BILIARY SURGERY VIA MINILAPAROTOMY - A LIMITED PROCEDURE FOR BILIARY LITHIASIS

TAKUKAZU NAGAKAWA

《HPB Surgery》 1993卷 (1993/12) Pp. 245-254

https://doi.org/10.1155/1993/56128

摘要

Cholelithiasis until now has been treated using solvents, lithotripsy via a biliary endoscope, laser or shock wave lithotripsy, and laparoscopic cholecystectomy. I have developed a new surgical treatment for cholelithiasis in which a cholecystectomy is performed through a minilaparotomy. This paper presents this new technique and discusses the principles of surgery for cholelithiasis using this technique. This procedure is performed by a 2 to 3 cm subcostal skin incision in the right hypochondrium. More than 400 patients were treated by this technique . This procedure is not different in terms of blood lossor operation time from conventional methods, and no significant complications have occurred. Intraoperative X-ray examination is performed routinely because of easy insertion of a tube from the cystic duct into the bile duct. Reduction of the length of the incision greatly facilitates postoperative recovery, shortening the hospital length-of-stay to within 3 days. The surgical manipulation of only a limited area of the upper abdomen is unlikely to induce postoperative syndromes, such as adhesions or ileus. Following this experience, a biliary drainage procedure based on cholangionmanomery and primary closure of the choledochotomy was introduced. This approach allowed even patients with choledocholithiasis to undergo a minilaparotomy and be discharged within one week.

關鍵字

Cholecystectomy ； minilaparotomy ； variable loading cholangiomanometry ； biliary drainage procedure ； primary closure of the choledochotomy