Laparoscopic cholecystectomy in a community hospital: experience with 600 laparoscopic cholecystectomies.
Cholecystectomy; Cholecystectomy/statistics & numerical data; Community; Female; Hospitals; Humans; Intraoperative Complications/epidemiology; Laparoscopic/mortality/*statistics & numerical data; Male; Middle Aged; Postoperative Complications/epidemiology; Retrospective Studies; Teaching
We reviewed 600 patients who underwent laparoscopic cholecystectomy (LC) in a teaching community hospital from May 1990 to August 1992. The safety, efficacy, morbidity, and mortality of LC, as performed by one surgeon or under his direct supervision, were studied. Five hundred forty-eight patients (91.3%) were treated electively; 52 (8.7%) were admitted for acute cholecystitis (41) or gallstone pancreatitis (11). Mean operating time was 54 min, with a range of 20 to 145 min. Twenty-four (4%) patients required conversion to traditional (open) cholecystectomy. Operative cholangiograms were completed in 106 patients. These revealed choledocholithiasis in 7. Five hundred thirty-seven patients (89.5%) were discharged within 24 h and 564 (94%) within 48 h. The overall morbidity of 9.2% compared favorably with both open and laparoscopic series previously reported. Three patients (0.5%) had small lacerations of the anterior wall of the common duct. Two were recognized and repaired immediately. The third patient came for treatment on the fifth postoperative day and was stented by a T-tube. There was 1 death in this group–a myocardial infarction on postoperative day 4.
Williams G B; Silverman R S
Journal of laparoendoscopic surgery
1994
1994-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1089/lps.1994.4.101" target="_blank" rel="noreferrer noopener">10.1089/lps.1994.4.101</a>
Total thyroidectomy: is morbidity higher for Graves' disease than nontoxic goiter?
Adult; Aged; Female; Goiter; Graves Disease/pathology/*surgery; Humans; Hypocalcemia/epidemiology; Male; Middle Aged; Morbidity; Nodular/pathology/*surgery; Postoperative Complications/epidemiology; Retrospective Studies; Thyroidectomy/*adverse effects
BACKGROUND: Total thyroidectomy for treatment of Graves' disease is controversial and much of the debate centers on the concern for complications. The purpose of this study was to evaluate the morbidity of total thyroidectomy for Graves' disease and determine if it is different than for patients with nontoxic nodular goiter. METHODS: The rates of life threatening neck hematoma, recurrent laryngeal nerve (RLN) injury, transient hypocalcemia, and hypoparathyroidism were determined for consecutive patients with Graves' disease treated with total thyroidectomy from 1996 to 2010. Results were compared with patients who underwent total thyroidectomy for nontoxic nodular goiter during the same period, matched for the weight of the excised thyroid gland. RESULTS: Total thyroidectomy was performed in 111 patients with Graves' disease (group I) and 283 patients with nontoxic nodular goiter (group II). Parathyroid autotransplantation was performed in 31(28%) patients in group I and 98 (35%) patients in group II (P = NS). Comparative analysis of morbidity revealed no significant difference in neck hematoma, 0(0%) (I) versus 3(1%) (II); permanent RLN injury, 0(0%) (I) versus 2(1%) (II); and permanent hypoparathyroidism in 1(1%) (I) versus 1 (0.4%) (II) (P = NS). Transient hypocalcemia was more common in patients with Graves' disease, 80(72%) (I) versus 170 (60%) (II) (P \textless 0.05), but not when matched for thyroid weight. CONCLUSIONS: Total thyroidectomy can be performed with low morbidity in patients with Graves' disease; only transient hypocalcemia occurred more often than in patients with nodular goiter. Total thyroidectomy should be presented as a therapeutic option for all patients with Graves' disease.
Welch Kellen C; McHenry Christopher R
The Journal of surgical research
2011
2011-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jss.2011.03.054" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2011.03.054</a>