RESUMEN
Laparoscopic cholecystectomy is on the way to become the procedure of choice for treatment of uncomplicated cholelithiasis. First experiences are summarized: Within the first year after introduction 139 patients, 100 women and 39 men, have been treated by this novel technique. 33 open cholecystectomies were carried out in the same period. In addition to simple cholecystolithiasis 11 patients had prior biliary pancreatitis and/or sphincterotomy because of choledocholithiasis, 16 patients had suffered before from acute cholecystitis, 3 patients were operated on with the diagnosis of acute cholecystitis and 3 patients underwent simultaneous laparoscopic intervention. Seven times the laparoscopic procedure had to be converted into an open one because of intraoperative complications, twice because of a lesion to the common bile duct, three times because of intractable bleeding, once because of obscure anatomic conditions and once because of a technical failure in establishing the pneumoperitoneum. Four postoperative complications could be treated conservatively. In the average, patients complained about pain for 2 days, stayed in the hospital 4.4 days and assumed their usual activity after 13 days. An extension of indications for laparoscopic cholecystectomy should be sought stepwise according to gained experience. The problem of technical training of surgeons persists and must be solved in priority.
Asunto(s)
Colecistectomía/métodos , Enfermedades de la Vesícula Biliar/cirugía , Laparoscopía , Adulto , Anciano , Anciano de 80 o más Años , Colelitiasis/cirugía , Contraindicaciones , Estudios de Evaluación como Asunto , Femenino , Humanos , Complicaciones Intraoperatorias/etiología , Tiempo de Internación , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiologíaRESUMEN
100 patients underwent laparoscopic cholecystectomy for symptomatic gallbladder stones. In seven cases the laparoscopic procedure had to be converted into an open cholecystectomy due to bleeding, choledochus injury and acute cholecystitis. There were no complications postoperatively. We feel that the indication of this method is advantageous. Independent of the size, the number and the chemical composition, this method is used for symptomatic gallbladder stones. All together the main advantages are higher comfort for the patient, better cosmetic results, shortening of hospital stay and sooner return to full activity.
Asunto(s)
Colecistectomía/métodos , Colelitiasis/cirugía , Laparoscopía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We describe a sibship affected by subsequent periampullary, colorectal and gastric carcinoma. Three of 4 siblings (2 males, 1 female) developed a periampullary carcinoma at the age of 20, and the 2 brothers subsequently had colorectal and gastric carcinoma. One of them also had familial adenomatous polyposis. There is suggestive evidence of vertical transmission of a gene predisposing to a hereditary colorectal carcinoma syndrome.