Emergency cholecystectomy

U ovom su radu analizirane kolecistektomije učinjene u hitnoj službi KBC-a Zagreb u dvogodišnjem razdoblju (2013./2014.). Uspoređen je broj kolecistektomija učinjen laparoskopskom i otvorenom metodom, učestalost komplikacija kod svake od metoda te učestalost i razlozi za konverziju iz laparoskopske u otvorenu metodu. ----- Operirano je ukupno 124 bolesnika, i to otvorenom metodom ukupno 38 (30,65%), a laparoskopski 86 (69,35%) bolesnika. Intraoperativnih komplikacija kod otvorene kolecistektomije bilo je kod jednog (2,63%) bolesnika, dok u skupini laparoskopski operiranih nije zabilježena pojava intraoperativnih komplikacija. Intraoperativnog mortaliteta nije bilo niti u jednoj skupini. Postoperativno se kod 14 (36,84%) bolesnika operiranih otvorenom metodom pojavila jedna ili više komplikacija, dok je postoperativni mortalitet u toj skupini iznosio 7,89% (3 bolesnika). Kod 10 (13,16%) bolesnika operiranih laparoskopski, a čija je operacija dovršena laparoskopski, pojavila se jedna ili više postoperativnih komplikacija, a postoperativni mortalitet u ovoj skupini iznosio je 1,32% (1 bolesnik). Kod ukupno 7 (8,14%) bolesnika moralo se pristupiti konverziji iz laparoskopske u otvorenu metodu. U skupini konvertiranih bolesnika nema intraoperativnih komplikacija niti intraoperativnog mortaliteta. Postoperativno je zabilježen 1 slučaj komplikacija, koji je naposljetku završio smrtnim ishodom. ----- Analiza i usporedba rezultata obiju skupina ukazuje na bolji postoperativni tijek i manji postoperativni mortalitet u laparoskopski operiranih bolesnika, što navodi na zaključak o prednosti laparoskopske nad otvorenom metodom kolecistektomije.The paper analyses the cholecystectomies performed in the emergency room of the University hospital center of Zagreb in a two-year period (2013/2014). The comparison was made between the number of laparoscopic and open cholecystectomies, the frequency of complications in each of the methods, and also between the frequency and the reasons for the conversion from laparoscopic to open method. ----- A total of 124 patients were operated. The open cholecystectomy was done in 38 (30,65%) cases, and the laparoscopic cholecystectomy was done in 86 (69,35%) cases. In the open cholecystectomy patient group there was 1 (2,63%) case of intraoperative complications, and in the laparoscopy patient group there were no intraoperative complications. There was no record of intraoperative mortality in either group. In the open cholecystectomy patient group there were 14 (36,84%) cases of postoperative complication(s), and the postoperative mortality in this group was 7,89% (3 patients). In the laparoscopic cholecystectomy group there were 10 (13,16%) cases of postoperative complication(s), and the postoperative mortality in this group was 1,32% (1 patient). Only patients whose operation was finished laparoscopically were taken into consideration in the laparoscopic cholecystectomy group. In the total of 7 (8,14%) operations, the operation was converted from laparoscopic to open method. In the converted patient group, there were no intraoperative complications, and no intraoperative mortality. There was 1 case of postoperative complication(s), which resulted in the patient’s death. ----- The analysis and comparison of the both groups’ results suggests a better postoperative course and a lower postoperative mortality in the group operated by the laparoscopic approach, which leads to a conclusion of the advantage of the laparoscopic approach in relation to the open method