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KMID : 0978820090120020118
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2009 Volume.12 No. 2 p.118 ~ p.122
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Clinical Usefulness of the Methods of Gallbladder Bed Dissection for Treating Acute Cholecystitis
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Lee Seung-Jin
Kim Byung-Chun
Jung Jae-Pil
Jung So-Young
Cho Ji-Woong
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Abstract
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Purpose: Laparoscopic cholecystectomy (LC) for treating acute cholecystitis (AC) is a technically demanding procedure even for experienced surgeons. The purpose of this study is to evaluate the clinical usefulness of the methods of gallbladder bed dissection for patients with acute cholecystitis.
Methods: We reviewed the medical records of 74 patients who were admitted for AC and they underwent early LC with ultrasonic shears dissection (UD) (n=40) or monopolar electrocautery dissection (MD) (n=34) at Kangnam Sacred Heart Hospital from August 2006 to December 2008. We compared many variables between the two methods.
Results: The mean operative time in the LC group with UD was 48.3 minutes versus 42.8 minutes for the MD group (p= 0.163). The conversion rate was 5.0%, and the postoperative morbidity rate was 12.5% in the UD group, versus an 8.8% conversion rate and an 8.8% morbidity rate in the MD group (p=0.426 and 0.254).
Conclusion: The use of UD in the dissection of the gallbladder bed has no specific advantage over MD for treating patients with acute cholecystitis, but further investigations are required to confirm this.
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KEYWORD
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Laparoscopic cholecystectomy, Acute cholecystitis, Monopolar electrocautery, Ultrasonic dissection
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