评估在无夹钳单切口腹腔镜胆囊切除术中使用 LigaSure 的安全性和可行性:前瞻性临床研究。

IF 1.1 4区 医学 Q3 SURGERY
Hosam Elghadban, Abdallah Mahmoud, Ahmed Negm, Ibrahim El-Sayed Dawoud, Ahmed Taki-Eldin
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引用次数: 0

摘要

背景:单切口腹腔镜胆囊切除术(SILC)是一种微创手术,旨在尽量减少胆囊切除术所需的切口数量和大小。钛夹传统上用于闭合胆囊管和胆囊动脉。虽然它被认为是安全的,但脱落可能导致出血和胆漏。使用 LigaSure 进行导管封堵仍存在争议。本研究旨在评估在 SILC 过程中使用 LigaSure 封闭膀胱导管的安全性和可行性。方法:曼苏尔大学医院普外科对 102 名患者进行了为期两年的前瞻性研究,每组 51 人。他们接受了使用 LigaSure(第 1 组)或钛夹(第 2 组)控制囊管和动脉的 SILC 手术。结果:分析的数据包括人口统计学数据、手术时间、术中和术后并发症、术后疼痛和住院时间。LigaSure 组的手术时间明显更短(68.5 ± 9.8 分钟,而夹子组为 72.9 ± 10.6 分钟,P .03)。两组在术后胆漏或出血方面无明显差异。不过,第一组和第二组分别有两例和四例患者转为多孔腹腔镜胆囊切除术,但在统计学上无显著差异。两组患者的术后疼痛和住院时间无明显差异。两组各有两名患者出现了切口疝。结论与使用夹子的 SILC 相比,使用 LigaSure 的无夹子 SILC 是一种可行且安全的手术,其发病率可接受,手术时间更短。不过,应向患者解释手术切口疝的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Safety and Feasibility of Using LigaSure During Clipless Single-Incision Laparoscopic Cholecystectomy: A Prospective Clinical Study.

Background: Single-incision laparoscopic cholecystectomy (SILC) is a minimally invasive procedure designed to minimize the number and size of the incisions needed for cholecystectomy. Titanium clips are traditionally used to close the cystic duct and artery. Although it is considered safe, dislodgement can result in bleeding and biliary leakage. Using LigaSure for duct sealing is still controversial. The aim of this study was to evaluate the safety and feasibility of using LigaSure to close the cystic duct during SILC. Methods: A prospective study over two years was conducted at the General Surgery Department, Mansoura University Hospital, on 102 patients, 51 in each group. They underwent SILC using LigaSure (Group 1) or titanium clips (Group 2) to control the cystic duct and artery. Results: The data analyzed included demographic data, operative time, intra- and postoperative complications, postoperative pain, and hospital stay. The operative time was significantly shorter in LigaSure group (68.5 ± 9.8 versus 72.9 ± 10.6 minutes in the clips group, P .03). There was no significant difference between the two groups regarding postoperative bile leak or bleeding. However, two cases in Group 1 and four cases in Group 2 were converted to multiple port laparoscopic cholecystectomy; this was statistically nonsignificant. Postoperative pain and hospital stay showed no significant difference between the two groups. Two patients in each group developed port-site incisional hernia. Conclusions: Clipless SILC using LigaSure is a feasible and safe procedure with acceptable morbidity with shorter operative time than SILC using clips. Nevertheless, the risk of port-site incisional hernia should be explained to the patients.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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