Influence of simultaneous laparoscopic cholecystectomy and Toupet fundoplication on physical status of patient

Abstract

Gallstone disease is one of the most common surgical pathology. Hiatal hernia is widespread easer. This fact forms basis of combination of gallstone disease and hiatal hernia, which is often to occur. Aim of our work was to assess the impact of simultaneous operations for patients with gallstone disease in combination with a hiatal hernia, to evaluate the safety of simultaneous laparoscopic operations performed using developed technique. Compare the impact of simultaneous technique with such using classic technique. Choose the optimal treatment strategy. To form the sample, we used the data accumulated involynian regional clinical hospital (Lutsk.Ukraine) in the minimal invasive surgery unit. The sample consisted of two groups: group 1 - 126 patients who underwent simultaneous laparoscopic treatment of cholelithiasis and hiatal hernia using our own developed technique, group 2 - 206 patients who underwent only cruroraphy and Toupet fundoplication. It was shown that the method of simultaneous laparoscopic treatment in the first group made it possible to prevent re-hospitalization, second operation, and all associated with hospital stay and surgery risks at the cost of a slight increasing the average duration of the operation (51 ± 9 versus 42 ± 6 minutes in the second group). No negative affect on RCRI, ARISCAT, P-POSSUM scales detected. At the same time, there was no statistically significant increase in complications (5.5% versus 6.3% for the first and second groups, respectively, p=0.832), mortality remained zero, which indicates safety. The method promises an increase of efficiency of surgical treatment.

Keywords

• surgery
• laparoscopy
• simultaneity
• hiatal hernia
• gallstone disease