腹腔鏡下胆嚢摘出術の経験

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  • Our Experience in Laparoscopic Cholecystectomy.

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In recent years, laparoscopic cholecystectomy has become widely available in France. America and other countries as an alternative to open cholecystectomy in the treatment of gallstone diseases. We have performed 188 laparoscopic cholecystectomies since July 17, 1990. No patient required additional open cholecystectomy. The indications for this procedure were confined to gallstone disease without acute cholecystitis, choledocholithiasis or a history of upper abdominal surgery. Cases in which gall bladder was not imaged by drip infusion cholangiography were excluded. Patients with cholecystic polyp were entered into this study. The patients consisted 63 males and 125 females aged from 17 to 80, with a mean age of 47. The mean operative time in the last 10 cases was 59 minutes, in contrast to 140 minutes in the first 10 cases, indicating a rapid learning curve for this procedure. The minimum operative time was 27 minutes. 2 cases were complicated with bile leakage, which stopped spontaneously. Subcutaneous emphysema was observed in 2 patients, but disappeared withinseveral hours. The mean period of hospitalization after surgery was 7 days, with the shorttest being 4 days. The percentage of complaints of pain with this method was much less than that in open cholecystectomy. Laparoscopic cholecystectomy seems to be a safe and effective treatment for gallstone disease, and will become a common procedure in the near futurein Japan.

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