Volume : 7, Issue : 4, April - 2018

A study of surgical techniques in difficult laparoscopic cholecystectomies

Dr. Virendra Nanaji Zambare

Abstract :

<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-bidi-font-style:&#10;italic">AIMS :</span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-weight:bold;mso-bidi-font-style:italic">This study aims to evaluate the impact of conversion from retrograde dissection to fundus-first technique (FF) or laparoscopic partial cholecystectomy (LPC) on complication rates, operation time, and duration of hospitalization.<b><o:p></o:p></b></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-bidi-font-style:&#10;italic">METHODS: </span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-weight:bold;mso-bidi-font-style:italic">The medical records of 210 consecutive patients who underwent laparoscopic cholecystectomy between January 2011 and December 2017 were retrospectively evaluated. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-bidi-font-style:&#10;italic">RESULTS: </span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-weight:bold;mso-bidi-font-style:italic">Of the 210 cases, LC was initiated and completed with RD in 197 cases. FF was implemented in 13 cases due to difficulties in dissection. In the FF group, laparoscopic total cholecystectomy was successfully accomplished in seven patients, and LPC was performed in the remaining six cases.<b><o:p></o:p></b></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-bidi-font-style:&#10;italic">CONCLUSION</span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-weight:bold;mso-bidi-font-style:italic">: In complicated cases where anatomic uncertainties are dominant, the performance of FF technique or LPC may decrease conversion rates to open surgery and contribute to accomplishing the laparoscopic intervention safely. <o:p></o:p></span></p>