[How to reduce morbidity in celioscopic biliary surgery. Apropos of a series of 446 consecutive operations].
We reported a series of 446 consecutive cholecystectomies performed laparoscopically between June 1990 and January 1993. There were 354 females and 92 men, mean age 53 +/- 17 years. Laparoscopic cholangiography was attempted in 410 cases (92%) and led to the discover of a stone in the main bile duct in 18 cases (4%) and an abnormal insertion of the bladder duct in 30% (6.7%). Conversion to laparotomy was required in 84 patients (18.8%) due to difficult dissection (52), peroperative incidents or accidents (15) and abnormal hepatogram (17). No accident inherent to the operation was encountered in this series. One death occurred after laparotomic conversion for acute angiocholitis. The rate of post-operative complications was 5.6% and reoperations were required in 7 patients (1.5%).
Atat
I
I
Service de Chirurgie digestive et thoracique, Centre hospitalier Saint-Philibert, Lomme.
Randoux
O
O
Vandevenne
P
P
Filoche
B
B
Desrousseaux
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged
Comment réduire la morbidité en chirurgie biliaire par voie coelioscopique. A propos d'une série de 446 interventions consécutives.