Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit's model.

Acta cirurgica brasileira Pub Date : 2023-12-01 eCollection Date: 2023-01-01 DOI:10.1590/acb383523

Monica Carolina Nery Wittmaack, Maria Eduarda Bastos Andrade Moutinho Conceição, María Camila Maldonado Vera, Rachel Inamassu Faccini, Guilherme Sembenelli, Gabriel Luiz Montanhim, Mareliza Possa de Menezes, Fabiana Del Lama Rocha, Luiz Paulo Nogueira Aires, Paola Castro Moraes

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Abstract

Purpose: The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed.

Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal.

Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique.

Conclusions: LC can be performed using different techniques, although the use of EBVS is highly recommended.

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三种腹腔镜胆囊切除术方法在兔模型中的比较评价。

目的:本随机研究的目的是比较三种不同腹腔镜胆囊切除术(LC)的并发症和围手术期预后。研究LC技术后肝功能的变化。我们还比较了术后肝床的粘连程度和组织病理学变化。方法:30只家兔随机分为3组:A)采用Hook解剖仪先行眼底法和Roeder活结法结扎胆囊管(CD);B组采用常规马里兰解剖钳联合电热双极血管密封(EBVS)进行CD密封;C组采用常规EBVS技术进行胆囊剥离和CD封闭。结果:A组大网膜剥离时间较B、c组长。各组大网膜邻近组织穿孔及出血情况相似。a组术后第3天γ -谷氨酰转移酶和碱性磷酸酶水平升高(p≤0.05)，术后第15天恢复到术前水平。各组肝转氨酶均在LC后短暂升高。A组的依从性评分高于B组和C组，并且与最不可预测的技术相关。结论:尽管强烈推荐使用EBVS，但LC可以使用不同的技术进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Acta cirurgica brasileira

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