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内镜逆行胰胆管造影术对腹腔镜胆囊切除术有负面影响吗?

Does endoscopic retrograde cholangiopancreatography have a negative effect on laparoscopic cholecystectomy?

作者信息

Çakır Murat, Küçükkartallar Tevfik, Tekin Ahmet, Yıldırım Mehmet Aykut, Kartal Adil

机构信息

Department of General Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey.

出版信息

Ulus Cerrahi Derg. 2015 Apr 9;31(3):128-31. doi: 10.5152/UCD.2015.2809. eCollection 2015.

Abstract

OBJECTIVE

We have observed that patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP) had some difficulties with laparoscopic cholecystectomy procedures. Through a retrospective study, we planned to compare the surgical procedures between patients who had undergone ERCP and those who had not in order to clarify this.

MATERIAL AND METHODS

The results of 122 patients who had undergone ERCP because of choledocholithiasis before undergoing laparoscopic cholecystectomy procedures between 2008 and 2011 were compared to the values of 2140 patients operated because of cholelithiasis only within the same period.

RESULTS

Among the patients who underwent surgical procedures following ERCP, 80 (65%) were female and 42 (35%) were male. The average age of the patients was 51.9 years (range: 20-83 years). The operation period after the procedure was 30.14 days (range: 1-93 days). Although the hospitalization period was 4.67 days (range: 1-22 days), the postoperative hospitalization period was 2.68 days (range: 1-15 days). Regarding the difficulty of operation, adhesion in 58 (47.5%) patients, bleeding in two (1.6%) patients, and conversion to open procedure in 12 (9.8) patients were observed. In two (1.6%) patients, bleeding and biliary fistula were the reasons for re-operation.

CONCLUSION

Laparoscopic cholecystectomy is more complicated in patients who underwent ERCP.

摘要

目的

我们观察到接受过内镜逆行胰胆管造影术(ERCP)的患者在腹腔镜胆囊切除术过程中存在一些困难。通过一项回顾性研究,我们计划比较接受过ERCP的患者与未接受过ERCP的患者之间的手术过程,以阐明这一问题。

材料与方法

将2008年至2011年间因胆总管结石接受ERCP后再进行腹腔镜胆囊切除术的122例患者的结果,与同期仅因胆结石接受手术的2140例患者的值进行比较。

结果

在接受ERCP后进行手术的患者中,80例(65%)为女性,42例(35%)为男性。患者的平均年龄为51.9岁(范围:20 - 83岁)。术后手术期为30.14天(范围:1 - 93天)。虽然住院期为4.67天(范围:1 - 22天),但术后住院期为2.68天(范围:1 - 15天)。关于手术难度,观察到58例(47.5%)患者有粘连,2例(1.6%)患者出血,12例(9.8%)患者转为开放手术。2例(1.6%)患者因出血和胆瘘而再次手术。

结论

接受过ERCP的患者进行腹腔镜胆囊切除术更为复杂。

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