Efficacy of laparoscopic cholecystectomy in acalculous gallbladder disease: long-term follow-up.
| Autor: | Dwivedi A; Department of Surgery, North Oakland Medical Centers, Pontiac, Michigan 48341, USA. amitdwivedi@hotmail.com, Shetty A, Sanghavi P, Phan T, Lakra Y, Silva Y |
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| Jazyk: | angličtina |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons [JSLS] 2004 Apr-Jun; Vol. 8 (2), pp. 119-22. |
| Abstrakt: | Objective: Our aim was to determine the efficacy of laparoscopic cholecystectomy in symptomatic patients with ultrasound negative and abnormal gallbladder ejection fractions; Patients with gallbladder ejection fractions less than 35% on hepatobiliary scan were offered laparoscopic cholecystectomy. Methods: Between January 1995 and January 2001, 1564 patients underwent laparoscopic cholecystectomy at our institution: 256 were confirmed to have acalculous gallbladder disease by pathology report and reconfirmation of abnormal hepatobiliary scan data. A 30-day postoperative follow-up was obtained by retrospective medical record review. For this study, we contacted all 256 patients by mail questionnaire and followed up on nonresponders with telephone interviews; we also reviewed hospital records to verify preoperative symptom patterns. The survey was completed by 154 patients (60%): 48 (31%) by mail and 106 (69%) by telephone interviews. The study included 115 (75%) female and 39 (25%) male patients, and the average age was 42 years (range, 13 to 95). All hepatobiliary laboratory parameters were normal pre- and postoperatively. The survey was completed in December 2001, 1 to 5 years postoperatively (mean 3 years). Results: Preoperatively, 142 patients (92%) had right upper quadrant pain, 114 (74%) had nausea, 88 (57%) had vomiting, 120 (73%) had heartburn, and 118 (77%) had food intolerance. In a 30-day postoperative period, these numbers had reduced to 48 (37%), 14 (90%), 8 (5%), 22 (14%), and 34 (22%), respectively. had laparoscopic cholecystectomy, and 95% stated that they would recommend laparoscopic cholecystectomy to other patients. Conclusion: This study shows that patients with acalculous gallbladder disease benefit from laparoscopic cholecystectomy. |
| Databáze: | MEDLINE |
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