腹腔镜胆囊切除术后医源性胆总管损伤的机器人辅助修复：手术技术与结果
Robotic-assisted repair of iatrogenic common bile duct injury after laparoscopic cholecystectomy: Surgical technique and outcomes.
作者信息
Marino Marco Vito, Mirabella Antonello, Guarrasi Domenico, Lupo Massimo, Komorowski Andrzej Lech
机构信息
Emergency and General Surgery Department, Azienda Ospedaliera, Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
General Surgery Department, Hospital Universitario Marques de Valdecilla, Santander, Spain.
出版信息
Int J Med Robot. 2019 Jun;15(3):e1992. doi: 10.1002/rcs.1992. Epub 2019 Mar 10.
BACKGROUND
Bile duct injury after cholecystectomy can be a life-threatening complication. Use of robotic approach to manage a complex biliary injury is in an early phase.
METHODS
We have performed an analysis of our prospectively maintained database that included 12 patients who underwent robotic-assisted repair of bile duct injury after laparoscopic cholecystectomy between 2014 and 2017.
RESULTS
All patients underwent robotic biliary repair within 2 weeks after primary injury. No conversion to open surgery was necessary, the estimated mean blood loss was 252 mL, and the mean operative time was 260 minutes. The mean length of stay was 9.4 days. The 30-day complication events were a subhepatic abscess and a recurrent episode of cholangitis. One patient underwent the reoperation. The mortality was null.
CONCLUSION
Robotic-assisted bile duct injury repair seems to be safe and feasible. It offers promising results, thus potentially capable of modifying the management of biliary injury.
背景
胆囊切除术后胆管损伤可能是一种危及生命的并发症。使用机器人手术方法处理复杂胆管损伤尚处于早期阶段。
方法
我们对前瞻性维护的数据库进行了分析，该数据库纳入了2014年至2017年间12例在腹腔镜胆囊切除术后接受机器人辅助胆管损伤修复的患者。
结果
所有患者均在初次损伤后2周内接受了机器人胆管修复术。无需转为开放手术，估计平均失血量为252毫升，平均手术时间为260分钟。平均住院时间为9.4天。30天并发症事件为肝下脓肿和胆管炎复发。1例患者接受了再次手术。死亡率为零。
结论
机器人辅助胆管损伤修复似乎是安全可行的。它提供了有前景的结果，因此有可能改变胆管损伤的处理方式。
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