Acute Kidney Injury Following Conversion From Laparoscopic to Open Cholecystectomy
Bibliographic record
Abstract
Pneumoperitoneum during laparoscopic surgery is a complex physiologic event associated with neuroendocrine, respiratory, cardiovascular and renal disturbances as well as compromised organ blood flow. Impaired renal perfusion from pneumoperitoneum is attributed to intra-abdominal hypertension. Several mechanisms contribute to acute kidney injury (AKI) in such patients, including renal vein compression with impairment of the venous drainage. Renal artery vasoconstriction induced by the neuro-hormonal systems worsens outcomes. The final result is progressive reduction in both glomerular perfusion and urine output. We present a case of 58-year-old man who underwent open cholecystectomy following a failed laparoscopic cholecystectomy attempt. Postoperatively, he developed AKI. This was attributed to pneumoperitoneum, an essential part of the laparoscopic procedure. This case illustrates that even when there are no obvious risk factors for postoperative complications, a high index of suspicion should be maintained for early recognition and treatment of complications from this surgery. J Med Cases. 2016;7(6):220-222 doi: http://dx.doi.org/10.14740/jmc2483w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".