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01.08.2021 | Original Article

SELSI Consensus Statement for Safe Cholecystectomy — Prevention and Management of Bile Duct Injury — Part A

verfasst von: Virinder Kumar Bansal, Mahesh C. Misra, Anil K Agarwal, JB Agrawal, PN Agarwal, Sandeep Aggarwal, Mohammad Aslam, Asuri Krishna, Aditya Baksi, Anu Behari, Hemanga K Bhattacharjee, Rajesh Bhojwani, Jagdish Chander, TK Chattopadhyay, Chintamani, Pradeep Chowbey, Abhay Dalvi, NR Dash, IK Dhawan, Shivanand Gamangatti, PK Garg, NM Gupta, Rajesh Gupta, SK Gupta, Vikas Gupta, L Kaman, BML Kapur, Kamal Kataria, Muneer Khan, Ajay K Khanna, Rajesh Khullar, Anand Kumar, Atin Kumar, Sandeep Kumar, Subodh Kumar, Pawanindra Lal, SD Maurya, GS Moirangthem, Sujoy Pal, Rajesh Panwar, Rajinder Parshad, Biju Pottakkat, Om Prakash Prajapati, Shailesh Puntambekar, Piyush Ranjan, Yashwant Singh Rathore, Peush Sahni, Rathindra Sarangi, Vuthaluru Seenu, Rajeev Sharma, VK Shukla, DP Singh, Jaspal Singh, Rajdeep Singh, Rajeev Sinha, Sadiq S Sikora, Amit Srivastava, Anurag Srivastava, KN Srivastava, Shaji Thomas, GR Verma, JD Wig, VK Kapoor

Erschienen in: Indian Journal of Surgery | Sonderheft 3/2021

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Abstract

Cholecystectomy is one of the most common general surgical operations performed worldwide. The risk of bile duct injury (BDI) during laparoscopic cholecystectomy is two to three times higher than during open cholecystectomy. The worldwide incidence of bile duct injury is 0.5% or 1 in 200 cases. BDI and its consequences result in significant morbidity and may even cause mortality; it also increases the cost of treatment and can be a common reason for medico-legal suits against the surgeons. To minimize the incidence of BDI and to manage it timely and appropriately, a set of guidelines was deemed necessary by a group of senior surgeons during a Society of Endoscopic and Laparoscopic Surgeons of India (SELSI) meeting in 2016. Guidelines for “Safe Laparoscopic Cholecystectomy” and bile duct injury management formulated by other international societies are already available. The applicability of these guidelines to Indian subjects, especially in small peripheral centers, was limited. Hence, a decision was taken to form a set of guidelines for general surgeons with basic laparoscopic skills with little or no advanced laparoscopic skills. Those working in a solo practice, nursing homes, and small private hospitals at talukas or districts should have “Safe Cholecystectomy” guidelines and management of BDI suitable to their situation. These guidelines were formed after three consensus meetings and have been approved by a SELSI Expert Group.

Shekelle PG, Woolf SH, Eccles M, Grimshaw J (1999) Developing clinical guidelines. West J Med 170:348–351PubMedPubMedCentral

Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW (1992) Laparoscopic cholecystectomy. The new “gold standard”? Arch Surg Chic Ill 1960 127:917-921-923

Barkun JS, Barkun AN, Sampalis JS et al (1992) Randomised controlled trial of laparoscopic versus mini cholecystectomy. The McGill Gallstone Treatment Group. Lancet Lond Engl 340:1116–1119CrossRef

Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D (1994) Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Br J Surg 81:1362–1365CrossRef

Okamoto K, Suzuki K, Takada T et al (2018) Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. J Hepato-Biliary-Pancreat Sci 25:55–72. https://doi.org/10.1002/jhbp.516CrossRef

Lyu Y, Cheng Y, Wang B, Zhao S, Chen L (2018) Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials. Surg Endosc 32:4728–4741. https://doi.org/10.1007/s00464-018-6400-0CrossRefPubMed

Wang A-J, Wang T-E, Lin C-C et al (2003) Clinical predictors of severe gallbladder complications in acute acalculous cholecystitis. World J Gastroenterol 9:2821–2823CrossRef

Abbas SH, Ghazanfar MA, Gordon-Weeks AN, Reddy SR, Soonawalla Z, Silva MA (2018) Acalculous cholecystitis: is an elective interval cholecystectomy necessary. Dig Surg 35:171–176. https://doi.org/10.1159/000477780CrossRefPubMed

Chung YH, Choi ER, Kim KM, Kim MJ, Lee JK, Lee KT, Lee KH, Choo SW, Do YS, Choo IW (2012) Can percutaneous cholecystostomy be a definitive management for acute acalculous cholecystitis? J Clin Gastroenterol 46:216–219. https://doi.org/10.1097/MCG.0b013e3182274375CrossRefPubMed

10.

Gu MG, Kim TN, Song J, Nam YJ, Lee JY, Park JS (2014) Risk factors and therapeutic outcomes of acute acalculous cholecystitis. Digestion 90:75–80. https://doi.org/10.1159/000362444CrossRefPubMed

11.

Soria Aledo V, Galindo Iñíguez L, Flores Funes D et al (2017) Is cholecystectomy the treatment of choice for acute acalculous cholecystitis? A systematic review of the literature. Rev Espanola Enfermedades Dig Organo Of Soc Espanola Patol Dig 109:708–718. https://doi.org/10.17235/reed.2017.4902/2017CrossRef

12.

Gurusamy KS, Davidson C, Gluud C, Davidson BR (2013) Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis. Cochrane Database Syst Rev CD005440. https://doi.org/10.1002/14651858.CD005440.pub3

13.

Yang D-J, Lu H-M, Guo Q et al (2018) Timing of laparoscopic cholecystectomy after mild biliary pancreatitis: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A 28:379–388. https://doi.org/10.1089/lap.2017.0527CrossRefPubMed

14.

Uhl W, Müller CA, Krähenbühl L, Schmid SW, Schölzel S, Büchler MW (1999) Acute gallstone pancreatitis: timing of laparoscopic cholecystectomy in mild and severe disease. Surg Endosc 13:1070–1076CrossRef

15.

Dedemadi G, Nikolopoulos M, Kalaitzopoulos I, Sgourakis G (2016) Management of patients after recovering from acute severe biliary pancreatitis. World J Gastroenterol 22:7708–7717. https://doi.org/10.3748/wjg.v22.i34.7708CrossRefPubMedPubMedCentral

16.

Marangoni G, Hakeem A, Toogood GJ, Lodge JP, Prasad KR (2012) Treatment and surveillance of polypoid lesions of the gallbladder in the United Kingdom. HPB 14:435–440. https://doi.org/10.1111/j.1477-2574.2012.00471.xCrossRefPubMedPubMedCentral

17.

Bhatt NR, Gillis A, Smoothey CO et al (2016) Evidence based management of polyps of the gall bladder: a systematic review of the risk factors of malignancy. Surg J R Coll Surg Edinb Irel 14:278–286. https://doi.org/10.1016/j.surge.2015.12.001CrossRef

18.

Chou S-C, Chen S-C, Shyr Y-M, Wang S-E (2017) Polypoid lesions of the gallbladder: analysis of 1204 patients with long-term follow-up. Surg Endosc 31:2776–2782. https://doi.org/10.1007/s00464-016-5286-yCrossRefPubMed

19.

Elmasry M, Lindop D, Dunne DFJ et al (2016) The risk of malignancy in ultrasound detected gallbladder polyps: a systematic review. Int J Surg Lond Engl 33(Pt A):28–35. https://doi.org/10.1016/j.ijsu.2016.07.061CrossRef

20.

Bansal VK, Misra MC, Rajan K, Kilambi R, Kumar S, Krishna A, Kumar A, Pandav CS, Subramaniam R, Arora MK, Garg PK (2014) Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with concomitant gallbladder stones and common bile duct stones: a randomized controlled trial. Surg Endosc 28:875–885. https://doi.org/10.1007/s00464-013-3237-4CrossRefPubMed

21.

Singh AN, Kilambi R (2018) Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and meta-analysis of randomized trials with trial sequential analysis. Surg Endosc 32:3763–3776. https://doi.org/10.1007/s00464-018-6170-8CrossRefPubMed

22.

Antoniou SA, Antoniou GA, Makridis C (2010) Laparoscopic treatment of Mirizzi syndrome: a systematic review. Surg Endosc 24:33–39. https://doi.org/10.1007/s00464-009-0520-5CrossRefPubMed

23.

Currò G, Iapichino G, Lorenzini C, Palmeri R, Cucinotta E (2006) Laparoscopic cholecystectomy in children with chronic hemolytic anemia. Is the outcome related to the timing of the procedure? Surg Endosc 20:252–255. https://doi.org/10.1007/s00464-005-0318-zCrossRefPubMed

24.

Khan ZS, Livingston EH (1960) Huerta S (2011) Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature. Arch Surg Chic Ill 146:1143–1147. https://doi.org/10.1001/archsurg.2011.257CrossRef

25.

Stephen AE, Berger DL (2001) Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 129:699–703. https://doi.org/10.1067/msy.2001.113888CrossRefPubMed

26.

Kilic A, Sheer A, Shah AS et al (2013) Outcomes of cholecystectomy in US heart transplant recipients. Ann Surg 258:312–317. https://doi.org/10.1097/SLA.0b013e318287ab27CrossRefPubMed

27.

Kao LS, Flowers C, Flum DR (2005) Prophylactic cholecystectomy in transplant patients: a decision analysis. J Gastrointest Surg Off J Soc Surg Aliment Tract 9:965–972. https://doi.org/10.1016/j.gassur.2005.04.011CrossRef

28.

Hill PA, Harris RD (2016) Clinical importance and natural history of biliary sludge in outpatients. J Ultrasound Med Off J Am Inst Ultrasound Med 35:605–610. https://doi.org/10.7863/ultra.15.05026CrossRef

29.

Lee YS, Kang BK, Hwang IK, Kim J, Hwang JH (2015) Long-term outcomes of symptomatic gallbladder sludge. J Clin Gastroenterol 49:594–598. https://doi.org/10.1097/MCG.0000000000000202CrossRefPubMed

30.

Persson GE, Thulin AJ (1991) Prevalence of gallstone disease in patients with diabetes mellitus. A case-control study. Eur J Surg Acta Chir 157:579–582

31.

Del Favero G, Caroli A, Meggiato T et al (1994) Natural history of gallstones in non-insulin-dependent diabetes mellitus. A prospective 5-year follow-up. Dig Dis Sci 39:1704–1707CrossRef

32.

Sedaghat N, Cao AM, Eslick GD, Cox MR (2017) Laparoscopic versus open cholecystectomy in pregnancy: a systematic review and meta-analysis. Surg Endosc 31:673–679. https://doi.org/10.1007/s00464-016-5019-2CrossRefPubMed

33.

Nasioudis D, Tsilimigras D, Economopoulos KP (2016) Laparoscopic cholecystectomy during pregnancy: a systematic review of 590 patients. Int J Surg Lond Engl 27:165–175. https://doi.org/10.1016/j.ijsu.2016.01.070CrossRef

34.

Muench J, Albrink M, Serafini F et al (2001) Delay in treatment of biliary disease during pregnancy increases morbidity and can be avoided with safe laparoscopic cholecystectomy. Am Surg 67(539):542–543

35.

Rollins MD, Chan KJ, Price RR (2004) Laparoscopy for appendicitis and cholelithiasis during pregnancy: a new standard of care. Surg Endosc 18:237–241. https://doi.org/10.1007/s00464-003-8811-8CrossRefPubMed

36.

Leandros E, Gomatos IP, Mami P et al (2005) Elective laparoscopic cholecystectomy for symptomatic gallstone disease in patients receiving anticoagulant therapy. J Laparoendosc Adv Surg Tech A 15:357–360. https://doi.org/10.1089/lap.2005.15.357CrossRefPubMed

37.

Ercan M, Bostanci EB, Ozer I, Ulas M, Ozogul YB, Teke Z, Akoglu M (2010) Postoperative hemorrhagic complications after elective laparoscopic cholecystectomy in patients receiving long-term anticoagulant therapy. Langenbeck's Arch Surg 395:247–253. https://doi.org/10.1007/s00423-009-0483-yCrossRef

38.

Leiva JI, Etter EL, Gathe J et al (1997) Surgical therapy for 101 patients with acquired immunodeficiency syndrome and symptomatic cholecystitis. Am J Surg 174:414–416CrossRef

39.

Ricci M, Puente AO, Rothenberg RE et al (1999) Open and laparoscopic cholecystectomy in acquired immunodeficiency syndrome: indications and results in fifty-three patients. Surgery 125:172–177CrossRef

40.

Carroll BJ, Rosenthal RJ, Phillips EH, Bonet H (1995) Complications of laparoscopic cholecystectomy in HIV and AIDS patients. Surg Endosc 9:874–878CrossRef

41.

Laurence JM, Tran PD, Richardson AJ, Pleass HC, Lam VW (2012) Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta-analysis of randomized trials. HPB 14:153–161. https://doi.org/10.1111/j.1477-2574.2011.00425.xCrossRefPubMedPubMedCentral

42.

de Goede B, Klitsie PJ, Hagen SM et al (2013) Meta-analysis of laparoscopic versus open cholecystectomy for patients with liver cirrhosis and symptomatic cholecystolithiasis. Br J Surg 100:209–216. https://doi.org/10.1002/bjs.8911CrossRefPubMed

43.

Machado NO (2012) Laparoscopic cholecystectomy in cirrhotics. JSLS 16:392–400. https://doi.org/10.4293/108680812X13462882736493CrossRefPubMedPubMedCentral

44.

Lal P, Agarwal P, Malik VK, Chakravarti A (2002) A difficult laparoscopic cholecystectomy that requires conversion to open procedure can be predicted by preoperative ultrasonography. JSLS 6:59–63PubMedPubMedCentral

45.

Liang B, Dai M, Zou Z (2016) Safety and efficacy of antibiotic prophylaxis in patients undergoing elective laparoscopic cholecystectomy: a systematic review and meta-analysis. J Gastroenterol Hepatol 31:921–928. https://doi.org/10.1111/jgh.13246CrossRefPubMed

46.

Kramp KH, van Det MJ, Totte ER, Hoff C, Pierie JP (2014) Ergonomic assessment of the French and American position for laparoscopic cholecystectomy in the MIS Suite. Surg Endosc 28:1571–1578. https://doi.org/10.1007/s00464-013-3353-1CrossRefPubMed

47.

Ahmad G, Gent D, Henderson D et al (2015) Laparoscopic entry techniques. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD006583.pub4

48.

Vilos GA, Ternamian A, Dempster J, Laberge PY (2007) Clinical Practice Gynaecology Committee. Laparoscopic entry: a review of techniques, technologies, and complications. J Obstet Gynaecol Can JOGC J Obstet Gynecol Can JOGC 29(5):433–447CrossRef

49.

Gurusamy KS, Vaughan J, Davidson BR (2014) Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy. Cochrane Database Syst Rev CD006930. https://doi.org/10.1002/14651858.CD006930.pub3

50.

Anatomy and Surgical Relevance of Rouviere’s Sulcus. https://www.hindawi.com/journals/tswj/2013/254287/abs/. Accessed 2 Jan 2019

51.

Strasberg SM, Hertl M, Soper NJ (1995) An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 180:101–125PubMed

52.

Avgerinos C, Kelgiorgi D, Touloumis Z et al (2009) One thousand laparoscopic cholecystectomies in a single surgical unit using the “critical view of safety” technique. J Gastrointest Surg Off J Soc Surg Aliment Tract 13:498–503. https://doi.org/10.1007/s11605-008-0748-8CrossRef

53.

Jiang H-P, Liu Y-D, Li Y-S et al (2017) Ultrasonic versus electrosurgical device for laparoscopic cholecystectomy: a systematic review with meta-analysis and trial sequential analysis. Int J Surg 40:24–32. https://doi.org/10.1016/j.ijsu.2017.02.020CrossRefPubMed

54.

Mangieri CW, Hendren BP, Strode MA, Bandera BC, Faler BJ (2019) Bile duct injuries (BDI) in the advanced laparoscopic cholecystectomy era. Surg Endosc 33:724–730. https://doi.org/10.1007/s00464-018-6333-7CrossRefPubMed

55.

Vadlamudi R, Conway J, Mishra G et al (2014) Identifying patients most likely to have a common bile duct stone after a positive intraoperative cholangiogram. Gastroenterol Hepatol 10:240–244

56.

Gurusamy KS, Koti R, Davidson BR (2013) Routine abdominal drainage versus no abdominal drainage for uncomplicated laparoscopic cholecystectomy. Cochrane Database Syst Rev CD006004. https://doi.org/10.1002/14651858.CD006004.pub4

57.

Nachnani J, Supe A (2005) Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroenterol Off J Indian Soc Gastroenterol 24:16–18

58.

Hussien M, Appadurai IR, Delicata RJ, Carey PD (2002) Laparoscopic cholecystectomy in the grossly obese: 4 years experience and review of literature. HPB 4:157–161. https://doi.org/10.1080/13651820260503792CrossRefPubMedPubMedCentral

59.

Akcakaya A, Okan I, Bas G, Sahin G, Sahin M (2015) Does the difficulty of laparoscopic cholecystectomy differ between genders? Indian J Surg 77:452–456. https://doi.org/10.1007/s12262-013-0872-xCrossRefPubMed

60.

Yol S, Kartal A, Vatansev C, Aksoy F, Toy H (2006) Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery. JSLS 10:359–363PubMedPubMedCentral

61.

Kartal A, Aksoy F, Vatansev C et al (2001) Does estrogen cause low conversion rates in laparoscopic cholecystectomies for acute and chronic cholecystitis in women? JSLS 5:309–312PubMedPubMedCentral

62.

Yetkin G, Uludag M, Oba S, Citgez B, Paksoy I (2009) Laparoscopic cholecystectomy in elderly patients. JSLS 13:587–591. https://doi.org/10.4293/108680809X1258998404604CrossRefPubMedPubMedCentral

63.

Hayama S, Ohtaka K, Shoji Y et al (2016) Risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis. JSLS 20. https://doi.org/10.4293/JSLS.2016.00065

64.

Pessaux P, Tuech J-J, Derouet N, Rouge C, Regenet N, Arnaud JP (2000) Laparoscopic cholecystectomy in the elderly. Surg Endosc 14:1067–1069. https://doi.org/10.1007/s004640010075CrossRefPubMed

65.

Ammori BJ, Vezakis A, Davides D et al (2001) Laparoscopic cholecystectomy in morbidly obese patients. Surg Endosc 15:1336–1339. https://doi.org/10.1007/s004640000019CrossRefPubMed

66.

da Costa DW, Schepers NJ, Bouwense SA et al (2018) Predicting a “difficult cholecystectomy” after mild gallstone pancreatitis. HPB. https://doi.org/10.1016/j.hpb.2018.10.015

67.

Sinha R (2008) Early laparoscopic cholecystectomy in acute biliary pancreatitis: the optimal choice? HPB 10:332–335. https://doi.org/10.1080/13651820802247078CrossRefPubMedPubMedCentral

68.

Bat O (2015) The analysis of 146 patients with difficult laparoscopic cholecystectomy. Int J Clin Exp Med 8:16127–16131PubMedPubMedCentral

69.

Malik A, Laghari AA, Talpur KAH, Memon A, Mallah Q, Memon JM (2007) Laparoscopic cholecystectomy in empyema of gall bladder: an experience at Liaquat University Hospital, Jamshoro, Pakistan. J Minimal Access Surg 3:52–56. https://doi.org/10.4103/0972-9941.33273CrossRef

70.

Machi J, Johnson JO, Deziel DJ, Soper NJ, Berber E, Siperstein A, Hata M, Patel A, Singh K, Arregui ME (2009) The routine use of laparoscopic ultrasound decreases bile duct injury: a multicenter study. Surg Endosc 23:384–388. https://doi.org/10.1007/s00464-008-9985-xCrossRefPubMed

71.

Santos BF, Brunt LM, Pucci MJ (2017) The difficult gallbladder: a safe approach to a dangerous problem. J Laparoendosc Adv Surg Tech 27:571–578. https://doi.org/10.1089/lap.2017.0038CrossRef

72.

Strasberg SM, Pucci MJ, Brunt LM, Deziel DJ (2016) Subtotal cholecystectomy-“fenestrating” vs “reconstituting” subtypes and the prevention of bile duct injury: definition of the optimal procedure in difficult operative conditions. J Am Coll Surg 222:89–96. https://doi.org/10.1016/j.jamcollsurg.2015.09.019CrossRefPubMed

73.

Henneman D, da Costa DW, Vrouenraets BC, van Wagensveld B, Lagarde SM (2013) Laparoscopic partial cholecystectomy for the difficult gallbladder: a systematic review. Surg Endosc 27:351–358. https://doi.org/10.1007/s00464-012-2458-2CrossRefPubMed

74.

Elshaer M, Gravante G, Thomas K et al (2015) Subtotal cholecystectomy for “difficult gallbladders”: systematic review and meta-analysis. JAMA Surg 150:159–168. https://doi.org/10.1001/jamasurg.2014.1219CrossRefPubMed

75.

Kulen F, Tihan D, Duman U, Bayam E, Zaim G (2016) Laparoscopic partial cholecystectomy: a safe and effective alternative surgical technique in difficult cholecystectomies. Ulus Cerrahi Derg 32:185–190. https://doi.org/10.5152/UCD.2015.3086CrossRefPubMedPubMedCentral

76.

Kelly MD (2009) Laparoscopic retrograde (fundus first) cholecystectomy. BMC Surg 9:19. https://doi.org/10.1186/1471-2482-9-19CrossRefPubMedPubMedCentral

77.

Gupta A, Agarwal PN, Kant R, Malik V (2004) Evaluation of fundus-first laparoscopic cholecystectomy. JSLS 8:255–258PubMedPubMedCentral

78.

Mahmud S, Masaud M, Canna K, Nassar AHM (2002) Fundus-first laparoscopic cholecystectomy. Surg Endosc 16:581–584. https://doi.org/10.1007/s00464-001-9094-6CrossRefPubMed

79.

Strasberg SM, Gouma DJ (2012) “Extreme” vasculobiliary injuries: association with fundus-down cholecystectomy in severely inflamed gallbladders. HPB 14:1–8. https://doi.org/10.1111/j.1477-2574.2011.00393.xCrossRefPubMedPubMedCentral

80.

Ali A, Saeed S, Khawaja R et al (2016) Difficulties in laparoscopic cholecystectomy: conversion versus surgeon’s failure. J Ayub Med Coll Abbottabad JAMC 28:669–671PubMed

81.

Becker CD, Hassler H, Terrier F (1984) Preoperative diagnosis of the Mirizzi syndrome: limitations of sonography and computed tomography. AJR Am J Roentgenol 143:591–596. https://doi.org/10.2214/ajr.143.3.591CrossRefPubMed

82.

Choi BW, Kim MJ, Chung JJ, Chung JB, Yoo HS, Lee JT (2000) Radiologic findings of Mirizzi syndrome with emphasis on MRI. Yonsei Med J 41:144–146. https://doi.org/10.3349/ymj.2000.41.1.144CrossRefPubMed

83.

Yip AW, Chow WC, Chan J, Lam KH (1992) Mirizzi syndrome with cholecystocholedochal fistula: preoperative diagnosis and management. Surgery 111:335–338PubMed

84.

Kapoor VK (2010) Safe cholecystectomy A to Z. Lucknow: Shubham book distributors

Titel: SELSI Consensus Statement for Safe Cholecystectomy — Prevention and Management of Bile Duct Injury — Part A
verfasst von: Virinder Kumar Bansal
Mahesh C. Misra
Anil K Agarwal
JB Agrawal
PN Agarwal
Sandeep Aggarwal
Mohammad Aslam
Asuri Krishna
Aditya Baksi
Anu Behari
Hemanga K Bhattacharjee
Rajesh Bhojwani
Jagdish Chander
TK Chattopadhyay
Chintamani
Pradeep Chowbey
Abhay Dalvi
NR Dash
IK Dhawan
Shivanand Gamangatti
PK Garg
NM Gupta
Rajesh Gupta
SK Gupta
Vikas Gupta
L Kaman
BML Kapur
Kamal Kataria
Muneer Khan
Ajay K Khanna
Rajesh Khullar
Anand Kumar
Atin Kumar
Sandeep Kumar
Subodh Kumar
Pawanindra Lal
SD Maurya
GS Moirangthem
Sujoy Pal
Rajesh Panwar
Rajinder Parshad
Biju Pottakkat
Om Prakash Prajapati
Shailesh Puntambekar
Piyush Ranjan
Yashwant Singh Rathore
Peush Sahni
Rathindra Sarangi
Vuthaluru Seenu
Rajeev Sharma
VK Shukla
DP Singh
Jaspal Singh
Rajdeep Singh
Rajeev Sinha
Sadiq S Sikora
Amit Srivastava
Anurag Srivastava
KN Srivastava
Shaji Thomas
GR Verma
JD Wig
VK Kapoor
Publikationsdatum: 01.08.2021
Verlag: Springer India
Erschienen in: Indian Journal of Surgery / Ausgabe Sonderheft 3/2021
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI: https://doi.org/10.1007/s12262-019-01993-2

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Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

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