延迟 laparoscopic 胆囊切除术与光胆囊造影用于急性胆囊炎:这是安全的吗?
Tsuyoshi Igami1, Takuya Ishikawa2, Kentaro Yamao2
1Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Asian journal of endoscopic surgery
|June 4, 2025
概括
延迟腹腔镜胆囊切除术与光胆道血管学 (FC) 是急性胆囊炎 (AC) 的安全有效的程序. 在手术期间,FC显著降低了并发症,转化率和血液损失.
科学领域:
- 手术创新 在外科创新.
- 胃肠病学 胃肠病学
- 医疗成像医学成像
背景情况:
- 2018年东京指南建议在病情不佳的患者中推迟腹腔镜胆囊切除术 (DLC) 治疗急性胆囊炎 (AC).
- 对于状态良好的患者使用DLC是有争议的,指南缺乏关于光胆血管学 (FC) 的信息.
研究的目的:
- 评估光胆血管学 (FC) 在延迟腹腔镜胆囊切除术 (DLC) 期间的临床价值和安全性.
主要方法:
- 在AC康复后接受DLC的226名患者的回顾性审查.
- 与FC (n=144) 和没有FC (n=82) 进行DLC的患者之间的结局比较.
- 分析的重点是手术内和手术后的并发症,转化率,手术时间和血液损失.
主要成果:
- 带有FC的DLC显示了0%的手术内并发症,而没有FC的DLC则为7.3% (p=0.002).
- 转换为开放性手术是显著低于FC (1.4%对比15.9%).
- 平均血液损失和术后并发症显著减少与FC (p=0.041和p=0.002,分别).
结论:
- 光胆血管学 (FC) 提高了延迟腹腔镜胆囊切除术 (DLC) 的安全性.
- FC利用导致手术内/术后并发症减少,转化率降低,血液流失减少.
- 与FC的DLC是急性胆囊炎患者的安全和推的程序.
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