Transgastric hybrid cholecystectomy
Transgastric hybrid cholecystectomy
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DOI：
10.1002/bjs.6704
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发表时间：
2009-10-01
影响因子：
9.6
通讯作者：
Marescaux, J.
中科院分区：
文献类型：
--
作者：
Dallemagne, B.;Perretta, S.;Marescaux, J.
背景：经自然腔道内镜手术的临床应用正在研究中。经阴道胆囊切除术的妇女和相关的技术问题的初步结果进行了描述。杂交transgastric cholecystectomy的技术和初步结果，现在reported.Methods：5例患者，年龄在18-60岁的单纯性胆石症进行了transgastric cholecystectomy的前瞻性意向治疗研究，包括选择transparietal援助（混合技术），如果需要的话。在腹腔镜引导下通过5 mm脐套管针进行胃切开术，该套管针还用于暴露胆囊、夹闭胆囊蒂并闭合胃切开术。胆道镜进行了使用灵活的仪器通过内窥镜，单独或与腹腔镜instrument.Results相结合：该程序是成功的，在所有患者的平均手术时间为150（范围120-180）分钟。没有术中或术后并发症。结论：直到技术问题得到解决，混合程序与自由使用的transparietal援助是最安全，最有效的方法经胃胆囊切除术。进一步的研究对评估这种新方法的作用至关重要。
Background: Clinical application of natural orifice transluminal endoscopic surgery is under investigation. Preliminary results of transvaginal cholecystectomy in women and associated technical issues have been described. The technique and initial results of hybrid transgastric cholecystectomy are now reported.Methods: Five patients; aged 18-60 years with Uncomplicated cholelithiasis underwent transgastric cholecystectomy in a prospective intention-to-treat study that included the Option of transparietal assistance (hybrid technique) if needed. The gastrotomy was created under laparoscopic guidance through a 5-mm umbilical trocar, which also served to expose the gallbladder, clip the cystic pedicle and close the gastrotomy. Cholecystectomy was carried out using flexible instruments through the endoscope, alone or in combination with laparoscopic instruments.Results: The procedure was successful in all patients with a median operating time of 150 (range 120-180) min. Transparietal assistance was necessary in all patients. There were no intraoperative or postoperative complications.Conclusion: Until technical issues have been resolved, a hybrid procedure with liberal use of transparietal assistance is the safest and most efficient approach for transgastric cholecystectomy. Further studies essential to evaluate the role of this new approach.