顺行腹腔镜胆囊切除术中解剖

顺行腹腔镜胆囊切除术中解剖

Antegrade Dissection in Laparoscopic Cholecystectomy

Abstract:
Background and Objectives: The aim of this study was to evaluate the usefulness of gallbladder antegrade dissection (GAD) cholecystectomy to reduce the risk of common biliary duct injuries and to demonstrate that it is an easier and more time-sparing technique than the traditional one.
Methods: The operative procedure performed since 2002 consists of the incision of the visceral peritoneum from the infundibulum away from Calot's triangle along the gallbladder bed up to the fundus. Then it continues from the fundus up to the infundibulum. This method was used to perform 127 laparoscopic cholecystectomies (LC) (first group). We compared the results of 119 LC (second group) performed from 1998 to 2001 by means of a completely retrograde method.
Results: In both groups, there were no major complications; 1 vs 4 conversions (0.8% vs 3.4%), mean operative time 70 minutes vs 90 minutes, residual choledocholithiasis in 2 patients in both groups (1.6% for the first group vs 1.7% for the second group).
Conclusions: GAD for laparoscopic cholecystectomy can reduce the time of surgery and is an easier technique to perform. Therefore, it can be proposed as the standard procedure and not only be used for difficult cholecystectomies.


Antegrade Dissection in Laparoscopic Cholecystectomy.pdf(66.71KB)

摘要：

背景与目的：本研究的目的是评估胆囊顺行切除胆囊切除术（GAD）的作用，以减少常见的胆管损伤的风险，并表明它是一个更容易，更比传统的保留时间的技术。
方法：自2002年以来进行的手术方法的切口的腹膜脏层的漏斗从Calot三角沿胆囊床的眼底。然后它继续从眼底的漏斗部。这种方法被用来执行127腹腔镜胆囊切除术（LC）（第一组）。我们比较了完全逆行的方法通过1998年至2001年进行的119 LC（第二组）。
结果：在这两个群体中，有没有严重的并发症，1比4的转化（0.8％比3.4％），平均手术时间70分钟比90分钟，在这两个群体中有2例（1.6％，第一组与1.7的残余胆管结石％，第二组）。
结论： GAD腹腔镜胆囊切除术可减少手术时间，是一个简单的技术来执行。因此，可以提出作为标准的程序，和不仅可用于难以胆囊切除术。

学习了，哈哈