J Korean Soc Endosc Laparosc Surg.  2009 Dec;12(2):118-122.

Clinical Usefulness of the Methods of Gallbladder Bed Dissection for Treating Acute Cholecystitis

• Lee SJ
• Jung SY
• Jung JP
• Cho JW
• Kim BC

Abstract

PURPOSE
Laparoscopic cholecystectomy (LC) for treating acute cholecystitis (AC) is a technically demanding procedure even for experienced surgeons. The purpose of this study is to evaluate the clinical usefulness of the methods of gallbladder bed dissection for patients with acute cholecystitis.
METHODS
We reviewed the medical records of 74 patients who were admitted for AC and they underwent early LC with ultrasonic shears dissection (UD) (n=40) or monopolar electrocautery dissection (MD) (n=34) at Kangnam Sacred Heart Hospital from August 2006 to December 2008. We compared many variables between the two methods.
RESULTS
The mean operative time in the LC group with UD was 48.3 minutes versus 42.8 minutes for the MD group (p=0.163). The conversion rate was 5.0%, and the postoperative morbidity rate was 12.5% in the UD group, versus an 8.8% conversion rate and an 8.8% morbidity rate in the MD group (p=0.426 and 0.254).
CONCLUSION
The use of UD in the dissection of the gallbladder bed has no specific advantage over MD for treating patients with acute cholecystitis, but further investigations are required to confirm this.

Keyword

Laparoscopic cholecystectomy; Acute cholecystitis; Monopolar electrocautery; Ultrasonic dissection

MeSH Terms

Cholecystectomy, Laparoscopic
Cholecystitis, Acute
Electrocoagulation
Gallbladder
Heart
Humans
Imidazoles
Medical Records
Nitro Compounds
Operative Time
Ultrasonics
Imidazoles
Nitro Compounds