복부 수술 기왕력이 있는 환자에 대한 복강경 담낭 절제술의 적용
Application of Laparoscopic Cholecystectomy in Patients with Previous Abdominal Surgery
민석기, 한호성, 김영우, 최용만, 유권,
소속 상세정보
민석기 ( Min Seog-Ki )
이화여자대학교 의과대학 외과학교실
한호성 ( Han Ho-Seong )
이화여자대학교 의과대학 외과학교실
김영우 ( Kim Young-Woo )
이화여자대학교 의과대학 외과학교실
최용만 ( Choi Yong-Man )
이화여자대학교 의과대학 외과학교실
유권 ( Yoo Kwon )
이화여자대학교 의학전문대학원 내과학교실
KMID : 0371320020630030238
Abstract
Purpose: Previous abdominal surgery has been one of the relative contraindications of laparoscopic cholecystectomy (LC). Recently, the accumulation of experience and the development of skill have widened the indications of LC. The aim of
this
study was to elucidate the effectiveness and safety of LC in patients with a history of previous abdominal surgery.
Methods: The medical records of patients treated with LC at Ewha Womans University, Mokdong Hospital from March 1997 to December 2000 were reviewed. Operative results were compared between the previous abdominal-surgery group (Group A) and
the
non-operative history group (Group B). Group A consisted of 99 cases: 91 cases with one operation history, 7 with two, and 1 with three. Group B consisted of 99 cases randomly selected out of 437 cases without a history of previous abdominal
surgery in
the same period. We compared the mean operative time, conversion rate, rate of drain insertion, starting day of postoperative diet and hospital stay.
Results: In groups A and B, the mean ages were 52 and 51.4 years olds, the male to female ratios 1：2.7 and 1：1.08, and the mean operative times 88.8 and 91.1minutes (P=0.740), respectively. The conversion rates were 3% and the time of
postoperative diet was 2.3 days in both groups. The rates of drain insertion were 21% and 15% (P=0.372), the hospital stay was 5.4 days and 5.6 days (P=0.769), the morbidity was 4% and 1% (P=0.371), respectively. There were no cases of mortality
in
either group.
Conclusion: The operative results of the patients with a history of previous abdominal surgery were similar to those of the patients without an operative history. Laparoscopic cholecystectomy was an effective and safe method in the patients
with
a history of previous abdominal surgery.
키워드
복강경 담낭 절제술; 복부 수술 기왕력; Laparoscopic cholecystectomy; Previous abdominal surgery;
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