Медицинская литература. Новинки

 

 

 

 

 

 

Конверсия доступа при лапароскопической холецистэктомии

Вы можете загрузить полный текст статьи в формате pdf

Авторы провели метаанализ данных литературы и собственных данных более 2100 лапароскопических холецистэктомий с целью установить факторы риска развития конверсии лапароскопического доступа в открытую холецистэктомию. Был выделен ряд объективных и субъективных факторов, позволяющих формировать группу больных с низким риском конверсии для выполнения операции хирургами на этапе повышения квалификации.

Ключевые слова:
лапароскопическая холецистэктомия, конверсия доступа, факторы риска.

Литература:
1. Alponat A., Kum C.K., Koh B.C. et al. Predictive factors for con
version of laparoscopic cholecystectomy // Wld J. Surg. 1997.
V. 21. P. 629–633.
2. Ji W., Li L.T., Wang Z.M. et al. A randomized controlled trial of
laparoscopic versus open cholecystectomy in patients with
cirhotic portal hypertension // Wld J. Gastroenterol. 2005. V. 11.
P. 2513–2517.
3. Johansson M., Thune A., Blomqvist A. et al. Management of acute
cholecystitis in the laparoscopic era: Results of a prospective,
randomized clinical trial // J. Gastrointest. Surg. 2003. V. 7.
P. 642–645.
4. Johansson M., Thune A., Nelvin L. et al. Randomized clinical
trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis // Br. J. Surg. 2005. V. 92. P. 44–49.
5. Kiviluoto T., Siren J., Luukkonen P., Kivilaakso F. Randomised
trial of laparoscopic versus open cholecystectomy for acute and
gangrenous cholecystitis // Lancet. l998. V. 351. P. 321–325.
6. Koo K.P., Thiriby R.C. Laparoscopic cholecystectomy in acute
cholecystitis. What is the optimal timing for operation? //
Arch. Surg. 1996. V. 131. P. 540–544.
7. Lo C.M., Lai E.C., Fan S.T. et al. Laparoscopic cholecystectorny
for acute cholecystitis in the elderly // Wld J. Surg. 1996. V. 20.
P. 983–986.
8. Lo C.M., Liu C.L., Fan S.T. et al. Prospective randomized study
of early versus delayed laparoscopic cholecystectomy for acute
cholecystitis // Ann. Surg. 1998. V. 227. P. 461–467.
9. Madan A.K., Aliabadi-Wahie, Tesi D. et al. How early is early
laparoscopic treatment of acute cholecystitis // Am. J. Surg.
2002. V. 183. P. 232–236.
10. Morgenstern L. Achilles’s heel and laparoscopic surgery //
Surg. Endosc. 1995. V. 9. P. 383.

Convertion of Approach during Laporoscopic Cholecystectomy

The authors conducted the meta-analysis of data of literature and our own data of more than 2100 laparoscopic cholecystectomy for the purpose to establish the risk factors of the development of convertion of the of the laparoscopic approach into open cholecystectomy. The authors isolated a number of the real (patientrelated and diseaserelated) and subjective factors, which make it possible to form the group of patients with the low risk of conversion for fulfilling the operation by surgeons in the stage of an increase in their qualification.

Keywords:
laparoscopic cholecystectomy, convertion, risk factors, proficiency gain curve.