Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/9592
Title: Laparoscopic cholecystectomy for complicated gallstone disease.
Authors: Fletcher, D R;Jones, Robert M;O'Riordan, B;Hardy, Kenneth John
Affiliation: Department of Surgery, Austin Hospital, Melbourne, Victoria, Australia.
Issue Date: 8-Jul-1992
Citation: Surgical Endoscopy; 6(4): 179-82
Abstract: After performing selectively 25 laparoscopic cholecystectomies (LC) to determine the place of LC in the management of complicated gallstones, all patients presenting with gallstones were evaluated by the authors for LC. Eighty-six consecutive patients were evaluated and 84 were studied. Follow-up in every case exceeded 6 months. In three of 10 patients with acute cholecystitis, LC was not possible; each had a history longer than 48 h and all had gangrene of the gallbladder. In four patients with empyema, LC was successful, but operative cholangiography failed. Operative cholangiography was successful in 76 of the remaining 77. Of eight patients suspected of having stones in the CBD, cholangiography excluded stones in six and confirmed them in two. Cholangiography identified three other patients with totally unsuspected CBD stones. Of the five patients with CBD stones, four had them flushed to the duodenum at LC following transcystic balloon dilatation of the papilla and one had a post-op. ERCP. Of four patients with acute pancreatitis, three had LC in the same admission. LC was possible in all three patients with morbid obesity. We conclude that with experience, LC is possible for complicated gallstones. In acute cholecystitis, the probability of success is higher with earlier operative intervention. Operative cholangiography is essential. It not only identifies unsuspected CBD stones but also allows LC without ERCP in those with suspected CBD stones and with modification it allows treatment of those stones.
Internal ID Number: 1387734
URI: http://ahro.austin.org.au/austinjspui/handle/1/9592
URL: http://www.ncbi.nlm.nih.gov/pubmed/1387734
Type: Journal Article
Subjects: Acute Disease
Adult
Aged
Cholangiography
Cholecystectomy.methods
Cholecystitis.surgery
Cholelithiasis.complications.radiography.surgery
Gallstones.surgery
Humans
Laparoscopy
Middle Aged
Pancreatitis.complications
Prospective Studies
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.