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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Updated: Sep 20, 2025

Application of Laparoscopic Ultrasonography in Primary Choledochal Suture during Combined Two-lens Surgery
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Solve study: a study to capture global variations in practices concerning laparoscopic cholecystectomy.

Matta Kuzman1, Khalid Munir Bhatti2, Islam Omar3

  • 1Health Education England North East, Newcastle upon Tyne, UK.

Surgical Endoscopy
|June 10, 2022
PubMed
Summary

This study reveals significant global variations in laparoscopic cholecystectomy practices. Surgeons worldwide differ in preoperative, perioperative, and postoperative management, highlighting a need for standardized guidelines in this common surgical procedure.

Keywords:
CholecystectomyCholecystitisGallbladder surgeryGallstone diseaseGallstone pancreatitisObstructive jaundiceVariation in practice

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Area of Science:

  • Surgical Practice
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Limited published data exists on practice variations for laparoscopic cholecystectomy.
  • Understanding these variations is crucial for improving patient care and surgical outcomes.

Purpose of the Study:

  • To document global variations in preoperative, perioperative, and postoperative practices related to laparoscopic cholecystectomy.
  • To identify areas of consensus and divergence in surgical approaches.

Main Methods:

  • A 45-item electronic survey was developed to assess practice variations.
  • The survey was distributed globally through professional surgical organizations and social media.
  • Data was collected from 638 surgeons across 70 countries.

Main Results:

  • Significant variations were observed in preoperative diagnostics, management of common bile duct stones (85.4% ERCP vs. 10.8% CBD exploration), and timing of cholecystectomy for gallstone pancreatitis (61.2%).
  • Antibiotic prophylaxis (57%) and DVT prophylaxis (70% do not use pharmacological) practices varied.
  • Techniques for pneumoperitoneum (open juxta umbilical preferred, but varied with obesity/prior laparotomy), port insertion (blunt ports preferred by 57.7%), and vessel/duct control (Liga clips and Hem-o-loks® commonly used) showed diversity.
  • Nearly all surgeons (97.4%) deemed removing stones from Hartmann's pouch important if total cholecystectomy was not feasible.

Conclusions:

  • This study underscores substantial global variations in laparoscopic cholecystectomy practices.
  • The findings highlight the need for further research and potential development of standardized protocols to optimize patient management.