目的 探討達芬奇機器人手術(shù)治療復(fù)雜肝內(nèi)膽管結(jié)石的療效和預(yù)后情況。
方法 對筆者所在單位2009年1月至2011年8月期間15例接受機器人輔助下手術(shù)治療的復(fù)雜肝內(nèi)膽管結(jié)石患者的臨床資料進行回顧性分析。
結(jié)果 15例患者均順利完成手術(shù),無中轉(zhuǎn)開腹,術(shù)中無損傷重要血管及臟器發(fā)生,術(shù)后并發(fā)癥4例(26.7%),其中膽道出血1例(6.7%),肝創(chuàng)面出血2例(13.3%),肺部感染1例(6.7%),無圍手術(shù)期肝功能衰竭及死亡病例。15例均獲隨訪,隨訪時間3個月~2年,平均11個月,總體隨訪率100%,療效優(yōu)良者12例(80.0%),殘余結(jié)石者3例(20.0%),結(jié)石復(fù)發(fā)者1例(6.7%)。
結(jié)論 達芬奇機器人輔助下治療高齡、多次手術(shù)史、肝功能差及伴急性膽管炎等復(fù)雜肝內(nèi)膽管結(jié)石患者具有巨大的潛力。
引用本文: 方晶晶,丁磊,解敬偉,周寧新. 達芬奇機器人輔助下復(fù)雜肝內(nèi)膽管結(jié)石的外科治療. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(6): 632-635. doi: 復(fù)制
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1. | Choi SB, Park JS, Kim JK, et al. Early experiences of roboticassisted laparoscopic liver resection [J]. Yonsei Med J, 2008,49(4):632-638. |
2. | Herron DM, Marohn M,SAGES-MIRA Robotic Surgery Consesus Group. A consensus document on robotic surgery [J]. Surg Endose, 2008, 22(2):313-315. |
3. | Ballantyne GH. Robotic surgery telerobotic surgery, telepresense,and telementoring [J]. Surg Endose, 2002, 16(10):1389-1402. |
4. | Murphy DG, Hall R, Tong R, et al. Robotic technology in surgery:current status in 2008 [J]. ANZ J Surg,2008, 78(12):1076-1081. |
5. | Lanfranco AR, Castellanos AE, Desai JP, et al. Robotic surgery:a current perspective [J] . Ann Surg, 2004, 239(1):14-21. |
6. | Huang CJ, Lin PW. Pole of right bepatic lebectomy in the treatment of isolated right-sided hepatolithiasia [J]. Surgery, 2007,121(2):130-134. |
7. | Cheung MT, Kwok PC. Liver resection for intraheoatic stones [J]. Arch Surg, 2005, 140(10):993-997. |
8. | Sun WB, Han BL,Cai JX, et al. The surgical treatment of leftsided hepatolithiasis:a 22-year expericence [J]. Surgery,2000, 127(5):493-497. |
9. | 黃志強. 醫(yī)源性膽管狹窄:膽道外科之痛 [J]. 中華消化外科雜志, 2008, 7(1):1-5. |
10. | 黃志強. 肝內(nèi)膽管結(jié)石的外科治療進展 [J]. 中國實用外科學雜志, 2004, 24(2):181. |
11. | Lazaridis C, Papaziogas B, Alexandrakis A, et al. Intrahepatic lithiasis as a late complication of hepaticojejunostomy [J]. Surg Endosc, 2003, 17(4):661. |
12. | Okugawa T, Tsuyuguchi T, Ando T, et al. Peroral cholangioscopic treatment of hepatolithiasis:long-term result [J]. Gastroinest Endose, 2002, 56(3):366-371. |
13. | Nadler RB, Rubenstein JN, Kim SC, et al. Percutaneous hepatolithotomy:the Northwestern University experience [J]. J Endourol, 2002, 16(5):293-297. |
14. | 董家鴻, 黃志強, 蔡景修, 等. 規(guī)則性肝段切除術(shù)治療肝內(nèi)膽管結(jié)石病 [J]. 中華普通外科雜志, 2002, 17(7):418-419. |
15. | Hwang S, Lee SG, Kim MH, et al. Intaoperative biliary expliration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis [J]. Langenbecks Arch Surg, 2007, 393(3):383-389. |
16. | Uchiyama K, Kawai M, Ueno M, et al. Reducing residual and recurrent stones by hepatectomy for hepatolithiasis [J]. J Gastrointest Surg, 2007, 11(5):626-630. |
17. | Vetrone G, Ercolani G, Grazi GL, et al. Surgical therapy for hepatolithiasis:a western experience[J]. J Am Coll Surg,2006, 202(2):306-312. |
18. | Lee TY, Chen YL, Chang HC, et al. Outcomes of hepatectomy for hepatolithiasis [J]. Word J Surg, 2007, 31(3):479-482. |
19. | Lee SE, Jang JY, Lee JM, et al. Selection of appropriate liver resection in left hepatolithiasis based on anatomic and clinical study [J]. Word J Surg, 2008, 32(3):413-418. |
20. | 付順軍, 李紹強, 梁力健, 等. 肝切除術(shù)治療肝內(nèi)膽管結(jié)石術(shù)后發(fā)生并發(fā)癥的危險因素分析 [J]. 中華肝膽外科雜志,2010, 16(5):325-327. |
21. | Karayiannakis AJ, Polychronidis A, Perente S, et al. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery [J]. Sury Endosc, 2004, 18(1):97-101. |
22. | Akyurek N, Salman B, Irkorucu O, et al. Laparoscopic cholecystectomy in patients with previous abdominal surgery [J].JSLS, 2005, 9(2):178-183. |
23. | 周寧新, 劉全達. 達芬奇系統(tǒng)在腹部外科的應(yīng)用 [J]. 腹部外科, 2009, 22(5):261-262. |
24. | Hashizume M, Tsugawa K. Robotic surgery and cancer:the present state, problems and future vision [J]. Jpn J Clin, 2004,34(5):227-237. |
25. | Camarillo DB, Krummel TM, Salisbury JK Jr. Robotic technology in surgery:past, present, and future [J]. Am J Surg, 2004,188(4A Suppl):2S-15S. |
- 1. Choi SB, Park JS, Kim JK, et al. Early experiences of roboticassisted laparoscopic liver resection [J]. Yonsei Med J, 2008,49(4):632-638.
- 2. Herron DM, Marohn M,SAGES-MIRA Robotic Surgery Consesus Group. A consensus document on robotic surgery [J]. Surg Endose, 2008, 22(2):313-315.
- 3. Ballantyne GH. Robotic surgery telerobotic surgery, telepresense,and telementoring [J]. Surg Endose, 2002, 16(10):1389-1402.
- 4. Murphy DG, Hall R, Tong R, et al. Robotic technology in surgery:current status in 2008 [J]. ANZ J Surg,2008, 78(12):1076-1081.
- 5. Lanfranco AR, Castellanos AE, Desai JP, et al. Robotic surgery:a current perspective [J] . Ann Surg, 2004, 239(1):14-21.
- 6. Huang CJ, Lin PW. Pole of right bepatic lebectomy in the treatment of isolated right-sided hepatolithiasia [J]. Surgery, 2007,121(2):130-134.
- 7. Cheung MT, Kwok PC. Liver resection for intraheoatic stones [J]. Arch Surg, 2005, 140(10):993-997.
- 8. Sun WB, Han BL,Cai JX, et al. The surgical treatment of leftsided hepatolithiasis:a 22-year expericence [J]. Surgery,2000, 127(5):493-497.
- 9. 黃志強. 醫(yī)源性膽管狹窄:膽道外科之痛 [J]. 中華消化外科雜志, 2008, 7(1):1-5.
- 10. 黃志強. 肝內(nèi)膽管結(jié)石的外科治療進展 [J]. 中國實用外科學雜志, 2004, 24(2):181.
- 11. Lazaridis C, Papaziogas B, Alexandrakis A, et al. Intrahepatic lithiasis as a late complication of hepaticojejunostomy [J]. Surg Endosc, 2003, 17(4):661.
- 12. Okugawa T, Tsuyuguchi T, Ando T, et al. Peroral cholangioscopic treatment of hepatolithiasis:long-term result [J]. Gastroinest Endose, 2002, 56(3):366-371.
- 13. Nadler RB, Rubenstein JN, Kim SC, et al. Percutaneous hepatolithotomy:the Northwestern University experience [J]. J Endourol, 2002, 16(5):293-297.
- 14. 董家鴻, 黃志強, 蔡景修, 等. 規(guī)則性肝段切除術(shù)治療肝內(nèi)膽管結(jié)石病 [J]. 中華普通外科雜志, 2002, 17(7):418-419.
- 15. Hwang S, Lee SG, Kim MH, et al. Intaoperative biliary expliration through the left hepatic duct orifice during left hepatectomy in patients with left-sided hepatolithiasis [J]. Langenbecks Arch Surg, 2007, 393(3):383-389.
- 16. Uchiyama K, Kawai M, Ueno M, et al. Reducing residual and recurrent stones by hepatectomy for hepatolithiasis [J]. J Gastrointest Surg, 2007, 11(5):626-630.
- 17. Vetrone G, Ercolani G, Grazi GL, et al. Surgical therapy for hepatolithiasis:a western experience[J]. J Am Coll Surg,2006, 202(2):306-312.
- 18. Lee TY, Chen YL, Chang HC, et al. Outcomes of hepatectomy for hepatolithiasis [J]. Word J Surg, 2007, 31(3):479-482.
- 19. Lee SE, Jang JY, Lee JM, et al. Selection of appropriate liver resection in left hepatolithiasis based on anatomic and clinical study [J]. Word J Surg, 2008, 32(3):413-418.
- 20. 付順軍, 李紹強, 梁力健, 等. 肝切除術(shù)治療肝內(nèi)膽管結(jié)石術(shù)后發(fā)生并發(fā)癥的危險因素分析 [J]. 中華肝膽外科雜志,2010, 16(5):325-327.
- 21. Karayiannakis AJ, Polychronidis A, Perente S, et al. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery [J]. Sury Endosc, 2004, 18(1):97-101.
- 22. Akyurek N, Salman B, Irkorucu O, et al. Laparoscopic cholecystectomy in patients with previous abdominal surgery [J].JSLS, 2005, 9(2):178-183.
- 23. 周寧新, 劉全達. 達芬奇系統(tǒng)在腹部外科的應(yīng)用 [J]. 腹部外科, 2009, 22(5):261-262.
- 24. Hashizume M, Tsugawa K. Robotic surgery and cancer:the present state, problems and future vision [J]. Jpn J Clin, 2004,34(5):227-237.
- 25. Camarillo DB, Krummel TM, Salisbury JK Jr. Robotic technology in surgery:past, present, and future [J]. Am J Surg, 2004,188(4A Suppl):2S-15S.