Schlumpf R, Klotz H P, Wehrli H, Herzog U
Department of Surgery, University of Zurick Hospital, Switzerland.
Surg Endosc. 1994 Jan;8(1):35-41. doi: 10.1007/BF02909491.
In a national prospective multicenter study 3,722 laparoscopic cholecystectomies (LC) performed by 179 surgeons in 50 institutions were analyzed with special regard to technique and complications. Conversion to open cholecystectomy was necessary in 259 patients (7.0%), either without intraoperative complications (4.5%) or due to intraoperative complications (2.5%). Three patients (0.08%) died within 30 days after operation and a total of 39 patients (1.0%) had to be reoperated; 22 (0.6%) bile duct injuries were registered. Common bile duct (CBD) stones were treated mainly by ERCP. In eight cases laparoscopic removal of common bile duct stones was attempted, and it was performed successfully in six patients. Postoperatively patients were discharged home after a mean of 4.4 days and returned to work after 14.0 days (range: 2-28). Laparoscopic cholecystectomy became the golden standard to remove the gallbladder, but further development is needed to establish laparoscopic treatment of biliary tract stones in the near future.
在一项全国性前瞻性多中心研究中，对50家机构的179名外科医生实施的3722例腹腔镜胆囊切除术（LC）进行了分析，特别关注了手术技术和并发症。259例患者（7.0%）需要转为开腹胆囊切除术，其中无术中并发症者占4.5%，因术中并发症者占2.5%。3例患者（0.08%）在术后30天内死亡，共有39例患者（1.0%）需要再次手术；记录到22例（0.6%）胆管损伤。胆总管（CBD）结石主要通过内镜逆行胰胆管造影（ERCP）治疗。8例尝试腹腔镜下取出胆总管结石，6例成功。术后患者平均4.4天出院，14.0天（范围：2 - 28天）后恢复工作。腹腔镜胆囊切除术已成为切除胆囊的金标准，但在不久的将来还需要进一步发展以确立腹腔镜治疗胆道结石的方法。
