FEASIBILITY OF COMBINED LAPAROSCOPIC CHOLECYSTECTOMY AND ANTI-REFLUX SURGERY: EVALUATION AND OUTCOME
|Full paper||Not Available|
This study was designed to evaluate the outcome of combined laparoscopic cholecystectorruy and fundoplication during one single laparoscopic procedure. The study included only patients assigned to undergo cholecystectorruy for calcuku- cholecystitis and had symptomatic gastroesophagent reflux disease (GERD), 22 patients (7 males 8r. 15 fernnies) were enrolled in the study. All patients underwent clinical history taking including duration of symptoms, physical examination and upper gastrointestinal endoscopy. Esophageal manometry was performed preoperatively and 2 and 6 months after surgery. Laparoscopic procedures were performed through 5-port access. Operative time and the frequency of conversion to open surgery, time till initiation of oral intake, postoperative hospital stay and complications and time to recover full activity were recordecL Through a monthly visit for 6 months after surgery, patients were monitored for the extent of resolution of GERD-related symptoms. There was a significant increase (p<0.001) of postoperative lower esophageal sphincter (LES) pressure compared to preoperative pressure with a nonsignificant difference between pressures estimated at 2 and 6 months. No intraoperative complications were encountered and there was no need for conversion to open surgery in any case. The mean operative time was 78.3+9.7; range: 60-90 minutes. All patients tolerated oral ingestions after the first 48 hours. The mean duration of postoperative hospital stay was 4+0.8; range: 3-5 days and 9 patients (40.9%) were discharged on of choledocholithiasis not resolved endoscopically, suspicion of gallbladder carcinoma, associated condition requiring open surgery, bilharzial hepato-spleenomegally, non-treatable coagulation disturbances and age over 70 years.