Hiratsuka Takahiro, Ohta Masayuki, Sonoda Kozo, Yamamura Shinji, Nishizaki Takashi, Matsusaka Toshimitsu, Kitano Seigo
Department of Surgery I, Oita University Faculty of Medicine, Oita, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1645-7.
BACKGROUND/AIMS: Laparoscopy-assisted distal gastrectomy (LADG) is now being performed increasingly in Japan, while laparoscopic cholecystectomy (LC) is still the standard procedure used elsewhere in the world. However, there has been no report on simultaneous operation of LADG and LC. This study aimed to evaluate the combined use of these 2 procedures.
LADG was performed in 55 patients with early gastric cancer between January 2000 and December 2002. Seven of 55 patients (12.7%) simultaneously underwent LC. These 7 patients all presented with gallbladder stones (asymptomatic in 5, and symptomatic in 2).
There was no conversion to conventional open surgery for all cases. Mean operation time and estimated blood loss were 359 +/- 61 min and 59 +/- 154mL, respectively. Time to walk independently was 1.5 +/- 0.6 days, time to first passage was 2.7 +/- 1.0 days, and postoperative hospital stay was 20.7 +/- 15.3 days. Only one of the 7 cases had minor complications of liver dysfunction and pancreatitis, which were treated conservatively.
The simultaneous operation of LADG and LC is feasible and safe in patients with early gastric cancer and cholelithiasis.
背景/目的：腹腔镜辅助远端胃切除术（LADG）目前在日本的开展越来越多，而腹腔镜胆囊切除术（LC）仍是世界其他地区使用的标准手术。然而，尚无关于LADG和LC同时手术的报道。本研究旨在评估这两种手术联合使用的情况。
2000年1月至2002年12月期间，对55例早期胃癌患者实施了LADG。55例患者中有7例（12.7%）同时接受了LC。这7例患者均患有胆囊结石（5例无症状，2例有症状）。
所有病例均未转为传统开放手术。平均手术时间和估计失血量分别为359±61分钟和59±154毫升。独立行走时间为1.5±0.6天，首次排便时间为2.7±1.0天，术后住院时间为20.7±15.3天。7例病例中仅1例出现肝功能障碍和胰腺炎等轻微并发症，经保守治疗。
对于早期胃癌合并胆石症患者，LADG和LC同时手术是可行且安全的。
