Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QI Dunfeng , ZHANG Xinhui , LI Huansong , SHI Kui , YUAN Bo ,  LIU Yangsui

Department of Hepatobiliary Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P. R. China;

Corresponding author：

LIU Yangsui, Email: yangsui-liu@163.com

Keywords：

acute cholecystitis; left side approach; laparoscopic cholecystectomy

DOI：

10.7507/1007-9424.201707032

Video：

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Objective To investigate clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis. Methods One hundred and twenty patients with acute cholecystitis from January 2015 to May 2017 were collected. All of the patients were divided into observation group and control group according to the operative mode, with 60 cases in each group. In the observation group, the patients were treated by laparoscopic cholecystectomy via left side approach using the ligation-free technique to the main trunk of the cystic artery; in the control group, the patients were treated by the conventional laparoscopic cholecystectomy. After treatment, the operative situation, postoperative recovery, and incidence of postoperative complications were compared between these two groups. Results Compared with the control group, the operative time, first anal exhaust time, hospitalization stay, leukocytes recovery time, and coagulation function recovery time were shortened and the intraoperative bloods loss was reduced in the observation group, the differences were statistically significant (P<0.05). Furthermore, the overall postoperative complication incidence rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion For patients with acute cholecystitis, laparoscopic cholecystectomy via left side approach using ligation-free technique to main trunk of cystic artery is reliable and safe, which can effectively improve operative situation, shorten operative time, promote recovery of patient, and reduce incidence of postoperative complications.

Citation： QI Dunfeng, ZHANG Xinhui, LI Huansong, SHI Kui, YUAN Bo, LIU Yangsui. Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(12): 1492-1495. doi: 10.7507/1007-9424.201707032 Copy

1.	Hayama S, Ohtaka K, Shoji Y, et al. Risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis. JSLS, 2016, 20(4). pii: e2016.00065.
2.	Cwik G, Skoczylas T, Wyroślak-Najs J, et al. The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc, 2013, 27(7): 2561-2568.
3.	尚培中, 李晓武, 李永庆. 腹腔镜胆囊切除困难与对策. 中华普外科手术学杂志(电子版), 2016, 10(6): 458-461.
4.	陈智勇, 陈文有, 杨爱国. 腹腔镜胆囊切除术并发症发生的相关影响因素分析. 中国普通外科杂志, 2016, 25(2): 214-218.
5.	Acar T, Kamer E, Acar N, et al. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. Pan Afr Med J, 2017, 26: 49.
6.	Onoe S, Maeda A, Takayama Y, et al. A preoperative predictive scoring system to predict the ability to achieve the critical view of safety during laparoscopic cholecystectomy for acute cholecystitis. HPB (Oxford), 2017, 19(5): 406-410.
7.	Flowers JL, Bailey RW, Scovill WA, et al. The Baltimore experience with laparoscopic mamagement of acute cholecystitis. Am J Surg, 1991,161(3): 388-392.
8.	何贤禄, 刘伟. 腹腔镜胆囊切除术治疗急性坏疽性胆囊炎的临床分析. 华西医学, 2016, 31(4): 731-733.
9.	夏明, 鄢利华. 腹腔镜胆囊次全切除术 83 例报道. 中国普外基础与临床杂志 2011, 18(3): 317-319.
10.	Csikesz N, Ricciardi R, Tseng JF, et al. Current status of surgical management of acute cholecystitis in the United States. World J Surg, 2008, 32(10): 2230-2236.
11.	Elshaer M, Gravante G, Thomas K, et al. Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis. JAMA Surg, 2015, 150(2): 159-168.
12.	许军, 董杰杰. 腹腔镜手术治疗急性胆囊炎合理选择及争议. 中国实用外科杂志, 2015, 35(5): 482-486.
13.	毛静熙, 陈训如, 余少明. 胆囊炎症期的腹腔镜胆囊切除术. 中国普外基础与临床杂志, 1997, 4(2): 89-91.
14.	孙彦波, 任伍保. 急性胆囊炎腹腔镜胆囊切除术中转开腹的危险因素分析. 肝胆外科杂志, 2017, 25(2): 147-148.
15.	陈大红, 汪泳, 王健, 等. 急性胆囊炎行腹腔镜胆囊切除术中转开腹的危险因素分析. 安徽医药, 2016, 20(8): 1527-1529.
16.	余同辉, 黄峻松, 黄奕江. 腹腔镜胆囊切除术中胆囊动脉出血的预防及处理. 中国微创外科杂志, 2012, 12(12): 1082-1084.
17.	余同辉, 黄峻松, 黄奕江. 腹腔镜胆囊切除术中特意分离结扎胆囊动脉的必要性分析. 腹腔镜外科杂志, 2017, 22(2): 126-129.
18.	罗东, 刘国栋, 唐能, 等. 腹腔镜胆囊切除术中转开腹的临床分析: 附 39 例报告. 中国普通外科杂志, 2017, 26(2): 157-165.
19.	冯一浮, 莫经刚, 陈建辉. 急性胆囊炎腹腔镜胆囊切除术中转开腹相关风险因素的分析. 中国普通外科杂志, 2016, 25(2): 286-290.
20.	Dandekar U, Dandekar K. Cystic artery: Morphological study and surgical significance. Anat Res Int, 2016, 2016: 7201858.
21.	符国珍, 吕明, 宋文渊, 等. 腹腔镜胆囊切除术左侧进路不分离断离胆囊动脉主干技术的临床研究. 中华肝胆外科杂志, 2015, 21(12): 826-829.
22.	熊美雪. 不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除的临床效果观察. 中国当代医药, 2016, 23(31): 28-29.
23.	包文中, 汤大纬, 周高潮, 等. 老年急性结石性胆囊炎不分离离断胆囊动脉主干左侧入路 LC 术的临床效果观察. 肝胆外科杂志, 2016, 24(2): 110-112.
24.	王耀东, 侯森, 时永, 等. 腹腔镜胆囊切除术并发症的临床分析. 中国实用医药, 2016, 11(1): 35-36.
25.	李钟声, 赵怀辉, 薛传信, 等. 腹腔镜胆囊切除技巧与严重并发症的预防. 安徽医学, 2008, 29(4): 437-438.
26.	朱锐昌, 李运福, 李辉, 等. 腹腔镜胆囊切除术并发症发生的相关影响因素分析. 海南医学, 2017, 28(12): 2022-2023.
27.	白正岩. 腹腔镜胆囊切除术患者术后并发症的临床分析. 临床医药文献杂志, 2016, 3(4): 615, 618.
28.	孙树领, 朱江峰, 彭元美. 腹腔镜下胆囊切除术及并发症分析. 华西医学, 2012, 27(10): 1515-1516.

1. Hayama S, Ohtaka K, Shoji Y, et al. Risk factors for difficult laparoscopic cholecystectomy in acute cholecystitis. JSLS, 2016, 20(4). pii: e2016.00065.
2. Cwik G, Skoczylas T, Wyroślak-Najs J, et al. The value of percutaneous ultrasound in predicting conversion from laparoscopic to open cholecystectomy due to acute cholecystitis. Surg Endosc, 2013, 27(7): 2561-2568.
3. 尚培中, 李晓武, 李永庆. 腹腔镜胆囊切除困难与对策. 中华普外科手术学杂志(电子版), 2016, 10(6): 458-461.
4. 陈智勇, 陈文有, 杨爱国. 腹腔镜胆囊切除术并发症发生的相关影响因素分析. 中国普通外科杂志, 2016, 25(2): 214-218.
5. Acar T, Kamer E, Acar N, et al. Laparoscopic cholecystectomy in the treatment of acute cholecystitis: comparison of results between early and late cholecystectomy. Pan Afr Med J, 2017, 26: 49.
6. Onoe S, Maeda A, Takayama Y, et al. A preoperative predictive scoring system to predict the ability to achieve the critical view of safety during laparoscopic cholecystectomy for acute cholecystitis. HPB (Oxford), 2017, 19(5): 406-410.
7. Flowers JL, Bailey RW, Scovill WA, et al. The Baltimore experience with laparoscopic mamagement of acute cholecystitis. Am J Surg, 1991,161(3): 388-392.
8. 何贤禄, 刘伟. 腹腔镜胆囊切除术治疗急性坏疽性胆囊炎的临床分析. 华西医学, 2016, 31(4): 731-733.
9. 夏明, 鄢利华. 腹腔镜胆囊次全切除术 83 例报道. 中国普外基础与临床杂志 2011, 18(3): 317-319.
10. Csikesz N, Ricciardi R, Tseng JF, et al. Current status of surgical management of acute cholecystitis in the United States. World J Surg, 2008, 32(10): 2230-2236.
11. Elshaer M, Gravante G, Thomas K, et al. Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis. JAMA Surg, 2015, 150(2): 159-168.
12. 许军, 董杰杰. 腹腔镜手术治疗急性胆囊炎合理选择及争议. 中国实用外科杂志, 2015, 35(5): 482-486.
13. 毛静熙, 陈训如, 余少明. 胆囊炎症期的腹腔镜胆囊切除术. 中国普外基础与临床杂志, 1997, 4(2): 89-91.
14. 孙彦波, 任伍保. 急性胆囊炎腹腔镜胆囊切除术中转开腹的危险因素分析. 肝胆外科杂志, 2017, 25(2): 147-148.
15. 陈大红, 汪泳, 王健, 等. 急性胆囊炎行腹腔镜胆囊切除术中转开腹的危险因素分析. 安徽医药, 2016, 20(8): 1527-1529.
16. 余同辉, 黄峻松, 黄奕江. 腹腔镜胆囊切除术中胆囊动脉出血的预防及处理. 中国微创外科杂志, 2012, 12(12): 1082-1084.
17. 余同辉, 黄峻松, 黄奕江. 腹腔镜胆囊切除术中特意分离结扎胆囊动脉的必要性分析. 腹腔镜外科杂志, 2017, 22(2): 126-129.
18. 罗东, 刘国栋, 唐能, 等. 腹腔镜胆囊切除术中转开腹的临床分析: 附 39 例报告. 中国普通外科杂志, 2017, 26(2): 157-165.
19. 冯一浮, 莫经刚, 陈建辉. 急性胆囊炎腹腔镜胆囊切除术中转开腹相关风险因素的分析. 中国普通外科杂志, 2016, 25(2): 286-290.
20. Dandekar U, Dandekar K. Cystic artery: Morphological study and surgical significance. Anat Res Int, 2016, 2016: 7201858.
21. 符国珍, 吕明, 宋文渊, 等. 腹腔镜胆囊切除术左侧进路不分离断离胆囊动脉主干技术的临床研究. 中华肝胆外科杂志, 2015, 21(12): 826-829.
22. 熊美雪. 不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除的临床效果观察. 中国当代医药, 2016, 23(31): 28-29.
23. 包文中, 汤大纬, 周高潮, 等. 老年急性结石性胆囊炎不分离离断胆囊动脉主干左侧入路 LC 术的临床效果观察. 肝胆外科杂志, 2016, 24(2): 110-112.
24. 王耀东, 侯森, 时永, 等. 腹腔镜胆囊切除术并发症的临床分析. 中国实用医药, 2016, 11(1): 35-36.
25. 李钟声, 赵怀辉, 薛传信, 等. 腹腔镜胆囊切除技巧与严重并发症的预防. 安徽医学, 2008, 29(4): 437-438.
26. 朱锐昌, 李运福, 李辉, 等. 腹腔镜胆囊切除术并发症发生的相关影响因素分析. 海南医学, 2017, 28(12): 2022-2023.
27. 白正岩. 腹腔镜胆囊切除术患者术后并发症的临床分析. 临床医药文献杂志, 2016, 3(4): 615, 618.
28. 孙树领, 朱江峰, 彭元美. 腹腔镜下胆囊切除术及并发症分析. 华西医学, 2012, 27(10): 1515-1516.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis

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