胆囊切除术后胆囊残余和胆囊管残端结石:手术陷阱、发生原因和完成胆囊切除术(开放与腹腔镜)作为一种安全的手术治疗选择:短期和长期结果随机对照

Q4 Medicine
Tamer A. A. M., Hatem Mohammad, Mohamed Ibrahim Mansour, Mohamed Farouk Amin
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引用次数: 0

摘要

背景:胆囊切除术是治疗症状性胆囊疾病的标准手术选择。10 - 20%的病例在胆囊切除术后症状仍然存在。残余胆囊/胆囊管残端结石是最重要的原因之一。本研究旨在评价和比较开放胆囊切除术和腹腔镜胆囊切除术治疗胆囊(GB)残余结石和胆囊管残端结石的术中和术后结果。方法:选取84例胆囊残余结石或胆囊管残端结石患者,将其分为2组,即开放全胆切除术组(A组42例)和腹腔镜全胆切除术组(B组42例)。经超声及磁共振胆管胰图诊断。结果:腹腔镜完全胆囊切除术手术时间(p=0.00)显著高于开放完全胆囊切除术,出血量(p=0.0026)显著高于开放完全胆囊切除术,术中胆道损伤两组差异无统计学意义(p=0.56)。开腹组和腹腔镜组平均手术时间分别为120±13 min和160±10 min。开放组8例,腹腔镜组2例,术中出血需输血。术中胆道损伤,开腹组3例,腹腔镜组2例。腹腔镜组4例发生转换:2例因广泛粘连,1例因囊性动脉出血失控,1例因胆漏。住院转换率;最小的术后并发症,即胆漏和出血;住院时间也更短。临床试验注册在clinicaltrials.gov方案注册质量控制审核标准:NCT04329143于2020年4月1日注册,回顾性注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-Cholecystectomy Gallbladder Remnant and Cystic Duct Stump Stone: Surgical Pitfalls, Causes of Occurrence and Completion Cholecystectomy (Open versus Laparoscopic) as a Safe Surgical Option of Treatment: Short and Long Term Outcome. Randomized Control
Background: Cholecystectomy is the standard surgical option for symptomatic gallbladder disease. The symptoms persist after cholecystectomy in 10 - 20% of cases. Residual gallbladder/cystic duct stump stone is one of the most important causes. This study aimed to evaluate and compare outcomes of open and laparoscopic completion cholecystectomy for gallbladder (GB) remnant stones and cystic duct stump stones as regards intraoperative and postoperative outcomes. Methods: This study was conducted on 84 cases with residual gallbladder remnant stone or cystic duct stump stone that were divided into 2 groups, the open completion cholecystectomy group (Group A=42 cases) and the laparoscopic completion cholecystectomy group (Group B=42 cases). The diagnosis was made by ultrasound and magnetic resonance cholangio-pancreatography. Results: Operative time (p=0.00) significantly higher at laparoscopic completion cholecystectomy and blood loss (p=0.0026) were significantly associated with open completion cholecystectomy while there was no statistically significant difference between both groups as regards intraoperative biliary injuries (p=0.56). The mean operative time was 120±13 min and 160±10 min in the open group and the laparoscopic group, respectively. 8 cases in the open group and 2 cases in the laparoscopic group showed intraoperative blood loss and required blood transfusion. Intraoperative biliary injuries occurred in 3 cases in the open group and 2 cases in the laparoscopic group. Conversion occurred in 4 cases in the laparoscopic group: 2 cases due to extensive adhesion, 1 case due to uncontrolled bleeding from the cystic artery, and I case from biliary leakage. Hospital stay conversion rate; minimal post-operative complications, namely biliary leakage and bleeding; and shorter hospital stay. Trial registration at clinicaltrials.gov protocol registration quality control review criteria: NCT04329143 registered on 01/04/2020, retrospective registered.
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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