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KMID : 1035920160190040141
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Journal of Minimally Invasive Surgery
2016 Volume.19 No. 4 p.141 ~ p.147
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Solo Three-incision Laparoscopic Cholecystectomy Using a Laparoscopic Scope Holder for Acute Cholecystitis
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Choi So-Yeon
Choi Young-Rok
Han Ho-Seong
Yoon Yoo-Seok
Cho Jai-Young
Kwon Seong-Uk
Jang Jae-Seong
Choi Jang-Kyu
Kim Sung-Ho
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Abstract
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Purpose: Laparoscopic cholecystectomy (LC) is a commonly performed procedure for the management of acute cholecystitis. The presence of an inexperienced scopist or a shortage of manpower could be problematic in emergency surgical cases. To overcome these potential problems while ensuring a stable surgical view during LC, we performed solo surgery.
Methods: We retrospectively reviewed the results of 22 patients who underwent solo three-incision LC (S-TILC) and 31 patients who underwent the conventional three-incision LC (C-TILC) from March 1, 2015, to August 31, 2015. We compared the two groups with respect to the patients’ clinical characteristics, and intraoperative and postoperative results; and severity grade as defined by the updated Tokyo guidelines 2013 (TG13) criteria.
Results: No significant differences in baseline characteristics were found between the two groups. The intraoperative perforation rates were higher in the C-TILC group than in the S-TILC group (p=0.016). Two cases were converted to human-assisted LC in the S-TILC group because of severe adhesions and the scope holder breaking down. No significant differences were found between the groups with respect to length of hospital stay; postoperative diet habit; or rates of post-cholecystectomy diarrhea, abdominal pain, wound complication, or complication according to the Clavien-Dindo grade.
Conclusion: S-TILC and C-TILC were comparable in terms of results, and this solo surgery in LC could be performed for cases of acute cholecystitis during shortage of skilled manpower.
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KEYWORD
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Laparoscopic cholecystectomy, Acute cholecystitis, Solo surgery
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