Analysis of Our Laparoscopic Cholecystectomy Cases

INTRODUCTION: Laparoscopic cholecystectomy (LC) is the gold standart operation in cholelithiasis. The aim of this study is to evaluate the LC performed in the General Surgery Department of Düzce University Medical School.
METHODS: The data obtained from the cholecystectomy 311 cases between January 2005 and December 2008 were analysed retrospectively.
RESULTS: The sex distribution of the cases was 191(%68,5) female and 88 (%31,5) male. Median age was 52.5±12 years and median age rate was higher in male patients (P<0.001). Indications for surgery were chronic cholecystitis in 261 (93.5 %), acute cholecystitis in 10 (3.6 %), adenocarcinoma 3(%1.1) gangrenous cholecystitis 2(%0,7) gallbladder polyps in 2 (0.7 %) and acalculous cholecystitis1(0,4%). Conversion to open cholecystectomy was needed in 12 (4.3%) patients. Causes of conversion were determined adhesions 5(41.2%) bleeding 2(16.8%), and biliary duct injury 2(16.8%) and intraoperative complications were gallbladder perforation (%46.2), bleeding 3(23.2%), biliary duct injury 2(15.3%) and the other problems 2(15.3%). Postoperative complications occured in 10(3.5 %) patients and wound infection 5(62.5%) biliary fistula 2(25.0%) and biliary duct bile leakage 1(%12.5). Operative time was 55 minutes. Median postoperative hospital stay was 2.6 days (8 hours-25 days). Overall morbidity rate was 14.9 % and there was no mortality.
DISCUSSION AND CONCLUSION: In conclusion based on our results LC include less post operative discomfort since the incisions are much smaller, shorter hospital stays and operation time, earlier return to full activities and much smaller scars.

Laparoskopik Kolesistektomi Olgularýmýzýn Analizi

GÝRÝÞ ve AMAÇ: Kolelitiyazisin tedavisinde altýn standart laparoskopik kolesistektomidir.(LK) Bu çalýþmada Düzce Üniversitesi Týp Fakültesi Genel Cerrahi Kliniði'nde yapýlan LK olgularýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ocak 2005 ile Aralýk 2008 tarihleri arasýnda kolesistektomi uygulanan 311 hastanýn verileri geriye dönük olarak analiz edilmiþtir.
BULGULAR: Olgularýn 279 (%89.7)’nu LK oluþtururken; 88’i (%31,5) erkek, 191’i (%68,5) kadýndý. Kadýn hastalarýn sayýsý erkeklerden daha yüksekti. (P<0.001). Ortalama yaþ 52.5±12 idi ve yaþ ortalamasý erkeklerde daha yüksekti(P<0.001). Histopatolojik
tanýlarý 261(%93.5)’i akut alevlenme gösteren kronik kolesistit, 10(%3.6)’u akut kolesistit, 3 (%1.1)’ü adenokarsinom,2(%0,7)’si gangrenöz kolesistit, 1(%0,4)’i akalküloz kolesistit ve 2(%0.7) olguda polip idi. Toplam 12 (% 4.3) olguda;en sýk 5(%41.2) yapýþýklýk, 2(%16.8) kanama ve 2(%16.8) safra yolu yaralanmasý nedeni ile açýða geçilmiþ ve intraoperatif komplikasyonlar ise en sýk 6(%46.2)’sý kese delinmesi, 3(%23.2)’ü kanama ve 2(%15.3)’si safra yollarý yaralanmasý ve 2(%15.3) ‘si diðer þeklinde geliþmiþtir. Olgularýn 10(%3.5) unda gözlenen postoperatif komplikasyonlarýn 5(%62.5)’i yara yeri enfeksiyonu, 2(%25.0)’i safra fistülü, 1(%12.5)’i safra sýzýntýsý idi. Ortalama operasyon süresi 55 dakika; hastanede yatýþ ortalama süresi 2.6 gün (8 saat - 26 gün) idi. Toplam morbidite oraný %14.9 olup mortalite yoktur.
TARTIÞMA ve SONUÇ: Sonuç olarak elde ettiðimiz bulgulara bakarak LK insizyon yerinin daha küçük olmasý, hastanede yatýþ ve operasyon süresinin daha kýsa olmasý, normal günlük aktivitelere daha çabuk dönülmesi ve daha küçük skar kalmasý sebebi ile daha cazip bir yöntem olduðu ortaya koyulmuþtur.