腹腔镜胆道探索的安全性和结果:一项英国范围的多中心研究 (R-ALiCE)
Somaiah Aroori1, Tanase Andrei2, Ahmad Nassar3
1Consultant HPB and Transplant Surgeon, University Hospitals Plymouth NHS Trust, Peninsula Medical School, University of Plymouth England, Plymouth, England, UK. s.aroori@nhs.net.
Surgical endoscopy
|January 13, 2026
概括
腹腔镜常见胆道探索 (LCBDE) 是一种安全有效的胆道结石 (BDS) 治疗方法. 通过囊的方法显示了较低的胆汁泄漏率比通过管道的方法,与整体低严重的并发症.
科学领域:
- 胃肠病学 胃肠病学
- 肝胆道手术 肝胆道手术
- 最少侵入性的手术
背景情况:
- 在患有胆结石的患者中,胆道结石 (BDS) 的最佳管理尚未确定.
- 腹腔镜检查常见胆道和胆囊切除术 (LCBDE) 是一种潜在的治疗选择.
研究的目的:
- 评估LCBDE对BDS的结果和安全性.
- 为了比较不同LCBDE方法的疗效和并发症率.
主要方法:
- 一个追溯的多中心审计 (R-ALiCE) 的1689名成年患者接受LCBDE为BDS在18个英国中心.
- 2015年1月至2019年12月期间收集的数据,不包括非石头疾病或并发操作.
主要成果:
- LCBDE显示了5%的开放转化率和较低的整体发病率 (18.7%).
- 跨胆固醇LCBDE (TD-LCBDE) 的成功率更高 (93.4%),但胆汁泄漏率明显更高 (8.8%),而不是跨囊LCBDE (TC-LCBDE) (77.6%的成功率,1.5%的胆汁泄漏).
- 术后胰腺炎和保留结石的发病率较低 (分别为0.9%和4.4%),90天没有胆道狭窄.
结论:
- LCBDE是一种安全有效的BDS管理方法,具有较低的严重并发症率.
- 对于LCBDE,通过囊的方法与通过导管的方法相比,与胆汁泄漏的风险降低有关.
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