Hydrodissection with adrenaline-lidocaine-saline solution in laparoscopic cholecystectomy.
OBJECTIVE
This investigation examined the effects of a solution injected to the gallbladder bed on operative time, bleeding, incidence of gallbladder perforation, and postoperative pain.


METHODS
One hundred sixty-four consecutive patients with cholelithiasis were randomized into two clinically comparable groups. In group 1 (84 patients), 40 ml of saline-adrenaline-lidocaine solution was injected between the gallbladder and liver. In group 2 (80 patients), laparoscopic cholecystectomy was performed without hydrodissection. The time taken to dissect the gallbladder from the liver, bleeding from the liver bed, incidence of gallbladder perforation and spillage of bile and stones, duration of operation, amount of gas used for the laparoscopic cholecystectomy, conversion to open cholecystectomy, postoperative pain and pain localization were recorded.


RESULTS
The mean dissection time, amount of gas used, incidence of gallbladder perforation, spillage of stones, and liver bed bleeding were not significantly different between the groups. There also was no significant difference between the groups regarding postoperative pain and pain localization.


CONCLUSIONS
Hydrodissection did not reduce time to dissect the gallbladder from the liver or risk of gallbladder perforation. Similarly, adrenaline and lidocaine injection between the gallbladder and the liver did not effect bleeding from the dissection area and did not alter postoperative pain or pain localization.
Caliskan
K
K
Department of General Surgery, Teaching and Medical Research Hospital, Başkent University, Adana, Turkey. ken_caliskan@yahoo.com
Nursal
T Z
TZ
Yildirim
S
S
Moray
G
G
Torer
N
N
Noyan
T
T
Haberal
M A
MA