Laparoscopic cholecystectomy has become a standard treatment of symptomatic gallstone disease. Although spilled gallstones are considered harmless, unretrieved gallstones can result in intra-abdominal abscess. We repo...Laparoscopic cholecystectomy has become a standard treatment of symptomatic gallstone disease. Although spilled gallstones are considered harmless, unretrieved gallstones can result in intra-abdominal abscess. We report a case of abscess formation due to spilled gallstones after laparoscopic cholecystectomy mimicking a retroperitoneal sarcoma on radiologic imaging. A 59-year-old male with a surgical history of a laparoscopic cholecystectomy complicated by gallstones spillage presented with a 1 mo history of constant right-sided abdominal pain and tenderness. Computed tomography and magnetic resonance imaging demonstrated a retroperitoneal sarcoma at the sub-hepatic space. On open exploration a 5 cm × 5 cm retroperitoneal mass was excised. The mass contained purulent material and gallstones. Final pathology revealed abscess formation and foreign body granuloma. Vigilance concerning the possibility of lost gallstones during laparoscopic cholecystectomy is important. If possible, every spilled gallstone during surgery should be retrieved to prevent this rare complication.展开更多
目的探索阑尾炎术中腹腔冲洗在治疗小儿阑尾炎中的临床疗效。方法通过计算机检索PubMed、Cochrane Library、Embase、Web of Science、知网、中国生物医学数据库、维普及万方等数据库中关于小儿阑尾炎术中是否进行腹腔冲洗的随机对照试...目的探索阑尾炎术中腹腔冲洗在治疗小儿阑尾炎中的临床疗效。方法通过计算机检索PubMed、Cochrane Library、Embase、Web of Science、知网、中国生物医学数据库、维普及万方等数据库中关于小儿阑尾炎术中是否进行腹腔冲洗的随机对照试验(RCT)和病例对照研究(CCS)的相关文献,筛选文献后采用Cochrane风险偏倚评估工具及NOS评估量表进行文献质量评价,并提取文献数据,采用RevMan 5.3软件进行Meta分析。结果共纳入15篇文献(6个RCT和9个CCS),包括5870例患儿。Meta分析结果显示腹腔冲洗组平均手术时间较未冲洗组长[MD=6.76,95%CI(4.64,8.87),P<0.00001],两组间差异具有统计学意义。腹腔冲洗组与未行腹腔冲洗组相比,术后并发症方面:腹腔脓肿发生率[OR=0.71,95%CI(0.45,1.12),P=0.14]、切口感染率[OR=0.55,95%CI(0.25,1.21),P=0.14]、粘连性肠梗阻发生率[OR=1.41,95%CI(0.48,4.17),P=0.53]和住院时间[MD=-0.69,95%CI(-1.90,0.52),P=0.27]在两组间差异无统计学意义。腹腔脓肿按不同冲洗物进行亚组分析发现生理盐水冲洗组[OR=0.59,95%CI(0.31,1.11),P=0.10]、聚维酮碘冲洗组[OR=0.63,95%CI(0.27,1.48),P=0.28]及抗生素溶液冲洗组[OR=1.28,95%CI(0.81,2.03),P=0.28]在两组间差异无统计学意义。敏感性分析结果显示:切口感染发生率的结果稳定性一般。结论小儿阑尾切除术中进行腹腔冲洗并不能降低术后腹腔脓肿、粘连性肠梗阻的发生率,反而增加了手术时间,而腹腔冲洗对切口感染率的影响尚待进一步研究。展开更多
We report the case of a 77-year-old male who came to the emergency department with epigastric pain accompanied by fever and chills. After the diagnosis of intra-abdominal abscess and gastric tumor, emergency surgery w...We report the case of a 77-year-old male who came to the emergency department with epigastric pain accompanied by fever and chills. After the diagnosis of intra-abdominal abscess and gastric tumor, emergency surgery was performed with resection of the tumor and abscess drainage. The patient had a good postoperative course.展开更多
Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of ...Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of EUS-guided drainage of postoperative intra-abdominal abscesses.Here we report our experience with 4 cases of postoperative intraabdominal abscesses for which EUS-guided drainage was performed between May 2011 and May 2014.Distal pancreatectomy had been performed in 3 cases,whereas low anterior resection for rectal cancer was performed in the remaining case.All patients underwent transgastric naso-cystic drainage,which resulted in clinical improvement without complications,even when performed within 4 wk after surgery.On average,the naso-cystic drain was removed 10 d after placement,with no abscess recurrence.Based on these findings,we believe that EUS-guided drainage of postoperative intraabdominal abscesses is a safe and effective method,although further large-scale investigations are required to confirm our findings.展开更多
文摘Laparoscopic cholecystectomy has become a standard treatment of symptomatic gallstone disease. Although spilled gallstones are considered harmless, unretrieved gallstones can result in intra-abdominal abscess. We report a case of abscess formation due to spilled gallstones after laparoscopic cholecystectomy mimicking a retroperitoneal sarcoma on radiologic imaging. A 59-year-old male with a surgical history of a laparoscopic cholecystectomy complicated by gallstones spillage presented with a 1 mo history of constant right-sided abdominal pain and tenderness. Computed tomography and magnetic resonance imaging demonstrated a retroperitoneal sarcoma at the sub-hepatic space. On open exploration a 5 cm × 5 cm retroperitoneal mass was excised. The mass contained purulent material and gallstones. Final pathology revealed abscess formation and foreign body granuloma. Vigilance concerning the possibility of lost gallstones during laparoscopic cholecystectomy is important. If possible, every spilled gallstone during surgery should be retrieved to prevent this rare complication.
文摘目的探索阑尾炎术中腹腔冲洗在治疗小儿阑尾炎中的临床疗效。方法通过计算机检索PubMed、Cochrane Library、Embase、Web of Science、知网、中国生物医学数据库、维普及万方等数据库中关于小儿阑尾炎术中是否进行腹腔冲洗的随机对照试验(RCT)和病例对照研究(CCS)的相关文献,筛选文献后采用Cochrane风险偏倚评估工具及NOS评估量表进行文献质量评价,并提取文献数据,采用RevMan 5.3软件进行Meta分析。结果共纳入15篇文献(6个RCT和9个CCS),包括5870例患儿。Meta分析结果显示腹腔冲洗组平均手术时间较未冲洗组长[MD=6.76,95%CI(4.64,8.87),P<0.00001],两组间差异具有统计学意义。腹腔冲洗组与未行腹腔冲洗组相比,术后并发症方面:腹腔脓肿发生率[OR=0.71,95%CI(0.45,1.12),P=0.14]、切口感染率[OR=0.55,95%CI(0.25,1.21),P=0.14]、粘连性肠梗阻发生率[OR=1.41,95%CI(0.48,4.17),P=0.53]和住院时间[MD=-0.69,95%CI(-1.90,0.52),P=0.27]在两组间差异无统计学意义。腹腔脓肿按不同冲洗物进行亚组分析发现生理盐水冲洗组[OR=0.59,95%CI(0.31,1.11),P=0.10]、聚维酮碘冲洗组[OR=0.63,95%CI(0.27,1.48),P=0.28]及抗生素溶液冲洗组[OR=1.28,95%CI(0.81,2.03),P=0.28]在两组间差异无统计学意义。敏感性分析结果显示:切口感染发生率的结果稳定性一般。结论小儿阑尾切除术中进行腹腔冲洗并不能降低术后腹腔脓肿、粘连性肠梗阻的发生率,反而增加了手术时间,而腹腔冲洗对切口感染率的影响尚待进一步研究。
文摘We report the case of a 77-year-old male who came to the emergency department with epigastric pain accompanied by fever and chills. After the diagnosis of intra-abdominal abscess and gastric tumor, emergency surgery was performed with resection of the tumor and abscess drainage. The patient had a good postoperative course.
文摘Although endoscopic ultrasound(EUS)-guided drainage has become the standard procedure for pancreatic pseudocysts in recent years and is generally regarded as a safe and effective method,there have been few reports of EUS-guided drainage of postoperative intra-abdominal abscesses.Here we report our experience with 4 cases of postoperative intraabdominal abscesses for which EUS-guided drainage was performed between May 2011 and May 2014.Distal pancreatectomy had been performed in 3 cases,whereas low anterior resection for rectal cancer was performed in the remaining case.All patients underwent transgastric naso-cystic drainage,which resulted in clinical improvement without complications,even when performed within 4 wk after surgery.On average,the naso-cystic drain was removed 10 d after placement,with no abscess recurrence.Based on these findings,we believe that EUS-guided drainage of postoperative intraabdominal abscesses is a safe and effective method,although further large-scale investigations are required to confirm our findings.
