Injuries Presentations in Laparoscopic Versus Open Cholecystectomy
Journal of Surgery
Volume 3, Issue 4, August 2015, Pages: 39-43
Received: Jul. 12, 2015; Accepted: Jul. 22, 2015; Published: Jul. 31, 2015
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Authors
Mohamed Salah Abdelhamid, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Ahmed Mohamed Sadat, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Ayman Hamdi Abouleid, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Amr Mohamed Aly Mohamed, Surgery department, Bani-Suef faculty of medicine, Bani-Suef university, Bani -Suef, Egypt
Mahmoud Ahmed Negida, Surgery department, Kasr Elaini faculty of medicine, Cairo university, Cairo, Egypt
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Abstract
The wide acceptance of LC in the early 1990s was based on several case series rather than randomized controlled trials. Community awareness that a minimally invasive procedure could dramatically reduce postoperative pain and improve recuperation made it impractical to conduct trials that might have better refined the technique. This study was to recognize the actual complication risk associated with cholecystectomy. Included in the study were 1486 patients operated upon between Feb. 1999 and April. 2014. Open cholecystectomy done in 292 (19.6%) mostly in patients with contra-indications for laparoscopy, 1194 (80.4%) initiated laparoscopically, 1086[91%] completed laparoscopically and 108 (9%) converted to open procedure. There were eighteen (1.2%) patients with bile duct injury. One patient (0.3%) in the open procedure and seventeen (1.4%) in the laparoscopic procedure. Nine cases presented with intra-operative injury, two with early post operative jaundice, two with late post operative jaundice, five with post operative leak. The patients with recognized intra-operative injury were significantly not higher in the laparoscopic group of patients (P<0.3) than in the open procedure. The post operative jaundice was significantly high in the laparoscopic group of patients (P<0.045). The post operative leak was significantly higher in the laparoscopic group of patients than in the open procedure (P<0.028). In general post operative morbidity was high in the laparoscopic group of patients than in the open procedure (P<0.01). On the other hand, the post operative mortality were four times more in the open procedure and was statistically significant (P<0.04). Conclusion: The risk of complications after cholecystectomy was slightly higher than that found in literature; Laparoscopic cholecystectomy was associated with a higher incidence of CBD injuries, leak, jaundice and technical factors leading to failure to recognize injuries when they occur.
Keywords
Cholecystectomy, Open, Laparoscopic, Complications
To cite this article
Mohamed Salah Abdelhamid, Ahmed Mohamed Sadat, Ayman Hamdi Abouleid, Amr Mohamed Aly Mohamed, Mahmoud Ahmed Negida, Injuries Presentations in Laparoscopic Versus Open Cholecystectomy, Journal of Surgery. Vol. 3, No. 4, 2015, pp. 39-43. doi: 10.11648/j.js.20150304.12
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