Day Case Laparoscopic Cholecystectomy Carried Out Using the Harmonic Scalpel: Analysis of a Standard Procedure

被引：23

作者：

Patel, Sanjay Dhanji ^{[1
]}

Patel, Hemanshu ^{[1
]}

Ganapathi, Senthal ^{[1
]}

Marshall, Nichollas ^{[1
]}

机构：

[1] Newham Univ Hosp NHS Trust, London E13 8RU, England

来源：

SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES | 2010年 / 20卷 / 01期

关键词：

Laparoscopic cholecystectomy; Harmonic scalpel; clipless cholecystectomy; RANDOMIZED CLINICAL-TRIAL; RISK-FACTORS; CYSTIC DUCT; COMPLICATIONS; DISSECTION; ELECTROCAUTERY; CONVERSION;

D O I：

10.1097/SLE.0b013e3181cd45f2

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Introduction: Our aim was to determine the efficiency and safety of laparoscopic cholecystectomy carried out using the harmonic scalpel as a day case procedure. Methods: A prospective study was done on patients presenting for Laparoscopic cholecystectomy. The harmonic scalpel was used with retrograde dissection. All patients were considered for discharge the same day unless considered medically unfit. Results: Laparoscopic cholecystectomy using the harmonic scalpel was carried out on 100 patients. Major complications were as follows: conversion to open procedure -1%, common bile duct injury -1%, and bile leak from the cystic duct stump -1%. Our same day discharge rate was 65%, and age more than 65 was the only independent predictor of overnight admission (P = 0.009). Conclusions: Laparoscopic cholecystectomy using the harmonic scalpel is associated with a low complication rate and a high-sameday discharge rate when carried out as a day case procedure.

引用

页码：20 / 23

页数：4

共 24 条

[1]

AMARAL JF, 1995, SURG LAPAROSC ENDOSC, V5, P255

[2]

AMARAL JF, 1994, SURG LAPAROSC ENDOSC, V4, P92

[3] Gallstones and cholecystectomy in modern Britain [J].

Bateson, MC .

POSTGRADUATE MEDICAL JOURNAL, 2000, 76 (901) :700-703

[4] Randomized clinical trial of traditional dissection with electrocautery versus ultrasonic fundus-first dissection in laparoscopic cholecystectomy [J].

Cengiz, Y ;

Jänes, A ;

Grehn, Å ;

Israelsson, LA .

BRITISH JOURNAL OF SURGERY, 2005, 92 (07) :810-813

[5]

Fullum Terrence M, 2005, JSLS, V9, P51

[6] Risk factors for perioperative complications in patients undergoing laparoscopic cholecystectomy:: Analysis of 22,953 consecutive cases from the swiss association of laparoscopic and thoracoscopic surgery database [J].

Giger, Urs F. ;

Michel, Jean-Marie ;

Opitz, Isabelle ;

Inderbitzin, Devdas Th ;

Kocher, Thomas ;

Kraehenbuehl, Lukas .

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2006, 203 (05) :723-728

[7] Meta-analysis of randomized controlled trials on the safety and effectiveness of day-case laparoscopic cholecystectomy [J].

Gurusamy, K. ;

Junnarkar, S. ;

Farouk, M. ;

Davidson, B. R. .

BRITISH JOURNAL OF SURGERY, 2008, 95 (02) :161-168

[8]

Gurusamy KS, 2008, COCHRANE DB SYST REV, V3

[9] Development of symptoms and complications in individuals with asymptomatic gallstones [J].

Halldestam, I ;

Enell, EL ;

Kullman, E ;

Borch, K .

BRITISH JOURNAL OF SURGERY, 2004, 91 (06) :734-738

[10] Bile leakage resulting from clip displacement of the cystic duct stump - A potential pitfall of laparoscopic cholecystectomy [J].

Hanazaki, K ;

Igarashi, J ;

Sodeyama, H ;

Matsuda, Y .

SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1999, 13 (02) :168-171

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