Novel Application of Hydrodissection in Laparoscopic Cholecystectomy for Gangrenous Gallbladders

Laparoscopic cholecystectomy (LC) for gangrenous gallbladders (GGBs) can be challenging and represent a significant number of LC cases, necessitating more efficacious surgical techniques. Currently, the standard treatment for GGBs is blunt dissection which can have high iatrogenic complication rates...

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Veröffentlicht in:The Journal of surgical research 2023-03, Vol.283, p.1124-1132
Hauptverfasser: Umemoto, Kayla K., Ananth, Shahini, Ma, Anthony, Ullal, Anvay, Ramdass, Prakash V.A.K., Lo, Peter C., Vyas, Dinesh
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Sprache:eng
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Zusammenfassung:Laparoscopic cholecystectomy (LC) for gangrenous gallbladders (GGBs) can be challenging and represent a significant number of LC cases, necessitating more efficacious surgical techniques. Currently, the standard treatment for GGBs is blunt dissection which can have high iatrogenic complication rates. To our knowledge, this is the first large retrospective study conducted on the novel application of hydrodissection (HD) in LCs for GGBs. In this retrospective study of 386 LCs, data were collected for patient demographics, medical comorbidities, operating time (OT), anesthesia time (AT), length of stay (LOS), estimated blood loss, conversion to open procedures, 30-day readmissions, and mortality. Patients were categorized into four groups: (1) Vyas employing HD for GGBs (VHG), (2) non-Vyas group of five surgeons not employing HD for GGBs (NVG), (3) Vyas treating non-GGBs, and (4) non-Vyas group of five surgeons treating non-GGBs. Control groups were age-matched and sex-matched. Statistical analysis used descriptive statistics, Mann–Whitney U testing, and chi-squared testing (α = 0.05). This study demonstrated significantly decreased (P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2022.11.060