胆道结石的腹腔镜胆囊切除术和管理在一个独立的门诊手术中心

摘要：
目的：我们进行了回顾4年的研究，腹腔镜胆囊切除术的病人在一个独立的门诊手术中心。入院，中转开腹手术，胆管损伤，术后胆漏，胆总管结石的发病率率的数据进行了分析。动态透视术中胆道造影的成功率计算，门诊腹腔镜胆总管探查术，麻醉管理进行了审查。
方法：从门诊手术中心，办公室，医院的病历进行了审查，通过4年的时间，1999年10月开始。所有病例均进行1 3外科医生，谁是有经验的门诊腹腔镜胆囊切除术和实践的常规动态透视术中胆道造影。

胆道结石的腹腔镜胆囊切除术和管理在一个独立的门诊手术中心.pdf (73.06 KB, 下载次数: 4)

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结果：总共有338腹腔镜胆囊切除术进行。动态透视术中胆道造影成功进行了89％（N = 302）。无胆管损伤或转换为开放性手术实例进行了报道。0.89％（n = 3）的发病率术后胆汁泄漏发生。6例患者入院住院治疗的比率为1.78％。胆总管结石发生的2.0％，并成功地在门诊设置。
结论：腹腔镜胆囊切除术，可适应独立的门诊手术环境非常高标准的护理和并发症的发生率非常低。

Laparoscopic Cholecystectomy and Management of Biliary Tract Stones in a Freestanding Ambulatory Surgery Center
Authors: Wenner, Donald E.1; Whitwam, Paul1; Turner, David1; Chadha, Amrita1; Degani, Jason2
Source: JSLS, Journal of the Society of Laparoendoscopic Surgeons, Volume 10, Number 1, January - March 2006 , pp. 47-51(5)

Abstract:
Objective: We conducted a retrospective 4-year study of patients undergoing laparoscopic cholecystectomy at a freestanding ambulatory surgery center. Data on rates of hospital admission, conversion to open surgery, bile duct injury, postoperative bile leakage, and incidence of choledocholithiasis were analyzed. The success rate for dynamic fluoroscopic intraoperative cholangiography was computed, and outpatient laparoscopic common bile duct exploration and anesthetic management were reviewed.
Methods: Patient charts from the ambulatory surgery center, office, and hospital were reviewed over a 4-year period commencing in October 1999. All cases were performed by 1 of 3 surgeons who are experienced with outpatient laparoscopic cholecystectomy and practice routine dynamic fluoroscopic intraoperative cholangiography.
Results: A total of 338 laparoscopic cholecystectomies were performed. Dynamic fluoroscopic intraoperative cholangiography was successfully performed in 89% (n=302). No instances of bile duct injury or conversions to open surgery were reported. A 0.89% (n=3) incidence of postoperative bile leak occurred. Six patients were admitted for inpatient care for a rate of 1.78%. Choledocholithiasis occurred in 2.0% and was managed successfully in the ambulatory setting.
Conclusion: Laparoscopic cholecystectomy can be adapted to the freestanding ambulatory surgery environment with very high standards of care and very low complication rates.