IS LAPAROSCOPIC CHOLECYSTECTOMY SAFE FOR ACUTE CHOLECYSTITIS?

Yıl 2017, , 487 - 495, 15.08.2017

Ferhat Çay , Mustafa Girgin

https://doi.org/10.30569/adiyamansaglik.375097

Cited By: 1

Öz

Purpose: Laparoscopic cholecystectomy has become the best treatment method
for the patients with symptomatic gallstones. However, "the gold
standard" treatment method is still not clear for patients with acute
cholecystitis. The aim of our study is to examine the results of early
cholecystectomy applied to patients with acute cholecystitis together with the
literature review.

Methods: 106 patients with acute cholecystitis who underwent early
laparoscopic cholecystectomy were retrospectively studied between September
2014 and September 2017.

Result: The total number of the patients was 106, 71 of which were female
and 35 of which were male. The average age of the patients was 49.5 (16-83).
Laparoscopic cholecystectomy was successfully performed in 92 of 106 acute cholecystitis
cases whereas 14 patients underwent open surgery. The average duration of the
surgery was determined to be 57.5 minutes. Drains were placed in the subhepatic
region at 56 patients (53%). The numbers of the patients with gallbladder
perforation, empyema of the gallbladder, and pericholecystic fluid were 9 (8%),
19 (18%), and 3 (3%) respectively. 11 patients (10%) developed postoperative
complication.

Conclusion: Surgical treatment has come to forefront for the patients with
early acute cholecystitis. Considering both the duration of the operation and
postoperative morbidity and mortality rates, laparoscopic cholecystectomy has
still been the effective treatment method for early acute cholecystitis.

 

Anahtar Kelimeler

Laparoscopy, cholecystitis, cholelithiasis

Akut Kolesistitte Laparoskopik Kolesistektomi Güvenli mi?

Öz

Amaç: Semptomatik safra kesesi taşı olan hastalarda laparoskopik
kolesistektomi en iyi tedavi yöntemi haline gelmiştir. Fakat akut kolesistitli
hastalarda hala altın standart tedavi yöntemi net değildir. Çalışmamızın amacı,
akut kolesistitli hastalara uygulanan erken kolesistektominin sonuçlarını
literatür eşliğinde irdelemek olacaktır. 

Yöntemler: Eylül 2014 ile Eylül 2017 tarihleri arasında akut
kolesistit tanısı alarak erken laparoskopik kolesistektomi uygulanan 106 hasta
retrospektif olarak incelendi. 

Bulgular: Hasta sayısı 71 kadın ve 35 erkek olmak üzeri
toplam 106 hastadan oluşup yaş ortalaması 49.5 (16-83) yıl idi. 106 akut
kolesistitli vakanın 92’inde başarılı laparoskopik kolesistektomi
gerçekleştirildi, 14 hastada açık ameliyatla devam edildi. Ameliyat süresi
ortalama 57.5 dakika oldu. 56 hastaya (%53) subhepatik alana dren konuldu. 9
hastada (% 8) safra kesesi perforasyonu, 19 hastada (% 18) safra kesesi ampiyemi,
3 hastada (% 3) perikolesistik sıvı vardı. Onbir hastada (%10) postoperatif
komplikasyon gelişti. 

Sonuç: Erken dönem akut kolesistitli hastaların tedavisinde
cerrahi planlamak düşüncesi ön plana çıkmaktadır. Gerek operasyon süresi ve
gerekse postoperatif morbidite ve mortalite oranları ile erken akut
kolesistitte laparoskopik kolesistektomi etkin bir tedavi şekli olmaya devam
etmektedir.

Anahtar Kelimeler

Laparaskopi, kolesistit, kolelitiazis

Kaynakça

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