BACKGROUND: The aim of this study was to evaluate the extent of postoperative adhesion formation after laparoscopic and open cholecystectomy. MATERIALS AND METHODS: Qualified surgeons performed 60 experimental laparoscopic cholecystectomies (LC) in dogs with the aim to acquire the laparoscopic technique. To assess the relation between the complications during the operation (bleeding, laceration of the liver bed, or gallbladder perforation) and the formation of adhesions, surviving animals were divided into four groups according to the type of complication occurred. Assessment of the results was made by second-look laparoscopy 4 weeks after LC using the adhesion index (AI; score range, 0-4). The animals then were killed so the extent of adhesion formation could be measured. As a control, open cholecystectomy was performed in 15 dogs without intraoperative complications. The Mann-Whitney rank-sum test and Dunn's method were used for statistical analysis. RESULTS: No adhesion formation or intraoperative complications were registered in the laparoscopic group I. In all the cases wherein bleeding or laceration of the liver bed occurred and was managed with electrocoagulation, adhesions formed. Adhesion formation in these groups was significantly higher than in "ideal LC" or cases of gallbladder perforation alone (p < 0.01). All the animals in the control group developed significantly more adhesions than those in the experimental group (p < 0.05). CONCLUSIONS: It seems that LC has a lower rate of adhesion formation than the conventional open technique. Complications such as bleeding or laceration of the liver bed during LC can enhance adhesion formation. No adhesion formation can be mentioned in relation to gallbladder perforation during LC.
BACKGROUND: The aim of this study was to evaluate the extent of postoperative adhesion formation after laparoscopic and open cholecystectomy. MATERIALS AND METHODS: Qualified surgeons performed 60 experimental laparoscopic cholecystectomies (LC) in dogs with the aim to acquire the laparoscopic technique. To assess the relation between the complications during the operation (bleeding, laceration of the liver bed, or gallbladder perforation) and the formation of adhesions, surviving animals were divided into four groups according to the type of complication occurred. Assessment of the results was made by second-look laparoscopy 4 weeks after LC using the adhesion index (AI; score range, 0-4). The animals then were killed so the extent of adhesion formation could be measured. As a control, open cholecystectomy was performed in 15 dogs without intraoperative complications. The Mann-Whitney rank-sum test and Dunn's method were used for statistical analysis. RESULTS: No adhesion formation or intraoperative complications were registered in the laparoscopic group I. In all the cases wherein bleeding or laceration of the liver bed occurred and was managed with electrocoagulation, adhesions formed. Adhesion formation in these groups was significantly higher than in "ideal LC" or cases of gallbladder perforation alone (p < 0.01). All the animals in the control group developed significantly more adhesions than those in the experimental group (p < 0.05). CONCLUSIONS: It seems that LC has a lower rate of adhesion formation than the conventional open technique. Complications such as bleeding or laceration of the liver bed during LC can enhance adhesion formation. No adhesion formation can be mentioned in relation to gallbladder perforation during LC.
Authors: A L Halverson; W L Barrett; P Bhanot; J E Phillips; A R Iglesias; L K Jacobs; J M Sackier Journal: Surg Endosc Date: 1999-01 Impact factor: 4.584
Authors: Rosa M Jimenez Rodriguez; Juan José Segura-Sampedro; Mercedes Flores-Cortés; Francisco López-Bernal; Cristobalina Martín; Verónica Pino Diaz; Felipe Pareja Ciuro; Javier Padillo Ruiz Journal: World J Gastroenterol Date: 2016-03-07 Impact factor: 5.742
Authors: Fausto Catena; Salomone Di Saverio; Michael D Kelly; Walter L Biffl; Luca Ansaloni; Vincenzo Mandalà; George C Velmahos; Massimo Sartelli; Gregorio Tugnoli; Massimo Lupo; Stefano Mandalà; Antonio D Pinna; Paul H Sugarbaker; Harry Van Goor; Ernest E Moore; Johannes Jeekel Journal: World J Emerg Surg Date: 2011-01-21 Impact factor: 5.469
Authors: Salomone Di Saverio; Fausto Catena; Federico Coccolini; Marica Galati; Nazareno Smerieri; Walter L Biffl; Luca Ansaloni; Gregorio Tugnoli; George C Velmahos; Massimo Sartelli; Cino Bendinelli; Gustavo Pereira Fraga; Michael D Kelly; Frederick A Moore; Vincenzo Mandalà; Stefano Mandalà; Michele Masetti; Elio Jovine; Antonio D Pinna; Andrew B Peitzman; Ari Leppaniemi; Paul H Sugarbaker; Harry Van Goor; Ernest E Moore; Johannes Jeekel Journal: World J Emerg Surg Date: 2013-10-10 Impact factor: 5.469