Timing of laparoscopic cholecystectomy for subacute calculous cholecystitis: early or interval--a prospective study
| Autor: | Utku Yilmaz, Ertan Tatlicioglu, Nusret Akyürek, Osman Yüksel, Bülent Salman |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Blood Loss Surgical Gallstones Time Cholangiography Recurrence Internal medicine medicine Cholecystitis Humans Prospective Studies Prospective cohort study Aged Intraoperative Care Hepatology medicine.diagnostic_test Bile duct business.industry General surgery Length of Stay Middle Aged medicine.disease Dissection medicine.anatomical_structure Cholecystectomy Laparoscopic Surgery Cholecystectomy Female Bile Ducts business Abdominal surgery |
| Zdroj: | Journal of hepato-biliary-pancreatic surgery. 13(5) |
| ISSN: | 0944-1166 |
| Popis: | Background/Purpose The aim of this prospective study was to evaluate the safety and feasibility of early laparoscopic cholecystectomy for subacute cholecystitis and to compare it with interval laparoscopic cholecystectomy. Methods The study was performed in 74 patients who had been diagnosed with subacute cholecystitis between January 2000 and June 2005. The patients were divided into two groups. The early laparoscopic cholecystectomy group was composed of 31 patients who underwent laparoscopic cholecystectomy 24 h after admission to the hospital. The interval laparoscopic cholecystectomy group was composed of 43 patients who underwent laparoscopic cholecystectomy 8–12 weeks after medical treatment. Results There was no significant difference between the conversion rate, intraoperative bleeding, need for intraoperative cholangiography, minor bile duct injury, and postoperative complications in the two groups. Eleven patients in the interval group underwent urgent laparoscopic cholecystectomy or additional procedures because of recurrent cholecystitis, choledocholithiasis, or biliary pancreatitis. The early group had a significantly shorter total hospital stay (P = 0.031), lower cost of treatment (P = 0.042), and less difficulty with Calot's triangle dissection (P = 0.008). Conclusions Early laparoscopic cholecystectomy can be done without hesitation in patients with subacute cholecystitis, in the light of obstacles observed in the interval group, such as dissection difficulty, lack of success in “cooling down”, and additional problems such as choledocholithiasis and biliary pancreatitis. |
| Databáze: | OpenAIRE |
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