单通道系统腹腔镜胆囊切除术15例。

A. Simon, E. Monnet
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引用次数: 12

摘要

目的评价单通道系统(SPAS)在犬腹腔镜胆囊切除术中的效果。研究设计回顾性研究。动物:15只患有非梗阻性胆囊疾病的狗。方法回顾患者的医疗记录,包括信号、临床体征、诊断影像、手术结果和拆线前的预后。结果SPAS放置于离脐1 cm处。在两个病例中,该程序仅由SPAS完成。12例追加插管。在最后10例中,在手术开始时放置额外的套管。11只狗(73%)从囊管处开始解剖。在3例(20%)中,SPAS手术转为剖腹手术;其中两种转换是选择性的,另一种是紧急的。转换风险受外科医生经验的影响(优势比= 0.53;P = 0.0105),当在手术开始时添加套管时,转换率降低(P = 0.022)。14条狗出院了。一只狗因严重胆管肝炎出院后死亡,另一只狗因胃造口管泄漏死亡。结论SPAS在犬胆囊切除术中应用效果良好。外科医生获得的经验和插管的增加降低了转换的风险。临床意义/影响腹腔镜胆囊切除术可采用SPAS。强烈建议在手术开始时再放置一根套管。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Laparoscopic Cholecystectomy with Single Port Access System in 15 Dogs.
OBJECTIVE To evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs. STUDY DESIGN Retrospective study. ANIMALS Fifteen client-owned dogs with nonobstructive gallbladder disease. METHODS Medical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal. RESULTS The SPAS was placed 1 cm caudal to the umbilicus. The procedure was completed with the SPAS alone in two cases. An additional cannula was added in 12 cases. In the last 10 cases, the additional cannula was placed at the beginning of the procedure. Dissection began at the cystic duct in 11 dogs (73%). In three cases (20%), the SPAS procedure was converted to a laparotomy; two of these conversions were elective, and one was emergent. The risk of conversion was affected by the experience of the surgeon (odds ratio = 0.53; P = .0105), and the rate of conversion was reduced when a cannula was added at the beginning of the procedure (P = .022). Fourteen dogs were discharged from the hospital. One dog died after being discharged due to severe cholangiohepatitis, and another dog died due to leakage of a gastrostomy tube. CONCLUSIONS The use of SPAS for cholecystectomy in dogs has an acceptable outcome. The experience gained by the surgeon and the addition of a cannula reduced the risk of conversion. CLINICAL RELEVANCE/IMPACT Laparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.
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