THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY
Yıl: 2021 Cilt: 23 Sayı: 1 Sayfa Aralığı: 19 - 24 Metin Dili: İngilizce DOI: 10.24938/kutfd.797290 İndeks Tarihi: 29-07-2022
THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY
Öz: Objective: It is stated in the literature that some patients have dyspeptic complaints after months from cholecystectomy. The reason for this situation has not been established. It is more often attributed to the bile leakage from the duodenum to the stomach. Therefore, in our study we investigated whether the surgical technique applied during cholecystectomy caused postoperative duodenogastric reflux. In this study, it was aimed to investigate the effects of Calot's triangle dissection type (high dissection, low dissection) on post-operative duodenogastric reflux due to Oddi’s sphincter dysfunction during laparoscopic cholecystectomy.Material and Methods: In the study, laparoscopic cholecystectomy was performed in two groups. One day before cholecystectomy, all patients underwent gastroscopy. During cholecystectomy, dissection of gallbladder was carried out close to the gallbladder in the first group (high dissection), while dissection was carried out close to ductus choledochus in the second group (low dissection). Two months after the operation, all patients were called back and gastroscopy was performed. Whether there was bile reflux from pylorus to the stomach was checked.Results: Of the patients, 78.3% were female and 21.7% were male. The average age was 51.5 years (min-max: 25-76 years). Most of the patients (n:19, 31.7%) were in the 4th decade. Post-operative bile reflux was detected in 25 (41.7%) of all patients. Duodenogastric reflux was detected in 6 patients in group 1 and 19 patients in group 2. While there was a statistically significant relationship between the occurrence of postoperative reflux and dissection type, age, ASA score and presence of diabetes, no relationship was found with gender.Conclusion: If less duodenogastric reflux is desired after cholestectomy, we recommend dissection rather close to the gallbladder during cholecystectomy.
Anahtar Kelime: Kolesistektomi Sırasında Cerrahi Tekniğin Duodenogastrik Reflü Üzerine Etkisi
Öz: Amaç: Kolesistektomiden aylar sonra bazı hastalarda dispeptik şikayetlerin olduğu literatürde belirtilmektedir. Bu durumun sebebi tam olarak ortaya konamamıştır. Daha çok duodenumdan mideye doğru olan safra kaçağına bağlanmaktadır. Bu nedenle çalışmamızda kolesistektomi sırasında uygulanan ameliyat tekniğinin ameliyat sonrası duodenogastrik reflüye sebep olup olmadığını araştırdık. Bu çalışmada laparaskopik kolesistektomi sırasında Calot üçgeni diseksiyon tipinin (yüksek diseksiyon, alçak diseksiyon) ameliyat sonrası duodenogastrik reflüye sebep olan Oddi sfinkteri yetmezliğine etkilerinin araştırılması amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya safra kesesi taşı tanısıyla laparoskopik kolesistektomi planlanmış 60 hasta alındı. Çalışma, her grupta 30 hasta olmak üzere iki grup olarak planlandı. Gruplardaki denekler randomize olarak belirlendi. American Society of Anesthesiologists (ASA) skoru 1-2 ve ameliyat öncesi gastroskopi ile duodenogastrik safra reflüsü saptanmayan hastalar çalışmaya dahil edildi. Birinci gruba alınan hastalara kolesistektomi sırasında safra kesesine yakın diseksiyon (yüksek diseksiyon), ikinci gruba alınan hastalar da ise koledoğa yakın diseksiyon (alçak diseksiyon) yapılarak kolesistektomi uygulandı. Hastalar ameliyattan iki ay sonra tekrar çağrılıp gastroskopi yapıldı. Pilordan mideye safra reflüsü olup olmamasına bakıldı.Bulgular: Hastaların %78.3’ü kadın ve %21.7’si erkekti. Yaş ortalamaları (minimum- maksimum) 51.5 yıl (25-76 yıl) idi. En çok 4. dekatta %31.7 (n:19) hasta mevcuttu. Tüm hastaların 25’inde (%41.7) ameliyat sonrası safra reflüsü tespit edildi. 1. grupta 6 hastada, 2. grupta 19 hastada duodenogastrik reflü saptandı. Ameliyat sonrası reflü oluşması ile yapılan diseksiyon tipi, yaş, ASA skoru ve diyabet varlığı arasındaki istatiksel olarak anlamlı ilişki bulunmuşken, cinsiyet ile ilişki tespit edilememiştir.Sonuç: Kolestektomi sonrası daha az duodenogastrik reflü gelişmesi isteniyorsa kolesistektomi sırasında safra kesesine oldukça yakın diseksiyon yapılmasını önermekteyiz.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | pirhan y, Taşova V (2021). THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. , 19 - 24. 10.24938/kutfd.797290 |
| Chicago | pirhan yavuz,Taşova Volkan THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. (2021): 19 - 24. 10.24938/kutfd.797290 |
| MLA | pirhan yavuz,Taşova Volkan THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. , 2021, ss.19 - 24. 10.24938/kutfd.797290 |
| AMA | pirhan y,Taşova V THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. . 2021; 19 - 24. 10.24938/kutfd.797290 |
| Vancouver | pirhan y,Taşova V THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. . 2021; 19 - 24. 10.24938/kutfd.797290 |
| IEEE | pirhan y,Taşova V "THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY." , ss.19 - 24, 2021. 10.24938/kutfd.797290 |
| ISNAD | pirhan, yavuz - Taşova, Volkan. "THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY". (2021), 19-24. https://doi.org/10.24938/kutfd.797290 |
| APA | pirhan y, Taşova V (2021). THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 23(1), 19 - 24. 10.24938/kutfd.797290 |
| Chicago | pirhan yavuz,Taşova Volkan THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 23, no.1 (2021): 19 - 24. 10.24938/kutfd.797290 |
| MLA | pirhan yavuz,Taşova Volkan THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol.23, no.1, 2021, ss.19 - 24. 10.24938/kutfd.797290 |
| AMA | pirhan y,Taşova V THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2021; 23(1): 19 - 24. 10.24938/kutfd.797290 |
| Vancouver | pirhan y,Taşova V THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2021; 23(1): 19 - 24. 10.24938/kutfd.797290 |
| IEEE | pirhan y,Taşova V "THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY." Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 23, ss.19 - 24, 2021. 10.24938/kutfd.797290 |
| ISNAD | pirhan, yavuz - Taşova, Volkan. "THE EFFECT OF SURGICAL TECHNIQUE ON DUODENOGASTRIC REFLUX AFTER CHOLECYSTECTOMY". Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 23/1 (2021), 19-24. https://doi.org/10.24938/kutfd.797290 |
