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      • Radiofrequency Ablation Technique in Hepatic Surgery: Clinical Experience

        ( Serdar Yormaz ),( Huseyin Yilmaz ),( Husnu Alptekin ),( Ilhan Ece ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

        Aims: The Korean Association of HBP Surgery firstly launched the protocol of Korean Surgical Quality Improvement Program (KSQIP) for cholecystectomy collaborating with NECA as a multicenter prospective study. I’d like to introduce the study protocol, web based database system and outcome. Laparoscopic cholecystectomy (LC) is the standard surgical treatment of benign gallbladder disease. However, the incidence of postoperative complication varies, and the risk factor was not well thoroughly investigated. The aim of this study is to develop and evaluate the surgical risk calculator for postoperative outcomes after laparoscopic cholecystectomy. A total of 3,002 patients were registered, and 2,514 patients who underwent laparoscopic cholecystectomy for benign gallbladder disease from 18 academic institutes in Korea were included in this prospective, multicenter cohort study. Preoperative or intraoperative variables were evaluated as risk factors for various postoperative outcomes including overall complications, and tendency to increase use of medical facilities including prolonged duration of hospital stay. After risk factor analysis, risk calculator after cholecystectomy was developed using multiple logistic regression analysis. Using standard preoperative variables from this multi-institutional prospective database, we tried to construct a risk calculator for predicting adverse perioperative outcomes after laparoscopic cholecystectomy. Such information may be useful for risk stratification before laparoscopic cholecystectomy.

      • Clinical Outcomes of Laparoscopic Partial Cystectomy and Conventional Partial Cystectomy for the Treatment of Hepatic Hydatid Cyst

        ( Ilhan Ece ),( Huseyin Yilmaz ),( Serdar Yormaz ),( Bayram Colak ),( Fahrettin Acar ),( Husnu Alptekin ),( Mustafa Sahin ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

        Aims: The aim of this study was to compare the mid-term outcomes of open and laparoscopic partial cystectomy (LPC). Methods: The medical records of patients who underwent conventional partial cystectomy (CPC) and LPC for liver hydatid cyst from March 2009 to January 2016 were retrospectively reviewed. Operative time, blood loss, length of hospital stay, postoperative morbidity, mortality, and follow up outcomes were evaluated. Results: Among 162 patients, 59 of patients were underwent LPC and 103 underwent CPC. Blood loss, postoperative complications were similar in both groups. The mean operative time in the LPC and the CPC groups was respectively 91.4±11.5 and 61.5±18.1 minutes, which showed a significant difference between the both groups. The mean length of hospital stay in CPC group was significantly longer when compared the LPC group. The mean diameter of cyst in LPC group was 6.1±1.1 cm, and 7.8±2.1 cm in CPC group with significant difference. The overall complication rates were 15.2 % in LPC group and 16.5 % in CPC group without significant difference. The most common complication was biliary leakage and surgical site infection. Conclusions: In the hands of experienced laparoscopic surgeons with appropriate technical tools; Laparoscopic drainage and partial cystectomy seem to be safe and effective techniques in carefully selected patients in the surgical treatment of liver hydatid cysts. Technical devices such as grinder aspirator and laparoscopic ultrasonography may expand the indication for laparoscopy.

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        The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress

        Ilhan Ece,Bahadir Ozturk,Huseyin Yilmaz,Serdar Yormaz,Mustafa ?ahin 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.4

        Purpose: Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA). Methods: In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation. Results: Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different. Conclusion: SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.

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