ABSTRAK
Latar belakang: Kolesistektomi merupakan tindakan abdomen tersering dan saat inikolesistektomi laparoskopi (KL) merupakan baku emas dan telah dilakukan pada 90% kasuskolesistitis simtomatik. Tujuan penelitian ini adalah untuk mengetahui hasil KL di RSCM,Jakarta. Metode: Penelitian retrospektif observasional ini menggunakan data dari departemen bedahdivisi digestif RSCM dari bulan Januari hingga Desember 2014. Partisipan penelitian iniadalah pria atau wanita yang berusia 23-66 tahun yang menjalani KL. Tindakan bedahdilakukan baik berupa perawatan 1 hari (one day care (ODC)) maupun elektif. Data yangdikaji adalah temuan preoperatif dan intraoperatif, durasi operasi, lama rawat inap, dan angkakonversi ke tindakan kolesistektomi terbuka (open). Kemudian kami menganalisis faktoryang mempengaruhi angka konversi. Hasil: Jumlah pasien yang masuk inklusi adalah 90 orang. Usia rata-rata 43,9 tahun (SE=1,26tahun) dengan jumlah pasien wanita 61 orang (67,8%). Median durasi operasi adalah 90±36,9menit dimana pasien yang konversi membutuhkan operasi lebih dari 2 jam lebih banyak(12% vs 1,5%), namun tidak bermakna secara statistik (p= 0,63). Median lama rawat inapadalah 9±27.2 hari dan meningkat bermakna pada kasus yag konversi (24±9 hari, p = 0.011).Median lama pre-operasi = 7±26,8 hari, dan pasca-operasi = 2±3.8 hari, dengan 13,3% pasiendilakukan endoscopic retrograde cholangio-pancreatography (ERCP) sebelum KL. Cederaduktus biliaris komunis (CBDK) ditemukan pada 3 kasus (3,33%). Konversi menjadilaparotomi dibutuhkan pada 4,44% kasus. Faktor yang mempengaruhi angka konversi hanyapada kasus adhesi (RR (95%IK) = 25,7 (2,4-273,5); p=0,007. Kesimpulan temuan: kolesistektomi laparoskopi menawarkan lama rawat inap yang lebihsingkat. Durasi operasi pendek dan prosedur ini standard, aman, dan efektif di institusi kami. ABSTRACT
Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution. |
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