Use of Stapling Devices for Safe Cholecystectomy in Acute Cholecystitis
| Autor: | Haci Hasan Abuoglu, Erkan Özkan, Emre Gunay, Mehmet Odabasi, Kemal Tekesin, Sami Akbulut, Cengiz Eris, M. A. Tolga Muftuoglu, Mehmet Kamil Yildiz |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Cholecystitis Acute Endo-GIA Fibrin Tissue Adhesive Surgical Staplers medicine Acute cholecystitis Humans Cholecystectomy Ligation Aged business.industry General surgery Cystic Duct Length of Stay Middle Aged Surgery medicine.anatomical_structure Stapler Cystic duct Female business Hepatobillary Surgery |
| Zdroj: | International Surgery |
| ISSN: | 2520-2456 0020-8868 |
| DOI: | 10.9738/intsurg-d-14-00035.1 |
| Popis: | Many techniques are described for the ligation of a difficult cystic duct (CD). The aim of this study is to assess the effectiveness and safety of stapling of a difficult CD in acute cholecystitis using Endo-GIA. From January 2008 to June 2012, 1441 patients with cholelithiasis underwent laparoscopic cholecystectomy (LC) at the Department of General Surgery, Haydarpasa Numune Education and Research Hospital. Of these, 19 (0.62%) were identified as having a difficult CD and were ligated using an Endo-GIA stapler. All patients were successfully treated with a laparoscopic approach. The length of hospital stay was 3.4 days. There were umbilical wound infections in 4 patients (21%). The length of follow-up ranged from 1.0 to 50.4 months. In conclusion, Endo-GIA is a safe and easy treatment method for patients with a dilated and difficult CD. The cystic artery should be isolated and ligated if possible before firing the Endo-GIA stapler. If isolation and stapling are not possible, fibrin sealant can be applied to avoid bleeding. The vascular Endo-GIA can be applied in a large CD, but for acute cholecystitis with an edematous CD, the Endo-GIA roticulator 4.8 or 3.5 stapler is preferred. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|