Avtor/Urednik		Huis, Marijan; Balija, Milivoj; Knezović, Ivanka; Štulhofer, Mladen
Naslov		Laparoscopic cholecystectomy: our experience 1994-1999
Prevedeni naslov		Laparoskopska holecistektomija - naše izkušnje v obdobju od 1994 do 1999
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 6, št. 12-13
Leto izdaje		2000
Obseg		str. 83-7
Jezik		eng
Abstrakt		Background. Laparoscopic cholecystectomy is the method of choice for the surgical treatment of cholelithiasis thanks to its low aggressiveness, minimal postoperative discomfort, low rate intra- and postoperative complications, short hospital stay compared with conventional cholecystectomy, rapid recovery, and favorable cosmetic effect. Mathod and results. From 15 December 1994, when the first laparoscopic cholecystectomy was performed at this Department, to 30 Decembr 1999, a total of 1816 biliary tract procedures were carried out. We use two 5-mm and two 10-mm trocars placed at typical sites, and other instrumentarium used in laparoscopic operations. The procedure was initiated laparoscopically in 1271 patients and completed by the same method in 1213 patients. In the remaining 58 (4.56%) patients, conversion of the laparoscopically innitiated procedure was required because of unclear anatomical relations, intraoperative bleeding, and complications of anaesthesia. The conventional operative method was employed in 603 patients. In the laparoscopic cholecystectomy cohort, 19 (1.56%) patients had to be reoperated because of early complication occurring in the early postoperative course. Late postoperative complications included postopeative hernia at the site of supraumbilical incision in three (0.24%) patients. The mean duration of the procedure was 50 min and the mean hospital stay was 3.1 days. The mortality rate was 0.08%. Most patients of working age resumed their daily activities in 3 weeks. Conclusion. Laparoscopic cholecystectomy is a well-established method in the Zabok Department of Surgery. It carries a very low rate of intraoperative or postoperative complications and leads to a rapis recovery. To our experience, favourable postoperative results depend to the greatest extent on a careful preoperative evaluation of the patient and expertise of the operating team.
Izvleček		Laparoskopska holecistektomija je metoda izbire v zdravljenju žolčnih kamnov iz naslednjih razlogov: minimalna agresivnost metode, manj bolečin po operaciji, redki zapleti med in po operaciji, krajši čas hospitalizacije v primerjavi s klasično holecistektomijo, krajši čas nezmožnosti za delo in boljši kozmetski učinek. Metode in rezultati. Od 15.12.1994, ko smo opravili prvo laparoskopsko holecistektomijo na našem oddelku, do 30.12.1999, smo napravili 1816 laparoskopskih posegov na biliarnem traktu. Uporabimo dva 10 mm in dva 5 mm troakarja, ki jih uvedemo na tipičnih mestih ob uporabi standardnih laparoskpskih instrumentov. Laparoskopsko operacijo smo pričli pri 1271 bolnikih in tudi dokončali pri 1213 bolnikih. Pri 58 bolnikih (4,56%) je bil napravljen preklop in sicer zaradi nejasnih anatomskih razmer, medoperativne krvavitve in anestezioloških zapletov. V tem času so bili operirani na klasičen način 603 bolniki. Med laparoskopsko operiranimi bolniki je bila potrebna ponovna operacija zaradi zgodnjih zapletov pri 19 bolnikih (1,56%). Med kasne pooperacijske zaplete prištevamo pooperacijsko kilo, ki se je pojavila na vstopnem mestu nad popkom pri treh bolnikih (,024%). Povprečno trajanje laparoskopske operacije je bilo 50 minut in povprečno trajanje hospitalizacije 3,1 dneva. Smrtnost je bila 0,08%. Veina delovno aktivnih bolnikov se je vrnila k svojemu običajnemu delu po treh tednih. Zaključek. Na kirurškem oddelku Zabok je laparoskopska holecistektomija uveljavljena metoda o hitrem in uspešnem okrevanju. Naše iskušnje pripisujejo največji pomen za dobre rezultate predvsem natančni predoperativni diagnostiki in dobro izurjenim kirurgom in anesteziologom.
Deskriptorji		CHOLECYSTECTOMY, LAPAROSCOPIC CHOLELITHIASIS TREATMENT OUTCOME REOPERATION