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【RAR】腹腔鏡膽囊切除術的7個里程碑（英文版） - 醫學資源下載
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上傳日期：2012-10-16 13:57:19

Abstrac t. The incide nce of bile duct injur y in laparo- scopic cholecys tectomy is 0 .3 % to 1.0 % . Thi s is high er than the incide nce report ed for ope n cholecys tecto my (i.e., 0.1–0. 2% ), and the surgeons all over the worl d are relent lessly trying to find the ways and means to low er this incide nce. Various operati ng strategies, techni ques, and inst rument ations su ch as the 0
tele scope, intrao p- erative cho langiogram, hydrodis section , and pean ut gauze dissection have been clai med by various au thors to mini mize the risk of bile duc t injur y dur ing chole- cyste ctomy. How ever, the surgical fraterni ty agrees that there has be en no substitut e for meticulous disse ction and display of various vita l structures ne ar the common bile duc t. The a uthors de scribe seven anatom ic land- marks enco untered during laparos copic cholecys tec- tomy that assi st in safe disse ction to prevent bile duc t and vascul ar injury. On the basis of their experi ence, they belie ve that if surgeons adh ere to these landma rks, excelle nt resul ts can be ach ieved.In the current era, laparos copic ch olecystect omy (LC) is the gold standa rd treat ment for gallstone disease. The rate for co nversion becau se of intr aoperat ive compli ca- tions has been report ed by various a uthors as ran ging from 2 % to 6 % [1–3]. The incidenc e of bile duct injur y in LC is 0.3% to 1.0 % [1, 3, 4], whi ch is higher than the incide nce report ed for open ch olecystect omy (0.1–0.2 % ) [5]. Conse quen tly, surgeons all over the world are relent lessly trying to find the ways and means to low er this incidenc e. The main cau ses of bile duc t injury in cholecys tect omy are intr insicall y dan gerous diseas e, dange rous anatom y, and dangerous surger y [5].

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