Comparative Analysis of Three-Versus Two-dimensional Imaging in Laparoscopic Cholecystectomy.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
accepted:
27
12
2020
pubmed:
22
1
2021
medline:
9
7
2021
entrez:
21
1
2021
Statut:
ppublish
Résumé
Three-dimensional (3D) imaging has been suggested to improve learning and performance of laparoscopy. We sought to investigate whether 3D imaging could improve the outcomes after laparoscopic cholecystectomy. Two-hundred and forty-one consecutive patients underwent elective or urgent laparoscopic cholecystectomy using 2D (n = 111) and 3D (n = 130) imaging equipments from March 2017 to March 2019 at the Kainuu Central Hospital, Finland. The main outcomes of this study were biliary tract injury, conversion to open procedure and procedure duration. In the overall series, there were 5 cases of biliary tract injury (2.1%). When compared to 3D imaging, 2D was associated with increased risk of biliary tract injury in the overall series (0% in 3D vs. 4.7% in 2D, p = 0.026) in addition to a subgroup of acute cholecystitis patients operated by senior surgeons (n = 92), 0% in 3D group (n = 60) vs. 10.0% in 2D group (n = 32), p = 0.037 in univariate analysis. The rates of conversion to open surgery did not differ between the groups in the overall series (5.3 vs 5.7%, p = 0.909) or any of the subgroups. Duration of surgery with 3D vs. 2D imaging were comparable in the elective (57.0 ± 16.3 vs. 54.1 ± 18.9 min, p = 0.228) and urgent setting (66.9 ± 15.1 vs. 67.4 ± 16.6 min, p = 0.805). Such differences were not significant in multivariate analysis. The present study suggests that the use of 3D imaging is significantly associated with a reduced risk of intraoperative biliary tract injury during laparoscopic cholecystectomy especially in acute cholecystitis.
Sections du résumé
BACKGROUND
Three-dimensional (3D) imaging has been suggested to improve learning and performance of laparoscopy. We sought to investigate whether 3D imaging could improve the outcomes after laparoscopic cholecystectomy.
MATERIALS AND METHODS
Two-hundred and forty-one consecutive patients underwent elective or urgent laparoscopic cholecystectomy using 2D (n = 111) and 3D (n = 130) imaging equipments from March 2017 to March 2019 at the Kainuu Central Hospital, Finland. The main outcomes of this study were biliary tract injury, conversion to open procedure and procedure duration.
RESULTS
In the overall series, there were 5 cases of biliary tract injury (2.1%). When compared to 3D imaging, 2D was associated with increased risk of biliary tract injury in the overall series (0% in 3D vs. 4.7% in 2D, p = 0.026) in addition to a subgroup of acute cholecystitis patients operated by senior surgeons (n = 92), 0% in 3D group (n = 60) vs. 10.0% in 2D group (n = 32), p = 0.037 in univariate analysis. The rates of conversion to open surgery did not differ between the groups in the overall series (5.3 vs 5.7%, p = 0.909) or any of the subgroups. Duration of surgery with 3D vs. 2D imaging were comparable in the elective (57.0 ± 16.3 vs. 54.1 ± 18.9 min, p = 0.228) and urgent setting (66.9 ± 15.1 vs. 67.4 ± 16.6 min, p = 0.805). Such differences were not significant in multivariate analysis.
CONCLUSIONS
The present study suggests that the use of 3D imaging is significantly associated with a reduced risk of intraoperative biliary tract injury during laparoscopic cholecystectomy especially in acute cholecystitis.
Identifiants
pubmed: 33475802
doi: 10.1007/s00268-020-05934-z
pii: 10.1007/s00268-020-05934-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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