OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH GALLSTONE DISEASE AT A SECONDARY LEVEL CARE HOSPITAL
- PMID: 29947681
- PMCID: PMC6049991
- DOI: 10.1590/0102-672020180001e1347
OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH GALLSTONE DISEASE AT A SECONDARY LEVEL CARE HOSPITAL
Abstract
Background: Laparoscopic cholecystectomy is the most commonly performed operation of the digestive tract. )It is considered as the gold standard treatment for cholelithiasis.
Aim: To evaluate the outcome of it regarding length of hospital stay, complications, morbidity and mortality at a secondary hospital.
Methods: Data of 492 patients who underwent laparoscopic cholecystectomy were retrospectively reviewed. Patients' demographics, co-morbid diseases, previous abdominal surgery, conversion to open cholecystectomy, operative time, intra and postoperative complications, and hospital stay were collected and analyzed from patients' files.
Results: Out of 492 patients, 386 (78.5%) were females and 106 (21.5%) males. The mean age of the patients was 49.35±8.68 years. Mean operative time was 65.94±11.52 min. Twenty-four cases (4.9%) were converted to open surgery, four due to obscure anatomy (0.8%), 11 due to difficult dissection in Calot's triangle (2.2%) and nine by bleeding (1.8%). Twelve (2.4%) cases had biliary leakage, seven (1.4%) due to partial tear in common bile duct, the other five due to slipped cystic duct stables. Mean hospital stay was 2.6±1.5 days. Twenty-one (4.3%) developed wound infection. Port site hernia was detected in nine (1.8%) patients. There was no cases of bowel injury or spilled gallstones. There was no mortality recorded in this series.
Conclusions: Laparoscopic cholecystectomy is a safe and effective line for management of gallstone disease that can be performed with acceptable morbidity at a secondary hospital.
Racional:: A colecistectomia laparoscópica é a operação mais comum do aparelho digestivo. É considerada como o tratamento padrão-ouro para colecistolitíase.
Objetivo:: Avaliar o resultado dela quanto ao tempo de internação, complicações, morbidade e mortalidade em um hospital secundário.
Métodos:: Foram analisados retrospectivamente dados de 492 doentes submetidos à colecistectomia laparoscópica. Os dados demográficos, as comorbidades, operação abdominal prévia, conversão para colecistectomia laparotômica, tempo cirúrgico, complicações intra e pós-operatórias e internação hospitalar foram coletados e analisados a partir dos prontuários.
Resultados:: Dos 492 pacientes, 386 (78,5%) eram mulheres e 106 (21,5%) homens. A idade média foi de 49,35±8,68 anos. O tempo operatório médio foi de 65,94±11,52 min. Vinte e quatro casos (4,9%) foram convertidos em laparotomia quatro devido à anatomia obscura (0,8%), 11 por dissecção difícil no triângulo de Calot (2,2%) e nove por sangramento (1,8%). Doze (2,4%) casos apresentaram vazamento biliar, sendo sete (1,4%) devido a ruptura parcial do ducto biliar comum, e os outros cinco por soltura da clipagem do ducto cístico. A média de internação foi de 2,6±1,5 dias. Vinte e um (4,3%) pacientes desenvolveram infecção da ferida. Hérnia do local dos portais foi detectada em nove (1,8%) pacientes. Não houve casos de lesão intestinal ou cálculos biliares soltos na cavidade. Não houve mortalidade
Conclusões:: Colecistectomia laparoscópica é operação segura e eficaz no tratamento da colecistolitíase e pode ser realizada com morbidade aceitável em hospitais secundários.
Conflict of interest statement
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