Summary
Between April and August 1991, 83 Japanese patients with symptomatic gallstones underwent laparoscopic cholecystectomy in our clinics. A prospective randomized trial was carried out to examine the safety, efficacy, and complications of the two techniques, pneumoperitoneum vs an elevating method using a U-shaped retractor. Forty-two patients were randomly allocated to the pneumoperitoneum (P) group and 41 to the U-shaped retractor (U) group. These two groups were well matched with respect to age, sex, etiology, and the severity of the chronic cholecystitis.
Laparoscopic resection was successful for 88.1% (37/42) in the P group and 100% (41/41) in the U group. In patients with a severe fibrotic gallbladder, the rate of success was significantly higher (P<0.05) in the U group (100%, 6/6) than in the P group (11.8%, 1/6). In the moderately inflamed group, the operation time (mean±SD) was significantly (P<0.01) less in the U group (58.7±22.7) than in theP group (87.3±18.3). With the U-shaped retractor the usual surgical instruments can be used, and a rapid and safer laparoscopic cholecystectomy can be carried out. We prefer this approach to a pneumoperitoneum for patients with an inflamed gallbladder as hospital stay and pain are minimal.
Similar content being viewed by others
References
Cuschieri A, Berci G, McSherry CR (1990) Laparoscopic cholecystectomy. Am J Surg 159: 273 (Editorial)
Holzman M, Sharp K, Richard W (1992) Hypercarbia during carbon dioxide gas insufflation for therapeutic laparoscopy: a note of caution. Surg Laparosc Endosc 2: 11–14
Kitano S, Tomikawa M, Iso Y, Iwata S, Gondo K, Moriyama M, Sugimachi K (1992) A safe and simple method to maintain a clear field of vision during laparoscopic cholecystectomy. Surg Endosc 6: 197–198
Kitano S, Moriyama M, Sugimachi K (1992) A simple and rapid technique to ligate the cystic duct at laparoscopic cholecystectomy. Surg Laparo Endosc 2: 321–322
Reddick EJ, Olsen Do (1989) Laparoscopic laser cholecystectomy: a comparison with mini-lap cholecystectomy. Surg Endosc 3: 131–133
Zucker KA, Bailey RW, Gadacz TR, Imbembo AL (1991) Laparoscopic guided cholecystectomy. Am J Surg 161: 36–44
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kitano, S., Iso, Y., Tomikawa, M. et al. A prospective randomized trial comparing pneumoperitoneum and U-shaped retractor elevation for laparoscopic cholecystectomy. Surg Endosc 7, 311–314 (1993). https://doi.org/10.1007/BF00725947
Issue Date:
DOI: https://doi.org/10.1007/BF00725947