Mini-laparotomia vs. video-laparoscopia en el tratamiento de la litiasis biliar. Estudio prospectivo y comparativo
DOI:
https://doi.org/10.31053/1853.0605.v72.n3.9205Keywords:
Litiasis vesicular, Colecistectomía con Incisiones pequeñas adaptadas, Colecistectomía laparoscópica, Complicaciones postoperatorias.Abstract
Background: Laparoscopic cholecystectomy is considerated as the gold standard for the gallbaldder stones treatment, however, in the international literature the adapted smaller incisions is still an alternative procedure.
Objetives: To compare the results of the laparoscopic cholecystectomy with the cholecystectomy by adapted smaller incisions.
Design: Prospective and comparative protocolized study.
Materials and Methods: Between January 1994 and December 2011, we have performed 3822 cholecystectomy in the General Surgic Service “Pablo Luis Mirizzi” of the National Clinic Hospital of Córdoba. In 1735 patients we made laparoscopic cholecystectomy (LC) and in 2087 cholecystectomy by adapted smaller incisions (ASI). This two groups are comparable in age, gender, previous surgeries and preoperative diagnostic.
Results: We had non mortality, 115 cases (6.62 %) in the laparoscopic cholecystectomy were converted to open surgery. Postoperative complications for LC were 2.40 % and for ASI 6.37 %. Bilirraghe was superior and more serious in LC with an incidence of 0.55 % while for ASI was 0.23%.
Conclusions: In expert hands, laparoscopic cholecystectomy is the gold standard for the treatment of gallbaldder stones. However, in place with restricted butget the cholecystectomy by adapted smaller incisions can be an alternative gold standard. It´s a sure and economic proceedment, with a reasonable complexity and less index of surgical lesions.
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