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同时进行经腹腹膜前腹股沟疝修补术(TAPP)和胆囊切除术——一种可行且安全的手术。

Simultaneous TAPP (transabdominal pre-peritoneal technique) for inguinal hernia and cholecystectomy - a feasible and safe procedure.

作者信息

Lehmann Andrzej, Piątkowski Jacek, Nowak Mariusz, Jackowski Marek, Pawlak Maciej, Witzling Mieczysław, Smietański Maciej

出版信息

Pol Przegl Chir. 2014 Feb;86(2):73-6. doi: 10.2478/pjs-2014-0013.

Abstract

UNLABELLED

Inguinal hernia repair and cholecystectomy are amongst the most common surgical procedures performed worldwide. In the recent decades, early disease detection has notably increased due to easily accessible ultrasound. The aim of the study was to assess the safety and the possibility of performing a simultaneous hernia repair and cholecystectomy using the laparoscopic approach.

MATERIAL AND METHODS

Eight patients (M=100%) with inguinal hernia (3 with bilateral hernia) and cholelithiasis were included in the study. The presence of gallstones was confirmed by imaging. Mean age of the patients was 61.75 years (ranging from 47-72). Simultaneous laparoscopic cholecystectomy and transabdominal pre-peritoneal hernia repair was performed in all patients. Postoperative complications were analyzed to assess the safety and feasibility of the procedure.

RESULTS

Mean operating time was 55 minutes (ranging from 30-60) and average length of stay was 3.625 days (ranging from 2-7). In order to perform a cholecystectomy, 1-2 additional trocars were used. No intra-operative complications were observed. At a follow-up visit on postoperative day 7, a small hematoma (10 ml of blood was punctured) in the right groin was noted in one patient. Another patient developed fever postoperatively, treated conservatively with antibiotics.

CONCLUSIONS

Simultaneous TAPP and cholecystectomy proved to be a safe and feasible procedure. Acceptable operating time and hospital stay, as well as lack of influence on the length of convalescence, may present an interesting alternative to two separate procedures.

摘要

未标注

腹股沟疝修补术和胆囊切除术是全球范围内最常见的外科手术之一。近几十年来,由于超声检查易于获得,早期疾病检测显著增加。本研究的目的是评估使用腹腔镜方法同时进行疝修补术和胆囊切除术的安全性和可能性。

材料与方法

本研究纳入了8例腹股沟疝(3例双侧疝)合并胆石症的患者(男性占100%)。通过影像学检查确认存在胆结石。患者的平均年龄为61.75岁(范围为47 - 72岁)。所有患者均同时进行了腹腔镜胆囊切除术和经腹腹膜前疝修补术。分析术后并发症以评估该手术的安全性和可行性。

结果

平均手术时间为55分钟(范围为30 - 60分钟),平均住院时间为3.625天(范围为2 - 7天)。为了进行胆囊切除术,额外使用了1 - 2个套管针。未观察到术中并发症。在术后第7天的随访中,1例患者右腹股沟出现小血肿(抽出10毫升血液)。另1例患者术后发热,采用抗生素保守治疗。

结论

同时进行经腹腹膜前疝修补术和胆囊切除术被证明是一种安全可行的手术。可接受的手术时间和住院时间,以及对康复时间无影响,可能是两种单独手术的一个有趣替代方案。

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