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Kurtulus I, Culcu OD, Degerli MS. Which Is More Effective: Laparoscopic or Open Partial Cholecystectomy? J Laparoendosc Adv Surg Tech A 2021; 32:476-484. [PMID: 34314632 DOI: 10.1089/lap.2021.0300] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: In laparoscopic cholecystectomy, partial cholecystectomy is usually preferred when the anatomic exploration is not enough to prevent bile duct injury and other complications. Some surgeons choose laparoscopically to perform partial cholecystectomy, whereas others convert to open surgery. In this study, we aim to discuss and compare the effectiveness of laparoscopic partial cholecystectomy (LPC) and open partial cholecystectomy (OPC). Materials and Methods: The data of 4712 patients who underwent laparoscopic cholecystectomy between 2012 and 2020 were reviewed. A total of 98 patients who had partial cholecystectomy were included in the study. Patients were examined in two groups according to whether the procedure was open or laparoscopic. The first group of patients was named the OPC group (n = 52), and the second group of patients was the LPC group (n = 46). The data of the two groups were comparatively analyzed. Results: The mean operative time and the postoperative hospital stay, respectively, were 118.2 minutes and 4.8 days in the OPC group, and 87.3 minutes and 2.55 days in the LPC group (P < .005 and P = .005). It was found that wound infection decreased by 83.1% (P = .026; odds ratio [OR] = 0.169) in the LPC group compared with the OPC group, and the probability of developing incisional hernia decreased by 81.1% (P = .014; OR = 0.189). At least one complication was observed in 17 patients in the OPC group and in 7 patients in the LPC group (P = .045). The probability of developing complications in any patient was 63% lower in the LPC group (P = .049; OR = 0.370). Conclusions: The indications that cause the surgeon to perform partial cholecystectomy are inherently open to complications, regardless of the surgical technique used. However, the laparoscopic operation has advantages such as shorter operation time, shorter postoperative hospital stay, lower risk of wound infection and incisional hernia rate, and lower complication rate than the open procedure. However, if the team performing the surgery does not have enough experience, they should never hesitate to switch to open cholecystectomy.
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Affiliation(s)
- Idris Kurtulus
- Department of General Surgery, Basaksehir State Hospital, Istanbul, Turkey
| | - Osman Deniz Culcu
- Department of General Surgery, Basaksehir State Hospital, Istanbul, Turkey
| | - Mahmut Said Degerli
- Department of General Surgery, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Kulen F, Tihan D, Duman U, Bayam E, Zaim G. Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies". Turk J Surg 2016; 32:185-90. [PMID: 27528821 PMCID: PMC4970776 DOI: 10.5152/ucd.2015.3086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/16/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Laparoscopic cholecystectomy has become the "gold standard" for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. MATERIAL AND METHODS The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. RESULTS The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. CONCLUSION LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.
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Affiliation(s)
- Fatih Kulen
- Clinic of General Surgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Deniz Tihan
- Clinic of General Surgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Uğur Duman
- Clinic of General Surgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Emrah Bayam
- Clinic of General Surgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
| | - Gökhan Zaim
- Clinic of General Surgery, Şevket Yılmaz Training and Research Hospital, Bursa, Turkey
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Mir IS, Mohsin M, Majid T, Wani K, Mehmood-ul-Hasan, Kirmani O, Naqshbandi J, Maqbool M. Laparoscopic cholecystectomy in a small rural hospital in Kashmir Valley, India. Trop Doct 2008; 38:213-6. [PMID: 18820185 DOI: 10.1258/td.2007.070277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study evaluates the feasibility of performing laparoscopic cholecystectomy in order to reduce the expenditure in a 28-bed sub-district hospital in Kashmir, India. We report on a prospective clinical trail involving patients with gall bladder disease reported to the hospital from June 2005 till May 2007.
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Affiliation(s)
- Iqbal Saleem Mir
- Minimal Access Surgery Unit, Government Gousia Hospital, Srinagar, Kashmir.
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Mir IS, Mohsin M, Kirmani O, Majid T, Wani K, Hassan MU, Naqshbandi J, Maqbool M. Is intra-operative cholangiography necessary during laparoscopic cholecystectomy? A multicentre rural experience from a developing world country. World J Gastroenterol 2007; 13:4493-7. [PMID: 17724807 PMCID: PMC4611584 DOI: 10.3748/wjg.v13.i33.4493] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the feasibility and safety of performing laparoscopic cholecystectomy (LC) in non-teaching rural hospitals of a developing country without intra-operative cholangiography (IOC). To evaluate the possibility of reduction of costs and hospital stay for patients undergoing LC.
METHODS: A prospective analysis of patients with symptomatic benign diseases of gall bladder undergoing LC in three non-teaching rural hospitals of Kashmir Valley from Jan 2001 to Jan 2007. The cohort represented a sample of patients requiring LC, aged 13 to 78 (mean 47.2) years. Main outcome parameters included mortality, complications, re-operation, conversion to open procedure without resorting to IOC, reduction in costs borne by the hospital, and the duration of hospital stay.
RESULTS: Twelve hundred and sixty-seven patients (976 females/291 males) underwent laparoscopic cholecystectomy. Twenty-three cases were converted to open procedures; 12 patients developed port site infection, nobody died because of the procedure. One patient had common bile duct (CBD) injury, 4 patients had biliary leak, and 4 patients had subcutaneous emphysema. One cholecystohepatic duct was detected and managed intraoperatively, 1 patient had retained CBD stones, while 1 patient had retained cystic duct stones. Incidental gallbladder malignancy was detected in 2 cases. No long-term complications were detected up to now.
CONCLUSION: LC can be performed safely even in non-teaching rural hospitals of a developing country provided proper equipment is available and the surgeons and other team members are well trained in the procedure. It is stressed that IOC is not essential to prevent biliary tract injuries and missed CBD stones. The costs to the patient and the hospital can be minimized by using reusable instruments, intracorporeal sutures, and condoms instead of titanium clips and endobags.
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Affiliation(s)
- Iqbal Saleem Mir
- Minimal Access Surgery Unit, Government Gousia Hospital, Khanyar, Kashmir, India.
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5
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REY S, YAMAKAWA T, KANO N, ISHIKAWA Y, HAKEEM R, SHA M, KOISHI K. Laparoscopic Cholecystectomy: Treatment o Choice in Elderly Patients. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1995.tb00386.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Samuel REY
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Tatsuo YAMAKAWA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Nobuyasu KANO
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Yasuro ISHIKAWA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Rachit HAKEEM
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Muneyaso SHA
- Department of Anesthesiology, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Keiko KOISHI
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
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Vagenas K, Karamanakos SN, Spyropoulos C, Panagiotopoulos S, Karanikolas M, Stavropoulos M. Laparoscopic cholecystectomy: a report from a single center. World J Gastroenterol 2006; 12:3887-90. [PMID: 16804976 PMCID: PMC4087939 DOI: 10.3748/wjg.v12.i24.3887] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Revised: 01/06/2006] [Accepted: 01/14/2006] [Indexed: 02/06/2023] Open
Abstract
AIM To review and evaluate our experience in laparoscopic cholecystectomy. METHODS A retrospective analysis was performed on data collected during a 13-year period (1992-2005) from 1220 patients who underwent laparoscopic cholecystectomy. RESULTS Mortality rate was 0%. The overall morbidity rate was 5.08% (n = 62), with the most serious complications arising from injuries to the biliary tree and the cystic artery. In 23 (1.88%) cases, cholecystectomy could not be completed laparoscopically and the operation was converted to an open procedure. Though the patients were scheduled as day-surgery cases, the average duration of hospital stay was 2.29 d, as the complicated cases with prolonged hospital stay were included in the calculation. CONCLUSION Laparoscopic cholecystectomy is a safe, minimally invasive technique with favorable results for the patient.
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Affiliation(s)
- Konstantinos Vagenas
- Department of Surgery, School of Medicine, University of Patras, Rion University Hospital, Greece.
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7
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Schmitz R, Rohde V, Treckmann J, Shah S. Randomized clinical trial of conventional cholecystectomy versus
minicholecystectomy. Br J Surg 2005. [DOI: 10.1046/j.1365-2168.1997.02814.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bueno Lledó J, Serralta Serra A, Planells Roig M, Rodero Rodero D. Colecistectomía laparoscópica en el paciente anciano. Cir Esp 2002. [DOI: 10.1016/s0009-739x(02)72042-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Tham TC, Carr-Locke DL. Endoscopic treatment of bile duct stones in elderly people. BMJ (CLINICAL RESEARCH ED.) 1999; 318:617-8. [PMID: 10066182 PMCID: PMC1115071 DOI: 10.1136/bmj.318.7184.617] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Popken F, Nassir F, Küchle R, Heintz A, Junginger T. Cholecystectomy in high-risk patients: A comparison between open cholecystectomy and laparoscopic cholecystectomy. MINIM INVASIV THER 1998. [DOI: 10.3109/13645709809152879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Schmitz R, Rohde V, Treckmann J, Shah S. Randomized clinical trial of conventional cholecystectomyversus minicholecystectomy. Br J Surg 1997. [DOI: 10.1002/bjs.1800841211] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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12
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Ahmad SA, Schuricht AL, Azurin DJ, Arroyo LR, Paskin DL, Bar AH, Kirkland ML. Complications of laparoscopic cholecystectomy: the experience of a university-affiliated teaching hospital. J Laparoendosc Adv Surg Tech A 1997; 7:29-35. [PMID: 9453862 DOI: 10.1089/lap.1997.7.29] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In most published reports on laparoscopic cholecystectomy, the cases have been accrued from small community hospitals in a multicenter fashion. The purpose of this study was to compare the rate of complication following laparoscopic cholecystectomy performed at a single university-affiliated teaching hospital to those quoted in the literature. STUDY DESIGN A retrospective review of the first 1300 laparoscopic cholecystectomies performed at the Videoscopic Surgery Center at Pennsylvania Hospital from May 1990 through January 1994 was undertaken. Complications were classified as those related to creation of the initial pneumoperitoneum and those related to cholecystectomy. RESULTS A 3% conversion rate to open cholecystectomy (n = 40) was noted due to the presence of dense adhesions, gangrenous cholecystitis, or difficult anatomic relationships. There were 18 complications (1.4%) related to creation of the initial pneumoperitoneum and 14 complications (1.1%) related to cholecystectomy. Complications related to laparoscopy included bleeding from the abdominal wall (n = 2), trocar site hernia (n = 11), hollow viscus injury (n = 1), and wound infection (n = 4). Complications related to cholecystectomy included unanticipated retained CBD stone (n = 5), symptomatic bile leak (n = 6), hollow viscus injury (n = 1), intraabdominal abscess (n = 1), and a retained portion of gallbladder (n = 1). There were no perioperative deaths related to laparoscopic cholecystectomy, and the overall morbidity was 2.4%. Long-term follow-up revealed no cases of benign biliary strictures. CONCLUSIONS With attention to anatomy, technique, and meticulous dissection, laparoscopic cholecystectomy can be safely performed in a university-affiliated teaching hospital setting.
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Affiliation(s)
- S A Ahmad
- Department of Surgery, Pennsylvania Hospital, Philadelphia 19107, USA
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Sharma KC, Kabinoff G, Ducheine Y, Tierney J, Brandstetter RD. Laparoscopic surgery and its potential for medical complications. Heart Lung 1997; 26:52-64; quiz 65-7. [PMID: 9013221 DOI: 10.1016/s0147-9563(97)90009-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Laparoscopic surgery is very popular among physicians and patients because this technique is associated with safety, shorter hospital stay, early return to normal activity, and cosmetic acceptance of the operative scar. Although the procedure involves minimal invasion and tissue damage, it has potentially serious complications, including cardiopulmonary effects that result mainly from hypercarbia and raised intraabdominal pressure caused by pneumoperitoneum. Absorbed carbon dioxide from the peritoneal cavity tends to cause acidosis. Leakage of the gas into tissue spaces may induce subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium. Cardiac effects include arrhythmias, hypotension, cardiac arrest, gas embolism, pulmonary edema, and myocardial ischemia or infarction. Some of these effects, though rare, are serious and potentially fatal. Physicians should anticipate these problems in their patients undergoing laparoscopic procedures. This review discusses the technique of and physiologic considerations in laparoscopic surgery as well as its potential complications.
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Affiliation(s)
- K C Sharma
- Department of Medicine, New Rochelle Hospital Medical Center, Valhalla, USA
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Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg 1996; 224:609-20. [PMID: 8916876 PMCID: PMC1235438 DOI: 10.1097/00000658-199611000-00005] [Citation(s) in RCA: 255] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to perform a meta-analysis of large laparoscopic cholecystectomy case-series and compare results concerning complications, particularly bile duct injury, to those reported in open cholecystectomy case-series. SUMMARY BACKGROUND DATA Since the introduction of laparoscopic cholecystectomy in the United States, hundreds of reports about the technique have been published, many including statements about the advantages of laparoscopic cholecystectomy compared with those of open cholecystectomy. There is an unevenness in scope and quality of the studies. Nevertheless, enough data have accumulated from large series to permit analyses of data regarding some of the most important issues. METHODS Articles identified via a MEDLINE (the National Library of Medicine's computerized database) search were evaluated according to standard criteria. Data regarding the patient sample, study methods, and outcomes of cholecystectomy were abstracted and summarized across studies. RESULTS Outcomes of laparoscopic cholecystectomy are examined for 78,747 patients reported on in 98 studies and compared with outcomes of open cholecystectomy for 12,973 patients reported on in 28 studies. Laparoscopic cholecystectomy appears to have a higher common bile duct injury rate and a lower mortality rate. Estimated rates of other types of complications after laparoscopic cholecystectomy generally were low. Most conversions followed operative discoveries (e.g., dense adhesions) and were not the result of injury. CONCLUSIONS There is wide variability in the amount and type of data reported within any single study, and patient populations may not be comparable across studies. Except for a higher common bile duct injury rate, laparoscopic cholecystectomy appears to be at least as safe a procedure as that of open cholecystectomy.
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Affiliation(s)
- J A Shea
- Division of General Internal Medicine, University of Pennsylvania, Philadelphia, USA
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Buanes T, Mjåland O. Complications in laparoscopic and open cholecystectomy: a prospective comparative trial. SURGICAL LAPAROSCOPY & ENDOSCOPY 1996; 6:266-272. [PMID: 8840447 DOI: 10.1097/00019509-199608000-00004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Laparoscopic cholecystectomy (n = 250) was compared with the open procedure (n = 250) in a prospective comparative study focusing on complications. Severity grade was classified according to the Toronto system. The frequency of severity grade 1 complications was equal after open and laparoscopic cholecystectomy (5.6%), but major complications (grade 2 and higher) were significantly more frequent in the open group (10.4 versus 3.6%). The only postoperative death occurred after open cholecystectomy. The conventional advantages of laparoscopic cholecystectomy were also verified: The need for postoperative analgesics was significantly reduced from 7 (range, 4-16) standard opiate doses in the open group to 3 (range, 0-7) in the laparoscopic group. Hospital stay was reduced from 6 (range, 4-31) days after open surgery to 2 (range, 1-7) days after laparoscopic surgery and sick leave from 28 (range, 18-48) to 10 (range, 2-21) days, respectively. The overall complication rate was significantly higher in the open group (16 versus 9%, p < 0.01). In our hands, laparoscopic cholecystectomy carries a lower risk of serious complications than the open procedure.
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Affiliation(s)
- T Buanes
- Surgical Department, Ullevaal Hospital, Oslo, Norway
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HAKEEM R, KANO N, YAMAKAWA T, ISHIKAWA Y, ISHIYAMA J, KASUGAI H, REY S, MIYAJIMA N, OTAKI S. Laparoscopic Cholecystectomy in Patients with Previous Gastrectomy. Dig Endosc 1996. [DOI: 10.1111/j.1443-1661.1996.tb00409.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Rachit HAKEEM
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Nobuyasu KANO
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Tatsuo YAMAKAWA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Yauro ISHIKAWA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Junji ISHIYAMA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Hisashi KASUGAI
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Sammuel REY
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Nobuyoshi MIYAJIMA
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
| | - Shuji OTAKI
- Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kawasaki, Japan
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Ido K, Suzuki T, Kimura K, Taniguchi Y, Kawamoto C, Isoda N, Nagamine N, Ioka T, Kumagai M. Laparoscopic cholecystectomy in the elderly: analysis of pre-operative risk factors and postoperative complications. J Gastroenterol Hepatol 1995; 10:517-22. [PMID: 8963026 DOI: 10.1111/j.1440-1746.1995.tb01340.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A retrospective study was conducted of two groups of patients over (group 1, n = 57) and under (group 2, n = 655) the age of 70 years who underwent laparoscopic cholecystectomy (LC). The pre-operative physical status and systemic complications, operation time, postoperative complications, postoperative hospital stay and other clinical features of the two groups were compared. The incidence of pre-operative complications in group 1 was significantly higher than that in group 2 (P < 0.05). Postoperatively no severe complication was found in any patient. Group 1 showed significantly prolonged operation time and postoperative hospital stay compared with group 2 (P < 0.05). The difference between the groups in the intra-operative treatment time and postoperative treatment is attributed to the greater prevalence of common bile duct stone in group 1 as there was little difference between the groups in the postoperative recovery after exclusion of these patients. No pulmonary complications, which are associated with LC, were observed; the postprocedure pain was slight and the period of bedrest was short. If complications associated with pneumoperitoneum can be prevented, this surgery is an excellent measure to improve the quality of life of even elderly patients with cholecystolithiasis.
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Affiliation(s)
- K Ido
- Department of Endoscopy, Jichi Medical School, Yakushiji, Tochigi, Japan
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Calhoun PC, Adams LH, Adams MR. Comparison of laparoscopic and minilap cholecystectomy for acute cholecystitis. Surg Endosc 1994; 8:1301-4. [PMID: 7831601 DOI: 10.1007/bf00188287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The charts of all patients with acute cholecystitis undergoing either laparoscopic or minilap cholecystectomy at the Chinle Comprehensive Health Care Facility between October 1, 1991, and August 15, 1993, were retrospectively reviewed. During that period, 54 patients underwent laparoscopic cholecystectomy and 45 patients had minilap procedures. The two groups had similar mean age, sex distribution, temperature, leukocyte count, gallbladder wall thickness, and duration of preoperative symptoms. While laparoscopic cholecystectomy took an average of 16 min longer to perform than minilap cholecystectomy, patients who had laparoscopic cholecystectomy had less blood loss, reduced postoperative narcotic needs, and shorter hospital stays.
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Affiliation(s)
- P C Calhoun
- Chinle Comprehensive Health Care Facility, AZ 86503
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20
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Deziel DJ. Complications Of Cholecystectomy: Incidence, Clinical Manifestations, and Diagnosis. Surg Clin North Am 1994. [DOI: 10.1016/s0039-6109(16)46382-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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