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Geleneksel laparoskopik kolesistektomi klinik sonuçlarımız

Year 2013, Volume: 19 Issue: 1, 35 - 39, 01.02.2013
https://doi.org/10.5455/GMJ-30-2012-118

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.

References

  • 1. Mouret P. From the first laparoscopic cholecystectomy to the frontiers of laparoscopic surgery: the future prospectives. Dig Surg 1991;8:124–6
  • 2. 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
  • 3. Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy
  • Surg Endosc 1989;3:131–4
  • 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
  • 5. Taylor AM, Li MKW. Laparoscopic management of complications following laparoscopic cholecystectomy. Aust N Z J Surg 1994;64:827–9
  • 6. Strasberg SM. Clinical practice. Acute calculous cholecystitis.N Engl J Med 2008;26:2804–11
  • 7. Solomkin JS. IDSA and 2002 SIS Guidelines on anti-infective agents for complicated IAIs. Clin Infect Dis 2003;37:997–1005
  • 8. 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
  • 9. 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
  • 10. Lacaine F, Corlette MB, Bismuth H. Preoperative evaluation of the risk of common bile duct stones. Arch Surg 1980;115:1114– 6
  • 11. 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
  • 12. Johnson AG, Hosking SW. Appraisal of the management of bile duct stones. Br J Surg 1987;74:555–60
  • 13. 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
  • 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
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. Rossi RL, Schirmer WJ, Braasch JW, Sanders LB, Munson JL.Laparoscopic bile duct injuries: risk factors, recognition, repair. Arch Surg 1992;127:596–601
  • 21. 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
  • 22. 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
  • 23. Riedel HH, Lehmann-Willenbrock E, Conrad P, Semm K
  • German pelviscopic statistics for the years 1978-1982
  • Endoscopy 1986;18:219–22
  • 24. Minz M. Risks and prophylaxis in laparoscopy: a survey of 100,000 cases. J Reprod Med 1977;18:269–72
  • 25. Hasson HM. Open laparoscopy: a report of 150 cases. J Reprod Med 1974;12:234–8
  • 26. 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
  • 27. 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
  • 28. Lim SH, Salleh I, Poh BK, Tay KH. Laparoscopic cholecystectomy: an audit of our training programme. ANZ J Surg 2005;75:231–3
  • 29. Singh K, Ohri A. Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy. Surg Endosc 2006;20:1754–8
  • 30. Van Eijck FC, van Veen RN, Kleinrensink GJ, Lange JF
  • Hartmann’s gallbladder pouch revisited 60 years later. Surg Endosc 2007;21:1122–5
  • 31. 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 32. 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
  • 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
  • 34. Leung KF, Lee KW, Cheung TY, Leung LC, Lau KW
  • Laparoscopic cholecystectomy: two-port technique. Endoscopy 1996;28:505–7
  • 35. 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

The clinical outcome of traditional laparoscopic cholecystectomy

Year 2013, Volume: 19 Issue: 1, 35 - 39, 01.02.2013
https://doi.org/10.5455/GMJ-30-2012-118

Abstract

Morbiditesi %0,1 lere kadar indirilen, düşük volümlü hastanelerde uygulanabilen, ciddi komplikasyonları ancak tecrübeli cerrahlarca tedavi edilen geleneksel LK tecrübelerimizi, komplikasyonlarımızı, ne seviyede olduğumuzu görmeyi ve paylaşmayı amaçladık. Ocak 2008- Haziran 2011 tarihleri arasında 3 ayrı merkezde, 3 ayrı laparoskopik tecrübeleri birbirine yakın cerrah tarafından elektif şartlarda yapılan Laparoskopik Kolesistektomi olgularının pre-intra-post operatif bulgularına ulaşılarak, demografik verileri, operasyon endikasyonları, operasyon şekli (port sayısı, süresi), daha önce operasyon geçirip geçirmediği, Sistemik bir hastalığı olup olmadığı, hastanede yatma süreleri, açığa dönüş sebepleri, ERCP yapılıp yapılmadığı, görülen komplikasyonlar retrospektif olarak incelendi. 165 (%72.6)' i kadın, 101 (%27.4)' i erkek 266 hasta dosyası retrospektif olarak incelendi. Yaş ortalaması 42.6 yıl (range:24-72) idi. Ortalama operasyon süresi 45 dakika (range:30-75) bulundu. 71 (%26.7) hastada 3 port, 195 (%73,3) hasta 4 port kullanılarak operasyon gerçekleştirildi. 25 (%9.4) hastaya batın içi dren kondu. 5 (%9.4) hastaya preoperatif olarak ERCP yapılmış, 6 (%2.3) hasta daha önce üst batın, 31(%11.7) hasta da alt batın operasyonu geçirmiş olduğu bulundu. 6 (%2.3) hastada kanama, 4 hastada (%1.5) anatominin ortaya konamaması (anatomik uyumsuzluk), 3 hastada (%1.1) yapışıklık ve zor teknik şartlar sebebiyle açık kolesistektomiye dönüldü. Gerekli hasta seçimi ile sorunsuz olarak, düşük volümlü hastanelerde laparoskopik kolesistektomi işlemi gerçekleştirilebilir. Komplikasyon durumunda multidisipliner yaklaşımın ön planda tutulması, hasta morbidite ve mortalitesi açısından daha faydalı olacağı kanaatindeyiz.

References

  • 1. Mouret P. From the first laparoscopic cholecystectomy to the frontiers of laparoscopic surgery: the future prospectives. Dig Surg 1991;8:124–6
  • 2. 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
  • 3. Reddick EJ, Olsen DO. Laparoscopic laser cholecystectomy
  • Surg Endosc 1989;3:131–4
  • 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
  • 5. Taylor AM, Li MKW. Laparoscopic management of complications following laparoscopic cholecystectomy. Aust N Z J Surg 1994;64:827–9
  • 6. Strasberg SM. Clinical practice. Acute calculous cholecystitis.N Engl J Med 2008;26:2804–11
  • 7. Solomkin JS. IDSA and 2002 SIS Guidelines on anti-infective agents for complicated IAIs. Clin Infect Dis 2003;37:997–1005
  • 8. 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
  • 9. 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
  • 10. Lacaine F, Corlette MB, Bismuth H. Preoperative evaluation of the risk of common bile duct stones. Arch Surg 1980;115:1114– 6
  • 11. 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
  • 12. Johnson AG, Hosking SW. Appraisal of the management of bile duct stones. Br J Surg 1987;74:555–60
  • 13. 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
  • 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
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. 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
  • 19. 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
  • 20. Rossi RL, Schirmer WJ, Braasch JW, Sanders LB, Munson JL.Laparoscopic bile duct injuries: risk factors, recognition, repair. Arch Surg 1992;127:596–601
  • 21. 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
  • 22. 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
  • 23. Riedel HH, Lehmann-Willenbrock E, Conrad P, Semm K
  • German pelviscopic statistics for the years 1978-1982
  • Endoscopy 1986;18:219–22
  • 24. Minz M. Risks and prophylaxis in laparoscopy: a survey of 100,000 cases. J Reprod Med 1977;18:269–72
  • 25. Hasson HM. Open laparoscopy: a report of 150 cases. J Reprod Med 1974;12:234–8
  • 26. 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
  • 27. 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
  • 28. Lim SH, Salleh I, Poh BK, Tay KH. Laparoscopic cholecystectomy: an audit of our training programme. ANZ J Surg 2005;75:231–3
  • 29. Singh K, Ohri A. Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy. Surg Endosc 2006;20:1754–8
  • 30. Van Eijck FC, van Veen RN, Kleinrensink GJ, Lange JF
  • Hartmann’s gallbladder pouch revisited 60 years later. Surg Endosc 2007;21:1122–5
  • 31. 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 32. 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
  • 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
  • 34. Leung KF, Lee KW, Cheung TY, Leung LC, Lau KW
  • Laparoscopic cholecystectomy: two-port technique. Endoscopy 1996;28:505–7
  • 35. 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
There are 43 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Kazım Duman This is me

SEZER Koray Halil This is me

Fahri Yılmaz This is me

Mehmet Levhi Akın This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 19 Issue: 1

Cite

APA Duman, K., Halil, S. K., Yılmaz, F., Akın, M. L. (2013). The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Medical Journal, 19(1), 35-39. https://doi.org/10.5455/GMJ-30-2012-118
AMA Duman K, Halil SK, Yılmaz F, Akın ML. The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Medical Journal. February 2013;19(1):35-39. doi:10.5455/GMJ-30-2012-118
Chicago Duman, Kazım, SEZER Koray Halil, Fahri Yılmaz, and Mehmet Levhi Akın. “The Clinical Outcome of Traditional Laparoscopic Cholecystectomy”. Gaziantep Medical Journal 19, no. 1 (February 2013): 35-39. https://doi.org/10.5455/GMJ-30-2012-118.
EndNote Duman K, Halil SK, Yılmaz F, Akın ML (February 1, 2013) The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Medical Journal 19 1 35–39.
IEEE K. Duman, S. K. Halil, F. Yılmaz, and M. L. Akın, “The clinical outcome of traditional laparoscopic cholecystectomy”, Gaziantep Medical Journal, vol. 19, no. 1, pp. 35–39, 2013, doi: 10.5455/GMJ-30-2012-118.
ISNAD Duman, Kazım et al. “The Clinical Outcome of Traditional Laparoscopic Cholecystectomy”. Gaziantep Medical Journal 19/1 (February 2013), 35-39. https://doi.org/10.5455/GMJ-30-2012-118.
JAMA Duman K, Halil SK, Yılmaz F, Akın ML. The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Medical Journal. 2013;19:35–39.
MLA Duman, Kazım et al. “The Clinical Outcome of Traditional Laparoscopic Cholecystectomy”. Gaziantep Medical Journal, vol. 19, no. 1, 2013, pp. 35-39, doi:10.5455/GMJ-30-2012-118.
Vancouver Duman K, Halil SK, Yılmaz F, Akın ML. The clinical outcome of traditional laparoscopic cholecystectomy. Gaziantep Medical Journal. 2013;19(1):35-9.