Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy

Brock M. Bordelon, Kimberly Ann Hobday, John Hunter

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

An unsolved problem of laparoscopic cholecystectomy is the optimal method of removing the gallbladder with thick walls and a large stone burden. Proposed solutions include fascial dilatation, stone crushing, and ultrasonic, high-speed rotary, or laser lithotripsy. Our observation was that extension of the fascial incision to remove the impacted gallbladder was time efficient and did not increase postoperative pain. We reviewed the narcotic requirements of 107 consecutive patients undergoing laparoscopic cholecystectomy. Fifty-two patients required extension of the umbilical incision, and 55 patients did not have their fascial incision enlarged. Parenteral meperidine use was 39.5±63.6 mg in the patients requiring fascial incision extension and 66.3±79.2 mg in those not requiring fascial incision extension (mean ± standard deviation). Oral narcotic requirements were 1.1±1.5 doses vs 1.3±1.7 doses in patients with and without incision extension, respectively. The wide range of narcotic use in both groups makes these apparent differences not statistically significant. We conclude that protracted attempts at stone crushing or expensive stone fragmentation devices are unnecessary for the extraction of a difficult gallbladder during laparoscopic cholecystectomy.

Original languageEnglish (US)
Pages (from-to)225-227
Number of pages3
JournalSurgical Endoscopy and Other Interventional Techniques
Volume6
Issue number5
DOIs
StatePublished - Sep 1992
Externally publishedYes

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Laparoscopic Cholecystectomy
Gallbladder
Narcotics
Laser Lithotripsy
Umbilicus
Meperidine
Postoperative Pain
Ultrasonics
Dilatation
Observation
Equipment and Supplies

Keywords

  • Analgesia
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy. / Bordelon, Brock M.; Hobday, Kimberly Ann; Hunter, John.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 6, No. 5, 09.1992, p. 225-227.

Research output: Contribution to journalArticle

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