日间腹腔镜胆囊切除术进展

被引：11

作者：

徐靖

王西墨

机构：

[1] 天津市人民医院普通外科

来源：

中华腔镜外科杂志(电子版) | 2012年 / 5卷 / 01期

关键词：

腔镜胆囊切除术; 患者; DLC; 外科医师; 胆囊结石; 急性胆囊炎; 日间手术; 麻醉医师; 胆囊息肉; 胆囊隆起性病变;

D O I：

暂无

中图分类号：

R657.4 [胆囊、胆管];

学科分类号：

摘要：

在Pubmed上随机检索近10年来(1997～2007年)关于日间腹腔镜胆囊切除术(DLC)的临床试验报道,总结分析行DLC患者的入选标准、手术方法及改革、术后复苏、术后治疗、出院标准以及术后随访。结果无胆管结石且近1个月内无急性胆囊炎发作的症状型胆石症、胆囊息肉和慢性胆囊炎患者可以行DLC。合并急性胆囊炎、胰腺炎的患者则应被排除。各家报道的其他标准也基本一致:如术前美国麻醉医师协会分级、家庭及社会背景、术前常规检查等等。结果的分析以患者术后被留院观察的原因以及患者满意度的评价为主。这些临床研究都证实DLC在选择好患者的基础上是安全可行的。严重并发症极为罕见,最常发生的是由于一些轻微的并发症或社会因素导致的留院观察及再住院治疗。日间手术需要完善的计划和充分的准备,才能令患者满意。术前仔细的筛选患者及充分的术前检查可以有效降低留院观察及再住院的发生率。一个有经验的手术医师,在DLC和普通住院腹腔镜胆囊切除术(LC)中发生并发症的几率差异无统计学意义。术后控制好疼痛、恶心、呕吐等症状是非常重要的,这些往往成为患者LC术后当天能否回家的决定性因素。本文对目前国外DLC的开展情况做一综述。

引用

页码：58 / 61

页数：4

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