Single incision laparoscopic cholecystectomy using Konyang Standard Method

PURPOSE: Single incision laparoscopic cholecystectomy (SILC) is a minimally invasive surgery that is growing rapidly among surgical procedures. However, there is no standard method for SILC. Therefore, we evaluated the adequacy and feasibility of SILC using Konyang Standard Method. METHODS: We retrospectively reviewed our series of 307 SILCs performed between April 2010 and August 2012. Initially we excluded the patients who were more than 70 years old, had cardiologic or pulmonologic problems and complications of acute cholecystitis. After 50 cases, we did not apply the exclusion criteria. We performed SILC by Konyang Standard Method using three-trocar single port (hand-made) and long articulated instruments. RESULTS: Three hundred and seven patients underwent SILC. Male were 131 patients and female were 176 patients. Mean age was 51.6 +/- 13.7 years old and mean body mass index was 24.8 +/- 3.6 kg/m2. Ninety-three patients had histories of previous abdominal operation. Patient's pathologies included: chronic cholecystitis (247 cases), acute cholecystitis (30 cases), gall bladder (GB) polyps (24 cases), and GB empyema (6 cases). Mean operating time was 53.1 +/- 25.4 minutes and mean hospital stay was 2.9 +/- 3.4 days. There were four cases of 3-4 ports conversion due to cystic artery bleeding. Complications occurred in 5 cases including wound infection (2 cases), bile duct injury (1 case), duodenal perforation (1 case), and umbilical hernia (1 case). CONCLUSION: SILC using Konyang Standard Method is safe and feasible. Therefore, our standard procedure can be applied to almost all benign GB disease.

Treatment Guidelines for Dyslipidemia: Summary of the Expanded Second Version

KSLA published our first version of treatment guidelines for dyslipidemia in 1996, which was based on health examination data gathered by the National Health Insurance Corperation in 1994. A number of academic societies including the Korean Endocrine Society, the Korean Society of Cardiology, the Korean Society for Laboratory Medicine, the Korean Society for Biochemistry and the Korean Nutrition Society participated in the development of this guideline. In 2003, the second version of our guidelines was published based on the Korean National Health and Nutrition Survey (KNHANES) data which was collected in 1998. In 2006, the second version was modified and expanded with using KNHANES data collected in 2005. This article summarizes the recommendations included in the expanded second version of treatment guidelines. The full version of treatment guidelines in Korean is available at the KSLA Homepage (http://www.lipid.or.kr).

The Outcome of Laparoscopic Common Bile Duct Exploration (LCBDE) with Stone Removal in Common Bile Duct Stone / 대한내시경복강경외과학회지

PURPOSE: ERCP (Endoscopic retrograde cholangiopancreatigraphy) and ES (endoscopic sphicterotomy) have become the main treatments for common bile duct (CBD) stone. However, when ERCP with ES fails to remove CBD stone, an operation is needed for stone removal. The aim of this study was to investigate the outcomes of laparoscopic CBD exploration (LCBDE) for the management of difficult choledocholothoasis. METHODS: This study was a retrospective analysis of 106 LCBDE cases that were performed from March 2001 to December, 2009. RESULTS: Of the 106 patients who underwent laparoscopic procedures, 74 were combined with gallstone and 105 underwent the choledochotomy approach. The mean operation time and mean hospital stay were 146.9+/-74.5 minutes and 11.0+/-6.4 days, respectively. The open conversion and stone clearance rates were 3.8% (4 cases) and 96% (102/106 cases). There were 10 complications with 3 cases of bile leakage, 2 cases of pulmonary complications, 4 cases of remnant stone and 1 case of subhepatic seroma. CONCLUSION: The LCBDE is a safe and feasible procedure. If ERCP is difficult or stone retrieval is incomplete, then LCBDE could be an alternative treatment for difficult CBD stone.