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Cirugía paraguaya

On-line version ISSN 2307-0420

Abstract

MACHAIN VEGA, Gustavo M. et al. "ADVANTAGES AND DISADVANTAGES OF VIDEOLAPAROSCOPIC SURGERY ON OPEN SURGERY IN CHOLECYSTECTOMY PERFORMED AT THE SECOND CATHEDRA OF SURGICAL CLINIC, HOSPITAL DE CLINICAS, SAN LORENZO, PARAGUAY 2017. Rev. Cir. Parag. [online]. 2017, vol.41, n.3, pp.21-32. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.diciembre.21-32.

Introduction:

Cholelithiasis, acute cholecystitis and chronic are common pathology of the hepatobiliary tract that clearly require surgical treatment. Open cholecystectomy has been the gold standard for over 100 years. Laparoscopic cholecystectomy was introduced in the 1980s taking its place. Nowadays, the discussions continues regarding the quirurgical management of the gallbladder disease.

Objective:

To expose the advantages and disadvantages of open and laparoscopic cholecystectomy.

Materials and Methods:

prospective, observational study. Two groups of patients with gallbladder pathology clinically diagnosed and confirmed by ultrasound that required surgical management of emergency or scheduled during the period from May to July 2017. The variables evaluated were: gender, age, origin, occupation, underlying pathologies, complaint, pre diagnostic and postoperative, mode of surgery, surgical time, intraoperative and postoperative complications, conversion rate, hospital stay pre and postsurgical, resume time intake oral food, independent to 12 hours, return to work, use of antibiotics and analgesia, fever, aesthetic satisfaction and ambulation.

Results:

Fifty cholecystectomies were recorded, of which 31 were performed laparoscopically (CVL) and 19 were conventional (CC). The conversion rate was 6%. An average surgical time of 1 hour 46 minutes for CC and 1 hour 28 minutes for CVL was found. Independent walking at 12 hours was recorded in 15.79% of patients undergoing CC, and in 70.97% of those operated by CVL. Patients undergoing CCT took an average of 25.5 hours to resume oral intake after surgery; and those operated by CVL took an average of 19.9 hours. The need for postoperative analgesia was 89.49% in CC with an average time of administration of 3.6 days; and in the CVL was 93.55% with an average time of 1.3 days. The rate of intraoperative complications was 15.79% in CC and 16.13% in CVL. Patients underwent CC delayed returning to work on average 39 days; and those operated by CVL, 25.5 days. The patient's satisfaction with his surgery in the CC was 59.37% and in the CVL 87.1%.

Conclusions:

laparoscopic cholecystectomy outperforms open cholecystectomy in the management of vesicular pathology, which results in the results with a shorter surgical, lower percentage of postoperative complications, greater percentage of independent walking at 12 hours after surgery, shorter hospital stay, less delay in return to work and a more accepted and preferred aesthetic result by patients.

Keywords : open cholecystectomy; laparoscopic cholecystectomy; complications; gallstones disease; comparison; laparoscopy.

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