Open Laparoscopy for Laparoscopic Cholecystectomy

Fitzgibbons, Robert J.; Schmid, Stephen; Santoscoy, Robert; Tyndall, Steve H.; Hinder, Ronald A.; Filipi, Charles J.; Jenkins, Joseph X.; Salerno, Giovanni

doi:10.1097/00129689-199112000-00002

Cited by 22 publications

(6 citation statements)

References 0 publications

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“…The average cost of these consum- Table 6. [13][14][15][16][17][18] Mortality is less than 0.1%, the overall morbidity about 4% and the incidence of common bile duct damage less than 0.5%. These are short-term followup reports and it would not be surprising if long-term randomised prospective trials showed a higher complication rate.…”

Section: Resultsmentioning

confidence: 99%

An evaluation of laparoscopic versus open cholecystectomy

Hardy¹,

Miller²,

Fletcher³

et al. 1994

Medical Journal of Australia

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Objective To compare open cholecystectomy (OC) with laparoscopic cholecystectomy (LC) in terms of clinical aspects and a limited review of costs. Setting The Austin Hospital, Melbourne, a university teaching hospital. Design Prospective LC patients were compared with a retrospective group of OC patients whose surgery had been performed by the same surgeons. Methods Consecutive patients undergoing LC were interviewed, their medical records were analysed and the cost of their hospitalisation was assessed. Similar data, collected previously from patients undergoing OC, were used for comparison. Results There were 108 patients in each group, 93.5% treated electively. All had gallstones. No deaths or common bile duct injury occurred. The mean operating room time was 131 ± 3.7 minutes for OC and 164 ± 4.7 minutes for LC. Operative cholangiography was attempted in 80% in each group, being successful when attempted in all OCs and in 95% of LCs. The conversion rate of LCs to OCs was 4.5%. Minor complications were more frequent with OCs. The mean duration of hospital stay was 6.5 + 0.3 days for OCs and 2.0 + 0.2 days for LCs. The amount and period of analgesia were significantly less in the LC group. Patients recovered significantly faster after LC (P<0.01) during the first eight weeks after surgery. There was no difference by 12 weeks. The overall cost for each LC was $838 less than OC for the entire hospital stay. Conclusion These results support the view that LC is a safe and justified replacement for OC in the elective situation, with benefits to the patient, hospital and general community. The hospital cost for LC was less than for OC.

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Section: Resultsmentioning

confidence: 99%

An evaluation of laparoscopic versus open cholecystectomy

Hardy¹,

Miller²,

Fletcher³

et al. 1994

Medical Journal of Australia

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“…Studies reporting on the use of open laparoscopy and its complications are shown in Table 3. 5,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The overall rate of wound infection was 0.4%; that of bowel injury was 0.1%. There were no instances of gas embolism or other visceral damage.…”

Section: Complications Of Open Laparoscopymentioning

confidence: 99%

“…Retrospective studies Hasson 22 Gynaecological surgery 800 6 (0.7%) 1 (0.1%) FitzGibbons et al 26 General surgery 343 2 (0.6%) 1 (0.3%) Perone 20 Gynaecological surgery 585 --0 Ballem et al 27 General surgery 150 0 0 Adana et al 28 General surgery d 184 2 (1.1%) 0 Bateman et al 29 High risk gynaecological reproductive surgery e 258 --1 f (0.4%) Wherry et al 30 General surgery 3 839 --11 (0.3%) Casey et al 31 High risk gynaecological oncology surgery 31 --0 Wallace 21 General surgery 568 4 0 Schnepper 24 Gynaecological sterilization (office setting, local anaesthesia) 815 2 (0.2%) 0 Bonjer et al 32 General surgery 438 3 (0.7%) 0 Decloedt et al 33 probable causation. Four were recognized and repaired intraoperatively without subsequent morbidity.…”

Section: Prospective Studiesmentioning

confidence: 99%

Open laparoscopy as a method of access in laparoscopic surgery

Hasson

1999

Gynaecol Endoscopy

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Objective To describe the technique of open laparoscopy and compare the rates of its complications to those of closed laparoscopy. Design Medline search, review of the literature and the author's experience. Results For open laparoscopy, the rate of umbilical infection in 15 622 cases was 0.4%, that of bowel injury in 20 335 cases was 0.1%, based on prospective, retrospective studies and a mail survey. Prospective and retrospective studies dealing with closed laparoscopy reported the following complication rates: umbilical infection: 1% of 4377 cases; vascular injury: 0.2% of 94 863 cases: visceral injury: 0.2% of 91 272 cases. The operating time for open and closed laparoscopy were substantially similar. Conclusion Open laparoscopy is advocated as the preferred method of access for laparoscopic surgery.

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“…This open technique, which avoids the blind moment in laparoscopy using pneumoperitoneum, is already being used by many authors (4,13,27,36) , and is especially recommended in situations of previous abdominal surgery because there may be points of adherence which increase the risks of perforation lesions. In Brazil, according to national research (32) , in 6.3% of cases opted for this open technique for creating the pneumoperitoneum.…”

Section: Discussionmentioning

confidence: 99%