Jha Pawan K, Jaiswal Pradeep, Gera Shitiz, Kumari Rinku, Kumar Kaushalendra, Darjee Rohit, Pankaj Deepak
General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2024 Jul 10;16(7):e64205. doi: 10.7759/cureus.64205. eCollection 2024 Jul.
Introduction With the use of advanced instruments and techniques, the reported incidence of bile duct injury is low; however, the actual frequency might be slightly higher than reported. Most surgeons might encounter bile duct injury or bile duct-related complications in their early training days. Nevertheless, with newer techniques and technologies, cases of bile duct injuries have been mostly observed in open cholecystectomy. The predominant cause of injury is the misinterpretation of the anatomy of the bile duct, cystic duct, or aberrant right sectoral hepatic duct. Laparoscopic cholecystectomy is currently the gold standard of therapy for cholecystitis. Materials and methods The study was conducted in the Department of General Surgery at the Indira Gandhi Institute of Medical Sciences in Patna, after obtaining clearance from the ethics committee. The duration of the study was one year. Results A total of 50 patients were enrolled in the study, whose ages ranged from 20 to 55 years. They were predominantly female. The mean operative time was 68.5 ± 8.7 minutes. There were no cases of conversion to an open procedure, bile duct injury, or biliary stricture. Conclusion The injection of methylene blue into the gallbladder fundus during laparoscopic cholecystectomy is a practical, affordable, and simple procedure that does not require any special equipment or radiation exposure for the improved delineation of the gallbladder and biliary system. The use of intraoperative methylene blue could be a low-cost and simple alternative for safe laparoscopic cholecystectomy.
引言 随着先进仪器和技术的应用,报告的胆管损伤发生率较低;然而,实际发生率可能略高于报告值。大多数外科医生在早期培训阶段可能会遇到胆管损伤或胆管相关并发症。尽管如此,随着新技术的出现,胆管损伤病例大多出现在开腹胆囊切除术中。损伤的主要原因是对胆管、胆囊管或异常右肝叶胆管解剖结构的误判。腹腔镜胆囊切除术目前是胆囊炎治疗的金标准。
材料与方法 本研究在巴特那英迪拉·甘地医学科学研究所普通外科进行,已获得伦理委员会批准。研究持续时间为一年。
结果 共有50例患者纳入研究,年龄在20至55岁之间。以女性为主。平均手术时间为68.5±8.7分钟。没有转为开腹手术、胆管损伤或胆管狭窄的病例。
结论 在腹腔镜胆囊切除术中向胆囊底部注射亚甲蓝是一种实用、经济且简单的操作,不需要任何特殊设备或辐射暴露即可更好地显示胆囊和胆道系统。术中使用亚甲蓝可能是安全腹腔镜胆囊切除术的一种低成本且简单的替代方法。