Ovaska J, Airo I, Haglund C, Kivilaakso E, Kiviluoto T, Palm J, Pääkkönen M, Ristkari S, Smitten K V
Department of Surgery, Turku University Central Hospital, Finland.
Ann Chir Gynaecol. 1996;85(3):208-11.
Between January 1992 and December 1994, 5,742 patients were treated by laparoscopic cholecystectomy in 35 Finnish hospitals. The operation was converted to open laparotomy in 360 (6.3%) patients, the most common causes for conversion being technical difficulties in dissection of the gall bladder (2.8%), bleeding (0.9%) and bile duct injury (0.48%). Intraoperative cholangiography was performed selectively in 18%, and common bile duct stones were found in 10.2% of these cases. Postoperative complications occurred in 208 (3.6%) patients, of whom 65 (1.1%) required reoperation. Twenty-eight (0.48%) of these patients had common bile duct injury. In eighteen patients bilio-digestive Roux-en-Y reconstruction was performed, whereas 10 cases could be handled by endoscopic drainage or suturing and T-tube drainage. Thus, the total number of patients with bile duct injury was 56 (0.96%). The reported hospital mortality was 0.08%. The mean hospital stay and the mean sick leave were three days (range 1-41) and 13 days (range 1-60), respectively. These data demonstrate that laparoscopic cholecystectomy can be performed with acceptable morbidity and mortality rates as a routine method in various different hospitals.
1992年1月至1994年12月期间，芬兰35家医院的5742例患者接受了腹腔镜胆囊切除术。其中360例（6.3%）患者中转开腹手术，最常见的中转原因是胆囊解剖技术困难（2.8%）、出血（0.9%）和胆管损伤（0.48%）。18%的患者选择性进行了术中胆管造影，其中10.2%的病例发现胆总管结石。208例（3.6%）患者发生术后并发症，其中65例（1.1%）需要再次手术。这些患者中有28例（0.48%）发生胆总管损伤。18例患者进行了胆肠Roux-en-Y重建，而10例患者可通过内镜引流或缝合及T管引流处理。因此，胆管损伤患者总数为56例（0.96%）。报告的医院死亡率为0.08%。平均住院时间和平均病假分别为3天（范围1 - 41天）和13天（范围1 - 60天）。这些数据表明，腹腔镜胆囊切除术作为一种常规方法，在不同医院进行时，其发病率和死亡率是可以接受的。
