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腹腔镜检查常见胆道胃外科手术后检查常见胆道结石

Xavier De Raeymaeker¹, Joris Blondeel¹, Bert Houben¹

¹Department of General and Abdominal Surgery, Jessa Ziekenhuis, Salvatorstraat 20, 3500, Hasselt, Belgium.

Surgical endoscopy

|February 5, 2025

概括

腹腔镜常见胆道探索 (LCBDE) 是胃外科手术后常见胆道结石的安全有效治疗方法. 这种单阶段的手术为通道清除提供了很高的成功率,并避免了复杂的内镜干预.

科学领域:

胃肠病学胃肠病学
手术瘤学手术瘤学
腹部外科腹部外科

背景情况:

胆结石疾病是胃和空腹手术后的常见并发症.
常见的胆道结石 (CBS) 的标准治疗包括内镜逆行胆道细胞造影 (ERCP) 和内镜膜切除术 (ES),通常随后是胆囊切除术.
在胃外科手术后改变了胃腺体解剖学,可以使内镜进入乳头具有挑战性.

研究的目的:

为了评估单阶段腹腔镜常见胆道探索和胆囊切除术 (LCBDE) 在之前经历过胃外科手术的患者的治疗成功.
评估LCBDE的安全性和有效性,作为复杂干预内镜的替代方案,用于该患者群体.

主要方法:

在2014年1月至2022年7月期间,对一组经历了各种类型的胃外科手术 (Roux-en-Y胃绕道,BII次总胃切除术,总胃切除术,Roux-en-Y重建的次总胃切除术) 后接受LCBDE的患者进行了回顾性审查.
评估的结果包括成功的胆道清除,术后不良事件和CBS复发.

主要成果:

44名患者接受LCBDE治疗,38例患者同时接受胆囊切除术.
在38名患者中,37名患者 (97%) 取得了成功的胆道清除.
术后的不良事件发生在8名患者中,其中3名被归类为Clavien-Dindo等级>3a. 在60个月的中位数随访期间,没有观察到CBS复发.

结论:

LCBDE是一种安全且非常成功的技术,用于管理有胃外科手术史的患者常见的胆道结石.
这种单阶段的方法是复杂的干预内镜的可行替代方案,特别是当乳头很难进入时.
LCBDE消除了创建胃胃的需要,简化了管理.

关键词:

常见的胆道结石胆道结石胃切除术是一种胃切除术.胃外科手术胃外科手术腹腔镜检查常见胆道的探索在Roux-en-Y的胃旁路术中.

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