Small-incision cholecystectomy (through a cylinder retractor) under local anaesthesia and sedation: a prospective observational study of five hundred consecutive cases

Grau-Talens, Enrique J.; Motos-Micó, José Jacob; Giraldo-Rubio, Rafael; Aparicio-Gallego, José M.; Salgado, J.; Ibáñez, Carlos D.; Mangione-Castro, Pablo G.; Arribas-Jurado, Martina; Jordán-Chaves, Carlos; Arias-Dı́az, Javier

doi:10.1007/s00423-018-1707-9

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…Another alternative that can even be performed under local anaesthesia as day-care surgery is a small-incision cholecystectomy through a cylinder retractor. Grau-Talens et al showed in a large prospective study that this operation is safe and feasible in three out of four patients with cholelithiasis [56].…”

Section: Discussionmentioning

confidence: 96%

Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up

Klein

Barutcu

Kröll

et al. 2020

Langenbecks Arch Surg

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Background Within the last years, single-incision laparoscopic cholecystectomy (SLC) emerged as an alternative to multiport laparoscopic cholecystectomy (MLC). SLC has advantages in cosmetic results, and postoperative pain seems lower. Overall complications are comparable between SLC and MLC. However, long-term results of randomized trials are lacking, notably to answer questions about incisional hernia rates, long-term cosmetic impact and chronic pain. Methods A randomized trial of SLC versus MLC with a total of 193 patients between December 2009 and June 2011 was performed. The primary endpoint was postoperative pain on the first day after surgery. Secondary endpoints were conversion rate, operative time, intraoperative and postoperative morbidity, technical feasibility and hospital stay. A long-term follow-up after surgery was added. Results Ninety-eight patients (50.8%) underwent SLC, and 95 patients (49.2%) had MLC. Pain on the first postoperative day showed no difference between the operative procedures (SLC vs. MLC, 3.4 ± 1.8 vs. 3.7 ± 1.9, respectively; p = 0.317). No significant differences were observed in operating time or the overall rate of postoperative complications (4.1% vs. 3.2%; p = 0.731). SLC exhibited better cosmetic results in the short term. In the long term, after a mean of 70.4 months, there were no differences in incisional hernia rate, cosmetic results or pain at the incision between the two groups. Conclusions Taking into account a follow-up rate of 68%, the early postoperative advantages of SLC in relation to cosmetic appearance and pain did not persist in the long term. In the present trial, there was no difference in incisional hernia rates between SLC and MLC, but the sample size is too small for a final conclusion regarding hernia rates. Trial registration German Registry of Clinical Trials DRKS00012447

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Section: Discussionmentioning

confidence: 96%

Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up

Klein

Barutcu

Kröll

et al. 2020

Langenbecks Arch Surg

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“…Before 1991, open cholecystectomy was the common procedure. 1 Presently most cholecystectomies are done by laparoscopic approach. 2 However, conversion to open cholecystectomy is needed in few circumstances.…”

Section: Introductionmentioning

confidence: 99%

Study of open cholecystectomy for gallbladder disorders

Kumar

Reddy

2021

Int Surg J

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Background: Cholecystectomy is one of the most common surgeries done worldwide. Most common indication is biliary colic due to cholelithiasis. Presently most cholecystectomies are done by laparoscopic approach, however conversion to open cholecystectomy is needed in few circumstances and there are some absolute indications for open cholecystectomy where laparoscopic procedure can’t be done.Methods: This is a prospective observational study of 50 open cholecystectomies operated during March 2017 to Feb 2019 in our medical college. Various data including demographic data of patients, different indications, post-operative complications were documented and analyzed.Results: Mean age of the patients was 40.58 (16-65) years. Female patients were more in number 32 (64%) when compared with males. Maximum patients were in the age group 31-40 years accounting to 17 (34%) of study population. Pain abdomen 24 (48%) was the chief presenting complaint. Cholelithiasis 38 (76%) was the major indication for surgery. Complications like bile leak, bleeding, subphrenic abscess and infection occurred in 04 (08%) patients. Total four cases of laparoscopic cholecystectomy were converted to open cholecystectomy. Mean hospital stay was 7.48 (5-14) days.Conclusions: Even though laparoscopic cholecystectomy is the gold standard in the present era, it is important that the surgeon is also competent in doing open cholecystectomy. Certain conditions require planned open cholecystectomy as the standard procedure. In difficult laparoscopic cases, the surgeon must take timely decision to convert to the open technique. Surgeons experience and proper clinical judgment skills are important in difficult cases.

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“…Laparotomy cholecystectomy is performed by creating an incision 4 -6 inches on the abdomen in the right upper quadrant, and taking vesica fellea through the incision. This procedure is performed in case of complications in laparoscopic cholecystectomy 7 .Laparoscopic cholecystectomy is performed by inserting a laparoscope through 3-4 small incisions. The doctor will perform the surgery through the monitor screen, then remove the vesica fellea through one of the incision that has been made.…”

Section: Introductionmentioning

confidence: 99%

The Difference of Length of Stay, Surgical Site Infection, Post Surgical Pain, and Bile Leak in Laparoscopic Cholecystectomy and Open Cholecystectomy

Putri

Jaeri

Prasetyo

et al. 2021

DMJ

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Background: The incidence of cholesistolithiasis is increased due to the changes of diet to the western diet. The cholecystectomy is one of the treatments for cholecystolithiasis. It can be divided into laparoscopic cholecystectomy and laparotomy cholecystectomi. The previous study demonstrated that the laparoscopic cholecystectomy was better than laparotomy cholecystectomy for postoperative length of stay, surgical site infection, postoperative pain, and bile leak in cholecystolithiasis, but there is no official data and research yet in Indonesia Objective: To determine the difference of postoperative length of stay, surgical site infection, postoperative pain, and bile leak in laparoscopic cholecystectomy and laparotomy cholecystectomy.Methods: An analytic observational study with cross sectional design. Subject was patient who had undergone laparoscopic or laparotomy cholecystectomy from Dr Kariadi Hospital, Semarang and RSND Semarang during period of 2013 to 2019. The Mann Whitney-U test was used to determine the difference of length of stay as well the Chi Square test for determining the difference of surgical site infection, postoperative pain, and bile leak among both groups.Results: 34 (41.5%) men and 48 (58.5%) women with an age avarage of 49.84 ± 13.54 years were included. There were a significant difference between laparoscopic and laparotomy cholecystectomy in cholecystectolithiasis cases on postoperative hospital stay (p = 0.000), postoperative pain (p = 0.000), surgical site nfection (p = 0.000), and bile leak ( p = 0.013).Conclusion: Laparoscopic cholecystectomy was better than open cholecystectomy in postoperative hospital stay, surgical site infection, postoperative pain, and bile leak for cholecystolithiasis cases. Keywords: bile leak , cholecystetomy, cholecystolithiasis, laparoscopy, laparotomy

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Small-incision cholecystectomy (through a cylinder retractor) under local anaesthesia and sedation: a prospective observational study of five hundred consecutive cases

Cited by 7 publications

References 33 publications

Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up

Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up

Study of open cholecystectomy for gallbladder disorders

The Difference of Length of Stay, Surgical Site Infection, Post Surgical Pain, and Bile Leak in Laparoscopic Cholecystectomy and Open Cholecystectomy

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