腹腔镜与机器人扩展胆囊切除术治疗胆囊癌的研究。

Kwang Hyun Kim, Tinna Osk Thrastardottir, Sung Hoon Choi
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引用次数: 0

摘要

微创手术在胆囊癌(GBC)中的应用还存在争议。本文讨论了腹腔镜和机器人扩大胆囊切除术的技术。1例确诊为cT1-2N0型GBC的69岁男性患者行腹腔镜手术,1例确诊为cT2N1型GBC的55岁男性患者术前化疗后行机器人手术。行非解剖性肝部分切除术及淋巴结切除术。采用腔室超声手术吸引器腹腔镜和马里兰双极解剖刀及谐波刀进行肝实质清扫。手术时间为180分钟和220分钟,估计失血量分别为140 mL和130 mL。最终病理为pT1bN0和pT2aN1,患者接受辅助化疗。33个月和18个月无复发,无并发症。腹腔镜和机器人扩展胆囊切除术都可以安全地进行,机器人手术系统作为GBC需要肝切除术和根治性淋巴结切除术的有效替代。
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The technique of laparoscopic and robotic extended cholecystectomy for gallbladder cancer.

The application of minimally invasive surgery for gallbladder cancer (GBC) is yet controversial. This article discusses the techniques of laparoscopic and robotic extended cholecystectomy. A 69-year-old male diagnosed with cT1-2N0 GBC underwent laparoscopic surgery, and a 55-year-old male with cT2N1 GBC underwent robotic surgery after preoperative chemotherapy. Nonanatomical partial hepatectomy with lymphadenectomy was performed. Liver parenchymal dissection was performed using Cavitron Ultrasonic Surgical Aspirator laparoscopically and Maryland bipolar dissector and Harmonic scalpel robotically. The operation time was 180 and 220 minutes, and the estimated blood loss was 140 and 130 mL, respectively. The final pathologies were pT1bN0 and pT2aN1, for which patients received adjuvant chemotherapy. There was no evidence of recurrence at 33 and 18 months without complications. Both laparoscopic and robotic extended cholecystectomy can be safely performed with the robotic surgical system as an effective alternative for GBC requiring liver resection with radical lymphadenectomy.

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