Sharma A K, Rangan H K, Choubey R P
Department of Gastrointestinal Surgery, Army Hospital (Referral and Research), Delhi, India.
Aust N Z J Surg. 1998 Nov;68(11):774-7. doi: 10.1111/j.1445-2197.1998.tb04674.x.
Laparoscopic cholecystectomy (LC) requires expensive equipment and special training. Mini-lap cholecystectomy (MLC) has no start-up costs but no large series from a single centre has been reported as the procedure is considered hazardous because of inadequate exposure of the surgical field.
We retrospectively reviewed the outcome of 737 cholecystectomies performed through a 3-5-cm transverse subcostal incision and compared the results to published series of laparoscopic cholecystectomy.
The operating time (61.6 min; range 35-130), conversion rate (4%), rate of postoperative complications (3.6%), bile duct injuries (0.3%), number of analgesic doses required (3.4; range 3-8), duration of postoperative hospital stay (1.4; range 1-15 days), and the time off work (13.3 days; range 8-61) compare well with the reported results of laparoscopic and MLC. Ninety-three per cent of the patients were followed up for a median period of 28.4 months and none developed biliary stricture.
Mini-lap cholecystectomy is considered a safe, viable alternative to LC in the Third World.
腹腔镜胆囊切除术（LC）需要昂贵的设备和特殊培训。迷你腹腔镜胆囊切除术（MLC）没有启动成本，但由于手术视野暴露不足，该手术被认为具有危险性，因此尚未有来自单一中心的大量病例报道。
我们回顾性分析了通过3 - 5厘米肋下横切口进行的737例胆囊切除术的结果，并将结果与已发表的腹腔镜胆囊切除术系列进行比较。
手术时间（61.6分钟；范围35 - 130分钟）、中转率（4%）、术后并发症发生率（3.6%）、胆管损伤率（0.3%）、所需镇痛剂量（3.4剂；范围3 - 8剂）、术后住院时间（1.4天；范围1 - 15天）以及误工时间（13.3天；范围8 - 61天）与已报道的腹腔镜胆囊切除术和迷你腹腔镜胆囊切除术的结果相当。93%的患者得到随访，中位随访期为28.4个月，无一例发生胆管狭窄。
在第三世界，迷你腹腔镜胆囊切除术被认为是腹腔镜胆囊切除术的一种安全、可行的替代方法。
