Laparoscopic General Surgery

Soper, Nathaniel J.; Brunt, L. Michael; Kerbl, Kurt

doi:10.1056/nejm199402103300608

Cited by 310 publications

(129 citation statements)

References 87 publications

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“…The duration 01' convalescence for LC patients was more prolonged than in reports from uncontrolled LC series (6,7,14,15), yet is strikingly similar to results noted in LC groups from two previous randomized trials from separate continents comparing LC to open surgery (9,16).…”

Section: Cost Analysissupporting

confidence: 81%

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Costs and Effectiveness of Extracorporeal Gallbladder Stone Shock Wave Lithotripsy Versus Laparoscopic Cholecystectomy: A Randomized Clinical Trial

Barkun

Sampalis

et al. 1997

Int J Technol Assess Health Care

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Thirty-five patients were randomized to extracorporeal shock-wave lithotripsy (ESWL) and 25 to laparoscopic cholecystectomy (LC). Stone disappearance occurred in only 12 of 32 ESWL patients [38% (95% Cl: 21–56%)] during a 15-month follow-up. Greater incremental gains in quality of life after 6 months were observed among LC patients (p <.01). Total duration of disability was 6.8 ± 8.5 days for ESWL, and 22.7 ± 16.6 days for LC (p <.01). Nine (28%) patients crossed over electively to the LC group, but only 44% of these underwent LC within the next 3 years. ESWL cost Can $58.9/ day of disability saved. ESWL is limited by its selective applicability and modest stone disappearance rate. Its cost-effectiveness is largely dependent on patient acceptance of recurrent episodes of biliary colic due to the persistence of stone fragments.

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Section: Cost Analysissupporting

confidence: 81%

“…Laparoscopic cholecystectomy: Le was initially practised in Europe (6,78) and soon thereafter in North America (7,14,15,48). The advantage of this procedure is its avoidance of a large incision slicing through skin and muscles of the right upper quadrant.…”

mentioning

confidence: 99%

Costs and Effectiveness of Extracorporeal Gallbladder Stone Shock Wave Lithotripsy Versus Laparoscopic Cholecystectomy: A Randomized Clinical Trial

Barkun

Sampalis

et al. 1997

Int J Technol Assess Health Care

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“…7,8 The classical four port method uses the fourth right flank port to retract the gall bladder funds (American technique) or liver (French technique) for better exposure of Calot's triangle. 12,13 Reduction in post-operative pain with better cosmesis and early return to work have been the goals to improve cost effectiveness and patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India

Kumar

Rana

2018

Int Surg J

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Background: Improvement of Laparoscopic Cholecystectomy (LC) technique in terms of reduction in size and number of ports is being tried to improve patient satisfaction and outcome. Present study was conducted to evaluate and compare the safety outcome and advantages of three-port and four-port LC. Methods: This prospective study included 90 patients presenting with symptomatic gall stone disease or gall bladder polyp more than 1cm at base. Patients with jaundice and choledocholithiasis were excluded. Patients were divided into two groups: A and B, who underwent three-port and four-port LC respectively. Outcomes of the two groups were assessed and compared in terms of duration of surgery, intra-operative and post-operative variables including rate and nature of complications, conversion rates, post-operative pain, duration of hospital stay, return to work and cosmetic outcome.Results: Statistically significant difference was found between the two groups in terms of Visual Analogue Score for pain at 6 and 24 hours, analgesic requirement, duration of hospital stay and return to work; all being less in the three- port LC group. Cosmetic outcome as perceived by patients was also better in the three-port group. Results of other variables were comparable in the two groups. Conclusions: Three-port procedure is safe and appears to be more cost effective than four-port LC. If LC is performed by an experienced surgeon, it can be started with three ports, if required, a fourth port can be inserted.

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“…Since the first laparoscopic cholecystectomy, laparoscopy has seen many changes and passed many milestones. Management has progressed through phases of non surgical management back to laparotomy, minilaparotomy and now laparoscopic cholecystectomy is the new gold standard for treatment of gallbladder disease 1,2 . Initially there was a lot of concern regarding efficacy of laparoscopy, operative time, patient's safety and cost effectiveness but now it is proven that laparoscopic cholecystectomy is ideal, most effective and feasible treatment for cholelithiasis and cholecystitis.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Cholecystectomy - A Cross Sectional Study

Pulate¹,

Narkhede²,

Chandak³

2015

MVP J Med Sci

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Aims and Objectives: 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. Methodology: Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. Results: Highest age incidence was seen in 4 th decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. Conclusion: Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4 th decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.

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Laparoscopic General Surgery

Cited by 310 publications

References 87 publications

Costs and Effectiveness of Extracorporeal Gallbladder Stone Shock Wave Lithotripsy Versus Laparoscopic Cholecystectomy: A Randomized Clinical Trial

Costs and Effectiveness of Extracorporeal Gallbladder Stone Shock Wave Lithotripsy Versus Laparoscopic Cholecystectomy: A Randomized Clinical Trial

Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India

Laparoscopic Cholecystectomy - A Cross Sectional Study

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