Yano Hiroshi, Okada Kazuyuki, Kinuta Masakatsu, Nakano Yoshiaki, Tono Takeshi, Matsui Shigeo, Iwazawa Takashi, Kanoh Toshiyuki, Monden Takushi
Department of Surgery, NTT West Osaka Hospital, 2-6-40 Karasugatsuji, Tennoji-ku, Osaka 543-8922, Japan.
Surg Today. 2003;33(1):18-23. doi: 10.1007/s005950300003.
This study was conducted to examine the usefulness and safety of absorbable clips in laparoscopic cholecystectomy (LC).
We retrospectively compared the clinical data of 328 patients who underwent LC using absorbable clips for cystic duct ligation and 444 patients who underwent LC using metal clips for cystic duct ligation.
The mean operative time in the absorbable clip group was significantly shorter than that in the metal clip group. The mean intraoperative blood loss and hospital stay were not significantly different between the two groups. The rate of conversion to open laparotomy in the absorbable clip group was significantly higher than that in the metal clip group, at 6.7% vs 2.3%, respectively. The most common reason for conversion was difficult adhesions and inflammation around the gallbladder. The morbidity of the metal clip group was significantly higher than that of the absorbable clip group, at 8.4% vs 4.0%, respectively. The incidence of major postoperative complications requiring laparotomy did not differ between the two groups. There were no deaths in the absorbable clip group, but 1 of the 444 patients (0.23%) in the metal clip group died from disseminated intravascular coagulation on postoperative day 3.
The results of this study suggest that absorbable clips are as safe and effective as standard metal clips for vessel and duct ligation in LC.
本研究旨在探讨可吸收夹在腹腔镜胆囊切除术（LC）中的有效性和安全性。
我们回顾性比较了328例行LC并使用可吸收夹结扎胆囊管的患者与444例行LC并使用金属夹结扎胆囊管的患者的临床资料。
可吸收夹组的平均手术时间显著短于金属夹组。两组的平均术中出血量和住院时间无显著差异。可吸收夹组中转开腹手术的比例显著高于金属夹组，分别为6.7%和2.3%。中转的最常见原因是胆囊周围粘连和炎症。金属夹组的发病率显著高于可吸收夹组，分别为8.4%和4.0%。两组术后需要开腹手术的主要并发症发生率无差异。可吸收夹组无死亡病例，但金属夹组的444例患者中有1例（0.23%）在术后第3天死于弥散性血管内凝血。
本研究结果表明，在LC中，可吸收夹在血管和胆管结扎方面与标准金属夹一样安全有效。
