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鲁维埃沟的解剖结构及其与腹腔镜胆囊切除术并发症的关系

Anatomy of Rouviere's Sulcus and Its Association with Complication of Laparoscopic Cholecystectomy.

作者信息

Kumar Abhijeet, Shah Rupesh, Pandit Narendra, Sah Suresh Prasad, Gupta Rakesh Kumar

机构信息

MIS Division, Department of Surgery, BPKIHS, Dharan, Nepal.

Surgical Gastroenterology Division, Department of Surgery, BPKIHS, Dharan, Nepal.

出版信息

Minim Invasive Surg. 2020 Aug 24;2020:3956070. doi: 10.1155/2020/3956070. eCollection 2020.

Abstract

METHODS

This is a prospective observational study involving patients of age ≥16 years who underwent laparoscopic cholecystectomy for uncomplicated gall stone at BPKIHS between May and July 2019.

RESULT

230 cases were analyzed, and RS was present in 90.4%. Open sulcus type was the commonest (54%), followed by scar type (22.9%), closed sulcus type (12.5%), and slit type (10.6%), respectively. In 59.1% of cases, it was oblique to the anterior, inferior, and external edge of the liver, while in the remaining cases, it was transverse. The mean ± SD values for operative time and duration of hospital stay in the RS visible and the RS not visible groups were 29.16 ± 8.736 and 42.9 ± 23.646 minutes, and 1.26 ± 0.440 and 1.90 ± 0.910 days, respectively ( value ≤0.001). One complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 complications occurred in the RS not visible group. Only one complication occurred in the RS not visible group.

CONCLUSION

Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy.

摘要

方法

这是一项前瞻性观察性研究,纳入了2019年5月至7月期间在BPKIHS接受腹腔镜胆囊切除术治疗单纯性胆结石的年龄≥16岁的患者。

结果

分析了230例病例,其中90.4%存在肝床。开放沟型最为常见(54%),其次是瘢痕型(22.9%)、闭合沟型(12.5%)和裂隙型(10.6%)。在59.1%的病例中,肝床与肝脏前、下和外缘呈斜行,其余病例中则为横行。肝床可见组和肝床不可见组的手术时间和住院时间的均值±标准差分别为29.16±8.736分钟和42.9±23.646分钟,以及1.26±0.440天和1.90±0.910天(P值≤0.001)。每组各发生1例并发症:肝床最初可见组和粘连松解时肝床可见组各1例,而肝床不可见组发生3例并发症。肝床不可见组仅发生1例并发症。

结论

手术医生识别肝床是安全进行腹腔镜胆囊切除术的一个预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21fd/7463368/91c29e1c154a/MIS2020-3956070.001.jpg

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