Simultaneous Laparoscopic Cholecystectomy and Cruroraphy With Toupet Fundoplication

Abstract

Summary. Aim of work: to determine and compare the level of visualization, comfort, safety and effectiveness of simultaneous technique of laparoscopic surgery of gallstone disease and concomitant hiatal hernia and standard «baseball diamond» technique of laparoscopic surgery of only hiatal hernia.
 Materials and methods: the study was performed based on data developed in MISU VRCH. 359 patients were treated and divided on two groups, of which the group №1 — patients who underwent simultaneous laparoscopic cholecystectomy and cruroraphy with Toupet fundoplication (n=155), and group №2 — patients who underwent only laparoscopic crurography with with Toupet fundoplication. The level of visualization, comfort, frequency of «fencing», duration of operation, length of hospital stay, complication frequency were determined. The method with the null hypothesis, Pearson’s analysis, Mann-Whitney method were used.
 The results of the study: the approach distance of the laparoscope was (8,11 ± 0,917) and (8,71 ± 0,256) cm for 30°-optics while (6,55 ± 0,491) and (6,66 ± 0,485) cm for 0°-optics in two groups, respectively. The frequency of fencing was just about 4 episodes in both groups and did not differ statistically significantly. The frequency of the need to change the viewing area` and the frequency of the need to change the position of the instruments did not differ statistically significantly in both groups. The operation time was longer in the group of simultaneous operations by 10 % or 4,24 minutes. The level of complications was comparable in both groups, no correlation was found. The length of hospital stay was (3,64 ± 0,71) days (2-8 days) versus (3,58 ± 0,67) days (2-8 days) for both groups, respectively (p = 0.967).