Day-care laparoscopic cholecystectomy with diathermy hook versus fundus-first ultrasonic dissection: a randomized study

Mattila, Anne; Mrena, Johanna; Kautiainen, Hannu; Nevantaus, Juha; Kellokumpu, Ilmo

doi:10.1007/s00464-015-4691-y

Cited by 9 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Discussions suggest that this is due to better hemostasis, which allows a more exact and faster dissection. However, two recent randomized studies have shown similar operative time for the two techniques [15,16].…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Surgical Unit’s Structure and Operative Technique on Quality in Two Swedish Rural Hospitals

Odelberg

Cengiz

Jänes

et al. 2019

Journal of Investigative Surgery

View full text Add to dashboard Cite

Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical procedure with a low complication rate. It is performed either as an acute or as an elective procedure. Most elective LCs are performed on nonlethal diseases and this is why good quality is important. Our study compared the quality of LC in two surgical units in northern Sweden (Sundsvall and € Ostersund) which use different clinical structures (subspecialised vs. general surgery) and surgical techniques (ultrasound fundus first vs. conventional diathermy). The study aimed to investigate whether these differences affected the quality of outcomes after LC. Materials and methods: This is a registry-based study which included 607 elective LCs from January 2014 to May 2016. There were 286 from Sundsvall and 321 from € Ostersund. Primary outcomes were operative time and the percentage of day surgeries. The secondary outcome was the presence of postoperative complications within the first 30 days in terms of bile duct injury, bleeding that necessitated reoperation, bile leakage and abscesses treated with drainage and mortality. Results: The time length of surgery was shorter in Sundsvall (mean 48.3 min) compared to € Ostersund (mean 108.6 min, p < 0.001. The percentage of day care surgeries was 94% in Sundsvall and 23% in € Ostersund, p < 0.001. Six patients (2.1%) had a complication in Sundsvall compared to seven patients (2.2%) in € Ostersund, p ¼ 1.00. Conclusion: There is a significant difference between the two hospitals regarding operative time and the percentage of day surgeries. Complication rates in both units were equal and low.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of a Surgical Unit’s Structure and Operative Technique on Quality in Two Swedish Rural Hospitals

Odelberg

Cengiz

Jänes

et al. 2019

Journal of Investigative Surgery

View full text Add to dashboard Cite

show abstract

“…Numeric rating scale for pain has been used, only in few studies. 12,13 In this study, we used the numeric rating scale, as it has the advantage of being self administered and can be even recorded verbally, over a telephone call.…”

Section: Limitations Of the Studymentioning

confidence: 99%

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

2020

View full text Add to dashboard Cite

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

show abstract

“…The surgeon considering LC should be familiar with a variety of methods for cystic duct dissection and ligation to avoid complications and reduce the rate of conversions [9][10][11][12][13][14][15][16] . Traditionally, LC is performed using a four-port approach.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit’s model

Wittmaack,

Conceição,

Vera

et al. 2023

Acta Cir. Bras.

View full text Add to dashboard Cite

The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed. Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal. Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups.Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. Conclusion:LC can be performed using different techniques, although the use of EBVS is highly recommended.

show abstract

Day-care laparoscopic cholecystectomy with diathermy hook versus fundus-first ultrasonic dissection: a randomized study

Abstract: Day-care LC using either diathermy hook or ultrasonic dissection resulted in excellent same-day discharge in both groups (87 %). LC with ultrasonic dissection does not offer any clinical advantages compared to diathermy dissection.

Cited by 9 publications

References 27 publications

The Impact of a Surgical Unit’s Structure and Operative Technique on Quality in Two Swedish Rural Hospitals

The Impact of a Surgical Unit’s Structure and Operative Technique on Quality in Two Swedish Rural Hospitals

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit’s model

Contact Info

Product

Resources

About