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Erschienen in: European Surgery 3/2021

07.08.2020 | main topic

The complicated gallbladder—is old-school treatment an alternative?

verfasst von: Dr. med. univ. Markus Ammann, Prim. Univ. Doz. Dr. Friedrich Längle

Erschienen in: European Surgery | Ausgabe 3/2021

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Summary

Background

Since implementation of the laparoscopic approach for removal of the gallbladder in the early 90s, a shift in numbers from open cholecystectomy (OC) to laparoscopic cholecystectomy (LC) has been observed. Despite initial reservations, LC has become the most favoured technique in the past 3 decades. Consecutive technical improvements support this trend. Considering this development, the question regarding the relevance of OC nowadays inevitably arises.

Methods

This study represents a literature review performed in PubMed.

Results

Laparoscopic cholecystectomy has evolved to be the leading technique for cholecystectomy. This technique has become well established in elective as well as in acute indications. However, concomitant to increasing numbers of performed LC, the proportion of performed OC is declining, leading to a decreasing expertise and a lack in training in OC nowadays. However, in complex situations, when the operation strategy has to be changed to maintain patient safety, conversion to OC is the most common strategy.

Conclusion

Owing to past and current developments, open cholecystectomy can hardly be assumed to be common surgical knowledge anymore. Hence, OC as bail-out strategy in cases of intraoperative difficulties must be critically evaluated. From this point of view, alternative patient management and treatment concepts should be considered to maintain patient safety.
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Metadaten
Titel
The complicated gallbladder—is old-school treatment an alternative?
verfasst von
Dr. med. univ. Markus Ammann
Prim. Univ. Doz. Dr. Friedrich Längle
Publikationsdatum
07.08.2020
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 3/2021
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-020-00653-0