Kolesistektomi ameliyatı sonrası hastaların memnuniyeti ve koledok çapındaki değişiklikler: uzun dönem sonuçları - SEMİZ OYSU, ASLIHAN; GÜLLÜOĞLU, MAHMUT BAHADIR; TÜNEY, DAVUT; EKİNCİ, GAZANFER (My University, 2001)
Amac: Kolesistektomi amellyati olmu§olgularda uzun dOnemde koiedok kanali capindakive ameliyat Oncesi ve sonrasi semptomlardaki degi§ikliklerin saptanmasi, koledok kanali cap! ile semptomatik iyile§me arasindaki ili§kinin ara§tirilmasi. Durum degerlendirilmesi: Daha Once yapilan call§malar kolesistektomi sonrasi erken dOnemde koledok kanali capinda anlamli bir art oldugunu gOstermektedir. Ancak uzun dOnemde yapilan cali§malarda bOyle birarh§saptanmami§tinSemptomatik iyile§me Ile cap deg§iklikleri arasindaki ill§kinin ise halen bilinmemektedir. Yontem: Elektif §artlarda semptomatik safra kesesi tai nedeni ile acik veya laparoskopik yOntemle kolesistektomi yapilmi olan ve preoperatif donem koledok kanali cap bilinen 28 olgu de 'Oerlendirmeye aiindi. Postoperatif donemde en az dortyilini dolduran olgularin koledok kanali cap ultrasonografi ile olcOlerek preoperatif OlcOmler ile kar ila tinldi. Ayrica hazirlanan anket formu ile olgulann ameliyat Oncesi varolan yakinmalannin ameliyatsonrasindaki durumu sorgulandi. pkanmlar: Olgular medyan 98.5 ay (53 -135 ay) takip ediidi. Postoperatif ultrasonografi incelemelerinde %29 olguda koledok kanali gape 7 mm`nin Ozerinde olguldu. Preoperatif clOnemde bu oranin%43 oldugu saptandi. Preoperatif ye postoperatif Olciamler arasinda istatistiksel olarak anlamli fork bulunmadi. Olgulann tOmOnde anneliyat Oncesinde var olan koliktarzda kann agrisi yakinmasinin ameliyattan sonra ortadan kalktigi saptandi. Ameliyatsonrasinda hastalann medikal tedavi gerektirmeyen yakinmalannin ise koiedok kanali capindaki degi§iklikler lie iii kisi olmadigi gbrOld0. Sonuclar: Kolesistektomi sonrasi uzun donem sonunda yapilan incelemelerde hastalann koledok kanali cap OlcCimlerInde aniamli bir degi§iklik saptanmadi. Postkolesistektomi yakinmalannin derecesi Ile koledok kanali cap' arasinda ili§ki saptanmadi. Olgularda elde edilmi§ klinik ba§annin uygun hasta segimine bagli oldugu dO§C.InUld6.

The effect of cholecystectomy on common bile duct diameter remains controvertial. It has been shown thatthe diameter of common bile duct increases significantly in the early postoperative period, but in the long term studies such an evidence has not been shown. This study investigates the long term changes in the diameter of common bile duct and its relationship with symptomatic relief following cholecystectomy. Twenty eight patients undergoing elective open or laparoscopic cholecystectomy due to symptomatic gall bladderstone were studied. The common bile duct diameter of these patients were measured by ultrasonography and compared with the preoperative values. Meanwhile the degree of symptomatic improvement was determined by a questionnaire to compare the preopera¬tive and postoperative symptoms. The median follow-up period was 98.5 (53 - 135) months. In the postoperative measurements, the diameter of common bile duct was found to be more than 7 mm in 29% of the patients (mean 6.1 mm) where as the corresponding figure was 43%, preoperatively (mean 7.4 mm). There was no statistically significant difference in measurements between two periods. Following cholecystectomy, 79% of patients had complete symptomatic relief. All patients were satisfied with the operation in various degrees. As the conclusion, cholecystectomy has no effect on changes of common bile duct diameter and clinical success as well as patient satisfaction can be achieved when patients with appropriate indication are chosen for surgery.
Keywords: Semptomatik safra kesesi ta§1; kolesistektomi; koiedok cap!; postkolesistektomi sendromu SUMMARY; Symptomatic gall bladder stone; common bile duct diameter; cholecystectomy; postcholecystectomy syndrome