Surgery, Tri-Service General Hospital.
Research Assistant Center, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation).
Rev Esp Enferm Dig. 2023 Aug;115(8):462-464. doi: 10.17235/reed.2022.9318/2022.
Gallbladder disease is very common in obese patients. Concomitant cholecystectomy with laparoscopic sleeve gastrectomy (CC-LSG) may be necessary in such cases, and it has been proven safe when indicated. Herein, we presented an experience of our practical four-port-sharing technique for CC-LSG that can substitute the conventional trocar placement. A cohort study was conducted between January 2017 and March 2022 using a prospective database. Out of 238 patients with obesity who underwent bariatric surgery, 45 patients with gallbladder disease received CC-LSG using our four-port-sharing technique. The patients' demographic characteristics, intraoperative outcomes, and postoperative outcomes were examined. Of 45 obese patients with gallbladder disease undergoing CC-LSG, 18 patients with symptomatic cholelithiasis, 25 patients with asymptomatic cholelithiasis, and 2 patients with gallbladder polyps were identified. The mean age of these 45 patients (26 men and 19 women) was 38.3 years, and the mean body mass index was 41.8 kg/m2. There was no case of conversion to laparotomy. The mean operative time of LC and following LSG, the volume of blood loss, and hospital stay were 52.7 minutes and 95.2 minutes, 13.3 mL, and 3.8 days, respectively. No postoperative complications, including hemorrhage, bile leakage, staple leakage, pulmonary embolism, incisional hernia, and wound infection were noted. In CC-LSG, the application of our four-port-sharing technique is safe and feasible for obese patients with gallbladder diseases.
胆囊疾病在肥胖患者中非常常见。在这种情况下，可能需要同时进行腹腔镜袖状胃切除术 (LSG)，并且在有指征的情况下已被证明是安全的。在此，我们介绍了一种实用的四孔共享技术用于 CC-LSG 的经验，该技术可替代传统的套管放置。一项队列研究于 2017 年 1 月至 2022 年 3 月期间使用前瞻性数据库进行。在接受减重手术的 238 例肥胖患者中，45 例患有胆囊疾病的患者接受了我们的四孔共享技术进行 CC-LSG。检查了患者的人口统计学特征、术中结果和术后结果。在 45 例患有胆囊疾病接受 CC-LSG 的肥胖患者中，有 18 例有症状性胆石症、25 例无症状性胆石症和 2 例胆囊息肉。这些 45 例患者（26 名男性和 19 名女性）的平均年龄为 38.3 岁，平均体重指数为 41.8kg/m2。没有中转开腹的病例。LC 和随后的 LSG 的平均手术时间、出血量和住院时间分别为 52.7 分钟和 95.2 分钟、13.3 毫升和 3.8 天。没有术后并发症，包括出血、胆漏、吻合钉渗漏、肺栓塞、切口疝和伤口感染。在 CC-LSG 中，我们的四孔共享技术的应用对于患有胆囊疾病的肥胖患者是安全可行的。
