维普中文期刊产品整合服务

Bile leakage after loop closure vs clip closure of the cystic duct during laparoscopic cholecystectomy:A retrospective analysis of a prospective cohort

查看全文 作　　者：Sandra C [1]Donkervoort;Lea M [2]Dijksman;Aafke H van [3]Dijk;Emile A [1]Clous;Marja A [3]Boermeester;Bert van [2]Ramshorst;Djamila [2]Boerma 高影响力作者 机构地区：[1]Department of Surgery,Onze Lieve Vrouwe Gasthuis,Amsterdam 1090 HM,Netherlands;[2]Department of Research and Epidemiology,St.Antonius Hospital,Nieuwegein 3435 CM,Netherlands;[3]Department of Surgery,Academic Medical Centre,Amsterdam 1105 AZ,Netherlands高影响力机构 出　　处：《World Journal of Gastrointestinal Surgery》索引2020年第12卷第1期,共8页高影响力期刊 摘　　要：BACKGROUND Laparoscopic cholecystectomy(LC)is one of the most frequently performed surgical procedures.Cystic stump leakage is an underestimated,potentially life threatening complication that occurs in 1%-6%of the patients.With a secure cystic duct occlusion technique during LC,bile leakage becomes a preventable complication.AIM To investigate the effect of polydioxanone(PDS)loop closure of the cystic duct on bile leakage rate in LC patients.METHODS In this retrospective analysis of a prospective cohort,the effect of PDS loop closure of the cystic duct on bile leakage complication was compared to patients with conventional clip closure.Logistic regression analysis was used to develop a risk score to identify bile leakage risk.Leakage rate was assessed for categories of patients with increasing levels of bile leakage risk.RESULTS Of the 4359 patients who underwent LC,136(3%)underwent cystic duct closure by a PDS loop.Preoperatively,loop closure patients had significantly more complicated biliary disease compared to the clipped closure patients.In the loop closure cohort,zero(0%)bile leakage occurred compared to 59 of 4223(1.4%)clip closure patients.For patients at increased bile leakage risk(risk score≥1)rates were 1.6%and up to 13%(4/30)for clip closure patients with a risk score≥4.This risk increase paralleled a stepwise increase of actual bile leakage complication for clip closure patients,which was not observed for loop closure patients.CONCLUSION Cystic duct closure with a PDS loop during LC may reduce bile leakage in patients at increased risk for bile leakage. 关 键 词：Laparoscopic cholecystectomy Cystic duct occlusion Bile leak Endo-loop
相关文献

参考文献(33)

引证文献(5)

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1　渝公网安备 50019002500403号　违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费