Minimal trauma cholecystectomy (a "no-touch" procedure in a "well").

摘要: Salient features of an operative technique designed to reduce a minimum the iatrogenic trauma cholecystectomy include limited incision, muscle retraction (instead division), specific packing and retraction, distant manipulations by long instruments. Eighty two unselected consecutive patients with primary gallbladder disease underwent operation this technique. Two permanently bed-confined were excluded from study. Acute cholecystitis was documented histopathology review in 23 cases chronic 57 cases. Case material included usual pre-existing concomitant medical problems; five meeting formal criteria for diagnosis morbid obesity; 15 exceeding 199 pounds one weighing 315 pounds; ambulatory (outpatient) cholecystectomy; 17 over 70 four 80 years age; gangrenous perforated gallbladders, perigallbladder abscesses without gangrene case; conspicuous absence respiratory complications. Median average incision length 5.5 cm. There no major minor Recent experience demonstrated safe performance elective disease, regardless degree patient obesity, median 5 cm, time 65 minutes post-operative hospital stay 2 days.