RESUMO
It has been shown that a video-laparoscopic approach is the preferred method for treatment of cholecystitis. However, when we consider acute cholecystitis, many questions must be answered. The aim of this study is to compare video-laparoscopic and conventional surgery in the management of acute cholecystitis.
Assuntos
Colecistectomia Laparoscópica , Colecistite/cirurgia , Cirurgia Vídeoassistida , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colecistectomia , Colecistectomia Laparoscópica/métodos , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Cirurgia Vídeoassistida/métodosRESUMO
The authors report a case of an asymptomatic 30-year-old female patient with an extensive cystic lesion continuous with the splenic parenchyma. A review of the literature and use of a videolaparoscopic approach to the treatment of these lesions is presented.
Assuntos
Cistos/cirurgia , Laparoscopia , Esplenopatias/cirurgia , Adulto , Feminino , Humanos , Gravação em VídeoRESUMO
BACKGROUND AND OBJECTIVE: Although videolaparoscopy has been considered a safe method for many elective procedures, its use in traumatic and non-traumatic acute abdomen needs to be evaluated. The aim of this article is to evaluate the role of videolaparoscopy in non-traumatic acute abdomen as a method of diagnosis and treatment. METHODS: Between January 1992 and December 1996, 462 patients' charts were reviewed, retrospectively. Patients were admitted to the emergency room of São Rafael Hospital with symptoms of non-traumatic acute abdomen. Routine investigation of abdominal pain was performed in all patients, followed by videolaparoscopy. The laparoscopic procedures were done with four main purposes: diagnosis (ie, enteritis); diagnosis and treatment (ie, appendicitis); treatment only, when the diagnosis was known (ie, acute cholecystitis); and in cases where the conversion to conventional laparotomy was necessary, indicating the best incision. RESULTS: The vast majority of patients had inflammatory causes of acute abdomen (82.03%); others causes were hemoperitoneum (11.03%), bowel obstruction (3.25%), perforation of a hollow viscera (1.74%), vascular occlusion (1.3%), and negative laparoscopy (0.65%). CONCLUSIONS: This study shows that laparotomy was necessary in only 7.14% of the patients. The videolaparoscopic approach was used for diagnosis (99.35%) and treatment (92.86%) of patients with acute abdomen.
Assuntos
Abdome Agudo/diagnóstico , Abdome Agudo/cirurgia , Laparoscopia/métodos , Cirurgia Vídeoassistida , Brasil , Serviço Hospitalar de Emergência , Endoscopia/métodos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
There are many questions regarding the advantages and disadvantages a videolaparoscopic approach in the treatment of acute appendicitis. The authors present the results of a non-randomized, prospective study with 496 patients admitted between January 1992 and March 1998 by the General Surgery Service of São Rafael Hospital Salvador-BA-Brazil. The patients were submitted for appendicectomy by video laparoscopy or by the traditional open method, and variables such as surgery duration, morbidity, mortality, costs, and length of stay (LOS) were compared. The results demonstrate that laparoscopic appendicectomy is a safe alternative for treatment of acute appendicitis; however, there are several disadvantages that gradually must be overcome.