出院后发生了什么?腹腔镜胆囊切除术后两年多的随访。

Sunjay S. Kumar, Erin Briggs, Sami Tannouri, Talar Tatarian, M. Pucci, Renée M. Tholey, K. Chojnacki, Courtney Foley, F. Palazzo
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引用次数: 0

摘要

腹腔镜胆囊次全切除术(LSC)可用于预防疑难胆囊切除术的并发症。关于胆囊穿孔和胆囊再造手术技术的中期效果研究较少。我们对单个机构的所有 LSC 进行了回顾性审查。通过电话调查确定了其他机构处理的并发症。我们按照手术方式和术后需要内窥镜干预(ERC)的患者进行了分组分析。28名患者符合纳入标准。中位随访时间为 32.7 个月。无胆管损伤或再次手术。21%的患者术后需要进行 ERC,50%的患者带着引流管出院回家。研究发现,胆汁漏发生率在有开口的 LSC 组更高(38% vs 0%,P = .003)。该系列病例表明,接受再造LSC手术的患者复发胆道疾病的情况更为严重。腹腔镜胆囊次全切除术的中期疗效似乎令人满意。重组 LSC 组患者的复发趋势更为严重,值得进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What Happens After Discharge? A 2+ Year Follow-Up After Laparoscopic Subtotal Fenestrating and Reconstituting Cholecystectomy.
Laparoscopic subtotal cholecystectomy (LSC) is utilized to prevent complications in the difficult cholecystectomy. Medium-term outcomes are poorly studied for fenestrating and reconstituting operative techniques. A single-institution retrospective review was undertaken of all LSCs. A telephone survey was used to identify complications addressed at other institutions. We performed subgroup analyses by operative approach and of patients requiring postoperative endoscopic intervention (ERC). 28 patients met inclusion criteria. The median follow-up was 32.7 months. There were no bile duct injuries or reoperations. 21% of patients required a postoperative ERC and 50% were discharged home with a drain. Bile leaks were found to be more prevalent in the fenestrating LSC group (38% vs 0%, P = .003). The case series suggested more severe recurrent biliary disease in patients undergoing reconstituting LSC. Laparoscopic subtotal cholecystectomy appears to have satisfactory medium-term outcomes. The reconstituting LSC group trends toward more severe recurrent disease which warrants further investigation.
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