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Transcylindrical cholecystectomy under local anesthesia plus sedation. A pilot study
E J Grau-Talens1, J H Cattáneo, R Giraldo
1Department of Surgery, Hospital Siberia-Serena, Talarrubias (Badajoz), Spain.
Endoscopy
|January 27, 2010
Summary
Transcylindrical cholecystectomy under local anesthesia is a feasible and safe technique for gallstone disease. This minimally invasive approach offers economic benefits and high patient satisfaction, making it a viable alternative to traditional methods.
Area of Science:
- Minimally invasive surgery
- Gastrointestinal surgery
- Anesthesiology
Background:
- Laparoscopic cholecystectomy under local anesthesia is rarely performed.
- The transcylindrical cholecystectomy technique has been used for 15 years for gallstone-related conditions.
- A prospective study was designed to evaluate this technique's feasibility.
Purpose of the Study:
- To assess the feasibility of transcylindrical cholecystectomy under local anesthesia.
- To evaluate the efficacy and safety of this minimally invasive approach.
- To determine patient outcomes and satisfaction.
Main Methods:
- Transcylindrical cholecystectomy performed gas-free via a single 3.8 cm x 10.0 cm cylinder.
- Study included 60 patients with cholelithiasis, planned for local anesthesia.
- Postoperative assessment included pain (VAS) and patient satisfaction questionnaire.
Main Results:
- Successful completion of the procedure in all patients.
- Local anesthesia converted to general anesthesia in 21.7% of cases (technical issues, patient factors).
- Low complication rates (wound infection 1.7%, seromas 3.3%, nausea 5%); minimal postoperative pain; high patient satisfaction.
Conclusions:
- Transcylindrical cholecystectomy under local anesthesia is feasible.
- The technique offers advantages over traditional laparoscopic cholecystectomy.
- It provides economic benefits and enhanced patient safety.