Clinical Review of Laparoscopic Cholecystectomy / 한국간담췌외과학회지

ABSTRACT

BACKGROUNDS: The biliary diseases were one of the most common diseases of intraabdominal diseases, and cholecystectomy was performed first in 1882 by Langenbuch, and since laparoscopic cholecystectomy( L.C) that was new noninvasive method of being avoid the laparotomies was performed first in France, in 1987 by Philippe Mouret, it has become the standard method of treatment for symptomatic cholelithiasis. Laparoscopic cholecystectomy offers the mafority of patients with symptomatic cholelithiasis as an improved treatment option, resulting in significantly less postoperative pain, shorter hospital stays, better cosmetic result, and more rapid return to normal activity than standard open cholecystectomy. METHODS: We compared the 82 patients who underwent laparoscopic cholecystectomy at Chung-nam National University Hospital from Jan. 1993 to Jun. 1998 to the 67 patients undergoing standard open cholectystectomy(O.C) during the same periods. RESULTS: 1) The mean age of L.C group was 53.9 years and that of O.C group was 58.0 years. The male to female ratio of L.C group was 1:1.47 and that of O.C group was 1:1.0. 2) Associated diseases were observed in 31 patients(37.8%) of the L.C group and 36 patients(53.7%) of the O.C group. 3) 6 patients(7.3%) had a previous abdominal operation, with appendectomy, the most frequent among them. 4) The shorter operative time and postoperative hospitalization stay were required to performed laparoscopic cholecystectomy than standad open cholecystectomy(p=0.03, p=0.02). 5) Postoperative compoications were occurred in 6 patients(7.3%) of L.C group. 1 patient was explorated, the remainders were recovered by conservative treatment. 6) On pathologic findings, chronic cholecystitis as seen in 70 pateints(85.4%) were the most frequent in the L.C group. In the O.C group, chronic cholecystitis as seen in 40 pateints(59.7%) were also the most frequent diseases. CONCLUSION: Laparoscopic cholecystectomy has the merits of short operation and admission time, lesser postoperative pain, smaller wound, rapid return to normal life than open cholecystectomy.