{"title":"单通道系统腹腔镜胆囊切除术15例。","authors":"A. Simon, E. Monnet","doi":"10.1111/vsu.13289","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs.\n\n\nSTUDY DESIGN\nRetrospective study.\n\n\nANIMALS\nFifteen client-owned dogs with nonobstructive gallbladder disease.\n\n\nMETHODS\nMedical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal.\n\n\nRESULTS\nThe 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.\n\n\nCONCLUSIONS\nThe 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.\n\n\nCLINICAL RELEVANCE/IMPACT\nLaparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.","PeriodicalId":123280,"journal":{"name":"Veterinary surgery : VS","volume":"23 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"12","resultStr":"{\"title\":\"Laparoscopic Cholecystectomy with Single Port Access System in 15 Dogs.\",\"authors\":\"A. Simon, E. Monnet\",\"doi\":\"10.1111/vsu.13289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nTo evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs.\\n\\n\\nSTUDY DESIGN\\nRetrospective study.\\n\\n\\nANIMALS\\nFifteen client-owned dogs with nonobstructive gallbladder disease.\\n\\n\\nMETHODS\\nMedical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal.\\n\\n\\nRESULTS\\nThe 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.\\n\\n\\nCONCLUSIONS\\nThe 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.\\n\\n\\nCLINICAL RELEVANCE/IMPACT\\nLaparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.\",\"PeriodicalId\":123280,\"journal\":{\"name\":\"Veterinary surgery : VS\",\"volume\":\"23 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"12\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary surgery : VS\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1111/vsu.13289\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary surgery : VS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1111/vsu.13289","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.