中山間地域の一施設における胆石症および胆嚢炎に対する手術法の変遷  [in Japanese] ADVANCE IN SURGICAL METHODS FOR CHOLELITHIASIS AND CHOLECYSTITIS IN A HOSPITAL IN MOUTAINOUS DISTRICTS IN JAPAN  [in Japanese]

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Abstract

愛媛県の中山間地域に位置する町立野村病院(以下,当院)も1992年9月に第1例目の腹腔鏡下胆嚢摘出術(以下, LC) を施行した.最近9年間の当院における胆石症および胆嚢炎症例82例(同期間の全身麻酔下手術症例320例)に対する手術法を検討し,以下のような結果・結論を得た.<br> (1)中山間地域に位置する当院でもLCは近年増加傾向にあり,全手術症例からみてその占める割合が大きい.また, 94年以降は予定手術に対しては全例, 96年以降胆嚢炎症例にもドレナージ後可能な限りLCを施行しており,胆石症・胆嚢炎症例に対する標準術式として定着している.<br> (2)当院のような施設では,急性胆嚢炎症例は高齢者に多く,しかも全身状態が悪いため,このような症例に対して,あえて危険を冒すことなくPTGBDやPTGBAなどのドレナージ後にLCを行うのが望ましいと思われる.

In September 1992, the first laparoscopic cholecystectomy (LC) was performed at the Municipal hospital of Nomura in a mountainous district of Ehime-Prefecture, Japan.<br> Thereafter, 82 cases of cholelithiasis or cholecystitis among a total of 320 cases undergone operation under general anesthesia in a recent 9 years were subjected to a study of surgical methods, and the following conclusions were drawn;<br> 1. In our hospital in mountainous districts, LC has been standardized and increasing recently as a surgical procedure for cholelithiasis and cholecystitis.<br> And also since 1994, LC has been performed in all of elective cases and in cases after drainage for acute cholecystitis, meaning that LC has now become a standardized surgical method for cholelithiasis and cholecystitis.<br> 2. In hospitals like ours located in mountainous districts, acute cholecystitis often occurs in elderly and poor-risk patients. We think that, for such patients with acute cholecystitis, LC following drainages including PTGBD and PTGBA is preferred rather than take a risk of laparotomy.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 60(8), 2039-2043, 1999-08-25

    Japan Surgical Association

References:  23

Codes

  • NII Article ID (NAID)
    10008495928
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    13452843
  • Data Source
    CJP  J-STAGE 
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