Improved outcome after laparoscopic cholecystectomy with ultrasonic dissection: a randomized multicenter trial
| Autor: | Anders Thorell, Arthur Jänes, Leif A. Israelsson, Gunnar Edlund, Mats Möller, Jan Dalenbäck, Yucel Cengiz |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Nausea Ultrasonic Therapy medicine.medical_treatment Blood Loss Surgical Dissection (medical) Statistics Nonparametric law.invention Postoperative Complications Randomized controlled trial Risk Factors law Multicenter trial Cholecystitis Electrocoagulation Humans Medicine Intraoperative Complications Aged business.industry Dissection Gallbladder Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Cholecystectomy Laparoscopic Anesthesia Postoperative Nausea and Vomiting Female Cholecystectomy Sick Leave medicine.symptom business Complication Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 24:624-630 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-009-0649-2 |
| Popis: | In conventional laparoscopic cholecystectomy, dissection with electrocautery starts at the triangle of Calot. In a randomized single-center trial, the fundus-first method (dome down) using ultrasonic dissection was faster, involved less pain or nausea, and had a shorter postoperative sick leave. This may relate to the fundus-first method or to the ultrasonic dissection. In a multicenter trial, 243 elective patients were randomized to conventional laparoscopic cholecystectomy using electrocautery (n = 85) or the fundus-first method using either electrocautery (n = 81) or ultrasonic dissection (n = 77). The fundus-first method had a shorter operating time with ultrasonic dissection (58 min) than with electrocautery (74 min; p = 0.002). The fundus-first method using ultrasonic dissection compared with electrocautery or the conventional method produced less blood loss (12 vs. 53 or 36 ml; p |
| Databáze: | OpenAIRE |
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