Data on laparoscopic cholecystectomy detailed by R.G. Manning and co-authors
2009 JUN 22 - (NewsRx.com) -- "We address the controversial issue of whether or not it is wise to perform and train laparoscopic cholecystectomy (LC) in a developing nation by reviewing the results of the first large series done in Afghanistan. Afghanistan has been devastated by 3 decades of war leaving it with deficiencies in training programs, medical technologies, and overall medical infrastructure that are among the worst in the developing world," scientists writing in the journal Annals of Surgery report. "We retrospectively reviewed 137 consecutive cholecystectomies, 102 laparoscopic and 35 open, performed by 4 senior and 3 junior surgeons trained at our hospital in Kabul from July 2005 until February 2008. Deaths, complications, conversion rate, operative time, and hospital length of stay were compared. Unrecognized major operative injuries occurred in 4 LC patients, 3 bile leaks, and I duodenal perforation, although there were no such injuries in the open cholecystectomy group. Complication rates were much higher for patients operated on for acute cholecystitis for both surgeon groups. Even though junior surgeons converted to open cholecystectomy more frequently than senior surgeons, they had a higher major complication rate. Hospital length of stay was 28% shorter for the laparoscopic group. The high rate of major unrecognized intraoperative complications during LC in our series underscores the difficulties inherent in performing and training LC in developing nations," wrote R.G. Manning and colleagues. The researchers concluded: "Practical changes are suggested to make LC more efficient and safer in a developing world hospital." Manning and colleagues published their study in Annals of Surgery (Should Laparoscopic Cholecystectomy be Practiced in the Developing World' The Experience of the First Training Program in Afghanistan Annals of Surgery, 2009;249(5):794-798). Additional information can be obtained by contacting R.G. Manning, 701 Bosler Avenue, Lemoyne, PA 17043, USA. The publisher of the journal Annals of Surgery can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA. Keywords: United States, Gastroenterology, Laparoscopic Cholecystectomy, Surgery. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.
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