Ostalo
Laparoscopic Three-Trocar Cholecystectomy at Bjelovar General Hospital
Darko Košćak
Josip Lovrić
Sažetak
A modified European technique of laparoscopic cholecystectomy with the use of three trocars, employed in 599 patients at Bjelovar General Hospital from July 1999 till July 2004, is described. The indications and patient selection for this operative method are the same as for laparoscopic cholecystectomy performed with four trocars. There is no modification in the preoperative procedure and treatment, anesthesia, patient.s position and preparation for the operation either. The instrumentarium and equipment used on laparoscopic cholecystectomy were manufactured by Olympus. In 577 (96%) cases, the procedure was completed laparoscopically, whereas conversion to open procedure was required in 22 (4%) cases. A fourth trocar had to be placed in 20 (3.5%) of 577 (96%) successful three-trocar procedures of laparoscopic cholecystectomy. The procedure took about 45 min on an average. Considering complications, shoulder pain developed in 60, minor hematoma in 12, and nausea for more than 12 hours in 40 patients. There was no mortality. Bile leak from the gallbladder bed that spontaneously stopped within 72 hours and postoperative drain bleeding that resolved spontaneously requiring no blood transfusion were recorded in one patient each. The mean patient stay at hospital was 2.7 days. It is concluded that laparoscopic cholecystectomy with a reduced number of incisions, i.e. with three trocars, is as successful procedure of gallbladder removal without increasing the rate of complications. However, a fourth trocar should be placed or conversion to open procedure performed whenever indicated by the local finding.
Ključne riječi
Cholecystectomy, laparoscopic -methods; Cholecystectomy, laparoscopic - instrumentation; Cholecystectomy, laparoscopic - complications; Cholelithiasis - surgery; Hospital Bjelovar; Croatia
Hrčak ID:
14086
URI
Datum izdavanja:
1.5.2006.
Posjeta: 2.972 *