:. 23 October 2017 3512:978-3-319-05407-0 3272:978-1-4557-4606-4 3082:10.5009/gnl210009 3019:Transl Cancer Res 2660:978-0-323-40232-3 2545:978-0-07-179674-3 1952:(SBU). 2018-08-17 1806:"Cholecystectomy" 1639:978-1-4377-2788-3 1599:978-0-323-37567-2 1510:978-0-07-179211-0 1362:978-0-323-29987-9 1320:consensus.nih.gov 1187:978-1-4698-9001-2 1083:List of -ectomies 850:colorectal cancer 535: 534: 477:Urinary retention 379:Contraindications 174: 173: 16:(Redirected from 4601: 4558:Child–Pugh score 4525:Urea breath test 4424: 4385:Frey's procedure 4362:Cholecystography 4236: 3933: 3768:Nasogastric tube 3693: 3684: 3654: 3647: 3640: 3631: 3626: 3624: 3622: 3606: 3604: 3603: 3594:. Archived from 3574: 3573: 3563: 3540:BMJ Case Reports 3531: 3525: 3524: 3498: 3492: 3491: 3490: 3484: 3474: 3450: 3444: 3443: 3441: 3439: 3424: 3415: 3414: 3404: 3380: 3374: 3373: 3363: 3339: 3318: 3317: 3307: 3283: 3277: 3276: 3258: 3245: 3244: 3224: 3218: 3217: 3207: 3175: 3166: 3165: 3163: 3162: 3148: 3142: 3141: 3117: 3104: 3103: 3093: 3061: 3055: 3054: 3044: 3034: 3010: 3004: 3003: 2993: 2961: 2955: 2954: 2936: 2912: 2906: 2905: 2868: 2859: 2858: 2848: 2838: 2814: 2805: 2804: 2768: 2759: 2758: 2748: 2715: 2709: 2708: 2679: 2673: 2672: 2646: 2631: 2630: 2590: 2581: 2580: 2563:(12): CD005265. 2556: 2550: 2549: 2531: 2516: 2515: 2486: 2480: 2479: 2451: 2445: 2444: 2415: 2409: 2408: 2398: 2388: 2364: 2358: 2357: 2328: 2322: 2321: 2292: 2286: 2285: 2256: 2250: 2249: 2237: 2231: 2230: 2220: 2196: 2190: 2189: 2179: 2147: 2141: 2140: 2130: 2098: 2092: 2091: 2055: 2049: 2048: 2019: 2013: 2012: 2002: 1970: 1961: 1960: 1958: 1957: 1938: 1929: 1928: 1900: 1891: 1890: 1880: 1848: 1837: 1836: 1834: 1833: 1819: 1810: 1809: 1802: 1796: 1795: 1784: 1778: 1777: 1766: 1760: 1759: 1748: 1742: 1741: 1731: 1699: 1686: 1685: 1675: 1650: 1644: 1643: 1625: 1612: 1611: 1585: 1576: 1575: 1559: 1553: 1552: 1550: 1548: 1529: 1523: 1522: 1492: 1479: 1478: 1468: 1436: 1430: 1429: 1392: 1375: 1374: 1348: 1335: 1334: 1332: 1331: 1322:. Archived from 1312: 1306: 1305: 1295: 1285: 1261: 1255: 1254: 1253: 1247: 1237: 1213: 1200: 1199: 1173: 1164: 1163: 1161: 1160: 1146: 1140: 1139: 1115: 975:Frequency of use 939:ERCP, short for 770:blood dyscrasias 714:bile duct injury 674:abdominal cavity 468:Wound infection 457: 345:common bile duct 204:bile duct injury 189:laparoscopically 167:edit on Wikidata 149: 110: 109: 106: 105: 102: 99: 96: 93: 90: 87: 84: 81: 78: 75: 72: 69: 66: 63: 60: 42: 30: 21: 4609: 4608: 4604: 4603: 4602: 4600: 4599: 4598: 4579: 4578: 4577: 4572: 4563:Ranson criteria 4529: 4493: 4465: 4409: 4371: 4340:Cholangiography 4336:Medical imaging 4319:Cholecystostomy 4314:Cholecystectomy 4296: 4217: 4189: 4101:Medical imaging 4095: 4057: 4029: 3991: 3987:Strictureplasty 3962:Bowel resection 3950:Duodenal switch 3918: 3889:Medical imaging 3883: 3748: 3679:Digestive tract 3673: 3664: 3658: 3620: 3618: 3609: 3601: 3599: 3586: 3583: 3581:Further reading 3578: 3577: 3533: 3532: 3528: 3513: 3500: 3499: 3495: 3485: 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1750: 1749: 1745: 1701: 1700: 1689: 1652: 1651: 1647: 1640: 1627: 1626: 1615: 1600: 1587: 1586: 1579: 1561: 1560: 1556: 1546: 1544: 1543:on 28 July 2016 1531: 1530: 1526: 1511: 1497:"Biliary Tract" 1494: 1493: 1482: 1438: 1437: 1433: 1394: 1393: 1378: 1363: 1350: 1349: 1338: 1329: 1327: 1314: 1313: 1309: 1263: 1262: 1258: 1248: 1215: 1214: 1203: 1188: 1175: 1174: 1167: 1158: 1156: 1148: 1147: 1143: 1130:(10): 795–802. 1117: 1116: 1101: 1096: 1074: 1028:, performed by 1015: 1007:cholecystostomy 999:Carl Langenbuch 988: 977: 957:Cholecystostomy 954: 952:Cholecystostomy 917: 896: 888: 877: 864: 859: 805: 796: 787: 778: 754:gallstone ileus 738: 722: 702: 700:Single incision 666: 637: 598: 583: 574: 449: 439:by the Swedish 426:total bilirubin 411: 402: 381: 364: 353: 330: 278: 259: 220: 177:Cholecystectomy 170: 145: 122:General surgery 57: 53: 45: 33:Cholecystectomy 28: 23: 22: 15: 12: 11: 5: 4607: 4605: 4597: 4596: 4591: 4581: 4580: 4574: 4573: 4571: 4570: 4568:Milan criteria 4565: 4560: 4555: 4550: 4545: 4539: 4537: 4531: 4530: 4528: 4527: 4518: 4517: 4516: 4505: 4503: 4499: 4498: 4495: 4494: 4492: 4491: 4486: 4481: 4475: 4473: 4467: 4466: 4464: 4463: 4458: 4453: 4448: 4443: 4438: 4432: 4430: 4421: 4419:Abdominopelvic 4415: 4414: 4411: 4410: 4408: 4407: 4402: 4397: 4395:Pancreatectomy 4392: 4387: 4381: 4379: 4373: 4372: 4370: 4369: 4364: 4359: 4358: 4357: 4352: 4347: 4332: 4331: 4326: 4321: 4316: 4310: 4308: 4298: 4297: 4295: 4294: 4293: 4292: 4287: 4277: 4272: 4267: 4262: 4261: 4260: 4258:Liver dialysis 4255: 4244: 4242: 4233: 4227: 4226: 4223: 4222: 4219: 4218: 4216: 4215: 4210: 4205: 4203:Fecal fat test 4199: 4197: 4191: 4190: 4188: 4187: 4182: 4177: 4172: 4167: 4162: 4157: 4152: 4147: 4141: 4140: 4135: 4130: 4125: 4120: 4115: 4105: 4103: 4097: 4096: 4094: 4093: 4088: 4083: 4078: 4073: 4067: 4065: 4059: 4058: 4056: 4055: 4050: 4045: 4039: 4037: 4031: 4030: 4028: 4027: 4022: 4017: 4012: 4007: 4001: 3999: 3993: 3992: 3990: 3989: 3984: 3979: 3974: 3969: 3964: 3959: 3958: 3957: 3952: 3941: 3939: 3930: 3928:Lower GI tract 3924: 3923: 3920: 3919: 3917: 3916: 3911: 3909:Barium swallow 3906: 3905: 3904: 3893: 3891: 3885: 3884: 3882: 3881: 3879:Schilling test 3876: 3871: 3866: 3861: 3856: 3855: 3854: 3844: 3839: 3834: 3833: 3832: 3827: 3822: 3812: 3807: 3806: 3805: 3800: 3795: 3790: 3785: 3775: 3773:Gastric lavage 3770: 3765: 3758: 3756: 3750: 3749: 3747: 3746: 3741: 3736: 3731: 3726: 3721: 3716: 3714:Heller myotomy 3711: 3705: 3703: 3690: 3688:Upper GI tract 3681: 3675: 3674: 3669: 3666: 3665: 3659: 3657: 3656: 3649: 3642: 3634: 3628: 3627: 3607: 3582: 3579: 3576: 3575: 3546:(1): e240056. 3526: 3511: 3493: 3445: 3416: 3375: 3319: 3278: 3271: 3246: 3219: 3167: 3143: 3105: 3076:(3): 465–473. 3056: 3025:(6): 1452–65. 3005: 2956: 2907: 2880:(9): 1733–40. 2860: 2806: 2760: 2710: 2674: 2659: 2632: 2582: 2551: 2544: 2517: 2481: 2446: 2410: 2359: 2323: 2287: 2251: 2232: 2191: 2142: 2107:Postgrad Med J 2093: 2050: 2014: 1985:(5): 2175–83. 1962: 1930: 1911:(2): 297–310. 1892: 1838: 1811: 1797: 1779: 1761: 1743: 1687: 1645: 1638: 1613: 1598: 1577: 1554: 1524: 1509: 1480: 1451:(4): 297–309. 1431: 1376: 1361: 1336: 1307: 1256: 1201: 1186: 1165: 1141: 1098: 1097: 1095: 1092: 1091: 1090: 1085: 1080: 1073: 1070: 1014: 1011: 987: 984: 976: 973: 953: 950: 916: 913: 895: 892: 887: 884: 876: 873: 863: 860: 858: 857:Considerations 855: 843:cholestyramine 835:terminal ileum 804: 801: 795: 792: 786: 783: 777: 774: 742:electrocautery 737: 734: 721: 718: 701: 698: 665: 662: 658:Foley catheter 636: 633: 597: 594: 581: 573: 570: 533: 532: 529: 523: 522: 519: 515: 514: 511: 507: 506: 503: 499: 498: 495: 491: 490: 487: 483: 482: 479: 473: 472: 469: 465: 464: 461: 448: 445: 415:biliary injury 410: 409:Biliary injury 407: 401: 398: 380: 377: 363: 360: 352: 349: 329: 326: 277: 274: 258: 255: 219: 216: 210:formation and 172: 171: 164: 161: 160: 157: 151: 150: 143: 137: 136: 131: 125: 124: 119: 113: 112: 51: 47: 46: 43: 35: 34: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 4606: 4595: 4592: 4590: 4587: 4586: 4584: 4569: 4566: 4564: 4561: 4559: 4556: 4554: 4551: 4549: 4546: 4544: 4541: 4540: 4538: 4536: 4532: 4526: 4522: 4519: 4515: 4512: 4511: 4510: 4507: 4506: 4504: 4500: 4490: 4487: 4485: 4482: 4480: 4479:Hernia repair 4477: 4476: 4474: 4472: 4468: 4462: 4459: 4457: 4454: 4452: 4449: 4447: 4444: 4442: 4439: 4437: 4434: 4433: 4431: 4429: 4425: 4422: 4420: 4416: 4406: 4403: 4401: 4398: 4396: 4393: 4391: 4388: 4386: 4383: 4382: 4380: 4378: 4374: 4368: 4365: 4363: 4360: 4356: 4353: 4351: 4348: 4346: 4343: 4342: 4341: 4337: 4334: 4333: 4330: 4327: 4325: 4322: 4320: 4317: 4315: 4312: 4311: 4309: 4307: 4303: 4299: 4291: 4288: 4286: 4283: 4282: 4281: 4278: 4276: 4273: 4271: 4268: 4266: 4263: 4259: 4256: 4254: 4251: 4250: 4249: 4246: 4245: 4243: 4241: 4237: 4234: 4232: 4228: 4214: 4211: 4209: 4208:Fecal pH test 4206: 4204: 4201: 4200: 4198: 4196: 4192: 4186: 4183: 4181: 4178: 4176: 4173: 4171: 4168: 4166: 4163: 4161: 4158: 4156: 4153: 4151: 4148: 4146: 4143: 4142: 4139: 4138:Sigmoidoscopy 4136: 4134: 4131: 4129: 4126: 4124: 4121: 4119: 4116: 4114: 4110: 4107: 4106: 4104: 4102: 4098: 4092: 4089: 4087: 4084: 4082: 4079: 4077: 4074: 4072: 4069: 4068: 4066: 4064: 4060: 4054: 4051: 4049: 4046: 4044: 4041: 4040: 4038: 4036: 4032: 4026: 4023: 4021: 4018: 4016: 4013: 4011: 4008: 4006: 4003: 4002: 4000: 3998: 3994: 3988: 3985: 3983: 3980: 3978: 3975: 3973: 3970: 3968: 3965: 3963: 3960: 3956: 3953: 3951: 3948: 3947: 3946: 3943: 3942: 3940: 3938: 3934: 3931: 3929: 3925: 3915: 3912: 3910: 3907: 3903: 3900: 3899: 3898: 3895: 3894: 3892: 3890: 3886: 3880: 3877: 3875: 3874:Pyloromyotomy 3872: 3870: 3867: 3865: 3862: 3860: 3857: 3853: 3850: 3849: 3848: 3845: 3843: 3840: 3838: 3835: 3831: 3828: 3826: 3823: 3821: 3818: 3817: 3816: 3813: 3811: 3808: 3804: 3801: 3799: 3796: 3794: 3791: 3789: 3786: 3784: 3781: 3780: 3779: 3776: 3774: 3771: 3769: 3766: 3763: 3760: 3759: 3757: 3755: 3751: 3745: 3742: 3740: 3737: 3735: 3732: 3730: 3727: 3725: 3722: 3720: 3717: 3715: 3712: 3710: 3709:Esophagectomy 3707: 3706: 3704: 3702: 3698: 3694: 3691: 3689: 3685: 3682: 3680: 3676: 3672: 3667: 3663: 3655: 3650: 3648: 3643: 3641: 3636: 3635: 3632: 3616: 3612: 3608: 3598:on 2019-08-01 3597: 3593: 3589: 3585: 3584: 3580: 3571: 3567: 3562: 3557: 3553: 3549: 3545: 3541: 3537: 3530: 3527: 3522: 3518: 3514: 3508: 3504: 3497: 3494: 3489: 3482: 3478: 3473: 3468: 3464: 3460: 3456: 3449: 3446: 3434: 3430: 3423: 3421: 3417: 3412: 3408: 3403: 3398: 3394: 3390: 3386: 3379: 3376: 3371: 3367: 3362: 3357: 3354:(1): 109–11. 3353: 3349: 3345: 3338: 3336: 3334: 3332: 3330: 3328: 3326: 3324: 3320: 3315: 3311: 3306: 3301: 3297: 3293: 3289: 3282: 3279: 3274: 3268: 3264: 3257: 3255: 3253: 3251: 3247: 3242: 3238: 3234: 3230: 3223: 3220: 3215: 3211: 3206: 3201: 3197: 3193: 3189: 3185: 3181: 3174: 3172: 3168: 3157: 3153: 3147: 3144: 3139: 3135: 3131: 3127: 3123: 3116: 3114: 3112: 3110: 3106: 3101: 3097: 3092: 3087: 3083: 3079: 3075: 3071: 3067: 3060: 3057: 3052: 3048: 3043: 3038: 3033: 3028: 3024: 3020: 3016: 3009: 3006: 3001: 2997: 2992: 2987: 2983: 2979: 2975: 2971: 2967: 2960: 2957: 2952: 2948: 2944: 2940: 2935: 2930: 2926: 2922: 2918: 2911: 2908: 2903: 2899: 2895: 2891: 2887: 2883: 2879: 2875: 2867: 2865: 2861: 2856: 2852: 2847: 2842: 2837: 2832: 2829:(10): 243–8. 2828: 2824: 2820: 2813: 2811: 2807: 2802: 2798: 2794: 2790: 2786: 2782: 2778: 2774: 2767: 2765: 2761: 2756: 2752: 2747: 2742: 2738: 2734: 2730: 2726: 2722: 2714: 2711: 2706: 2702: 2698: 2694: 2691:(2): 176–86. 2690: 2686: 2678: 2675: 2670: 2666: 2662: 2656: 2652: 2645: 2643: 2641: 2639: 2637: 2633: 2628: 2624: 2620: 2616: 2612: 2608: 2604: 2600: 2596: 2589: 2587: 2583: 2578: 2574: 2570: 2566: 2562: 2555: 2552: 2547: 2541: 2537: 2530: 2528: 2526: 2524: 2522: 2518: 2513: 2509: 2505: 2501: 2497: 2493: 2485: 2482: 2477: 2473: 2469: 2465: 2461: 2457: 2450: 2447: 2442: 2438: 2434: 2430: 2426: 2422: 2414: 2411: 2406: 2402: 2397: 2392: 2387: 2382: 2378: 2374: 2370: 2363: 2360: 2355: 2351: 2347: 2343: 2339: 2335: 2327: 2324: 2319: 2315: 2311: 2307: 2304:(8): 779–86. 2303: 2299: 2291: 2288: 2283: 2279: 2275: 2271: 2267: 2263: 2255: 2252: 2247: 2243: 2236: 2233: 2228: 2224: 2219: 2214: 2210: 2206: 2202: 2195: 2192: 2187: 2183: 2178: 2173: 2169: 2165: 2162:(2): rjy013. 2161: 2157: 2153: 2146: 2143: 2138: 2134: 2129: 2124: 2120: 2116: 2113:(940): 77–9. 2112: 2108: 2104: 2097: 2094: 2089: 2085: 2081: 2077: 2073: 2069: 2065: 2061: 2054: 2051: 2046: 2042: 2038: 2034: 2031:(5): 419–22. 2030: 2026: 2018: 2015: 2010: 2006: 2001: 1996: 1992: 1988: 1984: 1980: 1976: 1969: 1967: 1963: 1951: 1947: 1943: 1937: 1935: 1931: 1926: 1922: 1918: 1914: 1910: 1906: 1899: 1897: 1893: 1888: 1884: 1879: 1874: 1870: 1866: 1862: 1858: 1854: 1847: 1845: 1843: 1839: 1828: 1824: 1818: 1816: 1812: 1807: 1801: 1798: 1793: 1789: 1783: 1780: 1775: 1771: 1765: 1762: 1757: 1753: 1747: 1744: 1739: 1735: 1730: 1725: 1721: 1717: 1713: 1709: 1705: 1698: 1696: 1694: 1692: 1688: 1683: 1679: 1674: 1669: 1665: 1661: 1657: 1649: 1646: 1641: 1635: 1631: 1624: 1622: 1620: 1618: 1614: 1609: 1605: 1601: 1595: 1591: 1584: 1582: 1578: 1573: 1569: 1565: 1558: 1555: 1542: 1538: 1534: 1528: 1525: 1520: 1516: 1512: 1506: 1502: 1498: 1491: 1489: 1487: 1485: 1481: 1476: 1472: 1467: 1462: 1458: 1454: 1450: 1446: 1442: 1435: 1432: 1427: 1423: 1419: 1415: 1411: 1407: 1404:(4): 429–53. 1403: 1399: 1391: 1389: 1387: 1385: 1383: 1381: 1377: 1372: 1368: 1364: 1358: 1354: 1347: 1345: 1343: 1341: 1337: 1326:on 2018-03-20 1325: 1321: 1317: 1311: 1308: 1303: 1299: 1294: 1289: 1284: 1279: 1275: 1271: 1267: 1260: 1257: 1252: 1245: 1241: 1236: 1231: 1227: 1223: 1219: 1212: 1210: 1208: 1206: 1202: 1197: 1193: 1189: 1183: 1179: 1172: 1170: 1166: 1155: 1151: 1145: 1142: 1137: 1133: 1129: 1125: 1121: 1114: 1112: 1110: 1108: 1106: 1104: 1100: 1093: 1089: 1086: 1084: 1081: 1079: 1076: 1075: 1071: 1069: 1066: 1064: 1063:gold standard 1059: 1057: 1053: 1049: 1044: 1042: 1037: 1034: 1031: 1027: 1023: 1019: 1012: 1010: 1008: 1004: 1000: 992: 985: 983: 980: 974: 972: 968: 966: 961: 958: 951: 949: 946: 942: 934: 933:cholangiogram 929: 921: 914: 912: 908: 906: 902: 893: 891: 885: 883: 881: 874: 872: 870: 869:acute abdomen 861: 856: 854: 851: 846: 844: 840: 836: 832: 829:recycling of 828: 827:enterohepatic 824: 819: 817: 813: 808: 802: 800: 793: 791: 784: 782: 775: 773: 771: 767: 763: 759: 755: 751: 750:fistulization 747: 746:cholecystitis 743: 735: 733: 731: 727: 719: 717: 715: 711: 707: 699: 697: 693: 691: 687: 686:cystic artery 683: 679: 675: 670: 663: 661: 659: 655: 654:OG or NG tube 650: 646: 642: 634: 629: 623: 615: 608: 602: 595: 593: 589: 585: 584: 578: 571: 569: 567: 563: 559: 554: 552: 546: 544: 540: 530: 528: 525: 524: 520: 517: 516: 512: 509: 508: 504: 501: 500: 496: 493: 492: 488: 485: 484: 480: 478: 475: 474: 470: 467: 466: 462: 460:Complication 459: 458: 452: 446: 444: 442: 438: 433: 431: 427: 423: 418: 416: 408: 406: 399: 397: 395: 391: 387: 378: 376: 374: 369: 361: 359: 357: 350: 348: 346: 342: 338: 334: 327: 325: 321: 318: 313: 310: 306: 302: 298: 294: 289: 286: 282: 281:Cholecystitis 275: 273: 271: 267: 263: 262:Biliary colic 257:Biliary colic 256: 254: 252: 248: 243: 241: 237: 233: 224: 217: 215: 213: 209: 205: 201: 196: 194: 190: 186: 182: 178: 168: 158: 156: 152: 148: 144: 142: 138: 135: 132: 130: 126: 123: 120: 118: 114: 108: 52: 50:Pronunciation 48: 41: 36: 31: 19: 4456:Paracentesis 4313: 4270:Liver biopsy 4165:Enteroclysis 4150:Defecography 4005:Appendectomy 3619:. Retrieved 3614: 3600:. Retrieved 3596:the original 3591: 3543: 3539: 3529: 3502: 3496: 3462: 3458: 3448: 3436:. Retrieved 3432: 3395:(4): 341–6. 3392: 3388: 3378: 3351: 3347: 3298:(1): 89–94. 3295: 3291: 3281: 3262: 3232: 3222: 3190:(2): 102–6. 3187: 3183: 3159:. Retrieved 3155: 3146: 3121: 3073: 3069: 3059: 3022: 3018: 3008: 2976:(4): 315–7. 2973: 2969: 2959: 2927:(3): 627–9. 2924: 2920: 2910: 2877: 2873: 2826: 2822: 2776: 2772: 2728: 2724: 2713: 2688: 2684: 2677: 2650: 2602: 2598: 2560: 2554: 2535: 2495: 2492:World J Surg 2491: 2484: 2462:(4): 552–9. 2459: 2455: 2449: 2427:(3): 435–9. 2424: 2420: 2413: 2376: 2372: 2362: 2337: 2333: 2326: 2301: 2297: 2290: 2265: 2261: 2254: 2245: 2235: 2211:(5): 392–5. 2208: 2204: 2194: 2159: 2155: 2145: 2110: 2106: 2096: 2066:(4): 291–3. 2063: 2059: 2053: 2028: 2024: 2017: 1982: 1978: 1954:. Retrieved 1945: 1908: 1904: 1863:(4): 300–5. 1860: 1856: 1830:. Retrieved 1826: 1800: 1791: 1782: 1774:www.umms.org 1773: 1764: 1755: 1746: 1714:(1): 15–26. 1711: 1707: 1663: 1659: 1648: 1629: 1589: 1574:. NBK258747. 1563: 1557: 1545:. Retrieved 1541:the original 1536: 1533:"Gallstones" 1527: 1500: 1448: 1444: 1434: 1401: 1397: 1352: 1328:. Retrieved 1324:the original 1319: 1310: 1273: 1269: 1259: 1225: 1221: 1177: 1157:. Retrieved 1153: 1144: 1127: 1123: 1067: 1060: 1048:laparoscopic 1045: 1041:Lyon, France 1038: 1030:gynecologist 1026:appendectomy 1016: 997: 981: 978: 969: 962: 955: 938: 909: 897: 889: 878: 865: 847: 820: 809: 806: 797: 788: 779: 739: 723: 703: 694: 669:Laparoscopic 667: 638: 607:hair removal 590: 586: 580: 579: 575: 555: 547: 536: 502:Respiratory 450: 434: 419: 412: 403: 382: 365: 354: 331: 322: 316: 314: 290: 285:inflammation 279: 260: 244: 229: 197: 191:, or via an 176: 175: 4446:Laparoscopy 4302:Gallbladder 4265:Hepatectomy 4195:Stool tests 4133:Proctoscopy 4128:Enteroscopy 4113:Colonoscopy 3997:Large bowel 3977:Jejunostomy 3937:Small bowel 3864:Hill repair 3847:Gastrostomy 3825:Billroth II 3815:Gastrectomy 3719:Sialography 3465:: 196–204. 2731:(1): 91–7. 2340:(1): 54–8. 2060:Surg Endosc 1666:(1): 8–23. 1228:(1): 15–7. 758:cholangitis 682:cystic duct 678:laparoscope 463:Prevalence 341:cystic duct 333:Cholangitis 309:Murphy sign 218:Medical use 181:gallbladder 4583:Categories 4509:Laparotomy 4451:Omentopexy 4428:Peritoneum 4063:Anal canal 3842:Gastropexy 3820:Billroth I 3602:2018-03-20 3161:2018-03-19 2669:1003489504 1956:2019-09-02 1946:www.sbu.se 1832:2018-03-27 1519:1328625901 1330:2018-03-20 1159:2018-01-24 1094:References 1052:gallstones 1018:Erich Mühe 945:endoscopic 931:This is a 831:bile salts 630:dressings. 317:acalculous 266:gallstones 247:ultrasound 232:gallstones 185:gallstones 4306:bile duct 4231:Accessory 4109:Endoscopy 4020:Colostomy 4010:Colectomy 3967:Ileostomy 3897:Endoscopy 3830:Roux-en-Y 3701:Esophagus 3621:4 January 3521:880422516 3438:4 October 3070:Gut Liver 2298:Endoscopy 2262:JAMA Surg 1608:949278311 1371:951748294 1196:933274207 1046:By 2013, 1033:Kurt Semm 862:Pregnancy 816:dyspepsia 762:cirrhosis 596:Procedure 568:to form. 486:Bleeding 373:pediatric 293:infection 117:Specialty 4377:Pancreas 4118:Anoscopy 3570:33462065 3481:25958296 3411:10036125 3370:18402752 3314:11304004 3241:25535644 3214:26741665 3138:23939652 3100:35502586 3051:37434692 3042:10331452 3000:32003580 2951:28999270 2943:11280526 2894:19412642 2855:26523212 2793:26895901 2755:17252302 2705:20670855 2627:10656813 2619:20706739 2577:21154360 2512:23430003 2476:23419386 2441:22261836 2421:Ann Surg 2405:24106403 2318:17001567 2282:25133326 2246:GallRiks 2227:18823829 2186:29479416 2137:14970293 2045:25853929 2009:29556977 1925:24679422 1887:28149133 1738:17252293 1682:23307004 1572:25473723 1475:27467059 1426:19853338 1418:25850631 1302:25481385 1244:19857610 1136:24866215 1072:See also 943:, is an 839:diarrhea 823:diarrhea 628:Tegaderm 510:Cardiac 437:assessed 303:, or an 295:such as 212:stenosis 129:ICD-9-CM 3754:Stomach 3561:7816909 3402:3015244 3361:3016026 3305:3015420 3205:5210469 3091:9099388 2991:7099162 2902:8037138 2846:4621474 2801:5966494 2746:2784499 2396:3785624 2354:8454146 2177:5811847 2128:1742934 2080:9543518 2000:5897463 1878:5245728 1729:2784509 1547:27 July 1466:8802735 1293:4295332 1276:: 412. 986:History 905:opioids 690:ligated 566:abscess 558:abdomen 270:abdomen 208:abscess 147:D002763 4471:Hernia 4035:Rectum 3568: 3558: 3519: 3509: 3479: 3409: 3399: 3368: 3358: 3312: 3302: 3269: 3239: 3212: 3202: 3136: 3098: 3088: 3049: 3039: 2998: 2988: 2949: 2941: 2900: 2892: 2853: 2843: 2799: 2791: 2753: 2743: 2703: 2667: 2657: 2625: 2617: 2575: 2542: 2510: 2474: 2439: 2403: 2393: 2352: 2316: 2280: 2225: 2184: 2174: 2135: 2125: 2088:610548 2086: 2078: 2043: 2007: 1997: 1923: 1885: 1875: 1736: 1726: 1680: 1636: 1606: 1596: 1570: 1517: 1507: 1473: 1463: 1424: 1416: 1369: 1359: 1300: 1290: 1242: 1194: 1184: 1134: 1003:Berlin 901:NSAIDs 833:. The 776:Biopsy 768:, and 676:. The 531:0.21% 527:Hernia 521:0.34% 513:0.36% 505:0.48% 497:0.50% 489:0.79% 481:0.90% 471:1.25% 422:sepsis 301:chills 111: 4553:UKELD 4502:Other 4240:Liver 2947:S2CID 2898:S2CID 2797:S2CID 2623:S2CID 2084:S2CID 1537:NIDDK 1422:S2CID 726:NOTES 710:navel 551:stent 400:Risks 297:fever 283:, or 165:[ 159:47562 134:575.0 4548:PELD 4543:MELD 4350:MRCP 4324:ERCP 3623:2020 3566:PMID 3517:OCLC 3507:ISBN 3477:PMID 3440:2017 3407:PMID 3389:JSLS 3366:PMID 3348:JSLS 3310:PMID 3292:JSLS 3267:ISBN 3237:PMID 3210:PMID 3134:PMID 3096:PMID 3047:PMID 2996:PMID 2939:PMID 2890:PMID 2851:PMID 2789:PMID 2751:PMID 2701:PMID 2665:OCLC 2655:ISBN 2615:PMID 2573:PMID 2540:ISBN 2508:PMID 2472:PMID 2437:PMID 2401:PMID 2350:PMID 2314:PMID 2278:PMID 2223:PMID 2182:PMID 2160:2018 2133:PMID 2076:PMID 2041:PMID 2005:PMID 1921:PMID 1883:PMID 1734:PMID 1678:PMID 1634:ISBN 1604:OCLC 1594:ISBN 1568:PMID 1549:2016 1515:OCLC 1505:ISBN 1471:PMID 1414:PMID 1367:OCLC 1357:ISBN 1298:PMID 1240:PMID 1192:OCLC 1182:ISBN 1132:PMID 1054:and 915:ERCP 706:SILS 684:and 656:. 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