레이저 복강경 담낭 절제술 = Laser Laparoscopic Cholecystectomy

다국어 초록 (Multilingual Abstract)

Therapeutic laparoscopy has been largely in the domain of the Gynecologist. Following the first clinical report in the English literature of laparoscopic tuba] fulguration by Palmer in 1962, the laparoscopic principle has been subsequently applied to a number of other routine gynecological procedures. Semm reported salpingectomy, adnexectomy, myomectomy, oophrectomy, ovarian cystectomy, and salpingostomy under laparoscopic guidance as early as 1974.
Gallbladder disease continues to be one of the most common digestive disorders seen by physicians in this country. Approximately 500,000 cholecystectomies are performed each year in the United States. After conventional major abdominal surgery, patients experience considerable discomfort and their recovery time is lengthy. The resultant cost in total health care dollars is enormous. These factors have prompted investigators in recent years to purse alternatives to operative cholecystectomy. Procedures such as lithotripsy, percutaneous stone extraction, and stone dissolution are now being offered to more and more patients. The number of patients for whom these alternative theraputic modalities are suitable, however, remains limited. Furthermore, the recurrence rate for cholelithiasis following successful nonoperative therapy is significant. Therefore, it is doubtful that such nonsurgical approaches will have any significant impact on the reduction of healthcare expenses.
Another alternative to formal laparotomy and open cholecystectomy has been developed-Endo Cholecystectomy. This technique offers a number of advantages over the standard, open approach. Both hospital stay and postoperative recovery period are greatly reduced. Approximately 15% 20% of patients who undergo Endo Cholecystectomy are discharged on the day of surgery; the other two-thirds are hospitalized for only one night. The majority of patients are able to return to full activity within three to five days.
By contrast, patients who undergo routine open cholecystectomy require three to seven days in the hospital and a three to six week absence from work. The reduced hospital stay and shorter recovery time following Endo Cholecystectomy is expected to have a tremendous economic impact. In addition, patient discomfort and cosmetic disfigurement are dramatically reduced following Endo Cholecystectomy.