Feasibility of single-incision laparoscopic cholecystectomyfor acute cholecystitis

• 作者: Hidetsugu Yamagishi Masahito Kotaka Mineo Iwatate Taro Ikumoto Yasuo Imai Yasushi Sano
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Acute cholecystitis SINGLE-PORT accesssurgery SINGLE INCISION LAPAROSCOPIC cholecystectomy SINGLE INCISION LAPAROSCOPIC SURGERY Laparo-endoscopicsingle-site SURGERY
• 年，卷（期）: 2015,（19）
• 页码范围: 1327-1333
• 页数: 7页
• 分类号: R

摘要

AIM To assess the safety of single-incision laparoscopiccholecystectomy （SILC） for acute cholecystitis.METHODS： All patients who underwent SILC atSano Hospital （Kobe, Japan） between January 2010and December 2014 were included in this retrospectivestudy. Clinical data related to patient characteristics andsurgical outcomes were collected from medical records.The parameters for assessing the safety of the procedureincluded operative time, volume of blood loss,achievement of the critical view of safety, use of additionaltrocars, conversion to laparotomy, intraoperative and postoperativecomplications, and duration of postoperativehospital stay. Patient backgrounds were statisticallycompared between those with and without conversion tolaparotomy.RESULTS： A total of 100 patients underwent SILCfor acute cholecystitis during the period. Preoperativeendoscopic treatment was performed for suspectedcholedocholithiasis in 41 patients （41%）. The mean timefrom onset of acute cholecystitis was 7.7 d. According tothe Updated Tokyo Guidelines （TG13） for the severity ofcholecystitis, 86 and 14 patients had grade Ⅰ and gradeⅡ acute cholecystitis, respectively. The mean operativetime was 87.4 min. The mean estimated blood loss was80.6 mL. The critical view of safety was obtained in 89 patients （89%）. Conversion laparotomy was performedin 12 patients （12%）. Postoperative complications ofClavien-Dindo grade Ⅲ or greater were observed in4 patients （4%）. The mean duration of postoperativehospital stay was 5.7 d. Patients converted from SILC tolaparotomy tended to have higher days after onset.CONCLUSION： SILC is feasible for acute cholecystitis;in addition, early surgical intervention may reduce therisk of laparotomy conversion.