LAPAROSCOPIC CHOLECYSTECTOMY: THE RESULTS OF 200 CASES
AYDIN ALPER, ALİ EMRE, ORHAN BİLGE, RASİM GENÇOSMANOĞLU, KORAY ACARLI, ORHAN ARIOĞUL
İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Çapa/İSTANBUL
Laparoscopic cholecystectomy is the first choice method for the treatment of cholecystolithiasis. In this report, the results of 200 patients undergoing laparoscopic cholecystectomy during 16 months are given. One hundred and eighty four patients had symptomatic chronic cholecystolithiasis, 11 acute cholecystitis, 4 gallbladder polyps and 1 cholecystolithiasis+polyp. Seven patients were converted to open cholecystectomy. Four of them had acute cholecysitis. The reasons for converting in this group were ruptured empyema and severe adhesions. In elective group, 3 patients were converted to open procedure. The reasons were misdiagnosis of choledochal cyst in one patient, choledocholithiasis in another and preparation of the common bile duct instead of the ductus cysticus in the other. The rate of converting to open cholecystectomy was 36% in the acute cholecystitis group whereas it was 1.5% in the elective group. Nine peroperative cholangiography were done and choledocholithiasis was found in one patient. Fourteen complications (3 major, 11 minor) were reported. The major complications were intraabdominal bile collections in two, intraabdominal bleeding from the anterior wall of the abdomen due to trochar insertion which required relaparoscopy in one. Nine wound infection, one umbilical hernia and one pneumonia developed as minor complications. The morbidity and the mortality rates were 7%, 0% respectively. During the same period 10 cases directly underwent open cholecystectomy upon their requests.
Keywords: LAPAROSCOPIC CHOLECYSTECTOMY, CHOLECYSTECTOMY, CHOLELITHIASIS