摘要
胆囊良性疾病是临床常见病、多发病,腹腔镜胆囊切除术(LC)作为治疗胆囊良性疾病的常用手术方式,有手术损伤小、瘢痕短、术后疼痛轻、恢复快、住院时间短等优点.但LC容易受到炎症粘连、解剖变异、术者经验、患者身体状况等诸多因素的影响,医源性胆管损伤、出血等手术并发症时有发生,给患者造成伤害和痛苦,甚至威胁生命.本综述简述临床上常用的胆囊三角入路、胆囊后三角入路、"V"字形解剖入路、Rouviere沟引导精准解剖胆囊三角入路、胆囊管浆膜"Y"形入路、循"A-B-D"路径入路等手术入路途径的操作要点、优劣势及注意事项,并强调遵循关键视野技术(CVS)的重要性,为LC手术入路的选择提供借鉴,提高手术的安全性,降低手术并发症的发生率.
Abstract
Benign gallbladder diseases are common clinical diseases and frequently occurring diseases.Laparoscopic cholecystectomy(LC)is a frequently used surgical approach for benign gallbladder conditions,and it offers benefits such as reduced surgical trauma,shorter scars,decreased postoperative pain,faster recovery,and shorter hospital stays.However,LC is influenced by several variables,including inflammatory adhesions,anatomical variances,operator proficiency,and the patient's physical condition.Surgical procedures may result in complications,including bile duct injury and bleeding,lead-ing to harm and discomfort for patients and even posing a potential threat to their lives.This review briefly describes the op-erative points,advantages,disadvantages,and precautions of commonly used clinical surgical approaches including Calot's triangular approach,posterior Calot's triangular approach,"Ⅴ"-shaped anatomical approach,Rouviere's sulcus-guided pre-cise anatomical Calot's triangular approach,cystic duct serosal"Y"-shaped approach,and"A-B-D"path entry.Addition-ally,the review highlights the importance of a critical view of safety(CVS)technologies.This review provides a reference for selecting the surgical approach in LC to enhance the surgery's safety and to reduce the incidence of surgical complications.
维普
万方数据