New-Style Laparoscope and Endoscope Cooperative Gallbladder-Preserving Surgery for Polyps

作者：Li, Ming; Wu, Haorong; Wei, Shaohua^*

来源：Journal of the College of Physicians and Surgeons Pakistan, 2016, 26(2): 91-95.

• Laparoscope and endoscope cooperative surgery (LECS)
• CHIAO cholecystoscope
• Gallbladder-preserving surgery
• Gallbladder polyps

Objective: To evaluate the feasibility and safety of a new style of Laparoscope and Endoscope Cooperative gallbladder-preserving Surgery (LECS), an improved method of minimally invasive gallbladder-preserving polypectomy. @@@ Study Design: An experimental study. @@@ Place and Duration of Study: Department of General Surgery, The Second Affiliated Hospital of Soochow University, China, from January 2009 to July 2013. @@@ Methodology: Clinical data of patients subjected to LECS and Laparoscopic Cholecystectomy (LC) was analysed. The inclusion criteria were normal size clear gallbladder bile with total volume (FV) of the gallbladder = 15 - 25 ml, the Residual Volume (RV) = 5 ml, and the Emptying Figure (EF) > 75%, with polyps diagnosed definitively by B-type ultrasonic imaging or CT desirous of preserving gallbladder. Exclusion criteria were a history of midsection surgery, serious diseases of any organ, hepatic injury, or coagulation disturbance. Mean hospital stay and complications were also noted. Independent sample t-test, the frequency comparison used chi-square test (N > 5), and Fisher's exact test (N < 5) were used for statistical test. @@@ Results: The mean hospital stay after LECS was 3.50 +/- 0.31 days, and 3.50 +/- 0.31 days for the LC group. The mean age in LC and LECS group was 50 +/- 25.4 and 44 +/- 12.1 years, respectively. Complications after operation in the LECS were indigestion and diarrhea; LC group had indigestion (9.33%), diarrhea (10.67%), and gastroesophageal reflux (6.6.7%). In the 3 months follow-up after discharging from the hospital, no patient had recurrence of any gallbladder disease; at 1 year follow-up, 1 patient (1.28%) developed cholesterol crystals; at 3-year follow-up, 3 cases (3.84%) were found to have recurring polyps (2 similar to 4 pieces), and 2 (2.56%) patients developed cholesterol crystals. @@@ Conclusion: Minimally invasive gallbladder-preserving polypectomy which used a CHIAO cholecystoscopy compared with a laparoscope is safe, feasible, and can effectively reduce the vestiges and recrudescence of polyps in gallbladder-preserving surgery.

• 出版日期2016-2
• 单位苏州大学