Laparoscopic subtotal cholecystectomy for severe cholecystitis

被引:63
作者
Nakajima, Jun [1 ]
Sasaki, Akira [1 ]
Obuchi, Toru [1 ]
Baba, Shigeaki [1 ]
Nitta, Hiroyuki [1 ]
Wakabayashi, Go [1 ]
机构
[1] Iwate Med Univ, Dept Surg, Sch Med, Morioka, Iwate 0208505, Japan
关键词
Subtotal cholecystectomy; Laparoscopic; Cholecystitis; Liver cirrhosis; PREVIOUS ABDOMINAL-SURGERY; PERCUTANEOUS CHOLECYSTOSTOMY; PREDICTIVE FACTORS; CHOLELITHIASIS; GALLBLADDER; CONVERSION; TRIAL;
D O I
10.1007/s00595-008-3975-4
中图分类号
R61 [外科手术学];
学科分类号
摘要
To evaluate the efficacy and outcome of laparoscopic subtotal cholecystectomy (LSC) for patients with severe cholecystitis. Between April 1992 and May 2008, 1226 patients underwent laparoscopic cholecystectomy (LC). From 2000 onward 60 patients with severe cholecystitis underwent LSC. The outcomes of LC were compared between patients who underwent the procedure between 1992 and 1999 (group A; n = 643) and those who underwent the procedure between 2000 and 2008 after the introduction of LSC (group B; n = 583), respectively. In Group B, operative outcomes were also compared between the LC and LSC groups. The incidence of bile duct injury (1.6% vs 0.3%, P = 0.040) and conversion to open cholecystectomy (2.2% vs 0.3%, P = 0.046) was significantly lower in group B. The mean operative time was significantly longer (119.6 min vs 71.0 min., P < 0.001), and the mean blood loss was significantly higher (53.4 ml vs 12.9 ml, P < 0.001) in the LSC group. No significant differences were observed between LC and LSC in the incidence of postoperative morbidities or postoperative hospital stay. No patient had remnant gallstones or gallbladder cancers after a median follow-up of 42 months. Laparoscopic subtotal cholecystectomy is safe and effective for preventing bile duct injuries and lowering the conversion rate in patients with technically difficult severe cholecystitis.
引用
收藏
页码:870 / 875
页数:6
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