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丢失结石——腹腔镜探查胆囊切除术后脓肿腔及找回丢失的胆结石:病例系列及文献综述

The lost stone - Laparoscopic exploration of abscess cavity and retrieval of lost gallstone post cholecystectomy: A case series and review of the literature.

作者信息

Kaplan Uri, Shpoliansky Gregory, Abu Hatoum Ossama, Kimmel Boaz, Kopelman Doron

机构信息

Department of General Surgery B, Emek Medical Center, Afula, Israel.

Department of General Surgery B, Emek Medical Center, Afula, Israel.

出版信息

Int J Surg Case Rep. 2018;53:43-45. doi: 10.1016/j.ijscr.2018.10.020. Epub 2018 Oct 19.

Abstract

BACKGROUND

Laparoscopic cholecystectomy (LC) is considered the gold standard operation for symptomatic gallstones. Gallbladder perforation occurs in 6-40% of operations. It can lead to spillage of gallstones into the abdominal cavity with possible consequences of long-term complications. We report two cases where a unique use of laparoscopic technique was used to explore abscess cavity and retrieve lost gallstones without penetrating the peritoneal cavity.

CASE PRESENTATION

We report two cases of peri-hepatic abscess treated with laparoscopic cavity exploration, using 5 mm and 10 mm ports, to retrieve lost gallstones. It was done without entering the peritoneal cavity.

DISCUSSION

Today, minimally invasive technique is used in a variety of surgical cases. We report a novel technique, using laparoscopic skills, to drain abscesses caused by lost gallstones post LC without entering the peritoneal cavity. The use of minimally invasive surgery techniques in order to explore abscess cavities not only help us to extract the cause of the abscess but also prevents another surgery in the abdominal cavity.

CONCLUSION

Laparoscopic exploration of an abscess cavity is a feasible and safe technique treating long-term complications of gallbladder perforation post LC.

摘要

背景

腹腔镜胆囊切除术(LC)被认为是有症状胆结石的金标准手术。胆囊穿孔在6%至40%的手术中发生。它可导致胆结石溢入腹腔,可能引发长期并发症。我们报告两例独特运用腹腔镜技术探查脓肿腔并取出丢失胆结石而未穿透腹膜腔的病例。

病例介绍

我们报告两例肝周脓肿病例,采用腹腔镜腔镜探查,通过5毫米和10毫米的端口取出丢失的胆结石。手术未进入腹膜腔。

讨论

如今,微创技术应用于多种外科病例。我们报告一种新技术,运用腹腔镜技术引流LC术后因胆结石丢失所致的脓肿且不进入腹膜腔。使用微创手术技术探查脓肿腔不仅有助于我们找出脓肿病因,还能避免在腹腔进行另一次手术。

结论

腹腔镜探查脓肿腔是治疗LC术后胆囊穿孔长期并发症的一种可行且安全的技术。

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