Dr. Agarwal's Surgery & Yoga, F-81&82, Street 4, Virender Nagar, New Delhi - 110058, India.
Int J Surg. 2010;8(2):167-72. doi: 10.1016/j.ijsu.2009.11.015. Epub 2010 Jan 6.
Laparoscopic cholecystectomy (LC) a gold standard treatment of symptomatic gall stone disease has yet to become as safe as open cholecystectomy. The concerns of safety for both surgeon as well as patient are present even after the passage of "learning curve" phase. Emphasis on experience and technique have helped but for the morbidity associated with the use of energy sources. The purpose of this study was to evaluate the possibility of avoiding this morbidity by not using energy sources in LC.
Prospective case series, with a minimum follow up of 1 year. Consecutive, unselected patients of symptomatic gall stone disease operated by an experienced laparoscopic surgeon from July 2003-June 2005. Operative, early and late postoperative outcomes were evaluated.
LC was performed by dissecting in avascular Holy planes without using any energy source.
LC could be performed safely in all 135 patients. The technique was uniformly applicable irrespective of gender, age, time of presentation, grade of inflammation, adhesions or any comorbidity. There was no hemodynamic instability, conversion, injury manifesting early or late or any mortality.
The potential injury from use of energy sources in LC can be avoided as it can be safely performed without using any energy source.
腹腔镜胆囊切除术（LC）作为治疗有症状的胆囊结石病的金标准，其安全性尚未达到与开放胆囊切除术一样的水平。即使在“学习曲线”阶段之后，外科医生和患者对安全性的担忧仍然存在。对经验和技术的重视有所帮助，但与使用能源相关的发病率仍然存在。本研究旨在评估在 LC 中避免这种发病率的可能性，即不使用能源。
前瞻性病例系列研究，最少随访 1 年。对 2003 年 7 月至 2005 年 6 月期间由一位经验丰富的腹腔镜外科医生进行的有症状胆囊结石病的连续、非选择性患者进行了评估。评估了手术、早期和晚期术后结果。
LC 通过在无血管的 Holy 平面进行解剖而不使用任何能源来进行。
所有 135 例患者均能安全进行 LC。该技术适用于所有患者，不论性别、年龄、就诊时间、炎症程度、粘连或任何合并症。没有出现血流动力学不稳定、转换、早期或晚期表现出的损伤或任何死亡率。
LC 中使用能源可能造成的潜在损伤可以避免，因为它可以安全地进行，而无需使用任何能源。
