Shimoda Mitsugi, Kuboyama Yu, Suzuki Shuji
Tokyo Medical University, Ibaraki Medical Center, Department of Gastroenterological Surgery, Japan.
Heliyon. 2023 Sep 21;9(9):e20043. doi: 10.1016/j.heliyon.2023.e20043. eCollection 2023 Sep.
Recently, number of laparoscopic subtotal cholecystectomy (LSC) has been increasing.
LSC is suitable as a treatment as it can avoid intraoperative bile duct injury and bleeding for difficult laparoscopic cholecystectomy. On the other hand, improper handling of remnant of GB can lead to postoperative bile leakage.
Here, we report our positive experience utilizing new technique of continuous suture closure and omental covering using Lapra Ty® suture clips on the remnant of GB.
From January 2016 to July 2021, we experienced 30 cases of LSC for LC patients who had difficulty securing critical view of safety (CVS). In six of the 30 cases, we repaired remnant of GB using continuous suture closure and omental covering with Lapra Ty® suture clips. The median operating time was 136 min (range 112-199 ml), and amount of bleeding was 1 ml (range 1-100). There were no cases of postoperative bile leakage (postope. BL), remnant cystic duct stone, and abscess formation in abdomen.
we recommend this new suturing technique for closure of remnant of GB as it was very effective in preventing postope. BL after LSC.
近年来，腹腔镜胆囊次全切除术（LSC）的数量一直在增加。
LSC适合作为一种治疗方法，因为它可以避免在困难的腹腔镜胆囊切除术中出现术中胆管损伤和出血。另一方面，对胆囊残余部分处理不当可能导致术后胆漏。
在此，我们报告我们使用Lapra Ty®缝合夹对胆囊残余部分进行连续缝合关闭和网膜覆盖的新技术的积极经验。
2016年1月至2021年7月，我们对30例难以获得关键安全视野（CVS）的LC患者进行了LSC手术。在这30例患者中的6例中，我们使用Lapra Ty®缝合夹对胆囊残余部分进行连续缝合关闭和网膜覆盖修复。中位手术时间为136分钟（范围112 - 199分钟），出血量为1毫升（范围1 - 100毫升）。没有术后胆漏（postope. BL）、残余胆囊管结石和腹腔脓肿形成的病例。
我们推荐这种用于关闭胆囊残余部分的新缝合技术，因为它在预防LSC术后的postope. BL方面非常有效。
