Chitre V V, Studley J G
James Paget Hospital NHS Trust, Gorleston, Great Yarmouth, UK.
Br J Surg. 1999 Feb;86(2):185-8. doi: 10.1046/j.1365-2168.1999.00989.x.
The operation of laparoscopic cholecystectomy began the modern era of laparoscopic surgery. Refinements in technique continue to appear. The techniques currently favoured by British surgeons have been reviewed.
A questionnaire-based survey was carried out among surgeons with a special interest in minimal access surgery. The data collected were entered into a database and analysed. Current literature relating to surgical technique was reviewed.
Many aspects were evaluated and the results have shown that there is no uniform approach. It is interesting that only 30.8 per cent of surgeons use the open (Hasson) technique for peritoneal access. In addition, the use of intraoperative cholangiography continues to vary, with 65.8 per cent using the technique in selected cases. Fascial repair is not undertaken by 12.2 per cent of surgeons.
Some trends are clearly discernible. There is a greater willingness than previously to perform intraoperative cholangiography, but the consensus seems to be against performing it in all cases. Similarly, British surgeons seem to be largely unimpressed by the dangers of the Veress needle; the Hasson technique has not been widely adopted. The need to prevent port-site herniation seems to be generally accepted, with most surgeons performing fascial repair.
腹腔镜胆囊切除术的开展开启了现代腹腔镜手术时代。技术改进不断涌现。对英国外科医生目前青睐的技术进行了回顾。
对特别关注微创外科手术的外科医生进行了基于问卷的调查。收集的数据录入数据库并进行分析。对与手术技术相关的当前文献进行了回顾。
对多个方面进行了评估，结果表明没有统一的方法。有趣的是，只有30.8%的外科医生使用开放（哈森）技术进行腹膜穿刺。此外，术中胆管造影的使用情况仍存在差异，65.8%的医生在特定病例中使用该技术。12.2%的外科医生不进行筋膜修复。
一些趋势清晰可见。与以往相比，现在更愿意进行术中胆管造影，但似乎并未达成在所有病例中都进行造影的共识。同样，英国外科医生似乎对韦雷氏针的危险性不太在意；哈森技术尚未得到广泛采用。预防穿刺孔疝的必要性似乎已被普遍接受，大多数外科医生会进行筋膜修复。
