Testas P, Dewatteville J C
Service de chirurgie digestive, Centre Hospitalo-universitaire de Bicêtre, Le Kremlin Bicêtre.
Bull Acad Natl Med. 1993 Feb;177(2):219-26; discussion 226-32.
Laparoscopic digestive surgery is right now like a revolution. The author after a short historic homage to Raoul Palmer who in 1940 realized the first laparoscopy and also to Philippe Mouret and François Dubois who performed the first laparoscopic cholecystectomy in the world in 1987, is doing some comments. The comments are based in the experience of the author who performed in his surgical department about 400 cholecystectomies and another study realized with B. Delaitre on 6512 cases showing a decrease of morbidity however a dramatic increase of biliary complications from 1.0/00 to 1% this leads the author to two type of reflexions. One based on technical problem especially in high frequency surgery the other in training of this new surgical technic and also on rapid extension, sometime anarchistic of the indications of this new digestive laparoscopic surgery. In conclusion, we have to performed clinical research before doing next applications of laparoscopic surgery and keep in mind the necessity for a new technic to be better for patients.
腹腔镜消化外科手术目前犹如一场革命。作者在简短地缅怀了1940年实施首例腹腔镜检查的拉乌尔·帕尔默，以及1987年完成世界首例腹腔镜胆囊切除术的菲利普·穆雷和弗朗索瓦·杜布瓦之后，进行了一些评论。这些评论基于作者所在外科科室实施约400例胆囊切除术的经验，以及与B. 德莱特尔对6512例病例进行的另一项研究，该研究显示发病率有所下降，但胆系并发症从0.1‰急剧增至1%，这使作者产生了两种思考。一种基于技术问题，尤其是高频手术方面的问题；另一种涉及这种新手术技术的培训，以及这种新型腹腔镜消化外科手术适应证有时无节制的快速扩展。总之，在进行腹腔镜手术的下一步应用之前，我们必须开展临床研究，并牢记新技术必须对患者更有益这一必要性。
