Lee Mi-Ri, Chun Hyun-Tae, Roh Young-Hoon, Kim Sung-Heun, Kim Young-Hoon, Cho Se-Heon, Choi Hong-Jo, Jung Ghap Joong
Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
Hepatogastroenterology. 2011 Mar-Apr;58(106):285-9.
BACKGROUND/AIMS: Laparoscopic cholecystectomy has become the gold standard modality for treating gallbladder disease. There are many techniques for the ligation of a dilated and inflamed cystic duct. The aim of this study is to assess the efficacy and applicability of an Endo-GIA for dilated cystic duct ligation.
From October 1992 to September 2009, 3413 patients underwent laparoscopic cholecystectomy for gallbladder disease at the Dong-A Medical Center, and 92 (2.7%) patients' cystic ducts were ligated by an Endo-GIA. We retrospectively analyzed these 92 cases.
The cystic ducts were successfully ligated with an Endo-GIA in 88 patients. Four patients required conversion to open surgery. The mean operation time was 111.9 minutes. The mean length of the hospital stay was 4.1 days. Postoperative complication occurred in 16 patients (17%). The follow-up period ranged from 0.5 to 75 months.
Endo-GIA is safe and feasible. Postoperative complication occurred in 16 patients after application of an Endo-GIA. However, those complications were successfully managed by conservative treatment. The rate of complications was comparable to the best results from most of the large series in the West. Therefore, using an Endo-GIA could be attempted in carefully selected patients with difficult cases of laparoscopic cholecystectomy.
背景/目的：腹腔镜胆囊切除术已成为治疗胆囊疾病的金标准术式。对于扩张且发炎的胆囊管结扎有多种技术。本研究的目的是评估内镜切割吻合器（Endo-GIA）用于扩张胆囊管结扎的有效性和适用性。
1992年10月至2009年9月，3413例患者在东亚医疗中心因胆囊疾病接受腹腔镜胆囊切除术，其中92例（2.7%）患者的胆囊管用Endo-GIA结扎。我们对这92例病例进行了回顾性分析。
88例患者的胆囊管用Endo-GIA成功结扎。4例患者需要转为开腹手术。平均手术时间为111.9分钟。平均住院时间为4.1天。16例患者（17%）发生术后并发症。随访时间为0.5至75个月。
Endo-GIA安全可行。应用Endo-GIA后16例患者发生术后并发症。然而，这些并发症通过保守治疗成功处理。并发症发生率与西方大多数大型系列研究的最佳结果相当。因此，对于精心挑选的腹腔镜胆囊切除术困难病例患者，可以尝试使用Endo-GIA。
