Surgical endoscopy
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Randomized Controlled Trial Multicenter Study
Improved outcome after laparoscopic cholecystectomy with ultrasonic dissection: a randomized multicenter trial.
In conventional laparoscopic cholecystectomy, dissection with electrocautery starts at the triangle of Calot. In a randomized single-center trial, the fundus-first method (dome down) using ultrasonic dissection was faster, involved less pain or nausea, and had a shorter postoperative sick leave. This may relate to the fundus-first method or to the ultrasonic dissection. ⋯ The fundus-first method using ultrasonic dissection is associated with less blood loss, fewer gallbladder perforations, less pain and nausea, and shorter sick leave than the conventional and fundus-first method using electrocautery. The difference seems related to the use of ultrasonic dissection.
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Randomized Controlled Trial
Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy.
Dexamethasone has antiemetic and analgesic effects for various types of surgery. The efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirement has never been evaluated for patients undergoing laparoscopic cholecystectomy (LC). ⋯ Prophylactic therapy with dexamethasone 8 mg is effective in reducing PONV and analgesic requirement for patients undergoing LC.