比较兔子腹腔镜胆囊切除术中不同解剖技术的术后效果:随机研究。

Acta cirurgica brasileira Pub Date : 2024-10-25 eCollection Date: 2024-01-01 DOI:10.1590/acb396324
María Camila Maldonado Vera, Monica Carolina Nery Wittmaack, Maria Eduarda Bastos Andrade Moutinho Conceição, Rachel Inamassu Faccini, Guilherme Sembenelli, Gabriel Luiz Montanhim, Mareliza Possa de Menezes, Cléber Kazuo Ido, Luiz Paulo Nogueira Aires, Gabriel João Unger Carra, Paola Castro Moraes
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摘要

目的:腹腔镜胆囊切除术(LC)是治疗小动物胆囊疾病的金标准。本研究的目的是调查和比较不同类型的解剖器在兔子腹腔镜胆囊切除术中的效果;电热双极血管密封装置(EBVS-LigaSure)和标准电外科解剖器(双极马里兰)在腹腔镜胆囊切除术中解剖胆囊的效果,并对术前和术后(第 0、3、7、15 天)的肝功能检测(LFTs)进行相关分析;术后 15 天通过尸体解剖进行宏观检查;组织病理学、细菌培养和术中并发症。方法使用 20 只兔子,一组(n = 10)使用 EBVS 进行 GB 剥离和囊管封堵(GLL),另一组(n = 10)使用双极剥离钳和 EVBS 进行囊管封堵(GLE):结果:与 GLE 相比,术后 15 天 GLL 观察到的碱性磷酸酶浓度更高。此外,与 GLL 相比,GLE 在术后 3 天的丙氨酸氨基转移酶浓度更高:在 LC 中,EBVS 和双极 Maryland 之间没有发现明显的统计学差异;这两种设备在 LC 中同样安全有效。还需要进一步研究,以评估这些装置对胆囊病变动物的有效性。因此,有必要进行临床研究。
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Comparison of postoperative outcomes between different dissection techniques during laparoscopic cholecystectomy in rabbits: randomized study.

Purpose: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of gallbladder (GB) disease in small animals. The aims of this study were to investigate and compare the effect of different types of dissectors during LC in rabbits; electrothermal bipolar vessel sealing device (EBVS-LigaSure) and standard electrosurgical dissection (bipolar Maryland) for dissection of the GB in LC, correlating liver function tests (LFTs) in pre and postoperative periods (days 0, 3, 7, 15); macroscopic checking 15 days after surgery through necropsy; histopathological, bacteriological through bacterial growth by culture and intraoperative complications.

Methods: Twenty rabbits were used, group (n = 10) using EBVS for GB dissection and cystic duct seal (GLL), and group (n = 10) using bipolar dissecting forceps and EVBS for cystic duct seal (GLE).

Results: A higher concentration of alkaline phosphatase was observed on GLL 15 days after surgery when compared to GLE. In addition, GLE resulted in a higher concentration of alanine aminotransferase at three days when compared to GLL.

Conclusion: In LC no significant statistical differences were found between EBVS and bipolar Maryland; both devices are equally safe and effective in LC. Further studies are required to evaluate the effectiveness of these devices in animals with gallbladder pathologies. Therefore, clinical studies are necessary.

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