Krämling H J, Lange V, Heberer G
Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Chirurg. 1993 Apr;64(4):295-302.
Based on a representative poll, which included a retrospective data analysis, the current surgical approach to gallstone disease in Germany is presented. A total of 25,955 procedures in 1991 is analysed. 24.9% of all cholecystectomies were done laparoscopically. In 1992, already 81.4% of all surgeons reported own experiences with this new technique. Comparing open procedures with laparoscopic cholecystectomy the latter showed a lower incidence of complications (6.8 vs 8.7%) and perioperative death (0.14 vs. 0.43%). In contrast, relaparotomies were more frequent in the laparoscopy group (1.48 vs. 0.84%). The diagnostic and therapeutic approach for common bile duct stones is currently changing. There is a tendency towards less invasive endoscopic and laparoscopic procedures and towards their combination, respectively.
基于一项包含回顾性数据分析的代表性民意调查，介绍了德国目前针对胆结石疾病的手术方法。对1991年的25955例手术进行了分析。所有胆囊切除术中24.9%是通过腹腔镜完成的。1992年，已经有81.4%的外科医生报告了他们在这项新技术方面的经验。将开放手术与腹腔镜胆囊切除术进行比较，后者并发症发生率较低（6.8%对8.7%），围手术期死亡率也较低（0.14%对0.43%）。相比之下，腹腔镜组再次剖腹手术更为频繁（1.48%对0.84%）。目前，胆总管结石的诊断和治疗方法正在发生变化。分别有采用侵入性较小的内镜和腹腔镜手术以及将二者联合使用的趋势。
