Role of Laparoscopy and Mini – Incision in Management of Complicated Forms of Cholelithiasis

*,**abdulkadir Yakubu, MD MSc PhD, *viktor N Chernov, Prof. *Rostov State Medical University, Russia,** Kazaure General hospital, Jigawa state, nigeria

 

Background: To demonstrate the capability of laparoscopic and mini – incision in management of complicated gallstones
Methods and materials: Three hundred and nine two patients with different complications of calculous cholecystitis were evaluated prospectively and managed using a designed algorithm. Only patients with acute cholangitis were included. All patients had cholecystectomy with or without other surgical interventions. They were divided into 3 groups based on the approach used. Demographic information, Demographic information, clinical characteristics, types of surgery, operation time, hospital stay,complications and conversion rate were analyzed.
Results: Acute pyogenic cholangitis was revealed in 27(6.8%) subjects from the 392 evaluated. It occurred in 26 patients (88,9%) with mechanical jaundice, 22 patients (81,5%) with choledocholythias, 7 patients (25,9%) with biliary pancreatitis, 5 patients (18,5%) with common bile duct strictures, 4 patients (14,8%) with pericholecystic fibrotic mass and 3 patients (11,1%) with empyema.
Eleven patients (40.7%) were included in the LC group, 11(40.7%) had MC while the remaining 5(18.5%) patients underwent open conventional laparotomy.
A single surgical procedure was performed in 3 patients (11.1%); 2 patients  (7.4%) had MC and 1patients (3.7%) had LC. The remaining 24 patients (88.9%) were exposed to two or more procedures.
The average duration of surgery in LC was 72 ± 9 minutes and 55 ± 2 minutes in MC group. Hospital days were comparatively less in the LC group. There was no mortality in this study.
Conclusion: The designed diagnostic – therapeutic algorithm has clearly demonstrated the possibility of one stage management of complicated forms of cholelithiasis using MC.
 


Session Number: Poster – Poster Presentations
Program Number: P342
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