Cappuccino H, Cargill S, Nguyen T
Department of Surgery, Monmouth Medical Center, Long Branch, NJ.
Surg Laparosc Endosc. 1994 Jun;4(3):213-21.
Eleven surgeons attempted laparoscopic cholecystectomy in 563 patients over a 14-month period. Of these 563, 536 (95.3%) were performed successfully; the remaining patients required conversion to laparotomy, but only five because of complications. There were no mortalities associated with the procedure. Thirty-nine patients had complications, 14 surgical and related to the procedure itself. Weight was not considered a contraindication. The preoperative diagnosis in 83.6% patients with chronic cholecystitis, and in the remainder (16.4%) it was acute cholecystitis. Mean operative time was 86.4 min, and mean hospital stay for uncomplicated successful laparoscopic cholecystectomy was 1.9 days. An extensive review of the literature reveals an additional 9,792 laparoscopic cholecystectomies performed at the time of the writing of this paper. Our results compare favorably to these. A discussion of historical aspects of the procedure, contraindications to laparoscopic cholecystectomy, and the merits of selective intraoperative cholangiography are also presented.
在14个月的时间里，11位外科医生对563例患者实施了腹腔镜胆囊切除术。在这563例患者中，536例（95.3%）手术成功；其余患者需要转为开腹手术，但只有5例是因并发症所致。该手术无相关死亡病例。39例患者出现并发症，其中14例为手术相关并发症。体重未被视为禁忌证。83.6%的患者术前诊断为慢性胆囊炎，其余（16.4%）为急性胆囊炎。平均手术时间为86.4分钟，无并发症的成功腹腔镜胆囊切除术患者的平均住院时间为1.9天。对文献的广泛回顾显示，在撰写本文时另外还有9792例腹腔镜胆囊切除术。我们的结果与这些结果相比具有优势。本文还讨论了该手术的历史背景、腹腔镜胆囊切除术的禁忌证以及选择性术中胆管造影的优点。
