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一个系统的回顾腹腔镜子总胆囊切除术对于困难的胆囊:救生救助或不完整的手术?

M Al-Azzawi¹, M Abouelazayem², C Parmar³

¹University Hospital Crosshouse, UK.

Annals of the Royal College of Surgeons of England

|June 27, 2023

概括

腹腔镜次总胆囊切除术 (LSTC) 是难以治疗胆囊的安全替代方案. 这次审查发现LSTC的早期和晚期发病率和死亡率较低,使其成为可接受的程序.

科学领域:

胃肠道学和肝胆道外科
最少侵入性的手术

背景情况:

腹腔镜子全胆囊切除术 (LSTC) 作为一个救助程序,当腹腔镜全胆囊切除术是不安全的,因为密集的粘附在卡洛特三角形.
调查LSTC的早期和晚期结果对于手术决策至关重要.

研究的目的:

系统地审查和分析早期 (≤30天) 和晚期 (>30天) 患病率和死亡率与拉巴罗镜次总胆囊切除术 (LSTC) 相关.

主要方法:

在PubMed,Google Scholar和Embase数据库中进行了全面的文献搜索,寻找1985年至2020年12月期间发表的LSTC研究.
采用系统性审查方法来综合这些研究的发现.

主要成果:

该审查包括了45项研究,其中包括2,166名接受LSTC的患者,转化率为6.2%. 急性胆囊炎是最常见的迹象 (49%).
早期发病率包括胆道损伤 (0.23%),胆汁泄漏 (18%) 和腹腔内收集 (4%),30天死亡率为0.18%.
晚期发病率包括切口 (6%),症状胆结石 (4%) 和常见胆道结石 (2%),其中2%需要完成胆囊切除术.

结论:

laparoscopic 亚总胆囊切除术 (LSTC) 是一种可行的和可接受的手术选择,用于在卡洛特三角形中呈现具有挑战性的解剖的患者.
该程序表现出良好的安全性,可控的早期和晚期并发症.

关键词:

胆道手术是胆道手术.胆囊胆囊胆囊胆囊胆结石胆结石胆结石 laparoscopic 拉巴洛斯科比拉巴洛斯科比拉巴洛斯科比拉巴洛斯科比最少的侵入性侵袭性疾病部分总的胆囊切除术.

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