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KMID : 0371319940470030428
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Journal of the Korean Surgical Society
1994 Volume.47 No. 3 p.428 ~ p.436
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Laparoscopic Cholecystectomy for Acute Chelecystitis
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전송배
박신희/이광찬/김진승
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Abstract
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Laparoscopic Cholecystectomy has become the standared treatment for symtomatic gallstone. Acute cholecystitis had been considered to be a relative contraindication to laparoscopic surgery in the beginning period. But after gaining extensive
experience
in laparoscopic biliary tract surgery, this procedure was attempted in a selected patients with acute cholecystitis. but the role of laparoscopic surgery in patients presenting with acute cholecysitis remains controversial. This study was to
review
retrospectively the results of laparoscopic cholecystectomy in patients with acutely inflammed gallbladder. Laparoscopic cholecystectomy was attemted in 267 pateints with symptomatic gallbladder disease during the period from July 1991 to August
1993.
1) Eighty three (31.15) of 267 patients had acute inflammation gallbladder, 179 were chronic inflammation, 5 had GB polyp.
2) There were 34 males and 49 females. The age range of the patients was from 26 to 83 years.
3) The frequency of conversion to an open operation was 2.4% for acute inflammation, 0.5% for chronic inflammation.
4) The median operatin time for successful laparoscopic cholecystectomy for acutely inflammed gallbladder was 91.9min, which was longer than that with chronic inflammation (mean; 56.7min).
5) The mean postoperative stay for patients with acute cholecystitis was 5.1 days versus 3.5 days for chronic cholecystitis.
6) The overall operative morbidity rate was 8.4% in acute cholecystitis group but there was no mortality and no bile duct injury or major vascular injury in acute cholecystitis group 56 patients (67.5%) underwent surgery within 24 hour on
admission and
71 patients by 48 hours and 3 beyong 6 days, 2 of 3 patients underwent surgery beyong 6 days converted to open operation because of difficulty in identifying ductal anatomy.
Several modification to the technique of laparoscopic cholecystectomy and prompt operation can decrease the conversion rate and can reduce the operative time. Laparoscopic cholecystectomy seems to be a safe and beneficial operation in patients
with
acute cholecystitis.
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KEYWORD
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