The clinical outcome of traditional laparoscopic  cholecystectomy

Kazım Duman; Koray Halil Sezer; Fahri Yılmaz; Mehmet Levhi Akın

doi:10.5455/GMJ-30-2012-118

Authors

Kazım Duman Gümüşsuyu Military Hospital, Department of General Surgery, İstanbul
Koray Halil Sezer Balıkesir Military Hospital, Department of General Surgery, Balıkesir
Fahri Yılmaz Gölcük Military Hospital, Department of General Surgery, Kocaeli
Mehmet Levhi Akın GATA, Haydarpaşa Training Hospital, Department of General Surgery, İstanbul

DOI:

https://doi.org/10.5455/GMJ-30-2012-118

Keywords:

Cholecystectomy, laparoscopic, clinical outcome

Abstract

Laparoscopic cholecystectomy is a safety, efficacy,established method for the treatment of symptomatic gallstone disease. We aim to share traditional laparoscopic cholesistectomy experience and complications that treated with experienced surgeons in low-volume hospitals. This study was performed during the period of 2009- 2011 in three hospital. We analyzed retrospectively 266 patients, who were operated elective by three surgeon whose experiences were closely. We compared demographic data, patients age, gender, number of ports, operation time, length of hospital stay, whether or not previous abdominal surgery, whether or not systemic disease, whether or not has been performed ERCP, reason of converted from laparoscopic to open cholecystectomy and complications. 266 [165 (%72,6) female and 101 (%27,4) male] patients evaluated retrospectively. The average age was 42,6 (range 27-42). The average duration of operation was 45 minutes (range 35-72). The operation was performed by using four ports in 195 (73,3%) patients and by using three ports in 71 (26,7%) patients. 25 (9,4%) patients had intra-abdominal drainage. ERCP was performed preoperatively in 5 (9,4%) patients. We convert open cholecystectomy in6 (2,3%) patients, due to bleeding, in 4 patients (1,5%) due to anatomical mismatch, 3 patients (1,1%) due to adhesions and difficult technical conditions. Laparoscopic cholecystectomy can be performed seamlessly with appropriate patient selection in low-volume hospitals, We believe that multidisciplinary approach was a priority in case with complications, it will be useful in terms of patient morbidity and mortality.

Metrics

Metrics Loading ...

References

Mouret P. From the first laparoscopic cholecystectomy to the frontiers of laparoscopic surgery: the future prospectives. Dig Surg 1991;8:124–6.

Nuzzo G, Giuliante F, Giovannini I, Ardito F, D'Acapito F, Vellone M, et al. Bile duct injuryduring laparoscopic cholecystectomy: results of an Italian national survey on 56 591 cholecystectomies. Arch Surg 2005;140:986–92.

Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy. Surg Endosc 1989;3:131–4.

Krahenbuhl L, Sclabas G, Wente MN. Incidence, risk factors, and prevention of biliary tract injuries during laparoscopic cholecystectomy in Switzerland. World J Surg 2001;25:1325-30.

Taylor AM, Li MKW. Laparoscopic management of complications following laparoscopic cholecystectomy. Aust N Z J Surg 1994;64:827–9.

Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med 2008;26:2804–11.

Solomkin JS. IDSA and 2002 SIS Guidelines on anti-infective agents for complicated IAIs. Clin Infect Dis 2003;37:997–1005.

Daniak CN, Peretz D, Fine JM, Wang Y, Meinke AK, Hale WB. Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis. World J Gastroenterol 2008;14:1084–90.

Shikata S, Noguchi Y, Fukui T. Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials. Surg Today 2005;35: 553–60.

Lacaine F, Corlette MB, Bismuth H. Preoperative evaluation of the risk of common bile duct stones. Arch Surg 1980;115:1114–6.

Sahai AV, Mauldin PD, Marsi V, Hawes RH, Hoffman BJ. Bile duct stones and laparoscopic cholecystectomy: a decision analysis to assess the role of intraoperative cholangiography, EUS, and ERCP.Gastrointest Endosc 1999;49:334–43.

Johnson AG, Hosking SW. Appraisal of the management of bile duct stones. Br J Surg 1987;74:555–60.

Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of cholecystectomy: a national survey of 4292 hospitals and ananalysis of 77,604 cases. Am J Surg 1993;165:9–14.

Georgiades CP, Mavromatis TN, Kourlaba GC, Kapiris SA, Bairamides EG, Spyrou AM, et al. Is inflammation a significant predictor of bile duct injury during laparoscopic cholecystectomy? Surg Endosc 2008;22:1959–64.

Airan M, Appel M, Berci G, Coburg AJ, Cohen M, Cuschieri A, et al. Retrospective and prospective multi-institutional laparoscopic cholecystectomy study organized by the Society of American Gastrointestinal Endoscopic Surgeons. Surg Endosc 1992;6:169–76.

MacFadyen BV Jr, Vecchio R, Ricardo AE, Mathis CR. Bile duct injury after laparoscopic cholecystectomy. The United States Experience. Surg Endos. 1998;12:315–21.

Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN et al. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg. 1996;224:609–20.

Calvete J, Sabater L, Camps B, Verdú A, Gomez-Portilla A, Martín J, et al. Bile duct injury during laparoscopic cholecystectomy: myth or reality of the learning curve. Surg Endosc 2000;14:608–11.

Hasl DM, Ruiz OR, Baumert J, Gerace C, Matyas JA, Taylor PH, et al. A prospective study of bile leaks after laparoscopic cholecystectomy. Surg Endosc 2001;15:1299–300.

Rossi RL, Schirmer WJ, Braasch JW, Sanders LB, Munson JL. Laparoscopic bile duct injuries: risk factors, recognition, repair. Arch Surg 1992;127:596–601.

Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, et al. The European experience with laparoscopic cholecystectomy. Am J Surg 1991;161:385–438.

McDonald PT, Rich NM, Collins GJ Jr, Andersen CA, Kozloff L. Vascular trauma secondary to diagnostic and therapeutic procedures: aparoscopy. Am J Surg 1978;135:651–5.

Riedel HH, Lehmann-Willenbrock E, Conrad P, Semm K. German pelviscopic statistics for the years 1978-1982. Endoscopy 1986;18:219–22.

Minz M. Risks and prophylaxis in laparoscopy: a survey of 100,000 cases. J Reprod Med 1977;18:269–72.

Hasson HM. Open laparoscopy: a report of 150 cases. J Reprod Med 1974;12:234–8.

Larson GM, Vitale GC, Casey J, Evans JS, Gilliam G, Heuser L, et al. Multipractice analysis of laparoscopic cholecystectomy in 1,983 patients. Am J Surg 1991;163:221–6.

Wherry DC, Marohn MR, Malanoski MP, Hetz SP, Rich NM. An external audit of laparoscopic cholecystectomy in the steady state performed in medical treatment facilities of the Department of Defense. Ann. Surg 1996;224:145.

Lim SH, Salleh I, Poh BK, Tay KH. Laparoscopic cholecystectomy: an audit of our training programme. ANZ J Surg 2005;75:231–3.

Singh K, Ohri A. Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy. Surg Endosc 2006;20:1754–8.

Van Eijck FC, van Veen RN, Kleinrensink GJ, Lange JF. Hartmann’s gallbladder pouch revisited 60 years later. Surg Endosc 2007;21:1122–5.

Soffer D, Blackbourne LH, Schulman CI, Goldman M, Habib F, Benjamin R, et al: Is there an optimal time for laparoscopic cholecystectomy in acute cholecystitis? Surg Endosc 2007;21:805–9

Boike GM, Miller CE, Spirtos NM, Mercer LJ, Fowler JM, Summitt R, et al. Incisional bowel herniations after operative laparoscopy: a series of nineteen cases and review of the literature. Am J Obstet Gynecol 1995; 172:1726–33.

Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR.Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. J Gastrointest Surg. 2002;6:800–5.

Leung KF, Lee KW, Cheung TY, Leung LC, Lau KW. Laparoscopic cholecystectomy: two-port technique. Endoscopy 1996;28:505–7.

Brockmann JG, Kocher T, Senninger NJ, Schürmann GM. Complications due to gallstones lost during laparoscopic cholecystectomy. An analysis of incidence, clinical course, and management. Surg Endosc 2002;16:1226–32.