EVALUATION OF THE RESULTS OF SIMULTANEOUS LAPAROSCOPIC ALOHERNIOPLASTY AND CHOLECYSTECTOMY
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i4.11757Keywords:
laparoscopy, simultaneous operations, gallstone disease, inguinal herniaAbstract
SUMMARY. The prevalence of calculous cholecystitis and inguinal hernia reaches significant levels. Gallstone disease affects up to 20 % of the world's adult population, and inguinal hernia occurs in 30 % of the population during lifetime. The combination of these pathologies isn’t uncommon, so the methods of parallel treatment are relevant.
The aim – to study the consequences of using the developed technique of simultaneous laparoscopic operations; evaluate the results of treatment of gallstone disease and inguinal hernia and their combination; analyze and compare the main indicators of efficiency and safety of own technique with classical techniques of cholecystectomy and alohernioplasty.
Material and Methods. From 2013 to 2019, 190 patients with combined gallstone disease and inguinal hernia were treated, 19 of them with bilateral. The operations were performed using our own technique of simultaneous operations (group 1). Also, 312 patients with gallstone disease only were treated using standard “French technique” (group 2) and 237 patients with inguinal hernia only, 33 of them with bilateral, using standard transabdominal preperetonial technique (group 3). The assessment was performed by analyzing and comparing the duration of treatment, duration of surgery, serum creatinine concentration, glycemia, blood pressure. Shapiro-Wilk statistical methods, Mann-Whitney criteria or U-test were used.
Results. The duration of the operation was (58.24±5.74) minutes in group 1 against (41.8±4.66) minutes in group 2 and (39.62±5.13) minutes in group 3, and did not exceed 2 hours in any of the groups; serum creatinine concentration did not exceed the permissible 2 mg/dl in any of the cases and differed slightly (p=0.937/p=0.922), normalized in the period 6–12 hours; glycemia also had no differences between groups and returned to normal at the time of recovery of oral nutrition (p=0.822/p=0.954); AP was kept in notmotonia and the difference between intraoperative parameters in both groups was insignificant (p=0.912/p=0.874); the length of stay did not differ between groups (p=0.784/p=0.861) and was 3.55 days for the first and 3.51 for the second and 3.43 for the third group.
Conclusions. The technique developed in Volyn Regional Clinical Hospital is not inferior in efficiency and safety to the “French” technique of cholecystectomy, and allows simultaneous surgical treatment of cholecystitis and inguinal hernia (including bilateral) at the same time. The use of this technique is justified and appropriate.
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