TITLE

Abdominal Aortic Aneurysmorrhaphy and Cholelitiasis in the Era of Endovascular Surgery

AUTHOR(S)
Cadot, Hadley; Addis, Michael D.; Faries, Peter L.; Carroccio, Alfio; Burks Jr., James A.; Gravereaux, Edwin C.; Morrissey, Nicholas J.; Teodorescu, Victoria; Sparacino, Salvatorre; Hollier, Larry H.; Marin, Michael L.
PUB. DATE
October 2002
SOURCE
American Surgeon;Oct2002, Vol. 68 Issue 10, p839
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The incidence of acute cholecystitis complicating standard abdominal aortic aneurysm (AAA) repair has been reported between 0.3 and 18 per cent. This has prompted considerable debate regarding the management of cholelithiasis discovered incidentally during open aortic reconstruction. This study seeks to determine the incidence of cholelithiasis and acute cholecystitis after endovascular AAA repair and evaluate options for management. Between February 1996 and October 2001 492 patients underwent endovascular AAA repair. All the procedures were performed in the operating room under fluoroscopic guidance. Epidural (98.9%), local (0.5%), or general (1.7%) anesthesia was used during these cases. The incidence of cholelithiasis and acute cholecystitis was evaluated by CT scan and abdominal ultrasound. Serum measurements of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total and direct bilirubin, and amylase were performed and clinical assessment was conducted at 1, 6, and 12 months postoperatively and annually thereafter. The mean age of these patients was 76.6 years; 84% were male. Comorbid medical conditions were present in all patients (average 3.5 conditions/patient). Follow-up ranged from 2 to 35 months (mean 12.8 months). Endovascular stent graft deployment was successful in 486 of the 492 patients (98.8%). Six patients were converted to standard open repair because of inability to achieve successful endovascular aneurysm repair. The perioperative major morbidity rate was 14.9 per cent. Minor morbidity rate was 8.5 per cent. The perioperative mortality rate was 1.9 per cent. No deaths were related to biliary disease. Cholelithiasis was identified in 64 (13%) patients preoperatively. One of 64 patients with a prior Billroth II reconstruction for peptic ulcer disease developed jaundice 8 days after AAA repair as a result of choledocholithiasis that required surgical repair. One patient without gallstones developed acute acalculous...
ACCESSION #
7743895

 

Related Articles

  • Laparoscopic cholecystectomy in gallstone patients with acute cholecystitis. Isoda, Norio; Ido, Kenichi; Kawamoto, Chiaki; Suzuki, Takanori; Nagamine, Nobuhiko; Ono, Kazunori; Sato, Yoshiaki; Kaneko, Yoshinari; Kumagai, Machio; Kimura, Ken; Sugano, Kentaro; Isoda, N; Ido, K; Kawamoto, C; Suzuki, T; Nagamine, N; Ono, K; Sato, Y; Kaneko, Y; Kumagai, M // Journal of Gastroenterology;1999, Vol. 34 Issue 3, p372 

    It remains controversial whether patients with gallstones with acute cholecystitis should be operated on early, or whether surgery should be delayed until the acute phase subsides. To help resolve this question, we retrospectively studied 109 patients with acute cholecystitis, 56 of whom...

  • An Acute Care Surgery Model Improves Timeliness of Care and Reduces Hospital Stay for Patients with Acute Cholecystitis. LAU, BRIANA; DIFRONZO, L. ANDREW // American Surgeon;Oct2011, Vol. 77 Issue 10, p1318 

    In October 2009, an acute care surgery (ACS) model was implemented to facilitate urgent surgical consults. This study examines the impact of ACS on the timeliness of care and length of hospitalization for patients with acute cholecystitis. A retrospective cohort study was performed of patients...

  • Duplicate gallbladder: an unusual case report. Singh, B.; Ramsaroop, L.; Allopi, L.; Moodley, J.; Satyapal, K. // Surgical & Radiologic Anatomy;Dec2006, Vol. 28 Issue 6, p654 

    Duplication of the gallbladder, a rare congenital anomaly, is important in clinical practice as it may cause some clinical, surgical and diagnostic problems. In this report we present a case of duplicated gallbladder diagnosed serendipitously in a 63-year-old male patient who had previously...

  • Cholecystitis and cholelithiasis in adults in Zaria. Dauda, M. M.; Yusufu, L. M. D.; Attah, M. M. // Tropical Doctor;Oct2005, Vol. 35 Issue 4, p243 

    The article cites a study which highlights the pattern of gall bladder disease in Zaria, Nigeria over a 20-year period. Here, the author undertook a retrospective analysis of all patients who underwent surgery for gall bladder disease such as cholecystitis and cholelithiasis at the Ahmadu Bello...

  • Gallstones. Dhami, Sangeeta; Sheikh, Aziz // GP: General Practitioner;4/8/2002, p58 

    Presents information related to gallstones in Great Britain. Symptoms associated with acute cholecystitis; Differential diagnosis of having a peptic ulcer disease; Effectiveness of laparoscopic surgery in treating the condition.

  • Przetoka pÄ™cherzykowo-skórna w przebiegu nieleczonego przewlekÅ‚ego kamiczego zapalenia pÄ™cherzyka żółciowego -- opis przypadku. Żmudzki, Jakub; Orawczyk, Tomasz; Bolkowski, Tomasz; Kazibudzki, Marek // Polish Surgery / Chirurgia Polska;2009, Vol. 11 Issue 2, p75 

    Cholecystocutaneous fistula is a rare complication of chronic calculus cholecystitis. The article presents a 73-year old patient with cholecystocutaneous fistula and abscess in the right costal arch. The abscess contained gallstones. We present a diagnostic and performed surgical treatment.

  • cholecystectomy. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p168 

    An encyclopedia entry for "cholecystectomy" is presented. It is a procedure that surgically removes the gallbladder. The procedure is usually performed to deal with the presence of troublesome gallstones as well as cases of acute cholecystitis. It is also an emergency treatment for rupture of...

  • Recurrent Gallstone Complications Whilst Awaiting Cholecystectomy. Wallace, W.; Mulholland, K.; Taylor, L.; Walls, S.; Dolan, S. // European Surgical Research;May/Jun2004 Supplement 1, Vol. 36, p92 

    This article focuses on a study related to recurrent gallstone complications whilst awaiting cholecystectomy. Cholecystectomy is recommended either urgently or 6-8 weeks following conservative management of cholecystitis. However, in many units, timing of surgery is often determined by waiting...

  • A New Strategy of Minimally Invasive Surgery for Cholecystolithiasis: Calculi Removal and Gallbladder Preservation. Tan, Yu-Yan; Zhao, Gang; Wang, Dong; Wang, Jing-Min; Tang, Jie-Rong; Ji, Zhen-Ling // Digestive Surgery;Mar2014, Vol. 30 Issue 4-6, p466 

    Background: Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics