24. Results of laparoscopic cholecystectomy due to acute cholecystitis using laparoscopic suction irrigation tube to dissect: A retrospective analysis of 198 patients at Bach Mai Hospital
Main Article Content
Abstract
Acute cholecystitis may be complicated by abnormal anatomy, adhesions, inflammation, and stone impaction, resulting in difficulty in the identification of components of the Calot triangle even for experienced hands. This study aimed to evaluate the results of laparoscopic surgery using the laparoscopic suction tube to treat acute cholecystitis. All patients undergoing laparoscopic cholecystectomy (LC) by a single surgeon from January 2020 to April 2022 were prospectively included. There were 144 males and 54 females. The median age of the whole cohort was 62, IQR (47.2 - 73.5) years. CVS was achieved during LC in 135 (68.1%) patients. The rates of gallbladder edema, purulent, and necrotizing inflammation were 70.1%, 11.2%, and 18.7%, respectively. Calot triangle dissection and operation time were 34 minutes (IQR, 26 - 41) and 56.5 minutes (IQR, 49.2 - 67). Laparoscopic total cholecystectomy and subtotal cholecystectomy were performed in 89.8% and 10.2%, respectively. The rate of bleeding complications requiring re-operation and bile leak was 0.5% and 1.01%, respectively. The median time of hospital stay was four days (IQR, 3 - 5). Research shows that laparoscopic aspiration is effective for LC with a low morbidity.
Article Details
Keywords
Acute cholecystitis, laparoscopic, laparoscopic suction tube, complications, bile leakage, bleeding
References
2. Pisano M, Allievi N, Gurusamy K, et al. 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis. World J Emerg Surg. 2020;15(1):61.
3. Coccolini F, Solaini L, Binda C, et al. Laparoscopic Cholecystectomy in Acute Cholecystitis: Refining the Best Surgical Timing Through Network Meta-Analysis of Randomized Trials. Surg Laparosc Endosc Percutan Tech. 2022;32(6):755-763.
4. Chatterjee A, Kumar R, Chattoraj A. Three-Port Laparoscopic Cholecystectomy as a Safe and Feasible Alternative to the Conventional Four-Port Laparoscopic Cholecystectomy. Cureus. 2024;16(1):e52196.
5. Gupta V, Jain G. Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. World J Gastrointest Surg. 2019;11(2):62-84.
6. Mischinger H-J, Wagner D, Kornprat P, et al. The “critical view of safety (CVS)” cannot be applied-What to do? Strategies to avoid bile duct injuries. European Surgery. 2021;53(3):99-105.
7. Yamashita Y, Takada T, Strasberg SM, et al. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013;20(1):89-96.
8. Alius C, Serban D, Bratu DG, et al. When Critical View of Safety Fails: A Practical Perspective on Difficult Laparoscopic Cholecystectomy. Medicina (Kaunas). 2023;59(8).
9. Bhandari TR, Khan SA, Jha JL. Prediction of difficult laparoscopic cholecystectomy: An observational study. Ann Med Surg (Lond). 2021;72:103060.
10. Ozsan I, Yoldas O, Karabuga T, et al. Early laparoscopic cholecystectomy with continuous pressurized irrigation and dissection in acute cholecystitis. Gastroenterol Res Pract. 2015;2015:734927.
11. Wakabayashi G, Iwashita Y, Hibi T, et al. Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):73-86.
12. Teixeira JP, Saraiva AC, Cabral AC, et al. Conversion factors in laparoscopic cholecystectomy for acute cholecystitis. Hepatogastroenterology. 2000;47(33):626-630.
13. Kim JH, Kim JW, Jeong IH, et al. Surgical outcomes of laparoscopic cholecystectomy for severe acute cholecystitis. J Gastrointest Surg. 2008;12(5):829-835.
14. Yuval JB, Mizrahi I, Mazeh H, et al. Delayed Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis: Is it Time for a Change? World J Surg. 2017;41(7):1762-1768.
15. Shang P, Liu B, Li X, et al. A practical new strategy to prevent bile duct injury during laparoscopic cholecystectomy. A single-center experience with 5539 cases. Acta Cir Bras. 2020;35(6):e202000607.
16. Serban D, Socea B, Balasescu SA, et al. Safety of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Elderly: A Multivariate Analysis of Risk Factors for Intra and Postoperative Complications. Medicina (Kaunas). 2021;57(3).
17. Strasberg SM, Brunt LM. The Critical View of Safety: Why It Is Not the Only Method of Ductal Identification Within the Standard of Care in Laparoscopic Cholecystectomy. Ann Surg. 2017;265(3):464-465.
18. Strasberg SM. A three-step conceptual roadmap for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review. J Hepatobiliary Pancreat Sci. 2019;26(4):123-127.
19. Renz BW, Bosch F, Angele MK. Bile Duct Injury after Cholecystectomy: Surgical Therapy. Visc Med. 2017;33(3):184-190.
20. Prakash K, Jacob G, Lekha V, et al. Laparoscopic cholecystectomy in acute cholecystitis. Surg Endosc. 2002;16(1):180-183.
21. Bundgaard NS, Bohm A, Hansted AK, et al. Early laparoscopic cholecystectomy for acute cholecystitis is safe regardless of timing. Langenbecks Arch Surg. 2021;406(7):2367-2373.
22. Madni TD, Leshikar DE, Minshall CT, et al. The Parkland grading scale for cholecystitis. Am J Surg. 2018;215(4):625-630.
23. Lee W, Jang JY, Cho JK, et al. Does surgical difficulty relate to severity of acute cholecystitis? Validation of the parkland grading scale based on intraoperative findings. Am J Surg. 2020;219(4):637-641.
24. Shrestha A, Bhattarai A, Tamrakar KK, et al. Utility of the Parkland Grading Scale to determine intraoperative challenges during laparoscopic cholecystectomy: a validation study on 206 patients at an academic medical center in Nepal. Patient Saf Surg. 2023;17(1):12.
25. Low SW, Iyer SG, Chang SK, et al. Laparoscopic cholecystectomy for acute cholecystitis: safe implementation of successful strategies to reduce conversion rates. Surg Endosc. 2009;23(11):2424-2429.