[Laparoscopic cholecystectomy].
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Cholecystectomy, Laparoscopic↗
Biomedical subjects
L J Henríquez
Publications and source records attributed to L J Henríquez.
[Cholecystectomy by video laparoscopy in acute cholecystitis: report of 25 cases].
The cholecystectomy by video laparoscopy has made a big revolution in biliary surgery during de last three or four years. We present the first 25 cases with acute cholecystitis operated on by this technique with very low morbidity a convalescence period and hospitalization time inferior to the one expected for open cholecystectomy and a conversion to open laparotomy in a relatively low percentage of the cases. In order to perform this procedures a basic training in surgery and laparoscopy is necessary groups of surgeons that work coordinated with adequate instrumentation as well as experience in laparoscopic cholecystectomy in non acute cases is always necessary.
Acute Disease↗
[Acute cholecystitis: is it a laparoscopic procedure?].
One-hundred and twenty-seven consecutive patients with acute cholecystitis were operated using laparoscopic technique. Average Surgical operating time was 113 minutes with an average of 127 minutes if operative cholangiogram was performed and 96 minutes when cholangiogram was not done. Technical difficulties related to gallbladder edema and hyperemia was seen in all cases (100%), also poor exposure and difficulty in grasping the gallbladder in 87%. The most common post operative complication was the wound infection of the entry trocar port, mainly at the umbilicus. One patient with gangrenous cholecystitis and multiple organ failure died after endoscopic attempt and converted to open technique. The total number conversions was 3%. In 28% of the patients a ERCP was done with ten positive for common duct stones. Operative cholangiogram was attempted in all cases with 83% success rate and 5% where positive for common duct stones. In cases where ERCP was done postoperatively for suspicious stones, seven cases were positive. Hospital stay averaged 1.6 days. Acute cholecystitis does not contraindicate laparoscopic technique and chances of having concomitant common duct stone is 16%, for that reason radiologic studies are mandatory.
Acute Disease↗