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腹腔镜胆囊切除术中的胆囊床入路:一项连续回顾性分析

Cystic plate approach in laparoscopic cholecystectomy: a consecutive retrospective analysis.

作者信息

Zhou Yanjie, Xiao Le, Luo Zhulin, Luo Hao, Tan Zhen, Wang Tao

机构信息

Department of Hepatobiliary Surgery, Chengdu Medical College, Chengdu, Sichuan, China.

Department of General Surgery, The General Hospital of Western Theatre Command, Chengdu, Sichuan, China.

出版信息

Front Surg. 2024 Dec 3;11:1487568. doi: 10.3389/fsurg.2024.1487568. eCollection 2024.

Abstract

PURPOSE

This study aimed to investigate the safety, feasibility, and possible advantages of the cystic plate approach during laparoscopic cholecystectomy in a retrospective cohort of surgical patients.

METHODS

We summarized the key points of the technical approach, retrospectively analyzed the clinical outcomes of 156 patients in the cystic plate approach group from July 2018 to July 2023, and compared the findings with those of 173 cases in the routine approach group from the same period.

RESULTS

We observed no differences in the average stone size, operation time, postoperative hospital stay, conversion rate, complications, or Visual Analog Scale pain scores on the second day of surgery between the two groups ( = 0.076, 0.067, 0.278, 1.000, 0.633, and 0.131, respectively). However, intraoperative blood loss, number of clips used, volume of postoperative drainage fluid, and Visual Analog Scale pain scores on the day of surgery in the cystic plate approach group were significantly lower than those in the routine approach group ( = 0.000, 0.031, 0.027, and 0.021, respectively).

CONCLUSIONS

The cystic plate approach is a safe, feasible, and effective approach that has the advantages of minimal invasiveness with less bleeding and seepage, reduced use of biological clips, and less pain, potentially minimizing the risk of iatrogenic biliary injury.

TRIAL REGISTRATION

This study was registered at the International Clinical Trial Registry (ChiCTR2100052860). Registration date: November 6, 2021.

摘要

目的

本研究旨在回顾性分析一组外科手术患者,探讨腹腔镜胆囊切除术中胆囊床入路的安全性、可行性及潜在优势。

方法

我们总结了该技术入路的要点,回顾性分析了2018年7月至2023年7月采用胆囊床入路的156例患者的临床结局,并与同期采用常规入路的173例患者的结果进行比较。

结果

两组患者的平均结石大小、手术时间、术后住院时间、中转率、并发症及术后第二天的视觉模拟评分疼痛分数均无差异(分别为P = 0.076、0.067、0.278、1.000、0.633和0.131)。然而,胆囊床入路组的术中出血量、钛夹使用数量、术后引流量及手术当天的视觉模拟评分疼痛分数均显著低于常规入路组(分别为P = 0.000、0.031、0.027和0.021)。

结论

胆囊床入路是一种安全、可行且有效的入路,具有微创、出血少、渗漏少、生物钛夹使用减少及疼痛轻等优点,可能将医源性胆管损伤风险降至最低。

试验注册

本研究已在国际临床试验注册中心注册(ChiCTR2100052860)。注册日期:2021年11月6日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8a6/11649668/cada7d3283a1/fsurg-11-1487568-g001.jpg

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