results of Laparoscopic treatment of the gallbladder lithiasis about 500 cases

Laparoscopic cholecystectomy is at present the gold st and ard treatment of gallbladder lithiasis. Assesment of Laparoscopic cholecystectomy. Through a retrospective series of 500 laparoscopic cholecystectomies during a period going from January 1996 to March 2000, we tried to evaluate our experience by comparing our results to the literature data. There were 420 women and 80 men with a sex ratio of 0.19. Average age was 50 years. 16.2% of our patients were obese. 13 patients had a history of respiratory disease and 122 history of a cardiovascular pathology essentially arterial hypertension. All our patients benefited from at least one hepatobiliary ultrasound examination before the intervention. Antibioprophylaxy was administrated in 93.8% of cases. In 23 cases [4.6%], a conversion was necessary for different causes. We noted 11 surgical complications [2.2%] among which 2 required a surgical resumption, and 11 medical complications dominated by broncho-pulmonary infections. We had no death

[Late post-operative adhesive small bowel occlusions. About 258 cases]

This retrospective study reports a series of 258 patients operated on for late developing post-operative adhesive occlusions. The impact of anterior interventions on these occlusions. The impact of anterior interventions on the occlusions as well as the clinical and paraclinical patterns are discussed before any approach to the different therapeutic aspects of this complication. Previous surgery had an impact not by number of the operations performed [80% of patient had undergone only one intervention on the pelvis or abdomen] but essentially by the nature of the operations since most of the adhesions occurred following surgery on the appendix. The diagnosis should be made urgently on basis of findings yielded by physical examination and plain abdominal x-rays [ct-scan of the abdomen is hardly indicated for the absence of hydroaeric levels on the plain abdominal film does not definitely exclude the strangulation]. Laparoscopic adhesiolysis an adequate treatment in case of a single adhesion. This laparoscopic is an adequate treatment in case of a single adhesion. This laparoscopic procedure practised on 11 patients had to be transformed in 3 cases into an open laparoctomy. Resection rate was 11.6%. Mortality and morbidity rates were 2% and 17% respectively