Entrar/Registro  
HOME SPANISH
 
Cirujano General
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Cirujano General >Year 2001, Issue 3


Gómez CLR, Ramírez OBC, Ovando JE, Aguilar SJ, Aznar AJC, Pazarán MCD
Cholecystectomy through a reduced invasive technique. Response to pain according to the size of the mini-incision
Cir Gen 2001; 23 (3)

Language: Español
References: 19
Page: 158-162
PDF: 4. Kb.


Full text




ABSTRACT

Objective: To compare the response to pain in patients subjected to cholecystectomy according to the extension of the minilaparotomy.
Setting: Second level health care hospital.
Design: Prospective, longitudinal, observational study.
Method: We studied 139 patients subjected to cholecystectomy through subcostal minilaparotomy from November 1994 to November 1999. Four groups were assigned according to the size of the incision. Group I, smaller than 4 cm (11 patients); Group II, from 4.1 to 6 cm (45 patients); Group III, from 6 to 8 cm (51 patients); Group IV, from 8.1 to 10 cm (32 patients). Response to pain was determined through a visual analogue scale at the immediate postoperative period, 24 h after surgery, and at the time of hospital discharge. We studied the following variables: age, gender, preoperative diagnosis, concomitant diseases, trans- and post-operative complication, respiratory restriction, days of hospital stay, and mortality.
Results: Average age was 37.6 years, 114 patients were women and 25 were men; 133 patients had a diagnosis of chronic lithiasic cholecystitis, 6 were alithiasic, 10 were in acute stage. The main biliary tract was explored in 6 patients due to choledocholithiasis. Incisions smaller than 4 cm produced low intensity and short-lasted pain, no differences were found between groups II and III. Hospital stay averaged 2.6 days, seven (5%) patients presented complications: three with biliary effusion through the Penrose, two with wound infection, one patient formed a seroma, and one developed severe headache. No respiratory restriction was induced and no deaths occurred.
Conclusion: Cholecystectomy through reduced invasion is an alternative for the surgeon; patients refer minimal to moderate pain; it does not induce respiratory restriction and can be performed at any second level health care hospital.


Key words: Minilaparotomy, cholecystectomy, post-operative.


REFERENCIAS

  1. Martíns Torres OJ, Dasilva Costa D, Rodríguez Silva AJ, de Sena Pedro WJ, Malafaia O. Colecistectomía por minilaparotomía. Rev Bras Med 1994; 51: 647-50.

  2. Hunter JM, Sackier JM. Minimally invasive surgery. McGraw-Hill, USA 1993: p3-6.

  3. Rozsos I, Magyarodi Z, Orban P. The removal of cystic duct and gallbladder remnant by microlaparotomy. Acta Chir Hung 1997; 31(1-4): 297-8.

  4. Rozsos I, Bahek S, Szanto L. Micro and minilaparotomy surgery in the treatment of Mirizzi’s syndrome. Acta Chir Hung 1997; 36(1-4): 292-3.

  5. Assalia A, Kopelman D, Hashmonai M. Emergency minilaparotomy cholecystectomy for acute cholecystitis: prospective randomized trial-implications for the laparoscopic era. World J Surg 1997; 21: 53.

  6. Kumar N, Annudath KB, Shukla HS, Sing A, Kumar K. Postoperative intravenous drip infusion is not required after minilaparotomy cholecystectomy. HPB Surg 1997; 10: 279-81.

  7. Go PM, van Erp WF. Unfounded doubt in laparoscopic cholecystectomy. Ned Tijdschr Geneeskd 1997; 141: 667-8.

  8. Kobayashi N, Ishii S. Postoperative nausea, vomiting and pain in laparoscopic cholecystectomy: a comparison with minilaparotomy-cholecystectomy. Masui 1996; 45: 474-8.

  9. Rozsos I, Ferenczy I, Rozsos T. The surgical technique of microlaparatomy cholecystectomy. Acta Chir Hung 1997; 36(1-4): 294-6.

  10. Makinen AM, Nordback IH. Cholecystectomy: comparison of minilaparotomy and laparoscopy. Int Surg 1995; 80: 99-101.

  11. Rozsos I, Ferenczy J, Afshin D, Rozsos T. Especial complications of cholecystectomy performed by micro and modern mini-laparotomy. Orv Hetil 1995; 136: 1271-4.

  12. Grau-Talents EJ, García-Olives F, Ruperez-Arribas MP. Transcylindrical cholecystectomy: new technique for minimally invasive cholecystectomy. World J Surg 1998; 22: 453-8.

  13. Froschle GW, Kilary Z, Broelsch CE. Cholecystectomy by mini-laparotomy with the Jako retractor system. Langenbecks Arch Chir 1997; 328: 274-6.

  14. Qiu H, Tang W, Li Y. Minilaparotomy cholecystectomy with clinical analysis of 50 cases. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 1996; 18: 205-8.

  15. Rozsos I, Ferenczy J, Afshin D, Rozsos T. Cholecystectomy performed by macro-and modern mini-laparotomy. Orv Hetil 1995; 136: 475-81.

  16. Westerling D, Luttropp HH, Holmin T, Landquist E. Postoperative recovery after cholecystectomy by minilaparotomy: a randomized double-blind comparison between alpha-trinositol and placebo. Pharmacol Toxicol (abstract) 1997; 81: 253-8.

  17. Flores MA. Cholecystectomy vía an epigastric minilaparotomy. Ann Surg 1995; 222: 764-5.

  18. McMahon AJ, Ross S, Baxter JN, Russell IT, Anderson JR, Morran CG et al. Symptomatic outcome 1-year after laparoscopic and minilaparotomy cholecystectomy a randomized trial. Br J Surg 1995; 82: 1378-82.

  19. Gaetini A, Camandona M, De Simone M, Giaccome M. Minilaparotomia per colecistectomia. (abstract) Minerva Chir 1997; 52: 13-6.






>Journals >Cirujano General >Year 2001, Issue 3
 

· Journal Index 
· Links 






       
Copyright 2019