scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY OF SINGLE INCISION

ASJ. ◽  
2021 ◽  
Vol 1 (55) ◽  
pp. 4-8
Author(s):  
I. Aksenov

Abstract. this article presents the results of laparoscopic cholecystectomy on technology one access in 27 patients with chronic calculous cholecystitis. The conclusion about possibility of its successful application in clinical practice in patients without complications of gallstone disease and concomitant diseases.

2020 ◽  
pp. 572-579
Author(s):  
F.B. BOKIEV ◽  
◽  
F.SH. RASHIDOV ◽  
D.A. RAKHMONOV ◽  
SH.SH. AMONOV ◽  
...  

Objective: Analysis of our own experience in performing laparoscopic cholecystectomy (LCE) for cholelithiasis (CHL). Methods: The study is based on the results of 4360 LCE in patients with cholelithiasis. Among the patients, women predominated – 3732 (85.6%), the average age of patients was 52.0±3.5 years. The structure of nosologies: chronic calculous cholecystitis – 3310 (75.9%), acute calculous cholecystitis – 1050 (24.1%). The operations were performed under general endotracheal anaesthesia with carbon dioxide insufflations; the location of the operating team was of the «American» type. Results: LCE was performed in 96.5% of patients, access conversion to open surgery was required in 3.5% of cases. The most common causes of conversion were the presence of a massive adhesive process (59.6%) and destructive changes in the walls of the gallbladder (9.93%). In the ICU, the operated patients were observed on average for 4±2.5 hours, the postoperative stay of patients in the hospital ward was 1.7±1.2 days. Immediate postoperative complications were noted in 1.63% of cases, mortality was 0.13%. Conclusions: Based on their own experience, the authors agree with the postulate that the LCE is the «gold standard» in gallbladder surgery in patients with gallstone disease. At the same time, purposeful preoperative preparation, careful selection of patients, high qualification of the surgeon, as well as adequate postoperative management of patients are the main factors in achieving good outcome. The complexity of surgical techniques can be reduced by collectively addressing complex situations of general somatic status by the active involvement of associated professionals. Keywords: Gallstone disease, laparoscopic cholecystectomy, conversion, early postoperative complications.


2019 ◽  
Vol 72 (5) ◽  
pp. 790-794
Author(s):  
Oleg Y. Kanikovskyi ◽  
Yaroslav V. Karyi ◽  
Yura V. Babiichuk ◽  
Yevhen V. Shaprynskyi

Introduction: The laparoscopic cholecystectomy (LCE) has become “gold standard” in treatment of the gallstone disease (GSD). However, introduction of LCE is accompanied by increase in the frequency of the bile duct injuries by 2-5 times, and transfer to the conversion offsets main advantages of the laparoscopic access. The aim: Тo improve the results of treatment of the patients with complicated course of the calculous cholecystitis by developing new methods of the laparoscopic cholecystectomy. Materials and methods: The results of surgical treatment of 420 patients with complicated course of the calculous cholecystitis were analyzed. The patients were divided intwo groups: group I (n = 210) where the standard four-trocar LCE was used and the group II (n = 210) where the developed methods of LCE were used. The average age made up 62 ± 6.0 years. Duration of disease made up from 1 month to 35 years. Results: The patients in group I LCE with complicated course of the acute cholecystitis was performed in 108 (25.7%) cases, chronic – in 102 (24.3%) cases. The patients in group II surgical intervention with complicated course of the acute cholecystitis was performed in 112 (26.7%) cases, chronic – in 98 (23.3%) cases. The patients of group I intraoperative injuries were observed in 12 (5.7%) cases and patients of group II – in 4 (1.9%) cases. The conversion was applied in 13 (6.2%) and in 4 (1.9%) cases, respectively. 2 (0.9%) patients died. Conclusions: Introduction of the developed methods of LCE with complicated course of the calculous cholecystitis allows to reduce the frequency of intraoperative injuries by 3,8% and conversion rate – by 4,3% (p <0,001).


HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.


2021 ◽  
pp. 004947552110100
Author(s):  
Shamir O Cawich ◽  
Avidesh H Mahabir ◽  
Sahle Griffith ◽  
Patrick FaSiOen ◽  
Vijay Naraynsingh

Although laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis, many Caribbean surgeons are reluctant to operate during the acute attack. We collected data for all consecutive patients who underwent laparoscopic cholecystectomy for acute cholecystitis from January 1 to 31 December 2018. Delayed cholecystectomy was done >6 weeks after acute cholecystitis settled. We compared data between early and delayed groups. Delayed laparoscopic cholecystectomy was performed in 54 patients, and 42 had early laparoscopic cholecystectomy. Delayed surgery resulted in significantly more complications requiring readmission (39% vs 0), longer operations (2.27 vs 0.94 h) and lengthier post-operative hospitalisation (1.84 vs 1.1 days). Caribbean hospitals should abandon the practice of delayed surgery after cholecystitis has settled. Early laparoscopic cholecystectomy would be financially advantageous for our institutions, and it would save patients recurrent attacks of gallstone disease.


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