[Laparoscopic cholecystectomy. The first 45 operations].
During a period of 13 weeks, 45 patients with symptom-producing gall bladder stones (attacks of gall stone colic n = 39 (87%); acute cholecystitis n = 6 (13%)), corresponding to approximately 85% of the total number of gall bladder stone patients during the period were selected for laparoscopic cholecystectomy. Two patients had previously undergone upper abdominal operations and had adhesions and one patient suffered from cirrhosis of the liver with portal hypertension. It proved necessary to convert five of the laparoscopic cholecystectomies to open cholecystectomies (11%) on account of technical difficulties (severe acute changes due to cholecystitis (n = 3), indeterminable anatomical conditions (n = 1) and one case of liver metastases (n = 1)). The median duration of operation was 90 minutes with a range from 30 to 360 minutes. Peroperative cholangiography was not undertaken routinely. No cases of forgotten stones in the common bile duct occurred. No deaths occurred and, in all, three slight complications occurred (7%): two patients had haematoma in the abdominal wall and one patient minimal leakage of bile from the stump of the gall bladder on account of insufficient ligation of the cystic duct. This patient was treated with an endoscopically placed drain in the common bile duct for two weeks, after which she was well. No lesions of the common bile duct occurred. None of the complications required laparotomy. The median duration of hospitalization was 24 hours with a range from one to 14 days. All of the patients were at work or could manage their usual activities after 14 days. The median duration of sick leave was seven days.(ABSTRACT TRUNCATED AT 250 WORDS)
Jensen
S L
SL
Kirurgisk afdeling L, sektion AKH, Aarhus Universitetshospital.
Jensen
P F
PF
Wara
P
P
Rokkjaer
M
M
D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Laparoskopisk kolecystektomi. De første 45 operationer.