Aims and objectives: The role of mini-invasive surgery in management of acute cholangitis and other complications of gallstone disease
Background: To demonstrate the capability of laparoscopic and small-incision in management of acute cholangitis and other complications of cholelithiasis.
Material and methods: Records of 2973 patients who underwent cholecystectomy at Department of General Surgery, Rostov State Medical University between the year 2004 and 2007 were reviewed.
Three hundred ninety two cases of gallstone-related complications were evaluated retroprospectively and divided into three groups. Group1; LC included 258(65.8%) patients with laparoscopy cholecystectomy. Group 2; MC included 84(21.4%) patients with minilaparotomy cholecystectomy, while Group 3; OC included 50(12.8%) patients with conventional open cholecystectomy.
Demographic information, clinical characteristics, types of surgery, operation time, postoperative hospital stay, complications, conversion rate and postoperative mortality were evaluated.
Results: The age range of all subjects was 15 to 86 years; the mean age incidence was 57.12±1.60 years, and the male: female ratio was 1:3.4.The age of 81.5% of all patients was 51 to 80 years. There were 27 (6.8%) patients out of the 392 cases presented with a combination of acute pyegenic cholangitis with other complications of cholelithiasis; mechanical jaundice in 26(88.9%), choledocholythias in 22(81.5%),
biliary pancreatitis in 7(25.9%), common bile duct strictures in 5(18.5%) ,
pericholecystic fibrotic mass in 4(14.8%) and empyema in 3 (11.1%). Twenty three (85.2%) subjects had three and more of such combinations. Seventeen patients (63.0%) were associated with concomitant diseases.
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, 11.4±0 .6 days as against 16.3± 2.3 for MC group. The median length of hospital stay following LC and MC was 7 and 10 days respectively.
Conclusion: Both mini-incision and laparoscopic prompt cholecystectomy during the index admission can be practiced with low and similar rate of complications in cholangitis and gallstones related complications
Program Number: P476