腹腔镜胆囊切除术是否适用

Abd El Kalmoush
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引用次数: 0

摘要

背景腹腔镜胆囊切除术是治疗症状性胆结石的首选方法。腹腔镜胆囊切除术在世界范围内由普通外科医生完成,但即使对腹腔镜手术专家来说,困难的病例仍然具有挑战性。由于首次手术后间歇胆囊切除术或胆囊管残端或残余胆囊结石而行胆囊切除术。对病人最重要的检查是磁共振胆管造影。复诊手术适用于腹腔镜手术。患者与方法对11例开腹胆囊切除术和腹腔镜胆囊切除术患者进行回顾性研究,其中1例可行Foley 's导尿管胆囊造瘘,2例无法到达胆囊,9例可行腹腔镜手术(4例延期手术,5例胆囊残留或结石残留)。完成了临床检查、实验室检查和放射学评价。所有病例均行腹腔镜手术。结果1例需转开腹手术。手术时间1 ~ 3小时。无胆漏及胆总管损伤。术中出血2例,术后出血1例。术后住院1-2天,1例转为开放,住院3天。结论腹腔镜胆囊切除术是一种安全可行的手术方法,但需要熟练掌握腹腔镜技术。
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Redo-laparoscopic cholecystectomy: is it applicable
Background Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall stone disease. Laparoscopic cholecystectomy is done worldwide by general surgeons, but difficult cases remain challenging even to experts in laparoscopic surgery. Redo-cholecystectomy is done owing to either interval cholecystectomy after first surgery or stone in cystic duct stump or remnant gall bladder. The most important investigation done for the patients is magnetic resonance cholangiogram. Redo-surgery is applicable to be done laparoscopic. Patients and methods A retrospective study was conducted on 11 patients whom underwent to cholecystectomy either open or laparoscopic, where one case could undergo cholecystostomy by Foley’s catheter and second one could not reach the gall bladder, and nine cases could undergo laparoscopic (four cases postpone from the start and five cases have remnant of gall bladder or retained stone in it). Clinical examination, laboratory, and radiological evaluation was done. All cases of redo-surgery were by laparoscopy. Results One case needed to convert to open surgery. Time of surgery ranged from 1 to 3 h. There is no bile leakage or common bile duct injury. There were two cases of intraoperative bleeding and one case with postoperative bleeding. Postoperative stay in hospital was 1–2 days, except a case that was converted to open, which had 3 days of hospital stay. Conclusion Redo-laparoscopic cholecystectomy is applicable and safe but needs experience in laparoscopic skills.
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