胆囊切除术的技术方面。

Technical aspects of cholecystectomy.

机构信息

Division of Gastrointestinal Surgery, University of Buenos Aires, Vicente Lopez 1831 PB, Buenos Aires 1128, Argentina.

Hepatobiliary and Pancreas Program, General Surgery, Mayo College of Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.

出版信息

Surg Clin North Am. 2014 Apr;94(2):427-54. doi: 10.1016/j.suc.2014.01.007.

DOI:10.1016/j.suc.2014.01.007

PMID:24679430

Abstract

The gold standard for the surgical treatment of symptomatic cholelithiasis is conventional laparoscopic cholecystectomy (LC). Although it has been associated with a slightly higher incidence of bile duct injury (BDI) in comparison with open cholecystectomy (OC), LC is considered a very safe operation. Prevention of BDI should be routinely performed in every LC. Recent trends include the performance of cholecystectomy through a single incision and NOTES (Natural Orifice Transluminal Endoscopic Surgery). However, lack of evidence of clinical advantages prevents their widespread adoption, and more data are needed to assess whether their use is warranted.

摘要

对于有症状的胆石症的手术治疗，金标准是传统的腹腔镜胆囊切除术（LC）。尽管与开腹胆囊切除术（OC）相比，LC 导致胆管损伤（BDI）的发生率略高，但 LC 仍被认为是一种非常安全的手术。LC 应常规预防 BDI。最近的趋势包括通过单切口和NOTES（经自然腔道内镜外科）进行胆囊切除术。然而，由于缺乏临床优势的证据，它们的广泛应用受到阻碍，需要更多的数据来评估其使用是否合理。