Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QI Dunfeng , ZHANG Xinhui , LI Huansong , SHI Kui , YUAN Bo ,  LIU Yangsui

Department of Hepatobiliary Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P. R. China;

Corresponding?author：

LIU Yangsui, Email: yangsui-liu@163.com

Keywords：

acute cholecystitis; left side approach; laparoscopic cholecystectomy

DOI：

10.7507/1007-9424.201707032

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis. Methods One hundred and twenty patients with acute cholecystitis from January 2015 to May 2017 were collected. All of the patients were divided into observation group and control group according to the operative mode, with 60 cases in each group. In the observation group, the patients were treated by laparoscopic cholecystectomy via left side approach using the ligation-free technique to the main trunk of the cystic artery; in the control group, the patients were treated by the conventional laparoscopic cholecystectomy. After treatment, the operative situation, postoperative recovery, and incidence of postoperative complications were compared between these two groups. Results Compared with the control group, the operative time, first anal exhaust time, hospitalization stay, leukocytes recovery time, and coagulation function recovery time were shortened and the intraoperative bloods loss was reduced in the observation group, the differences were statistically significant (P<0.05). Furthermore, the overall postoperative complication incidence rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion For patients with acute cholecystitis, laparoscopic cholecystectomy via left side approach using ligation-free technique to main trunk of cystic artery is reliable and safe, which can effectively improve operative situation, shorten operative time, promote recovery of patient, and reduce incidence of postoperative complications.

Citation： QI Dunfeng, ZHANG Xinhui, LI Huansong, SHI Kui, YUAN Bo, LIU Yangsui. Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(12): 1492-1495. doi: 10.7507/1007-9424.201707032 Copy

1.	Hayama S, Ohtaka K, Shoji Y, et al. Risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis. JSLS, 2016, 20(4). pii: e2016.00065.
2.	Cwik G, Skoczylas T, Wyro?lak-Najs J, et al. The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc, 2013, 27(7): 2561-2568.
3.	尚培中, 李曉武, 李永慶. 腹腔鏡膽囊切除困難與對策. 中華普外科手術學雜志(電子版), 2016, 10(6): 458-461.
4.	陳智勇, 陳文有, 楊愛國. 腹腔鏡膽囊切除術并發癥發生的相關影響因素分析. 中國普通外科雜志, 2016, 25(2): 214-218.
5.	Acar T, Kamer E, Acar N, et al. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. Pan Afr Med J, 2017, 26: 49.
6.	Onoe S, Maeda A, Takayama Y, et al. A preoperative predictive scoring system to predict the ability to achieve the critical view of safety during laparoscopic cholecystectomy for acute cholecystitis. HPB (Oxford), 2017, 19(5): 406-410.
7.	Flowers JL, Bailey RW, Scovill WA, et al. The Baltimore experience with laparoscopic mamagement of acute cholecystitis. Am J Surg, 1991,161(3): 388-392.
8.	何賢祿, 劉偉. 腹腔鏡膽囊切除術治療急性壞疽性膽囊炎的臨床分析. 華西醫學, 2016, 31(4): 731-733.
9.	夏明, 鄢利華. 腹腔鏡膽囊次全切除術 83 例報道. 中國普外基礎與臨床雜志 2011, 18(3): 317-319.
10.	Csikesz N, Ricciardi R, Tseng JF, et al. Current status of surgical management of acute cholecystitis in the United States. World J Surg, 2008, 32(10): 2230-2236.
11.	Elshaer M, Gravante G, Thomas K, et al. Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis. JAMA Surg, 2015, 150(2): 159-168.
12.	許軍, 董杰杰. 腹腔鏡手術治療急性膽囊炎合理選擇及爭議. 中國實用外科雜志, 2015, 35(5): 482-486.
13.	毛靜熙, 陳訓如, 余少明. 膽囊炎癥期的腹腔鏡膽囊切除術. 中國普外基礎與臨床雜志, 1997, 4(2): 89-91.
14.	孫彥波, 任伍保. 急性膽囊炎腹腔鏡膽囊切除術中轉開腹的危險因素分析. 肝膽外科雜志, 2017, 25(2): 147-148.
15.	陳大紅, 汪泳, 王健, 等. 急性膽囊炎行腹腔鏡膽囊切除術中轉開腹的危險因素分析. 安徽醫藥, 2016, 20(8): 1527-1529.
16.	余同輝, 黃峻松, 黃奕江. 腹腔鏡膽囊切除術中膽囊動脈出血的預防及處理. 中國微創外科雜志, 2012, 12(12): 1082-1084.
17.	余同輝, 黃峻松, 黃奕江. 腹腔鏡膽囊切除術中特意分離結扎膽囊動脈的必要性分析. 腹腔鏡外科雜志, 2017, 22(2): 126-129.
18.	羅東, 劉國棟, 唐能, 等. 腹腔鏡膽囊切除術中轉開腹的臨床分析: 附 39 例報告. 中國普通外科雜志, 2017, 26(2): 157-165.
19.	馮一浮, 莫經剛, 陳建輝. 急性膽囊炎腹腔鏡膽囊切除術中轉開腹相關風險因素的分析. 中國普通外科雜志, 2016, 25(2): 286-290.
20.	Dandekar U, Dandekar K. Cystic artery: Morphological study and surgical significance. Anat Res Int, 2016, 2016: 7201858.
21.	符國珍, 呂明, 宋文淵, 等. 腹腔鏡膽囊切除術左側進路不分離斷離膽囊動脈主干技術的臨床研究. 中華肝膽外科雜志, 2015, 21(12): 826-829.
22.	熊美雪. 不分離離斷膽囊動脈主干左側入路腹腔鏡下膽囊切除的臨床效果觀察. 中國當代醫藥, 2016, 23(31): 28-29.
23.	包文中, 湯大緯, 周高潮, 等. 老年急性結石性膽囊炎不分離離斷膽囊動脈主干左側入路 LC 術的臨床效果觀察. 肝膽外科雜志, 2016, 24(2): 110-112.
24.	王耀東, 侯森, 時永, 等. 腹腔鏡膽囊切除術并發癥的臨床分析. 中國實用醫藥, 2016, 11(1): 35-36.
25.	李鐘聲, 趙懷輝, 薛傳信, 等. 腹腔鏡膽囊切除技巧與嚴重并發癥的預防. 安徽醫學, 2008, 29(4): 437-438.
26.	朱銳昌, 李運福, 李輝, 等. 腹腔鏡膽囊切除術并發癥發生的相關影響因素分析. 海南醫學, 2017, 28(12): 2022-2023.
27.	白正巖. 腹腔鏡膽囊切除術患者術后并發癥的臨床分析. 臨床醫藥文獻雜志, 2016, 3(4): 615, 618.
28.	孫樹領, 朱江峰, 彭元美. 腹腔鏡下膽囊切除術及并發癥分析. 華西醫學, 2012, 27(10): 1515-1516.

1. Hayama S, Ohtaka K, Shoji Y, et al. Risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis. JSLS, 2016, 20(4). pii: e2016.00065.
2. Cwik G, Skoczylas T, Wyro?lak-Najs J, et al. The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc, 2013, 27(7): 2561-2568.
3. 尚培中, 李曉武, 李永慶. 腹腔鏡膽囊切除困難與對策. 中華普外科手術學雜志(電子版), 2016, 10(6): 458-461.
4. 陳智勇, 陳文有, 楊愛國. 腹腔鏡膽囊切除術并發癥發生的相關影響因素分析. 中國普通外科雜志, 2016, 25(2): 214-218.
5. Acar T, Kamer E, Acar N, et al. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. Pan Afr Med J, 2017, 26: 49.
6. Onoe S, Maeda A, Takayama Y, et al. A preoperative predictive scoring system to predict the ability to achieve the critical view of safety during laparoscopic cholecystectomy for acute cholecystitis. HPB (Oxford), 2017, 19(5): 406-410.
7. Flowers JL, Bailey RW, Scovill WA, et al. The Baltimore experience with laparoscopic mamagement of acute cholecystitis. Am J Surg, 1991,161(3): 388-392.
8. 何賢祿, 劉偉. 腹腔鏡膽囊切除術治療急性壞疽性膽囊炎的臨床分析. 華西醫學, 2016, 31(4): 731-733.
9. 夏明, 鄢利華. 腹腔鏡膽囊次全切除術 83 例報道. 中國普外基礎與臨床雜志 2011, 18(3): 317-319.
10. Csikesz N, Ricciardi R, Tseng JF, et al. Current status of surgical management of acute cholecystitis in the United States. World J Surg, 2008, 32(10): 2230-2236.
11. Elshaer M, Gravante G, Thomas K, et al. Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis. JAMA Surg, 2015, 150(2): 159-168.
12. 許軍, 董杰杰. 腹腔鏡手術治療急性膽囊炎合理選擇及爭議. 中國實用外科雜志, 2015, 35(5): 482-486.
13. 毛靜熙, 陳訓如, 余少明. 膽囊炎癥期的腹腔鏡膽囊切除術. 中國普外基礎與臨床雜志, 1997, 4(2): 89-91.
14. 孫彥波, 任伍保. 急性膽囊炎腹腔鏡膽囊切除術中轉開腹的危險因素分析. 肝膽外科雜志, 2017, 25(2): 147-148.
15. 陳大紅, 汪泳, 王健, 等. 急性膽囊炎行腹腔鏡膽囊切除術中轉開腹的危險因素分析. 安徽醫藥, 2016, 20(8): 1527-1529.
16. 余同輝, 黃峻松, 黃奕江. 腹腔鏡膽囊切除術中膽囊動脈出血的預防及處理. 中國微創外科雜志, 2012, 12(12): 1082-1084.
17. 余同輝, 黃峻松, 黃奕江. 腹腔鏡膽囊切除術中特意分離結扎膽囊動脈的必要性分析. 腹腔鏡外科雜志, 2017, 22(2): 126-129.
18. 羅東, 劉國棟, 唐能, 等. 腹腔鏡膽囊切除術中轉開腹的臨床分析: 附 39 例報告. 中國普通外科雜志, 2017, 26(2): 157-165.
19. 馮一浮, 莫經剛, 陳建輝. 急性膽囊炎腹腔鏡膽囊切除術中轉開腹相關風險因素的分析. 中國普通外科雜志, 2016, 25(2): 286-290.
20. Dandekar U, Dandekar K. Cystic artery: Morphological study and surgical significance. Anat Res Int, 2016, 2016: 7201858.
21. 符國珍, 呂明, 宋文淵, 等. 腹腔鏡膽囊切除術左側進路不分離斷離膽囊動脈主干技術的臨床研究. 中華肝膽外科雜志, 2015, 21(12): 826-829.
22. 熊美雪. 不分離離斷膽囊動脈主干左側入路腹腔鏡下膽囊切除的臨床效果觀察. 中國當代醫藥, 2016, 23(31): 28-29.
23. 包文中, 湯大緯, 周高潮, 等. 老年急性結石性膽囊炎不分離離斷膽囊動脈主干左側入路 LC 術的臨床效果觀察. 肝膽外科雜志, 2016, 24(2): 110-112.
24. 王耀東, 侯森, 時永, 等. 腹腔鏡膽囊切除術并發癥的臨床分析. 中國實用醫藥, 2016, 11(1): 35-36.
25. 李鐘聲, 趙懷輝, 薛傳信, 等. 腹腔鏡膽囊切除技巧與嚴重并發癥的預防. 安徽醫學, 2008, 29(4): 437-438.
26. 朱銳昌, 李運福, 李輝, 等. 腹腔鏡膽囊切除術并發癥發生的相關影響因素分析. 海南醫學, 2017, 28(12): 2022-2023.
27. 白正巖. 腹腔鏡膽囊切除術患者術后并發癥的臨床分析. 臨床醫藥文獻雜志, 2016, 3(4): 615, 618.
28. 孫樹領, 朱江峰, 彭元美. 腹腔鏡下膽囊切除術及并發癥分析. 華西醫學, 2012, 27(10): 1515-1516.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content