[Indications and advantages of transhepatic cholangiography with the Chiba needle].
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Biomedical subjects
Publications and source records attributed to A Faggioni.
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This paper describes the experience gained and the techniques used by the authors in the laparoscopic treatment of biliary calculosis in patients who previously underwent abdominal surgery, excluding cases with incisions below the horizontal line passing through the umbilicus (in these cases there are usually no adhesions to hinder operative laparoscopy of the gallbladder). Between October 1991 and July 1995,776 laparoscopies were performed on bile ducts (715 for calculosis of the gallbladder and 61 for cholecysto-choledochal calculosis). In 18 cases there was scarring of the abdominal wall due to previous major surgery (12 gastric resections, 3 resections of the colon, 1 splenectomy, 1 case of fundoplication for hiatal hernia, 1 resection of the ileum). In all cases access was by open laparoscopy to the lower right or periumbilical abdominal quadrant. When necessary, local viscerolysis was performed using various techniques with variations depending on the adhesions encountered. In all cases surgery was performed laparoscopically. In 2 cases a calculosis of the common bile duct was treated at the same time. The average duration of surgery was 70 min for cholelithiasis and 145 min for cholecysto-choledochal calculosis. On average patients were released from hospital 4 and 7 days after surgery respectively. No major or minor complications were encountered.
BACKGROUND/AIMS: The authors describe their experience in performing cholecystectomy using mini-laparoscopy in selected cases of uncomplicated cholelithiasis. This involved making one 10 mm, one 5 mm and two 2 mm incisions. METHODOLOGY: From July 1996 to August 1997, 60 cholecystectomies were performed using mini-laparoscopy, out of a total of 203 video-laparocholecystectomies performed during the same period. RESULTS: Average length of the operations was 36 minutes from insertion of the first trocar to extraction of the gallbladder. All patients were discharged in the second day after surgery. No short-term intra- or post- operative complications occurred. CONCLUSIONS: The benefits of mini-cholecystectomy are potential advantages in improved appearance, reduced pain, better respiratory function, fewer wall complications. Therefore, the authors believe that mini-laparoscopy should not be assessed in terms of percentage of use or success, but rather considered as a part of the laparoscopic method to be used in selected cases.