Li Ming, Wu Haorong, Wei Shaohua
Department of General Surgery, The Second Affiliated Hospital of Soochow University, San Xiang Road 1055, Suzhou, China.
J Coll Physicians Surg Pak. 2016 Feb;26(2):91-5.
To evaluate the feasibility and safety of a new style of Laparoscope and Endoscope Cooperative gallbladderpreserving Surgery (LECS), an improved method of minimally invasive gallbladder-preserving polypectomy.
An experimental study.
Department of General Surgery, The Second Affiliated Hospital of Soochow University, China, from January 2009 to July 2013.
Clinical data of patients subjected to LECS and Laparoscopic Cholecystectomy (LC) was analysed. The inclusion criteria were normal size clear gallbladder bile with total volume (FV) of the gallbladder = 15 - 25 ml, the Residual Volume (RV) = 5 ml, and the Emptying Figure (EF) > 75%, with polyps diagnosed definitively by B-type ultrasonic imaging or CTdesirous of preserving gallbladder. Exclusion criteria were a history of midsection surgery, serious diseases of any organ, hepatic injury, or coagulation disturbance. Mean hospital stay and complications were also noted. Independent sample t-test, the frequency comparison used chi-square test (N > 5), and Fisher's exact test (N < 5) were used for statistical test.
The mean hospital stay after LECS was 3.50 ±0.31 days, and 3.50 ±0.31 days for the LC group. The mean age in LC and LECS group was 50 ±25.4 and 44 ±12.1 years, respectively. Complications after operation in the LECS were indigestion and diarrhea; LC group had indigestion (9.33%), diarrhea (10.67%), and gastroesophageal reflux (6.6.7%). In the 3 months follow-up after discharging from the hospital, no patient had recurrence of any gallbladder disease; at 1 year follow-up, 1 patient (1.28%) developed cholesterol crystals; at 3-year follow-up, 3 cases (3.84%) were found to have recurring polyps (2~4 pieces), and 2 (2.56%) patients developed cholesterol crystals.
Minimally invasive gallbladder-preserving polypectomy which used a CHIAO cholecystoscopy compared with a laparoscope is safe, feasible, and can effectively reduce the vestiges and recrudescence of polyps in gallbladderpreserving surgery.
评估一种新型腹腔镜与内镜协作保胆手术（LECS）的可行性和安全性，这是一种改良的微创保胆息肉切除术方法。
一项实验研究。
2009年1月至2013年7月在中国苏州大学附属第二医院普通外科。
分析接受LECS和腹腔镜胆囊切除术（LC）患者的临床资料。纳入标准为胆囊大小正常、胆汁清澈、胆囊总体积（FV）=15 - 25毫升、残余体积（RV）=5毫升、排空率（EF）>75%，经B型超声成像或CT确诊有息肉且希望保留胆囊。排除标准为有上腹部手术史、任何器官的严重疾病、肝损伤或凝血障碍。记录平均住院时间和并发症情况。采用独立样本t检验，频率比较采用卡方检验（N>5）和Fisher精确检验（N<5）进行统计学检验。
LECS术后平均住院时间为3.50±0.31天，LC组为3.50±0.31天。LC组和LECS组的平均年龄分别为50±25.4岁和44±12.1岁。LECS术后并发症为消化不良和腹泻；LC组有消化不良（9.33%）、腹泻（10.67%）和胃食管反流（6.67%）。出院后3个月随访，无患者出现任何胆囊疾病复发；1年随访时，1例患者（1.28%）出现胆固醇结晶；3年随访时，3例患者（3.84%）发现息肉复发（2～4枚），2例患者（2.56%）出现胆固醇结晶。
与腹腔镜相比，采用乔氏胆囊镜的微创保胆息肉切除术安全、可行，能有效减少保胆手术中息肉的残留和复发。
