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Abstract
Backgrounds/Aims
Laparoscopic cholecystectomy is the best treatment choice for acute cholecystitis. However, its higher conversion rate and postoperative morbidities remain controversial. The purpose of this retrospective study is to evaluate the clinical significance of laparoscopic cholecystectomy that is performed at our institution in patients with acute cholecystitis.
Methods
Between January 2003 and December 2009, a retrospective study was carried out for 190 cases of acute cholecystitis undergoing laparoscopic cholecystectomy at our institution. They were divided into 2 groups, based on the time of operation from the onset of the symptom and other previous abdominal operation history. These groups were compared in the conversion rate and perioperative clinical outcomes, such as sex, age, accompanied disease, operation time, complications, postoperative hospital stay, total hospital stay and total costs.
Results
We compared the two groups based on the timing of laparoscopic cholecystectomy and history of previous abdominal operation. There were no significant differences in the open conversion rate, postoperative complications and postoperative hospital stay, total hospital stay and total costs. The sex ratio, female in the previous abdominal operation group, was larger than the non-previous abdominal operation group (70.2% vs. 43.2%, p=0.003, OR=0.32 [95% CI, 0.15-0.70]). Early operation group was larger than delayed operation group, at previous abdominal operation history (26.1% vs. 13.3%, p=0.026, OR=0.43 [95% CI, 0.20-0.91]) and closed suction drain use (79.3% vs. 66.3%, p=0.044, OR=0.51 [95% CI, 0.27-0.99]).
References
1. Zucker KA, Flowers JL, Bailey RW, Graham SM, Buell J, Imbembo AL. Laparoscopic management of acute cholecystitis. Am J Surg. 1993. 165:508–514.
2. Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998. 351:321–325.
3. Habib FA, Kolachalam RB, Khilnani R, Preventza O, Mittal VK. Role of laparoscopic cholecystectomy in the management of gangrenous cholecystitis. Am J Surg. 2001. 181:71–75.
4. Majeski J. Laparoscopic cholecystectomy in geriatric patients. Am J Surg. 2004. 187:747–750.
5. Miller K, Hölbling N, Hutter J, Junger W, Moritz E, Speil T. Laparoscopic cholecystectomy for patients who have had previous abdominal surgery. Surg Endosc. 1993. 7:400–403.
6. Karayiannakis AJ, Polychronidis A, Perente S, Botaitis S, Simopoulos C. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery. Surg Endosc. 2004. 18:97–101.
7. Spira RM, Nissan A, Zamir O, Cohen T, Fields SI, Freund HR. Percutaneous transhepatic cholecystostomy and delayed laparoscopic cholecystectomy in critically ill patients with acute calculus cholecystitis. Am J Surg. 2002. 183:62–66.
8. Eldar S, Sabo E, Nash E, Abrahamson J, Matter I. Laparoscopic cholecystectomy for acute cholecystitis: prospective trial. World J Surg. 1997. 21:540–545.
9. Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998. 227:461–467.
10. Kum CK, Eypasch E, Lefering R, Paul A, Neugebauer E, Troidl H. Laparoscopic cholecystectomy for acute cholecystitis: is it really safe? World J Surg. 1996. 20:43–48.
11. Yamashita Y, Takada T, Kawarada Y, et al. Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007. 14:91–97.
12. Lo CM, Liu CL, Lai EC, Fan ST, Wong J. Early versus delayed laparoscopic cholecystectomy for treatment of acute cholecystitis. Ann Surg. 1996. 223:37–42.
13. Koo KP, Thirlby RC. Laparoscopic cholecystectomy in acute cholecystitis. What is the optimal timing for operation? Arch Surg. 1996. 131:540–544.
14. Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998. 351:321–325.
15. Lai PB, Kwong KH, Leung KL, et al. Randomized trial of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 1998. 85:764–767.
16. Glenn F. Acute cholecystitis. Surg Gynecol Obstet. 1976. 143:56–60.
17. Choi SI, Lee SM, Ko YG, Koh SH, Hong SW, Joo HZ. Early Versus Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis. J Korean Surg Soc. 2000. 58:702–707.
18. Kim JS, Cho BS, Kang YJ, Park JS. Effect of percutaneous cholecystostomy on laparoscopic cholecystectomy. J Korean Surg Soc. 2001. 60:78–82.
19. Rattner DW, Ferguson C, Warshaw AL. Factors associated with successful laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1993. 217:233–236.
20. Paran H, Zissin R, Rosenberg E, Griton I, Kots E, Gutman M. Prospective evaluation of patients with acute cholecystitis treated with percutaneous cholecystostomy and interval laparoscopic cholecystectomy. Int J Surg. 2006. 4:101–105.
21. Kim DG, Oh CH, Kim GH, et al. Percutaneous gallbladder drainage for delayed laparoscopic cholecystectomy in patients with acute cholecystitis. Korean J Hepatobiliary Pancreat Surg. 2001. 60:78–82.
22. Kim IG, Jeon JY. Benefits of percutaneous transhepatic gallbladder drainage for laparoscopic cholecystectomy in patients with acute cholecystitis. Korean J Hepatobiliary Pancreat Surg. 2010. 14:46–52.
23. Mo LR, Chang KK, Wang CH, Yau MP, Yang TM. Preoperative endoscopic sphincterotomy in the treatment of patients with cholecystocholedocholithiasis. J Hepatobiliary Pancreat Surg. 2002. 9:191–195.
24. Materia A, Pizzuto G, Silecchia G, et al. Sequential endoscopic-laparoscopic treatment of cholecystocholedocholithiasis. Surg Laparosc Endosc. 1996. 6:273–277.
25. Taylor EW, Rajgopal U, Festekjian J. The efficacy of preoperative endoscopic retrograde cholangiopancreatography in the detection and clearance of choledocholithiasis. JSLS. 2000. 4:109–116.
26. Beck DE, Ferguson MA, Opelka FG, Fleshman JW, Gervaz P, Wexner SD. Effect of previous surgery on abdominal opening time. Dis Colon Rectum. 2000. 43:1749–1753.
27. Menzies D, Ellis H. Intestinal obstruction from adhesions-how big is the problem? Ann R Coll Surg Engl. 1990. 72:60–63.
28. Van Der Krabben AA, Dijkstra FR, Nieuwenhuijzen M, et al. Morbidity and mortality of inadvertent enterotomy during adhesiotomy. Br J Surg. 2000. 87:467–471.
29. Schirmer WJ, Rossi RL. Laparoscopic cholecystectomy: technique more important than tool. Arch Surg. 1991. 126:1161.
30. Yu SC, Chen SC, Wang SM, Wei TC. Is previous abdominal surgery a contraindication to laparoscopic cholecystectomy? J Laparoendosc Surg. 1994. 4:31–35.
31. Kama NA, Kologlu M, Doganay M, Reis E, Atli M, Dolapci M. A risk score for conversion from laparoscopic to open cholecystectomy. Am J Surg. 2001. 181:520–525.
32. Kwon AH, Inui H, Imamura A, Kaibori M, Kamiyama Y. Laparoscopic cholecystectomy and choledocholithotomy in patients with a previous gastrectomy. J Am Coll Surg. 2001. 193:614–619.
33. Curet MJ. Special problems in laparoscopic surgery. Previous abdominal surgery, obesity, and pregnancy. Surg Clin North Am. 2000. 80:1093–1110.
34. Akyurek N, Salman B, Irkorucu O, et al. Laparoscopic cholecystectomy in patients with previous abdominal surgery. JSLS. 2005. 9:178–183.
35. Sasaki A, Nakajima J, Nitta H, Obuchi T, Baba S, Wakabayashi G. Laparoscopic cholecystectomy in patients with a history of gastrectomy. Surg Today. 2008. 38:790–794.
36. Bouasker I, El Ouaer MA, Smaali I, et al. Laparascopic cholecystectomy on a previously operated abdomen. Tunis Med. 2010. 88:88–91.
37. Stevens KA, Chi A, Lucas LC, Porter JM, Williams MD. Immediate laparoscopic cholecystectomy for acute cholecystitis: no need to wait. Am J Surg. 2006. 192:756–761.
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