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[腹腔镜下Nissen-Rossetti胃底折叠术联合胆囊切除术:我们的经验]

[Laparoscopic combined Nissen-Rossetti fundoplication and cholecystectomy: our experience].

作者信息

Tosato F, Paltrinieri G, Monsellato I, Leonardo G, Martire I, Palombi L

机构信息

Università degli Studi di Roma "La Sapienza", Policlinico Umberto I, Dipartimento di Chirurgia Generale e Day Surgery "F. Durante".

出版信息

G Chir. 2008 Mar;29(3):102-5.

Abstract

OBJECT

The aim of this study is to valuate the opportunity to associate both laparoscopic Nissen-Rossetti fundoplication and cholecystectomy in patients with gallbladder cholelithiasis and gastro-oesophageal acid reflux (endoscopically and pHmetrically assessed), considerating that the gallbladder removal makes duodenal-gastric reflux worse.

PATIENTS AND METHODS

From 2005 until 2007 we associated laparoscopic Nissen-Rossetti fundoplication and cholecystectomy in 10 patiens, who presented surgical indications for gallbladder cholelithiasis and gastro-oesophageal reflux. Clinical data, surgical procedures and post-operative complications were compared to our esperiency on the singular procedure (laparoscopic Nissen-Rossetti fundoplication and cholecystectomy). Results were valuated at 3, 6 and 12 months after surgical interventions by clinical and instrumental follow up (24-pH-metry and oesophagus-gastro-duodenoscopy).

RESULTS

The analysis of instrumental data of these associated procedures doesn't present significative differences between the singular surgical approach. In all the patients treated by combined procedure, the follow-up shows a normal pHmetric exam, a good control on the acid reflux by fundosplication, absence of distal oesophagitis and gastric reflux symptoms.

CONCLUSIONS

The association of laparoscopic Nissen-Rossetti fundoplication and laparoscopic cholecystectomy is indicated in patients who present both pathologies and needs to be considerating in relations to the good results and the low postoperatoric morbidity.

摘要

目的

本研究的目的是评估在患有胆囊结石和胃食管酸反流(经内镜和pH值测定评估)的患者中联合进行腹腔镜Nissen-Rossetti胃底折叠术和胆囊切除术的机会,同时考虑到切除胆囊会使十二指肠-胃反流恶化。

患者和方法

从2005年到2007年,我们对10例患者联合进行了腹腔镜Nissen-Rossetti胃底折叠术和胆囊切除术,这些患者有胆囊结石和胃食管反流的手术指征。将临床数据、手术过程和术后并发症与我们在单一手术(腹腔镜Nissen-Rossetti胃底折叠术和胆囊切除术)中的经验进行比较。在手术干预后的3、6和12个月,通过临床和器械随访(24小时pH值测定和食管-胃-十二指肠镜检查)对结果进行评估。

结果

对这些联合手术的器械数据分析显示,单一手术方法之间没有显著差异。在所有接受联合手术治疗的患者中,随访显示pH值测定检查正常,胃底折叠术对酸反流控制良好,无远端食管炎和胃反流症状。

结论

对于同时患有这两种疾病的患者,腹腔镜Nissen-Rossetti胃底折叠术和腹腔镜胆囊切除术联合应用是可行的,鉴于其良好的效果和较低的术后发病率,应予以考虑。

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