Displaying publications 1 - 20 of 39 in total

  1. Khan TF
    Med J Malaysia, 1992 Mar;47(1):65-8.
    PMID: 1387453
    Modified subtotal cholecystectomy involves removal of the gall bladder after circumferential division of the neck. Either the impacted stone or the surgeons finger was used as a guide to identify the neck. The stump cavity in the neck is obliterated with interrupted sutures to prevent recurrent stone formation. Indications for this procedure are obscure anatomy, due either to the severe inflammation in acute cholecystitis or dense adhesions in the small fibrosed gall bladder. The decision to perform modified subtotal cholecystectomy is taken during the operation. Forty three patients (14%) underwent this procedure during the period between August 85 and April 90. Out of 289 cholecystectomies performed seven were emergency and thirty-six were early cholecystectomies. With the increasing trend towards urgent and early cholecystectomy in acute cholecystitis the author has found this to be a safe and definitive procedure.
    Matched MeSH terms: Cholecystectomy/methods*
  2. Koong JK, Ng GH, Ramayah K, Koh PS, Yoong BK
    Asian J Surg, 2021 Mar;44(3):537-543.
    PMID: 33223453 DOI: 10.1016/j.asjsur.2020.11.002
    BACKGROUND: Achieving critical view of safety (CVS) is vital during laparoscopic cholecystectomy (LC). There is no known study determining use of indocyanine green fluorescence cholangiography (ICGFC) in early identification of CVS during LC. This study aims to compare use of ICGFC in LC against conventional LC in early identification of CVS.

    METHODOLOGY: Patients undergoing LC in a single centre were randomized into ICGFC-LC and conventional LC. Surgery was performed by a single surgeon and the time taken to achieve CVS from the time of gallbladder fundus retraction was measured. Difficulty level for each surgery was rated and analysed using a modified scoring system (Level 1- Easy to Level 4-Very difficult).

    RESULTS: 63 patients were recruited where mean time (min) to achieve CVS was 22.3 ± 12.9 in ICGFC-LC (n = 30) and 22.8 ± 14.3 in conventional LC (p = 0.867). The time taken to achieve CVS was shorter in ICGFC-LC group across all difficulty levels, although not significant (p > 0.05). No major complication was observed in the study.

    CONCLUSIONS: This study had shown ICGFC-LC reduces time to CVS across all difficulty levels but not statistically significant. ICGFC-LC maybe useful in difficult LC and in surgical training.

    TRIAL REGISTRATION: Clinical Trials NCT04228835.

    STUDY GRANT: UMMI Surgical - Karl Storz Distributor (Malaysia).

    Matched MeSH terms: Cholecystectomy, Laparoscopic*
  3. Che Jusoh MA, Hassan J, Mohd Nor R, Kong CF, Zahirah Awang NF
    Med J Malaysia, 2013 Jun;68(3):273-4.
    PMID: 23749024 MyJurnal
    Pancreatic pseudocyst is a well recognized complication of acute or chronic pancreatitis. Active treatment (surgical or endoscopic) has been recommended if the pseudocyst persists for more than 6 weeks after the diagnosis. Open trans-abdominal drainage was initially the mainstay treatment for it. However, over the past decade, laparoscopic techniques have been developed to provide patient with minimal access alternative. We report a case of a large symptomatic pseudocyst which developed following attack of severe gallstone pancreatitis. Laparoscopic cholecystectomy and cysto-gastrostomy were done at the same sitting. The operative technique is briefly explained.
    Matched MeSH terms: Cholecystectomy, Laparoscopic*
  4. Jee SL, Lim KF, Krishnan R
    Med J Malaysia, 2014 Aug;69(4):191-2.
    PMID: 25500850 MyJurnal
    Hemobilia is a rare but potentially lethal condition. The commonest cause of hemobilia is trauma, accounting up to 85% of all cases. Hemobilia caused by gallstones is very rare. Most of the cases of hemobilia are either managed conservatively or treated by embolization. Surgery is indicated only when there is an associated surgical condition or when embolization fails. We report a case of a 72-year-old patient with massive hemobilia caused by gallstone erosion to the adjacent artery, diagnosed intraoperatively. The complication was successfully managed by cholecystectomy and repair of the bleeding vessel. This case highlights the importance that hemobilia should be suspected in patients presenting with upper gastrointestinal bleeding. Although rare, massive hemobilia can be life threatening, leading to significant morbidity and mortality. Therefore, a high index of suspicion and timely intervention are important.
    Matched MeSH terms: Cholecystectomy
  5. Chen CK, Tan PC, Phui VE, Teo SC
    Korean J Anesthesiol, 2013 Jun;64(6):511-6.
    PMID: 23814651 DOI: 10.4097/kjae.2013.64.6.511
    The ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP) block provides a wider area of sensory block to the anterior abdominal wall than the classical posterior approach. We compared the intra-operative analgesic efficacy of OSTAP block with conventional intravenous (IV) morphine during laparoscopic cholecystectomy.
    Matched MeSH terms: Cholecystectomy, Laparoscopic
  6. Ramanathan T
    Med J Malaya, 1971 Jun;25(4):305-6.
    PMID: 4261308
    Matched MeSH terms: Cholecystectomy
  7. Marjmin Osman, Razman, J., Shaharin, S.
    One of the causes of post cholecystectomy pain is due to stone in the cystic duct. This is a very rare occurrence although it can be debilitating to the patient. We report a case of a 64 year old man presented with retained cystic duct stone post cholecystectomy complicated by liver abscess and biloma. The management of this unusual presentation is discussed.
    Matched MeSH terms: Cholecystectomy
  8. Podda M, Pacella D, Pellino G, Coccolini F, Giordano A, Di Saverio S, et al.
    Pancreatology, 2022 Nov;22(7):902-916.
    PMID: 35963665 DOI: 10.1016/j.pan.2022.07.007
    BACKGROUND/OBJECTIVES: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines.

    METHODS: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data.

    RESULTS: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P 

    Matched MeSH terms: Cholecystectomy
  9. Strong RW
    Med J Malaysia, 2005 Jul;60 Suppl B:141-3.
    PMID: 16108198
    Matched MeSH terms: Cholecystectomy, Laparoscopic/adverse effects*
  10. Muhd Yusairi K, Vasu Pillai L, Voon ML, Manisekar KS
    Med J Malaysia, 2018 12;73(6):418-419.
    PMID: 30647219
    No abstract provided.
    Matched MeSH terms: Cholecystectomy/methods*
  11. Maarof SR, Ahmad CA, Atkins L, Devol EB, Hussain A, Abdullah KL
    J Perianesth Nurs, 2023 Feb;38(1):58-62.
    PMID: 36085130 DOI: 10.1016/j.jopan.2022.02.006
    PURPOSE: To determine if listening to verses of the Qur'an during the immediate postoperative period has an effect on patients' anxiety levels, the number of opioids used to control pain, and the length of stay (LOS) in the Post Anesthesia Care Unit (PACU).

    DESIGN: Randomized Control Trial. Adult Muslim patients who had undergone a laparoscopic cholecystectomy through the Day Surgery Unit were randomly selected using computer-generated sequence into two groups, interventional and control groups.

    METHODS: The control group listened to the natural environment and received Fentanyl for pain relief, and the interventional group listened to the Qur'an recitation and received Fentanyl for pain relief. A total of 112 (79.4%) participants completed the study. The level of the pain and anxiety was measured using the Wong-Baker Faces pain scale and Spielberger State-Trait Anxiety Inventory, respectively. Statistical analysis was conducted using SAS version 9.3 (Statistical Analysis System, SAS Institute Inc, Cary, North Carolina).

    FINDINGS: This study compared the effects of Qur'an audio therapy on patients' anxiety levels, opioid consumption, pain, and LOS in the PACU. The findings showed that by listening to chosen verses from the Qur'an in the recovery period post-anaesthesia, anxiety scores were significantly reduced (P = .0001), opiate use was reduced (P = .0081), and overall PACU LOS was also reduced (P = .0083).

    CONCLUSIONS: Adding the use of listening to the Qur'an as a complementary therapy is a simple and cost-effective measure to reduce the need for narcotics in the PACU, and reduce the overall PACU length of stay. This intervention benefits the patient, the PACU, and reduces health care organization costs.

    Matched MeSH terms: Cholecystectomy, Laparoscopic*
  12. Stephens TJ, Bamber JR, Beckingham IJ, Duncan E, Quiney NF, Abercrombie JF, et al.
    Implement Sci, 2019 08 23;14(1):84.
    PMID: 31443689 DOI: 10.1186/s13012-019-0932-0
    BACKGROUND: Acute gallstone disease is the highest volume Emergency General Surgical presentation in the UK. Recent data indicate wide variations in the quality of care provided across the country, with national guidance for care delivery not implemented in most UK hospitals. Against this backdrop, the Royal College of Surgeons of England set up a 13-hospital quality improvement collaborative (Chole-QuIC) to support clinical teams to reduce time to surgery for patients with acute gallstone disease requiring emergency cholecystectomy.

    METHODS: Prospective, mixed-methods process evaluation to answer the following: (1) how was the collaborative delivered by the faculty and received, understood and enacted by the participants; (2) what influenced teams' ability to improve care for patients requiring emergency cholecystectomy? We collected and analysed a range of data including field notes, ethnographic observations of meetings, and project documentation. Analysis was based on the framework approach, informed by Normalisation Process Theory, and involved the creation of comparative case studies based on hospital performance during the project.

    RESULTS: Chole-QuIC was delivered as planned and was well received and understood by participants. Four hospitals were identified as highly successful, based upon a substantial increase in the number of patients having surgery in line with national guidance. Conversely, four hospitals were identified as challenged, achieving no significant improvement. The comparative analysis indicate that six inter-related influences appeared most associated with improvement: (1) achieving clarity of purpose amongst site leads and key stakeholders; (2) capacity to lead and effective project support; (3) ideas to action; (4) learning from own and others' experience; (5) creating additional capacity to do emergency cholecystectomies; and (6) coordinating/managing the patient pathway.

    CONCLUSION: Collaborative-based quality improvement is a viable strategy for emergency surgery but success requires the deployment of effective clinical strategies in conjunction with improvement strategies. In particular, achieving clarity of purpose about proposed changes amongst key stakeholders was a vital precursor to improvement, enabling the creation of additional surgical capacity and new pathways to be implemented effectively. Protected time, testing ideas, and the ability to learn quickly from data and experience were associated with greater impact within this cohort.

    Matched MeSH terms: Cholecystectomy/methods*; Cholecystectomy/standards
  13. Ikhwan SM, Zamri Z, Hairol O, Razman J, Affirul C
    Extrahepatic bile ducts constitute a significant anatomic site for surgeons when performing hepatobiliary
    operations from minor procedure such as cholecystectomy to major operation such as hepatectomy. The
    challenges for surgeon in performing such cases increase when congenital variance of biliary tree occurs which
    may lead to unintentional bile duct injuries. We reported a case of a lady who presented with obstructive
    jaundice secondary to huge distal common bile duct stone. The presence of right posterior segmental hepatic
    duct, which rarely occurs, was discovered during intraoperative cholangiogram before common bile duct
    exploration. The operation was successful without incidence of biliary duct injury.
    Matched MeSH terms: Cholecystectomy
  14. Leow VM, Faizah MS, Mohd Sharifudin S, Letchumanan VP, Yang KF, Manisekar KS
    Med J Malaysia, 2014 Jun;69(3):129-32.
    PMID: 25326354 MyJurnal
    OBJECTIVE: Conventional laparoscopic cholecystectomy (LC) involves the use of four ports, but the number of ports has gradually been reduced to one for cosmetic reasons. however, single-incision LC is technically demanding, and there is a substantial learning curve associated with its successful application. The aim of this clinical study was to evaluate the safety and feasibility of a less demanding alternative LC technique with a faster learning curve.

    METHODS: This prospective descriptive study was performed from September 2009 to February 2011 at Sultanah Bahiyah hospital in Kedah, Malaysia. A total of 58 patients underwent two-incision threeport laparoscopic cholecystectomy (TILC), which was performed by the senior consultant hepato-pancreato-biliary surgeon and two hepato-pancreato-biliary trainees. Study end points included operative time, postoperative pain, length of hospital stay and early postoperative complications. The follow-up period was 4 weeks.

    RESULTS: The overall operative time taken was 44 ± 18 minutes. none of the patients had major complication or incisional hernia postoperatively. All but one of the patients were discharged within 24 h. nonsteroidal anti-inflammatory drugs were the main postoperative analgesic used.

    CONCLUSION: TILC is feasible and safe cholecystectomy technique.
    Matched MeSH terms: Cholecystectomy; Cholecystectomy, Laparoscopic
  15. Salleh AA, Affirul CA, Hairol O, Zamri Z, Azlanudin A, Hilmi MA, et al.
    Clin Ter, 2015;166(3):e165-8.
    PMID: 26152626 DOI: 10.7417/CT.2015.1848
    BACKGROUND: This present study sought to review the feasibility and patients' satisfaction of laparoscopic cholecystectomy to be perform as daycare procedure.

    MATERIAL AND METHODS: Sixty-two patients with symptomatic gallstones were recruited within a year. They were randomized into overnight stay and daycare groups. The outcomes and post-operative complications were analyzed.

    RESULTS: Fifty-eight patients were eligible for analysis and four patients were excluded because of conversion to open cholecystectomy. All patients in daycare group reported no fever but two patients in the overnight stay group complaint of post-operative fever (p=0.150). The mean pain score using Visual Analogue Score (VAS) in daycare group was 2.93 but in the overnight stay was recorded as 3.59 (p=0.98). Five patients had post-operative nausea and vomiting (PONV) in daycare group compared to 2 patients in the overnight stay group (p=0.227). Patient's satisfaction were higher in the daycare group (p=0.160). All patients in daycare group were back at work within a week but in overnight stay, 11 patients had to stay off work for more than one week (p=0.01).

    CONCLUSIONS: Daycare laparoscopic cholecystectomy is safe and feasible. The satisfaction of daycare surgery is higher than overnight stay group. Patients' selection is an important aspect of its success.

    Matched MeSH terms: Cholecystectomy, Laparoscopic/methods*
  16. Amjad N, Nor AM, Singh H
    Hosp Med, 2001 Jun;62(6):370-1.
    PMID: 11436449
    Matched MeSH terms: Cholecystectomy/methods
  17. Jasmi AY, Thambidorai CR, Khairussalleh J
    Med J Malaysia, 2003 Aug;58(3):443-5.
    PMID: 14750388
    Gallstone disease is a common association in patients with haematological splenomegaly. When indicated, simultaneous splenectomy and cholecystectomy should be performed and traditionally this is accomplished by open surgery. We report a 17 year old thalassaemic girl with splenomegaly complicated by gallstone pancreatitis. We treated her with a combination of needlescopic cholecystectomy and laparoscopic splenectomy as well as delivering the huge spleen via a pfannenstiel incision to hide the scar. We believe this technique is an acceptable alternative mainly for rapid delivery of the spleen and to minimize visible scars hence improving cosmesis.
    Matched MeSH terms: Cholecystectomy, Laparoscopic/methods*
  18. Hlaing KP, Thwin SS, Shwe N
    Singapore Med J, 2011 Dec;52(12):e262-4.
    PMID: 22159949
    The cystic artery (CA) is known to exhibit variations in its origin and branching pattern. This is attributed to the developmental changes occurring in the primitive ventral splanchnic arteries. During routine dissection of a male cadaver, we observed that the CA originated from the middle hepatic artery (MHA) at a distance of about 1 cm from its origin, and the MHA originated from the right hepatic artery at a distance of 2.1 cm from its origin. The CA traversed for a distance of 1.5 cm, giving off a branch to the cystic duct. It then passed anterior to the cystic duct. The origin of the CA was located to the left of the common hepatic duct, outside the Calot's triangle. The topographical anatomy of the arterial system of the hepatobiliary region and their anomalous origin should be considered during hepatobiliary surgeries. This knowledge is also important for interventional radiologists in routine clinical practice.
    Matched MeSH terms: Cholecystectomy/methods
  19. Hassan R, Johari M, Nijhar JS, Sharifah BSA, Low LL, Amri N
    Med J Malaysia, 2021 03;76(2):254-257.
    PMID: 33742640
    We describe here the first laparotomy involving a COVID-19 patient in Malaysia. A 60-year-old man screened positive for SARS-CoV-2 in March 2020 and developed acute abdomen in the ward in Hospital Sultanah Bahiyah, Kedah. He underwent laparotomy and cholecystectomy for gangrenous cholecystitis. All personnel adhered to infectious control precautions, donning full personal protective equipment (PPE) throughout the surgery. Post-operatively, due to raised septic parameters, he was carefully diagnosed with and treated empirically for superimposed bacterial sepsis instead of cytokine release syndrome, with confirmed blood culture of Klebsiella pneumoniae. Patient was discharged well later. None of the staff involved in his care developed COVID-19 infection.
    Matched MeSH terms: Cholecystectomy
  20. Koong JK, Rajandram R, Sidambram N, Narayanan V
    Surgeon, 2021 May 08.
    PMID: 33975807 DOI: 10.1016/j.surge.2021.04.002
    BACKGROUND: Consent is an important component of surgical care. Poorly attempted consent bears significant ethical and legal implications. We assessed the effectiveness of handouts in improving postoperative consent understanding and recall compared to standard verbal consent during laparoscopic cholecystectomy as a tool that may improve information retention and leads to better treatment satisfaction.

    METHODS: This is a prospective block randomized, non-blinded study conducted at a single tertiary hospital. Patients undergoing elective laparoscopic cholecystectomy between August 2017 and October 2018 were recruited and randomized into Handout Assisted Consent (HC) and Verbal Consent (VC) group. The HC group was given an adjunct handout on laparoscopic cholecystectomy during consent process in addition to the standard verbal consent. A validated open-ended verbal understanding and recall questionnaire was administered to all patients in both groups at Day 1, 30 and 90 after surgery. Patient satisfaction of the consent process was evaluated with Likert scale.

    RESULTS: A total of 79 patients were enrolled, 41 patients and 38 patients in VC and HC groups respectively. Level of understanding among patients were equal and consistent across time in both groups (P > 0.05). There was significant decline (P  0.05).

    CONCLUSION: There is good consistent understanding of the surgery in both groups. However, recall of specific surgical consent items decreased significantly over time in both groups. Handouts may have increased satisfaction among patients but did not improve recall in this preliminary study.

    TRIAL REGISTRATION: MREC No.:201783-5468.

    Matched MeSH terms: Cholecystectomy, Laparoscopic
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