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Akut Kolesistitlerde Laparoskopik Kolesistektominin Yeri

The Role of Laparoscopic Cholecystectomy In Acute Cholecystitis

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: We aimed to determine the predictive factors for conversion from laparoscopic to open cholecystectomy in the treatment of acute cholecystitis. Material and Method: We investigated 28 patients on whom laparoscopic cholecystectomy was performed for acute cholecystitis from January 1997 to December 2000. Nineteen patients were female and 9 were male and the average age was 53.5+13.7 (range, 28-75). Conversion rates were evaluated for white blood cell count, age, sex and degree of acute cholecystitis. Results: Ten of 28 patients underwent conversion. Increase in white blood cells and degree of acute cholecystitis were found significant (respectively p=0.011 and p=0.0007). There were no relationship between male sex, age, increase in alkaline phosphatase and conversion rate (respectively p=0.677, p=0.432 and p=0.601). There were no major complications in all patients ins ide there were much more minor complications such as wound infection and prolonged fever in conversion group. Hospitalization time and operation time were longer in conversion group (respectively p<0.001 and p=0.021). Conclusion: Laparoscopic cholecystectomy is a safe technique in patients with acute cholecystitis but selection of patients is important and increasing of white blood cells and the degree of acute cholecystitis are related with conversion.
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Abstract (Original Language): 
Amaç: Akut kolesistitin laparoskopik kolesistektomi ile tedavisinde konversiyon için belirleyici faktörleri ortaya koymayı amaçladık. Gereç ve Yöntem: Ocak 1997-Aralık 2000 tarihleri arasında akut taşlı kolesistit nedeniyle ameliyat edilen 28 olgu incelemeye tabi tutuldu. Olguların 19'u kadın 9'u erkek olup en genç hasta 28 ve en yaşlı hasta ise 75 yaşında olmak üzere ortalama yaş 53.5+13.7 idi.Beyaz küre, yaş, cinsiyet, alkalen fosfataz ve akut kolesistitin şidetine göre konversiyon oranları karşılaştırıldı. Bulgular: 28 hastanın 10'unda konversiyon (açık kolesistektomi) gerçekleşti (%35.7). Beyaz küre yüksekliği (>18000/uL) ve kolesistitin şiddeti konversiyon için anlamlı olarak bulundu (sırayla p=0.011 ve p=0.0007). Erkek cinsiyet, hastanın yaşının 60'ın üzerinde olması ve alkalen fosfataz yüksekliğinin, konversiyonla ilişkisi ortaya konulamadı (sırayla p=0.677, p=0.432 ve p=0.601). Hiçbir hastada postoperatif major komp likasyon gözlenmezken uzamış ateş ve yara enfeksiyonu gibi minor komplikasyonlar konversiyon grubunda laparoskopi grubuna göre daha fazla gözlendi. Konversiyon grubunda, hastanede kalış ve operasyon süresi anlamlı olarak daha uzundu (Sırayla; p<0.001 ve p=0.021). Sonuç: Akut kolesistitli hastaların coğunda laparaskopik girişimin güvenle yapılabileceği görüşündeyiz. Ancak, hasta seçimi üzerinde durulması gereken konudur ve beyaz küre yüksekliği (>18.000 u/L) ve kolesititin şiddeti konversiyonla ilişkilidir.
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  • 2
84-87
  • Turkish

REFERENCES

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