복강경 담낭절제술 300예의 임상분석 = A Clinical Analysis of 300 Case of Laparoscopic Cholecystectomy

다국어 초록 (Multilingual Abstract)

Depiartment of General Surgery, Cdlege of Medicine, Chung-AstB University
With advancement of endoscopical instruments and technique, gallstone diseases can be managed with laparoscopic cholacystectomy which had rapidly and radically changed the surgicl treatment of gallstone diseases.
The ideas of laparoacopic surgery was introduced 11y Germany gynecologist Serum, in 1967 and was first performed by French surgeon Mouret, Dtbois in 1987.
Although many reports of early laparoscopic cholec,stectomy were excellent, many surgeons want to know the surgical results of laparoscopie cholcystectomy are enough good to perform comparing with the conventional cholecystectomy, especially in early complications and late complications.
To know about above problems, we had clinical analysis of 300 patients with laparoscopic cholecystectomy who were admitted to the Departme$gt;tt of Surgery, Yong San Hospital, Chung Ang University from September 1990 to December 1991.
The authors intentionally divided the observation periods into 3 groups. The first group including from 1st case to 100 cases, the second group f#om IOlth to 200th cases, the third group from 201th cases to 300th cases and observed periodical change of early and late complications fo laparoscopic cholecystectomy with accumulations kf surgical experience and improvement of surgical techniques.
It's results were as follows.
1) The most prevalent age group was 4th decades arid the male to female ratio was 1 : 1.5 and had no periodical change.
2) Coexistent diseases were obesity of 30 cases(35%), hypertension of 20 cases(24%), pulmonary tuberculosis of 16 cases(19% ) in order.
3) The number of previous abdominal operations were appendectomy of 29 cases(38%), TAH of 18 cases(24%), C-section of 14 cases(l8%) in order.
4) The average operation time was 42.5 minutes and decreased compared with the past period.
5) The average postoperative hospitalization was 6 days.
6) The most predominant type in pathalogical clasfication was chronic cholecystitis(79%) and next common type was cholesterolosis(12%)
7) The most common postoperative complications mere bleeding of 3 cases(1%). bile leakage of 3 cases(1%) in order and had no periodical change.
8) The number of p41c),ts that needed Parentral'narcotics were as follows: Postoperative day: 163 casest54%)$gt; Pf.1D I: 154 cas(5L.3%), Pt7D 2: 96 cases(32.0%) and had no periodical change.
9) The frequency of parenteral narcotics were as follow: Postoperative day: 1.8, POD 1: 1.6, POD 2: 1.4 and had no periodical change.
10) According to oral cholecystogram, opacification correlated with operation time of laparoscopic cholecystectomy.