臨牀消化器内科 Vol.12 No.3(2-2)


特集名 腹腔鏡下手術のPitfall
題名 臓器別の立場から b.胆石・胆嚢手術のPitfall
発刊年月 1997年 03月
著者 柵山 年和 東京慈恵会医科大学青戸病院外科
著者 三穂 乙實 東京慈恵会医科大学青戸病院外科
【 要旨 】 教室における胆道疾患の腹腔鏡下胆嚢摘出術(LC)の適応,合併症と開腹移行症例について検討し,さらに教室での術者の胆道系手術経験度別にLCの手術時間,合併症率,開腹移行率について調べた.合併症の頻度もLCの経験数と反比例し減少しており,術者のトレーニングと経験が合併症の頻度と密接な関係があることは否定できないと考えられた.また,LCの一般的な偶発症,合併症について,その予防と対策を述べた.LCのpitfallの防止対策は,技術的なことだけでなく,むしろこれを行う者に対する教育,トレーニングを充実させることが重要と考えられた.
Theme Pitfalls of Laparoscopic Surgery
Title Pitfalls of Laparoscopic Cholecystectomy
Author Toshikazu Sakuyama Department of Surgery, Aoto Hospital, Jikei University School of Medcine
Author Otomi Miho Department of Surgery, Aoto Hospital, Jikei University School of Medcine
[ Summary ] A retrospective study of complications, converted operations and teaching laparoscopic techniques for laparoscopic cholecystectomy (LC) was conducted in our hospital during a recent 5 year period. Complications decreased according to the grade of experience which the operator had with LC. Thus, there is a close connection between the amount of training and experience, and the frequency of complications. As we pointed out, prophylaxis and counterplans are needed for general complications. According to the prophylaxis regimen against complications of laparoscopic cholecystectomy, not only techniques but also education and training are needed, such that patients are assured the maximum benefit from surgery, rather than being harmed by this procedure.
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