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在腹腔镜胆囊切除术中结扎胆囊管。

Ligating the cystic duct in laparoscopic cholecystectomy.

作者信息

Saha S K

机构信息

Department Of Surgery, West Wales Hospital, Carmarthen, Dyfed, United Kingdom.

出版信息

Am J Surg. 2000 Jun;179(6):494-6. doi: 10.1016/s0002-9610(00)00391-3.

DOI:10.1016/s0002-9610(00)00391-3
PMID:11004339
Abstract

BACKGROUND

In laparoscopic cholecystectomy, bile leak from the cystic duct stump is a recognised postoperative complication. This could be due to dislodgement of the metal clips. Migration of the clip is an added problem.

METHODS

Since 1995, 70 patients were included in the study of intracorporeal cystic duct ligation in laparoscopic cholecystectomy. Construction of a ligature is a single handed procedure using a free end of the thread. It is quite different from the other two methods described in the literature.

RESULTS

There was not a single case of postoperative morbidity in these patients, but in a retrospective study, postoperative biliary dyspepsia with fatty food was evident in a few patients among those cases in which the liga-clips were applied to the cystic duct.

CONCLUSION

The cystic duct ligation with absorbable thread should be a gold standard in laparoscopic cholecystectomy. It reduces the risk of postoperative morbidity.

摘要

背景

在腹腔镜胆囊切除术中,胆囊管残端胆汁漏是一种公认的术后并发症。这可能是由于金属夹移位所致。夹子的迁移是一个额外的问题。

方法

自1995年以来,70例患者纳入了腹腔镜胆囊切除术中体内胆囊管结扎的研究。结扎线的构建是使用线的自由端的单手操作。它与文献中描述的其他两种方法有很大不同。

结果

这些患者中没有一例术后发病,但在一项回顾性研究中,在那些将结扎夹应用于胆囊管的病例中,少数患者术后出现了进食油腻食物后的胆汁消化不良。

结论

可吸收线胆囊管结扎术应成为腹腔镜胆囊切除术的金标准。它降低了术后发病的风险。

相似文献

1
Ligating the cystic duct in laparoscopic cholecystectomy.在腹腔镜胆囊切除术中结扎胆囊管。
Am J Surg. 2000 Jun;179(6):494-6. doi: 10.1016/s0002-9610(00)00391-3.
2
Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature.不结扎胆囊管和胆囊动脉的超声刀腹腔镜胆囊切除术
Surg Endosc. 2003 Mar;17(3):442-51. doi: 10.1007/s00464-002-9068-3. Epub 2002 Oct 29.
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Absorbable clips for cystic duct ligation in laparoscopic cholecystectomy.腹腔镜胆囊切除术中用于胆囊管结扎的可吸收夹
Surg Endosc. 1996 Jan;10(1):49-51. doi: 10.1007/s004649910012.
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An experience with 1000 consecutive cystic duct ligation in laparoscopic cholecystectomy.腹腔镜胆囊切除术中连续1000例胆囊管结扎的经验。
Surg Laparosc Endosc Percutan Tech. 2008 Apr;18(2):155-6. doi: 10.1097/SLE.0b013e3181685834.
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[Value of absorbable clips in laparoscopic cholecystectomy. A randomized prospective study].[可吸收夹在腹腔镜胆囊切除术中的价值。一项随机前瞻性研究]
J Chir (Paris). 1997 Sep;134(4):180-4.
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Efficacy of electrocoagulation in sealing the cystic artery and cystic duct occluded with only one absorbable clip during laparoscopic cholecystectomy.在腹腔镜胆囊切除术中,电凝法封闭仅用一个可吸收夹夹闭的胆囊动脉和胆囊管的疗效。
J Laparoendosc Adv Surg Tech A. 2014 Feb;24(2):72-6. doi: 10.1089/lap.2013.0193. Epub 2013 Nov 1.
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Absence of cystic duct leakage using locking clips in 1017 cases of laparoscopic cholecystectomy.在1017例腹腔镜胆囊切除术中使用锁定夹未出现胆囊管渗漏情况。
Am Surg. 2012 Nov;78(11):1228-31.
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Bile leakage and the number of metal clips on the cystic duct during laparoscopic cholecystectomy.腹腔镜胆囊切除术中胆漏和胆囊管金属夹的数量。
Scand J Surg. 2022 Apr-Jun;111(2):14574969221102284. doi: 10.1177/14574969221102284.
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Laparascopic cholecystectomy: cystic duct occlusion with titanium clips or ligature? A prospective randomized study.腹腔镜胆囊切除术:使用钛夹或结扎线闭塞胆囊管?一项前瞻性随机研究。
Trop Gastroenterol. 2004 Oct-Dec;25(4):180-3.
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New aspects in laparoscopic cholecystectomy.腹腔镜胆囊切除术的新进展
J Laparoendosc Adv Surg Tech A. 2007 Jun;17(3):290-5. doi: 10.1089/lap.2006.0090.

引用本文的文献

1
Clip as Nidus for Choledocholithiasis after Cholecystectomy-Literature Review.胆囊切除术后夹子作为胆总管结石核心的文献综述
JSLS. 2020 Jan-Mar;24(1). doi: 10.4293/JSLS.2019.00053.
2
Bile leakage after loop closure clip closure of the cystic duct during laparoscopic cholecystectomy: A retrospective analysis of a prospective cohort.腹腔镜胆囊切除术中胆囊管套扎夹闭术后胆漏:一项前瞻性队列的回顾性分析
World J Gastrointest Surg. 2020 Jan 27;12(1):9-16. doi: 10.4240/wjgs.v12.i1.9.
3
Use of stapling devices for safe cholecystectomy in acute cholecystitis.
在急性胆囊炎中使用吻合器进行安全的胆囊切除术。
Int Surg. 2014 Sep-Oct;99(5):571-6. doi: 10.9738/INTSURG-D-14-00035.1.
4
A single-institution review of the absorbable clips used in laparoscopic colorectal and gallbladder surgery: feasibility, safety, and effectiveness.单中心研究:腹腔镜结直肠和胆囊手术中使用的可吸收夹的可行性、安全性和有效性。
Updates Surg. 2011 Jun;63(2):103-7. doi: 10.1007/s13304-011-0059-6. Epub 2011 Mar 11.
5
Safety of cystic duct clipping in healthy and cirrhotic livers: a cadaveric study.健康肝脏与肝硬化肝脏中胆囊管夹闭的安全性:一项尸体研究
JSLS. 2004 Apr-Jun;8(2):155-7.