Needlescopic Cholecystectomy: Lessons Learned in 10 Years of Experience
Needlescopic Cholecystectomy: Lessons Learned in 10 Years of Experience
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针镜胆囊切除术：10 年经验教训
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
K. Berghoff
中科院分区：
文献类型：
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作者：
M. Franklin;E. J. Jaramillo;J. Glass;J. Treviño;K. Berghoff
目的：针式胆囊切除术（NC）是腹腔镜胆囊切除术（LC）的改良，使用2 mm器械，而不是标准的5 mm和10 mm端口。我们回顾我们的经验，针镜胆囊切除术。方法：1994 ~ 2004年，303例患者接受了NC。所有患者均使用2 mm器械和一个10 mm腹腔镜套管针进行手术。记录患者的特征、总手术时间、并发症、术后疼痛和住院时间。结果：患者平均年龄41.86岁，女性262例，男性41例。平均BMI为25.7。平均手术时间为59.33分钟。所有病例均行术中胆道造影。平均失血量为14.88 mL。发生1例术中并发症。平均住院时间为22.68小时。采用0 - 10疼痛量表测量术后疼痛;第0天为4.4，第1天为1.7。6.89%的患者需要0剂镇痛药，20.68%的患者需要1剂镇痛药，24.13%的患者需要2剂镇痛药，34.48%的患者需要3剂镇痛药，13.79%的患者需要4剂镇痛药，不需要>4剂镇痛药。无术后并发症发生。在3个月的随访中，患者满意度为100%，99%的患者的疤痕难以察觉。结论：NC安全可行，不增加手术风险，美容效果好，疼痛少，患者接受度好。
Objectives: Needlescopic cholecystectomy (NC) is a refinement of laparoscopic cholecystectomy (LC) using 2-mm instruments compared with the standard 5-mm and 10-mm ports. We review our experience with needlescopic cholecystectomy. Methods: From 1994 to 2004, 303 patients underwent NC. All patients were operated on using 2-mm instruments and one 10-mm trocar for the laparoscope. The characteristics of patients, total operation time, complications, postoperative pain, and hospital course were documented. Results: Patients’ average age was 41.86 years; 262 were female and 41 were male. Mean BMI was 25.7. Mean length of surgery was 59.33 minutes. Intraoperative cholangiography was performed in all cases. Mean blood loss was 14.88 mL. One intraoperative complication occurred. Mean hospital stay was 22.68 hours. Postoperative pain was measured on a 0 –10 pain scale; on day 0 it was 4.4 and on the first day it was 1.7. Analgesic doses required were 0 doses in 6.89%, 1 in 20.68%, 2 in 24.13%, 3 in 34.48%, 4 in 13.79%, and >4 doses was not required. No postoperative complications occurred. At 3-month follow-up, patient satisfaction was 100%, and in 99% of patients scars were imperceptible. Conclusions: NC is safe and feasible without increased operative risk, with better cosmetic results, less pain, and good acceptance among patients.