Ome Yusuke, Hashida Kazuki, Yokota Mitsuru, Nagahisa Yoshio, Okabe Michio, Kawamoto Kazuyuki
Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Michio Okabe, Kazuyuki Kawamoto, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
World J Gastroenterol. 2017 Apr 14;23(14):2556-2565. doi: 10.3748/wjg.v23.i14.2556.
To evaluate a laparoscopic approach to gallbladder lesions including polyps, wall-thickening lesions, and suspected T1 and T2 gallbladder cancer (GBC).
We performed 50 cases of laparoscopic whole-layer cholecystectomy (LCWL) and 13 cases of laparoscopic gallbladder bed resection (LCGB) for those gallbladder lesions from April 2010 to November 2016. We analyzed the short-term and long-term results of our laparoscopic approach.
The median operation time was 108 min for LCWL and 211 min for LCGB. The median blood loss was minimal for LCWL and 28 ml for LCGB. No severe morbidity occurred in either procedure. Nine patients who underwent LCWL and 7 who underwent LCGB were postoperatively diagnosed with GBC. One of these patients had undergone LCGB for pathologically diagnosed T2 GBC after LCWL. All of the final surgical margins were negative. Three of these 15 patients underwent additional open surgery. The mean follow-up period was 26 mo, and only one patient developed recurrence.
LCWL and LCGB are safe and useful procedures that allow complete resection of highly suspected or early-stage cancer and achieve good short-term and long-term results.
评估腹腔镜治疗胆囊病变的方法，包括息肉、胆囊壁增厚病变以及疑似T1和T2期胆囊癌（GBC）。
2010年4月至2016年11月，我们对这些胆囊病变患者实施了50例腹腔镜全层胆囊切除术（LCWL）和13例腹腔镜胆囊床切除术（LCGB）。我们分析了腹腔镜手术方法的短期和长期结果。
LCWL的中位手术时间为108分钟，LCGB为211分钟。LCWL的中位失血量极少，LCGB为28毫升。两种手术均未发生严重并发症。9例行LCWL和7例行LCGB的患者术后被诊断为GBC。其中1例患者在LCWL后因病理诊断为T2期GBC而接受了LCGB。所有最终手术切缘均为阴性。这15例患者中有3例接受了额外的开放手术。平均随访期为26个月，只有1例患者复发。
LCWL和LCGB是安全有效的手术方法，能够完整切除高度怀疑或早期癌症，并取得良好的短期和长期效果。
