TY  - JOUR
TI  - Fundus-first technique and partial cholecystectomy for difficult laparoscopic cholecystectomies
AB  - BACKGROUND: This study aims to evaluate the impact of conversion from retrograde dissection to fundus-first technique (FF) or laparoscopic partial cholecystectomy (LPC) on complication rates, operation time, and duration of hospitalization.METHODS: The medical records of 210 consecutive patients who underwent laparoscopic cholecystectomy between January 2010 and December 2014 were retrospectively evaluated. All laparoscopic cholecystectomies were initiated with retrograde dissection (RD). In cases of difficulty in dissection of critical view of safety , the operation strategy was first converted to FF and then to LPC when FF was considered insufficient for safe cholecystectomy.RESULTS: Of the 210 cases, LC was initiated and completed with RD in 197 cases. FF was implemented in 13 cases due to difficulties in dissection. In the FF group, laparoscopic total cholecystectomy was successfully accomplished in seven patients, and LPC was performed in the remaining six cases. Three postoperative complications occurred in the RD group and two in the LPC group. No major intraoperative complications or perioperative mortality occurred in any patients.CONCLUSION: In elective, noncomplicated cases, the safe posterior window (critical view of safety) principle should be implemented. However, in complicated cases where anatomic uncertainties are dominant, the performance of FF technique or LPC may decrease conversion rates to open surgery and contribute to accomplishing the laparoscopic intervention safely
AU  - Ozgur, Ilker
AU  - Soytaş, Yiğit
AU  - Avtan, Levent
AU  - SORMAZ, İsmail Cem
AU  - GÖK, Ali Fuat Kaan
PY  - 2018
JO  - Ulusal Travma ve Acil Cerrahi Dergisi
VL  - 24
IS  - 1
SN  - 1306-696X
SP  - 66
EP  - 70
DB  - TRDizin
UR  - http://search/yayin/detay/281342
ER  -