Alaa M Sewefy1, Aymen M Hassanen2, Ahmed M Atyia2, Amr M Gaafar2. 1. Department of Surgery, Minia University Hospital, Egypt. Electronic address: sewafy@yahoo.co.uk. 2. Department of Surgery, Minia University Hospital, Egypt.
Abstract
BACKGROUND: Laparoscopic cholecystectomy becomes the gold standard surgical procedure for treating gallstones. Standard laparoscopic cholecystectomy (SLC) requires proper dissection of Calot's triangle to achieve the critical view of safety. This may be difficult in certain conditions, resulting in higher incidence of bile duct injury and conversion to open. We aimed to compare the outcomes of laparoscopic cholecystectomy by retroinfundibular (RI) approach to that of SLC, in difficult cases. PATIENTS AND METHODS: This study is prospective cohort study, in which 60 patients were operated by SLC and 65 patients by laparoscopic cholecystectomy by RI approach. RESULTS: From the total 125 cases, 95 (76%) patients were male and 30 (24%) were female. The mean age was 59.5 ± 5.5 years. The mean operative time in SLC group was 128 ± 17 min VS. 114 ± 10 min in RI group. Conversion to open occurred in 10% in SLC group VS. 1.5% in RI group. Biliary injury occurred in 3.3% in SLC group VS. 0% in RI group. The mean hospital stay in SLC was 3.7 ± 5.3 days VS. 2.1 ± 0.3 days in RI group. CONCLUSION: In difficult cholecystectomy, RI approach is feasible and safe alternative to SLC.
BACKGROUND: Laparoscopic cholecystectomy becomes the gold standard surgical procedure for treating gallstones. Standard laparoscopic cholecystectomy (SLC) requires proper dissection of Calot's triangle to achieve the critical view of safety. This may be difficult in certain conditions, resulting in higher incidence of bile duct injury and conversion to open. We aimed to compare the outcomes of laparoscopic cholecystectomy by retroinfundibular (RI) approach to that of SLC, in difficult cases. PATIENTS AND METHODS: This study is prospective cohort study, in which 60 patients were operated by SLC and 65 patients by laparoscopic cholecystectomy by RI approach. RESULTS: From the total 125 cases, 95 (76%) patients were male and 30 (24%) were female. The mean age was 59.5 ± 5.5 years. The mean operative time in SLC group was 128 ± 17 min VS. 114 ± 10 min in RI group. Conversion to open occurred in 10% in SLC group VS. 1.5% in RI group. Biliary injury occurred in 3.3% in SLC group VS. 0% in RI group. The mean hospital stay in SLC was 3.7 ± 5.3 days VS. 2.1 ± 0.3 days in RI group. CONCLUSION: In difficult cholecystectomy, RI approach is feasible and safe alternative to SLC.
Authors: Nicola de'Angelis; Fausto Catena; Riccardo Memeo; Federico Coccolini; Aleix Martínez-Pérez; Oreste M Romeo; Belinda De Simone; Salomone Di Saverio; Raffaele Brustia; Rami Rhaiem; Tullio Piardi; Maria Conticchio; Francesco Marchegiani; Nassiba Beghdadi; Fikri M Abu-Zidan; Ruslan Alikhanov; Marc-Antoine Allard; Niccolò Allievi; Giuliana Amaddeo; Luca Ansaloni; Roland Andersson; Enrico Andolfi; Mohammad Azfar; Miklosh Bala; Amine Benkabbou; Offir Ben-Ishay; Giorgio Bianchi; Walter L Biffl; Francesco Brunetti; Maria Clotilde Carra; Daniel Casanova; Valerio Celentano; Marco Ceresoli; Osvaldo Chiara; Stefania Cimbanassi; Roberto Bini; Raul Coimbra; Gian Luigi de'Angelis; Francesco Decembrino; Andrea De Palma; Philip R de Reuver; Carlos Domingo; Christian Cotsoglou; Alessandro Ferrero; Gustavo P Fraga; Federica Gaiani; Federico Gheza; Angela Gurrado; Ewen Harrison; Angel Henriquez; Stefan Hofmeyr; Roberta Iadarola; Jeffry L Kashuk; Reza Kianmanesh; Andrew W Kirkpatrick; Yoram Kluger; Filippo Landi; Serena Langella; Real Lapointe; Bertrand Le Roy; Alain Luciani; Fernando Machado; Umberto Maggi; Ronald V Maier; Alain Chichom Mefire; Kazuhiro Hiramatsu; Carlos Ordoñez; Franca Patrizi; Manuel Planells; Andrew B Peitzman; Juan Pekolj; Fabiano Perdigao; Bruno M Pereira; Patrick Pessaux; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Luca Portigliotti; Raffaele Romito; Boris Sakakushev; Behnam Sanei; Olivier Scatton; Mario Serradilla-Martin; Anne-Sophie Schneck; Mohammed Lamine Sissoko; Iradj Sobhani; Richard P Ten Broek; Mario Testini; Roberto Valinas; Giorgos Veloudis; Giulio Cesare Vitali; Dieter Weber; Luigi Zorcolo; Felice Giuliante; Paschalis Gavriilidis; David Fuks; Daniele Sommacale Journal: World J Emerg Surg Date: 2021-06-10 Impact factor: 5.469