Jones D B, Soper N J
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Annu Rev Med. 1996;47:31-44. doi: 10.1146/annurev.med.47.1.31.
Video technology allows surgeons to offer patients operations through small incisions. While these minimally invasive techniques have been employed for a wide range of operations for many years, only recently has a laparoscopic cholecystectomy been possible. Compared to the same operation performed via laparotomy, it is deemed the "gold standard." Overall mortality after laparoscopic cholecystectomy ranges from 0-1%, and the rate of major complications is less than 5%. As a group, general surgeons are beyond their initial learning curve for laparoscopic cholecystectomy, but the majority of iatrogenic injuries can be successfully avoided by appreciating the limitations and pitfalls of laparoscopic surgery, and by carefully dissecting the hepatocystic triangle before dividing any structure. Early identification and management of complications will minimize potentially devastating complications of small, unrecognized injuries. Physicians need to accurately advise patients of the proposed advantages and potential problems of laparoscopic cholecystectomy before referring them to a surgeon.
视频技术使外科医生能够通过小切口为患者实施手术。虽然这些微创技术多年来已被广泛应用于各种手术，但直到最近才得以进行腹腔镜胆囊切除术。与通过剖腹手术进行的相同手术相比，它被视为“金标准”。腹腔镜胆囊切除术后的总体死亡率为0 - 1%，主要并发症发生率低于5%。作为一个群体，普通外科医生已度过腹腔镜胆囊切除术的初始学习曲线，但通过认识到腹腔镜手术的局限性和陷阱，并在分离任何结构之前仔细解剖肝胆囊三角，大多数医源性损伤是可以成功避免的。早期识别和处理并发症将使小的、未被识别的损伤可能造成的毁灭性并发症降至最低。在将患者转介给外科医生之前，医生需要准确地告知患者腹腔镜胆囊切除术的预期优势和潜在问题。
