Furman R, Dean C, Frazier H, Furman L
Department of Surgery, Watauga Hospital, Boone, North Carolina 28607.
Am Surg. 1992 Jan;58(1):55-60.
Laparoscopic cholecystectomy has quickly become the treatment of choice by most surgeons for the treatment of gallstone disease. The authors reviewed their first 100 consecutive patients undergoing laparoscopic cholecystectomy at a rural hospital. Twenty-three patients had previous abdominal procedures. The open insufflation technique was used on all patients with previous abdominal operations, with the exception of those who had an appendectomy only. Operative cholangiography was performed routinely and successfully on all patients, with the exception of the first seven because of nonavailability of a cholangiocath. In 54 percent of the first two-thirds of these patients, the operation was completed in less than 1.5 hours. In contrast, 88 percent of the last one-third of the patients were operated on within the same time period. All but 9 of the 100 patients were discharged within 24 hours of their surgery. Laparoscopic cholecystectomy can be performed safely and routinely in the rural hospital setting with results similar to those expected in larger metropolitan centers.
腹腔镜胆囊切除术已迅速成为大多数外科医生治疗胆结石疾病的首选治疗方法。作者回顾了他们在一家乡村医院连续进行的首批100例腹腔镜胆囊切除术患者。23例患者曾接受过腹部手术。除仅接受过阑尾切除术的患者外，所有曾接受过腹部手术的患者均采用开放式气腹技术。除了前7例因没有胆管造影导管而未进行外，所有患者均常规且成功地进行了术中胆管造影。在这些患者前三分之二的病例中，54%的手术在不到1.5小时内完成。相比之下，在同一时间段内，最后三分之一的患者中有88%接受了手术。100例患者中除9例以外，其余均在术后24小时内出院。在乡村医院环境中可以安全、常规地进行腹腔镜胆囊切除术，其结果与在较大的大都市中心预期的结果相似。
