Avtor/Urednik		Rifel, Marko; Guna, Tadej; Jazbec, Ladislav
Naslov		Laparoskopsko holecistektomirani bolniki v Splošni bolnišnici Trbovlje
Prevedeni naslov		Laparoscopic cholecystectomy in the Trbovlje general hospital
Tip		članek
Vir		Endoskopska Revija
Vol. in št.		Letnik 4, št. 8
Leto izdaje		1999
Obseg		str. 17-23
Jezik		slo
Abstrakt		Background. In 1993, the first laparoscopic cholecystectomy (LC) was performed in the Trbovlje General Hospital. Hospital, followed by 403 such procedures until end-June 1998. The authors compare the results of the unitial 100 operations with those of the procedures carried out in the past 2.5 years, and with those reported in the literature. Patients and methods. The study involved 263 patients treated by LC between 1 January 1996 and 31 June 1998. There was a preponderance of women; the mean age was 48 years, and most patients (80%) had no previous abdominal operation. The most frequent indication for surgery was chronic calculous cholecystitis. Results. The average length of LC decreased from 75 minutes in 1996 to 52 minutes in 1998. Complications included bleeding in 18.2% of cases, perforation of the gallbladder in 13.7%, loss of stone in 3.4%, loss of clip 2.3%, and anomalous anatomy in 2%. During this period conversion was required in 1.3-2.7% of cases (mean 2.3%), mostly because of poor visualization of the gallbladder anatomy. Postoperative haematoma developed in 1.5% of patients and bile leakage in 0.76%. ERCP was required in 0.38% of patients. Postoperative hospital stay was 3.6 to 3.9 days.
Izvleček		Izhodišča. Od leta 1993, ko smo opravili prvo laparoskopsko holecistektomijo (LH), pa do konca junija 1998 smo v Splošni bolnišnici Trbovlje naredili 403 tovrstnih posegov. Članek analizira opravljeno delo, tako primerja rezultate prvih stotih posegov z rezultati posegov v zadnjih dveh letih in pol, pa tudi z rezultati iz literature. Bolniki in metode. V študijo smo vključili 263 bolnikov, laparoskopsko operiranih od 1.1.1996 do 31.06.1998. Prevladovale so bolnice, povprečna starost je bila 48 let, večina (80%) pa jih ni bila pred tem intraabdominalno operirana. Najpogosteješa indikacija za operacijo je bil kronični kalkulozni holecistitis. Rezultati. Povprečno trajanje LH se je od leta 1996 do polovice leta 1998 znižalo s 75 na 52 minut. Med operativnimi zapleti so bili krvavitev (18,2%), perforacija žolčnika (13,7%), izguba kamna (3,4%), izguba klipa (2,3%), anatomska varianta (2%). Odstotek konverzij v obravnavanem obdobju je bil med 1,3 do 2,6%, povrečno 2,3%. Najpogostejši vzrok za konverzijo je bila slaba preglednost anatomije žolčnika. Pooperativno se je hematom pojavil pri 1,5%, iztekanje žolča pri 0,76%, ERCP je bil potreben pri 0,38% bolnikov. Pooperativna hospitalizacija je trajala povprečno od 3,6 do 3,9 dni. Zaključki. Laparoskopska metoda holecistektomije je na našem oddelku uveljavljena metoda, rezultati pa so primerljivi z rezultati domačih in tujih avtorjev.
Deskriptorji		SURGERY, LAPAROSCOPIC CHOLECYSTECTOMY, LAPAROSCOPIC CHOLELITHIASIS SLOVENIA TREATMENT OUTCOME