Nagral Sanjay
Department of GI Surgery, Jaslok Hospital and Research Centre, G Deshmukh Marg, Mumbai, India.
J Minim Access Surg. 2005 Jun;1(2):53-8. doi: 10.4103/0972-9941.16527.
This review discusses anatomical facts that are of relevance to the performance of a safe cholecystectomy. Misinterpretation of normal anatomy and anatomical variations contribute to the occurrence of major postoperative complications like biliary injuries following a cholecystectomy, the incidence being higher with laparoscopic cholecystectomy. A look at the basic anatomy is therefore important for biliary and minimally invasive surgeons. This includes normal anatomy and variations of the biliary apparatus as well as the arterial supply to the gallbladder. Specific anatomical distortions due to the laparoscopic technique, their contribution in producing injury and a preventive strategy based on this understanding are discussed. Investigative modalities that may help in assessing anatomy are considered. Newer insights into the role of anatomic illusions as well as the role of a system-based approach to preventing injuries is also discussed.
本综述讨论了与安全实施胆囊切除术相关的解剖学事实。对正常解剖结构和解剖变异的误解会导致胆囊切除术后出现诸如胆管损伤等主要术后并发症，腹腔镜胆囊切除术后此类并发症的发生率更高。因此，对于胆道外科医生和微创外科医生而言，了解基本解剖结构很重要。这包括胆道系统的正常解剖结构和变异以及胆囊的动脉供应。文中还讨论了腹腔镜技术导致的特定解剖结构变形、其在造成损伤方面的作用以及基于这种认识的预防策略。同时考虑了有助于评估解剖结构的检查方法。此外，还讨论了对解剖学错觉作用的新见解以及基于系统方法预防损伤的作用。
