Surgical risks and their prevention in laparoscopic cholecystectomy

Sazhin, V P; Yudin, V. A.; Сажин, И В; Nuzhdikhin, A. V.; Osipov, V V; Podyablonskaya, I.A.; Айвазян, С.А.

doi:10.17116/hirurgia2015617-20

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…несомненное значение имеют врожденные особенности анатомической зоны треугольника Кало и предшествующие заболевания желчного пузыря, а также связанные с ними спаечные и воспалительные процессы [11,12,19]. и, конечно, важен опыт хирурга не только в эндохирургии, но и в операциях на гепатобилиарной зоне [8,10,11,13].…”

Section: Discussionunclassified

“…В настоящее время лапароскопическая холецистэктомия (лХЭ) считается золотым стандартом при холелитиазе в связи с малой инвазивностью методики, сокращением срока госпитализации за счет уменьшения периода реабилитации после хирургического вмешательства [8,9]. однако результаты анализа опыта хирургов, оперирующих взрослых пациентов, показали, что число интраоперационных и ранних послеоперационных осложнений при лХЭ варьирует от 1 до 19,8 % [10][11][12][13]. В литературе существует мало работ, посвященных осложнениям лХЭ у детей [14][15][16][17], поэтому из представленных нами наблюдений специалисты могут извлечь полезные уроки для своей клинической практики.…”

Section: Introductionunclassified

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Postoperative complications of laparoscopic cholecystectomy in children: two cases report

Karpova

Стриженок

Egorskaya

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Only a few studies have investigated the complications of laparoscopic cholecystectomy in children. Therefore, relevant case reports will be of interest to pediatric surgeons. The patient was a 10-month-old boy diagnosed with calculous cholecystitis who underwent laparoscopic cholecystectomy. He had peripheral edema and adhesions in the neck of the gallbladder. After 10 h, a clinical picture of intra-abdominal bleeding developed. During relaparoscopy in the area of the gallbladder bed, arterial bleeding from the liver vessel was noted, which was eliminated by coagulation. The postoperative period was uneventful, and the child was discharged on day 8. In the second case, a 10-year-old girl was admitted for chronic calculous cholecystitis, and laparoscopic cholecystectomy was performed, in which a pronounced adhesion process was noted in the gallbladder neck region. On day 8, the child was discharged home; however, after 26 days, the patient was admitted again, with a clinical picture of diffuse biliary peritonitis. During laparoscopy, bile outflow from the gallbladder bed was noted, which only partially eliminated by monopolar electrocoagulation. Drainages were installed, through which bile began to be abundantly secreted in the postoperative period. Laparoscopy with a transition to open surgery was performed, during which a perforation in the wall of the common bile duct was found, and stenting and suturing of the defect were performed. In the postoperative period, active infusional infusion and antibacterial therapy were given. The patient was discharged on day 29. Postoperative complications of the ClavienDindo type IIIb are associated both with the presence of congenital anatomical features and inflammatory-adhesive changes in the Calo triangle zone and with the possibility of latent lesions during monopolar coagulation in both cases. The evaluation of the tactics of eliminating biliary peritonitis in the second patient emphasized the necessity to switch to open laparotomy during the second operation. These cases indicate the need to comply with the principles of safe laparoscopic cholecystectomy, including the availability of modern endoscopic equipment and the experience of surgeons in endosurgery. This requires the concentration of patients with cholelithiasis in specialized clinics.

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Section: Discussionunclassified

Section: Introductionunclassified

Postoperative complications of laparoscopic cholecystectomy in children: two cases report

Karpova

Стриженок

Egorskaya

et al. 2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

View full text Add to dashboard Cite

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About non-triviality of the concept 'patient's safety in surgery'

Karsanov

2018

Khir. Z. im. N.I. Pirogova

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Our Experience of 4360 Laparoscopic Cholecystectomy for Cholelithiasis

Бокиев¹,

Rashidov²,

Рахмонов³

et al. 2020

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Objective: Analysis of our own experience in performing laparoscopic cholecystectomy (LCE) for cholelithiasis (CHL). Methods: The study is based on the results of 4360 LCE in patients with cholelithiasis. Among the patients, women predominated – 3732 (85.6%), the average age of patients was 52.0±3.5 years. The structure of nosologies: chronic calculous cholecystitis – 3310 (75.9%), acute calculous cholecystitis – 1050 (24.1%). The operations were performed under general endotracheal anaesthesia with carbon dioxide insufflations; the location of the operating team was of the «American» type. Results: LCE was performed in 96.5% of patients, access conversion to open surgery was required in 3.5% of cases. The most common causes of conversion were the presence of a massive adhesive process (59.6%) and destructive changes in the walls of the gallbladder (9.93%). In the ICU, the operated patients were observed on average for 4±2.5 hours, the postoperative stay of patients in the hospital ward was 1.7±1.2 days. Immediate postoperative complications were noted in 1.63% of cases, mortality was 0.13%. Conclusions: Based on their own experience, the authors agree with the postulate that the LCE is the «gold standard» in gallbladder surgery in patients with gallstone disease. At the same time, purposeful preoperative preparation, careful selection of patients, high qualification of the surgeon, as well as adequate postoperative management of patients are the main factors in achieving good outcome. The complexity of surgical techniques can be reduced by collectively addressing complex situations of general somatic status by the active involvement of associated professionals. Keywords: Gallstone disease, laparoscopic cholecystectomy, conversion, early postoperative complications.

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Surgical risks and their prevention in laparoscopic cholecystectomy

Cited by 3 publications

References 3 publications

Postoperative complications of laparoscopic cholecystectomy in children: two cases report

Postoperative complications of laparoscopic cholecystectomy in children: two cases report

About non-triviality of the concept 'patient's safety in surgery'

Our Experience of 4360 Laparoscopic Cholecystectomy for Cholelithiasis

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