在先前的胃切除术后进行 laparoscopic 常见胆道探索:手术的安全性和可行性
Sun Min Park1, Kwang Yeol Paik2
1Department of Surgery, Yeoiudo St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #10,63-Ro,Yeongdengpo-Gu, Seoul, 07345, Korea.
Langenbeck's archives of surgery
|July 28, 2023
概括
腹腔镜检查常见胆道 (LCBDE) 是以前胃切除术 (PG) 和胆道结石患者的安全和可行的选择. 虽然需要谨慎管理,但结果与没有PG的患者相似.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 胆道外科手术 胆道外科手术
背景情况:
- 以前的胃切除术 (PG) 增加了胆管结石的风险.
- 内镜逆行胆血管细胞切除术 (ERCP) 的成功率通常在胃切除术后有限.
- 腹腔镜常见胆道探索 (LCBDE) 成为这些患者胆道结石管理的潜在替代方案.
研究的目的:
- 评估LCBDE的安全性和可行性,以往有胃切除术 (PG) 病史的患者.
- 为了比较患有PG和没有PG的患者之间LCBDE的术后结果.
主要方法:
- 对LCBDE程序的回顾性分析.
- 与PG (n=27) 和没有PG (n=155) 的患者之间的术后数据的比较.
主要成果:
- 患有PG的患者住院时间较长 (P=.006),术后出血率较高 (P=.021).
- 在PG患者中,ERCP率较低 (P<.001),T管使用量增加 (P=.002).
- 在失血,手术时间,胆汁泄漏,胰腺炎,结石清除,再录取或复发率方面没有发现显著差异.
结论:
- 对于以前经过胃切除术 (PG) 的患者来说,LCBDE是一种可行的和安全的手术.
- 尽管可能需要更密集的术后管理,但结果与没有PG的患者相似.
- 在胃切除术后,LCBDE为胆道结石管理提供了可行的解决方案.
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