Use of Stapling Devices for Safe Cholecystectomy in Acute Cholecystitis

Odabasi M., Muftuoglu M., Ozkan E., Eris C., Yildiz M., Gunay E., ...Daha Fazla

INTERNATIONAL SURGERY, cilt.99, sa.5, ss.571-576, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 99 Sayı: 5
  • Basım Tarihi: 2014
  • Doi Numarası: 10.9738/intsurg-d-14-00035.1
  • Dergi Adı: INTERNATIONAL SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.571-576
  • Anahtar Kelimeler: Cholecystectomy, Endo-GIA, Acute cholecystitis, Stapler, DELAYED LAPAROSCOPIC CHOLECYSTECTOMY, CYSTIC DUCT, ULTRASONIC DISSECTION, RANDOMIZED-TRIAL, CLINICAL-TRIAL, ENDO-GIA, LIGATION, MANAGEMENT, SURGERY, LIGATURE
  • İnönü Üniversitesi Adresli: Evet

Özet

Many techniques are described for the ligation of a difficult cystic duct (CD). The aim of this study is to assess the effectiveness and safety of stapling of a difficult CD in acute cholecystitis using Endo-GIA. From January 2008 to June 2012, 1441 patients with cholelithiasis underwent laparoscopic cholecystectomy (LC) at the Department of General Surgery, Haydarpasa Numune Education and Research Hospital. Of these, 19 (0.62%) were identified as having a difficult CD and were ligated using an Endo-GIA stapler. All patients were successfully treated with a laparoscopic approach. The length of hospital stay was 3.4 days. There were umbilical wound infections in 4 patients (21%). The length of follow-up ranged from 1.0 to 50.4 months. In conclusion, Endo-GIA is a safe and easy treatment method for patients with a dilated and difficult CD. The cystic artery should be isolated and ligated if possible before firing the Endo-GIA stapler. If isolation and stapling are not possible, fibrin sealant can be applied to avoid bleeding. The vascular Endo-GIA can be applied in a large CD, but for acute cholecystitis with an edematous CD, the Endo-GIA roticulator 4.8 or 3.5 stapler is preferred.