단일 술자가 시행한 복강경 담낭절제술 1,000예에 대한 임상적 고찰
1,000 Cases of Laparoscopic Cholecystectomy by a Single Surgeon
박근준, 신준호,
소속 상세정보
박근준 ( Park Geun-Jun )
성균관대학교 의과대학 강북삼성병원 외과학교실
신준호 ( Shin Jun-Ho )
성균관대학교 의과대학 강북삼성병원 외과학교실
KMID : 0371320040660020123
Abstract
Purpose: A Laparoscopic cholecystectomy has been the treatment of choice for acute and chronic disease of the gallbladder. We have performed about 1,500 cases of laparoscopic cholecystectomy since 1991. The purpose of this study is to analyse 1,000 cases of laparoscopic cholecystectomy performed by a single surgeon and observe the effectiveness of this form of treatment of for gallbladder disease.
Methods: From March 1993 to December 2001, 1,000 patients underwent a laparoscopic cholecystectomy at our department by a single surgeon. They were divided into 2 groups; group 1 being those of the first half of the period and group 2 being those of second half. We reviewed the patient´s charts, age, sex, associated medical diseases, final diagnosis, operation time, occurrence of conversion from laparoscopic to open cholecystectomy, surgical complication and hospital stay.
Results: The nean age was 51.2±2.37 years and the male-to-female ratio was 1 : 1.3. There was no difference of age or sex between two groups. Nineteen percent from group 1 and 16.6% from group 2 had a history of previous abdominal surgery. 22.2% from group 1 and 28.6% from group 2 had a associated disease. Chronic cholecystitis was the most common final diagnosis in both groups. But while the incidence of acute cholecystitis of group 1 was 7%, that of group 2 was 20.6%, which significantly increased (P<0.05). The mean operation time was 69.4 and 45.2 minutes, the conversion rate was 3.8% and 1.2% (P<0.05). The surgical complication rate was 4.4% and 2.4%, and the length of hospital stay was 4.7 and 3.9 days in groups 1 and 2, respectively
Conclusion: Laparoscopic cholecystectomy is a safe and effective treatment for gallbladder diseases. As surgical experience incerased with a rising number of cases, the conversion rate, complication rate and hospital stay decreased. However, the rate of acute cholecystitis increased. For this result, we think that an excellent skill and significant. experience of surgeon is essential for this results.
키워드
복강경 담낭절제술;급성 담낭염;Laparoscopic cholecystectomy;Acute cholecystitis
원문 및 링크아웃 정보
등재저널 정보