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Comparative Analysis of Three-Versus Two-dimensional Imaging in Laparoscopic Cholecystectomy

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Abstract

Background

Three-dimensional (3D) imaging has been suggested to improve learning and performance of laparoscopy. We sought to investigate whether 3D imaging could improve the outcomes after laparoscopic cholecystectomy.

Materials and methods

Two-hundred and forty-one consecutive patients underwent elective or urgent laparoscopic cholecystectomy using 2D (n = 111) and 3D (n = 130) imaging equipments from March 2017 to March 2019 at the Kainuu Central Hospital, Finland. The main outcomes of this study were biliary tract injury, conversion to open procedure and procedure duration.

Results

In the overall series, there were 5 cases of biliary tract injury (2.1%). When compared to 3D imaging, 2D was associated with increased risk of biliary tract injury in the overall series (0% in 3D vs. 4.7% in 2D, p = 0.026) in addition to a subgroup of acute cholecystitis patients operated by senior surgeons (n = 92), 0% in 3D group (n = 60) vs. 10.0% in 2D group (n = 32), p = 0.037 in univariate analysis. The rates of conversion to open surgery did not differ between the groups in the overall series (5.3 vs 5.7%, p = 0.909) or any of the subgroups. Duration of surgery with 3D vs. 2D imaging were comparable in the elective (57.0 ± 16.3 vs. 54.1 ± 18.9 min, p = 0.228) and urgent setting (66.9 ± 15.1 vs. 67.4 ± 16.6 min, p = 0.805). Such differences were not significant in multivariate analysis.

Conclusions

The present study suggests that the use of 3D imaging is significantly associated with a reduced risk of intraoperative biliary tract injury during laparoscopic cholecystectomy especially in acute cholecystitis.

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Authors and Affiliations

  1. Department of Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland

    Asta Tauriainen

  2. Department of Surgery, Kainuu Central Hospital, Sotkamontie 13, 87300, Kajaani, Finland

    Asta Tauriainen & Tuomas Tauriainen

  3. Research Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, University of Oulu, Oulu, Finland

    Fausto Biancari & Tuomas Tauriainen

  4. Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland

    Fausto Biancari & Tuomas Tauriainen

  5. Department of Surgery, University of Turku, Turku, Finland

    Fausto Biancari

Authors
  1. Asta Tauriainen
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  2. Fausto Biancari
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  3. Tuomas Tauriainen
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Corresponding author

Correspondence to Tuomas Tauriainen.

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Conflict of interest

Asta Tauriainen, Fausto Biancari and Tuomas Tauriainen have no conflicts of interest or financial ties to disclose.

Ethical approval

A research coordinator from the institutional review board was consulted on. Based on the consultation, approval for the study was granted. Written consent from the study population or from the institutional review board was not required for the present study.

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Tauriainen, A., Biancari, F. & Tauriainen, T. Comparative Analysis of Three-Versus Two-dimensional Imaging in Laparoscopic Cholecystectomy. World J Surg 45, 1370–1375 (2021). https://doi.org/10.1007/s00268-020-05934-z

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  • DOI: https://doi.org/10.1007/s00268-020-05934-z

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