Rickman A, Kistner R L, Schlinkert R T
Mayo Clinic Scottsdale, AZ.
J Laparoendosc Surg. 1993 Jun;3(3):205-8. doi: 10.1089/lps.1993.3.205.
The development of laparoscopic and non-operative methods for the management of cholelithiasis has been based on the premise that abdominal exploration during cholecystectomy is unnecessary. In the current study, 305 patients undergoing complete abdominal exploration during routine cholecystectomy were evaluated to assess the incidence and significance of intraabdominal pathology found at the time of exploration. While 41 patients (13.4%) were found to have additional diagnosis at the time of exploration, the majority of these were either minor in nature or would easily have been recognized utilizing laparoscopic techniques. Only one patient would have had significant intraabdominal pathology missed by laparoscopic techniques. It can be concluded that abdominal exploration at the time of treatment of cholelithiasis is unnecessary and that laparoscopic cholecystectomy will not compromise patient care in this regard.
腹腔镜及非手术方法治疗胆结石的发展基于这样一个前提，即胆囊切除术中进行腹部探查是不必要的。在本研究中，对305例行常规胆囊切除术时进行全腹探查的患者进行评估，以确定探查时发现的腹内病变的发生率及意义。虽然有41例患者（13.4%）在探查时被发现有其他诊断，但其中大多数要么性质轻微，要么使用腹腔镜技术很容易就能识别出来。只有1例患者的严重腹内病变会被腹腔镜技术漏诊。可以得出结论，治疗胆结石时进行腹部探查是不必要的，并且在这方面腹腔镜胆囊切除术不会影响患者的治疗。
