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[瑞士的腹腔镜胆囊切除术。对最初3722例病例的批判性回顾性评估。瑞士腹腔镜与胸腔镜外科学会]

[Laparoscopic cholecystectomy in Switzerland. Critical retrospective evaluation of the first 3,722 cases. Swiss Professional Society of Laparoscopic and Thoracoscopic Surgery].

作者信息

Schlumpf R, Klotz H P, Wehrli H, Herzog U

机构信息

Departement Chirurgie, Universitätsspital Zürich.

出版信息

Chirurg. 1993 Apr;64(4):307-13.

PMID:8482148
Abstract

In a national prospective multicenter study 3722 laparoscopic cholecystectomies (LC) performed by 179 surgeons in 50 Swiss institutions were analysed with special regard to technique and complications. Conversion to open cholecystectomy was necessary in 259 patients (7.0%), either expectively 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. 31 (0.8%) bile duct injuries were registered. Common bile duct (CBD) stones were treated mainly by ERCP. In 8 cases laparoscopic removal of common bile duct stones was attempted and performed successfully in 6 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 gold standard to remove the gallbladder, but further development is needed, to establish laparoscopic treatment of biliary tract stones in the near future.

摘要

在一项全国性前瞻性多中心研究中,对瑞士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,特别关注了技术和并发症情况。259例患者(7.0%)需要转为开腹胆囊切除术,其中4.5%是预期性的且无术中并发症,2.5%是由于术中出现并发症。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31例(0.8%)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例尝试腹腔镜切除胆总管结石,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胆囊切除的金标准,但仍需进一步发展,以便在不久的将来确立腹腔镜治疗胆道结石的方法。

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