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    Comparison between laparoscopic and conventionaltechnique in the surgical treatment of choledocholithiasis
    (2020) AYDIN, Mehmet Can; KARAHAN, Servet Rüştü; KÖSE, Emin
    Öz: Introduction: The aim of the study is to compare f conventional and laparoscopic techniques in common bile duct exploration in terms of efficacy and safety.Materials and Methods: The data of 280 patients who underwent surgical procedure for common bile duct stones between January 2011 and December 2016 were retrospectively analyzed. This was an Ethics Committee-approved retrospective analysis of data between 2011 and 2016. The patients were divided into two groups according to the common bile duct exploration technique: laparoscopic (Group 1, 164 patients) and conventional (Group 2, 116 patients). The two groups were compared in terms of surgical findings and short-term results.Results: 170 (60.7%) of the patients were women. The mean age was 61.9±16.9 years. Clinical results showed that the operative time (120±35.9 vs 169±48.4 minutes, p<0.01) and hospital stay (6.3±3.9 vs 10.9±6.8 days, p<0.01) were shorter in Group 1; overall morbidity (9% vs 24%, p<0.01) and mortality rates (1.2% vs 6%, p<0.03) were lower. Postoperative endoscopic sphincterotomy requirement was less (7% vs 18.1%, p <0.01). In addition, in Group 1, there was a higher rate of stone clearance (93.9% vs 82.8%, p<0.01) with a lower rate of wound infection (0.6% vs 10.3%, p<0.01). No difference was observed in terms of re-operation, bile leakage or drain dislocation.Conclusion: In terms of stone clearance, hospital stay, morbidity, mortality and complication rates, laparoscopic common bile duct exploration is a significantly safer and more effective method compared to conventional exploration.
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    Is jejunoduodenostomy anastomosis better than jejunogastrostomy anastomosis in laparoscopic gastrectomyand jejunal interposition?
    (2020) Kayaalp, Cüneyt; AYDIN, Mehmet Can; ZENGİN, Akile; BAĞ, Yusuf Murat
    Öz: Introduction: The jejunal interposition can be preferred for reconstruction after laparoscopic gastrectomy because it functions as a reservoir and maintains the connection with the duodenal passage. In this procedure, the jejunal segment can be anastomosed between the proximal stomach and the duodenum or distal stomach. We aimed to present our initial experience with the jejunoduodenostomy and jejunogastrostomy inin jejunal interposition after laparoscopic gastrectomy and the differences between the results of these two anastomoses.Materials and Methods: Six patients who underwent laparoscopic gastrectomy with jejunal interposition between January and August 2020 were investigated. Demographic data and perioperative parameters were analyzed retrospectively. Digestive symptoms following the surgery were assessed by phone call.Results: Five (83.3%) of the total six patients were male. The median age was 70 (range 19–78) years, with a median body mass index (BMI) of 25.8 (range 23–31) kg/m2. The most common surgical indication was gastric adenocarcinoma (n=4). The median operative time was 280 (200–360) minutes, and the median blood loss was 95 (50–100) ml. The median time to oral intake was 3.5 (2–13) days. The median hospital stay was 7.5 (4–16) days. Jejunogastrostomy was performed in three (50%) patients. Postoperative complications occurred in four (66.6%) patients, three of whom were with jejunogastrostomy. The most common postoperative complication was anastomotic leak (n=2).Conclusion: Jejunoduodenostomy is safer than jejunogastrostomy after laparoscopic gastrectomy and jejunal interposition.