在胆囊切除术后保留胆结石的手术选择
Ali Mohtashami1,2, William A Ziaziaris1,2, Chris S H Lim1
1Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, St Leonards.
Surgical laparoscopy, endoscopy & percutaneous techniques
|October 22, 2024
概括
手术干预有效地管理胆囊切除术后保留的胆结石,特别是在内镜逆行胆管脑图 (ERCP) 失败的情况下. laparoscopic 方法为残留胆囊,囊性管道或常见胆管中保留的结石提供了有利的结果.
科学领域:
- 肝胆道手术 肝胆道手术
- 胃肠病学 胃肠病学
- 最少侵入性的手术
背景情况:
- 留住的胆结石是胆囊切除术后疼痛的常见原因,通常在残留的囊性通道,常见的胆管或部分胆囊切除术后残留的胆囊中发现.
- 当内镜管理失败或不可行时,有时需要进行手术清除.
- 由于子总胆囊切除术的增加,残留胆囊结石手术的发生率正在增加.
研究的目的:
- 审查症状保留胆结石的手术治疗方法.
- 评估第三级肝胆中心保留结石的手术干预结果.
主要方法:
- 对从2004年到2022年前性收集的数据进行了回顾性分析.
- 包括在之前的胆囊切除术后接受了保留结石手术的患者.
- 专注于患有常见胆道结石的患者,这些患者未能或无法接受内镜逆行胆血管瘤造影仪 (ERCP).
主要成果:
- 14名患者接受了手术干预,其中11/14 (78%) 的腹腔镜手术成功.
- 保留的结石位于剩余的胆囊 (29%),剩余的囊性管道 (36%) 和常见的胆管道 (36%).
- 三名患者需要转换为开放性手术; 一名患者经历了轻微的术后伤口感染,所有患者在随访时没有症状.
结论:
- 对于保留的胆结石而言, laparoscopic 的干预表明了有利的结果.
- 对手术前检查和手术管理有系统的方法对于成功治疗至关重要.
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