Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series.

Autor:	Abdelrahim WE; Department of Surgery, Faculty of Medicine, Nile Valley University, Atbara, Sudan., Elsiddig KE; Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan., Wahab AA; Department of Surgery, Atbara Teaching Hospital, Atbara, Sudan., Saad M; Department of Surgery, Atbara Teaching Hospital, Atbara, Sudan., Saeed H; Department of Surgery, Atbara Teaching Hospital, Atbara, Sudan., Khalil EAG; Department of Clinical Pathology & Immunology, Institute of Endemic Diseases, University of Khartoum, Sudan.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2017 May 25; Vol. 19, pp. 19-22. Date of Electronic Publication: 2017 May 25 (Print Publication: 2017).
DOI:	10.1016/j.amsu.2017.04.018
Abstrakt:	Objectives: This study aimed to show that subtotal laparoscopic cholecystectomy (SLC) is a safe procedure that reduces the rate of conversion in patients with difficult laporoscopic cholecystectomies in resource-meagre settings. Patients and Methods: Following informed consent, patients with gallstones reporting to Atbara Medical Centre, Atbara, Northern Sudan from February 2012 to July 2013 were managed laparoscopically except those with choledocholithiasis. SLC was done for patients with difficult cholecystectomy and obscured Callot's triangle. Clinical presentation, duration of symptoms, ultrasound findings, frequency of conversion to open operation, frequency of difficult cholecystectomy, operation duration and numbers/types of complications were recorded. Statistical analysis was carried out using SPSS. Results: One hundred and nine patients with a median age of 48 years, F:M ratio of 9 and mean duration of symptoms of 14.8 ± 12.9 months were enrolled. A quarter (29/109, 26.6%) had acute choleycystitis, 13% had difficult laparoscopic cholecystectomy. SLC was done for 16.2%. Retained stones were statistically significant in patients who underwent subtotal laparoscopic cholecystectomy (p = 0.02) with a conversion rate of 5.5%. Conclusion: SLC is feasible, safe and can reduce the rate of conversion for patients with difficult laporoscopic cholecystectomy. Sub-total laparoscopic cholecystectomy is not a substitute to conversion and in difficult conditions it is not a failure for the surgeon but a wisdom.
Databáze:	MEDLINE
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