Reyes RLA, Hernández RMA, Aranda PJC, Leal MG, Larracilla SI, Loeza MV

Language: Spanish
References: 9
Page: 13-17
PDF size: 160.95 Kb.

ABSTRACT

Background: Laparoscopic cholecystectomy is the standard method currently used to treat gallbladder´s pathology. The original technical description requires the use of four ports, one for optics and three work ports. However, there has been variants of this method, in spite of the descriptions for safe cholecystectomy. Our goal was to evaluate the technique of laparoscopic cholecystectomy with three ports used in the Naval High Specialty General Hospital. Material and methods: A retrospective, observational, longitudinal and descriptive study was conducted through the revision of electronic clinical records of those patients undergone laparoscopic cholecystectomy at the Naval High Specialty General Hospital, from January 1st, 2011 to January 1st, 2016. The following variables were studied: age, sex, type of programmed surgery, added comorbidities, surgical time, conversion to open surgery and its causes, bleeding and postoperative complications such as surgical site infection, common bile duct injury, port hernias, etcetera. Results: 571 patients were included, 434 (76%) women and 137 (24%) were men, the mean age was 48.72 years, the average number of bleeding 63.3 ml, and the average surgical time was 79.43 minutes. 17 (2.97%) patients had intraoperative complications, five (0.87%) patients experienced operative bleeding greater than 500 ml, four (0.69%) with common bile duct injury and one (0.17%) duodenal lesion, six (1.04%) had surgical site infection and one patient (0.17%) died. Twenty-three surgical procedures (4.02%) were converted from laparoscopic to open surgery, being bleeding the main cause for these conversions. In none of the interventions, a fourth port was added prior to conversion. Conclusion: The laparoscopic cholecystectomy with three ports used in our hospital is not only a reproducible technique, but also it has given good results. Data obtained in this paper was comparable to those reported in the literature with regard to the percentages of complications using the conventional technique

REFERENCES

1. García RA, Sereno TS. Colecistectomía laparoscópica más allá de la «curva de aprendizaje». Rev Mex Cir Endoscop. 2010; 11: 63-70.

2. Vega CGR, Preciado BCY, Becerril DRA, Serrano MV y cols. Colecistectomía laparoscópica con tres puertos. Una modificación al abordaje. Rev Mex Cir Endoscop. 2003; 4: 134-140.

3. Perissat J. Laparoscopic cholecystectomy: the European experience. Am J Surg. 1993; 165: 444-449.

4. Gurusamy KS, Vaughan JM, Rossi M, Davidson BR. Fewer-than-four ports versus four ports for laparoscopic cholecystectomy. Cochrane Database Syst Rev. 2014; (2): CD007109. doi: 10.1002/14651858.CD007109.pub2

5. Chalkoo M, Ahangar S, Patloo AM, Matoo AR, Baqal FS, Iqbal S. A medical school experience with three port laparoscopic cholecystectomy with a new modification in technique. Int J Surg. 2013; 11: 37-40.

6. Cicero LA, Valdés FJA, Decanini MA, Golffier RC, Cicero LC, Cervantes CJ, Rojas R. Factores que predicen la conversión de la colecistectomía laparoscópica: cinco años de experiencia en el Centro Médico ABC. Rev Mex Cir Endoscop. 2005; 6: 66-73.

7. Mayir B, Dogan U, Koc U, Aslaner A, Bılecık T, Ensarı CO et al. Burhan MU. Safety and effectiveness of three-port laparoscopic cholecystectomy. Int J Clin Exp Med. 2014; 7: 2339-2342.

8. Deziel DJ, Millikan KW, Economou SG, Doolas A, Ko ST, Airan MC. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg. 1993; 165: 9-14.

9. Perissat J. Laparoscopic cholecystectomy: The European experience. Am J Surg. 1993; 165: 444-449.