医学
套管
外科
胆囊切除术
脐(软体动物)
剖腹手术
解剖(医学)
病历
胆囊管
普通外科
作者
Allen Simon,Eric Monnet
摘要
Abstract Objective To evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs. Study Design Retrospective study. Animals Fifteen client‐owned dogs with nonobstructive gallbladder disease. Methods Medical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal. Results The SPAS was placed 1 cm caudal to the umbilicus. The procedure was completed with the SPAS alone in two cases. An additional cannula was added in 12 cases. In the last 10 cases, the additional cannula was placed at the beginning of the procedure. Dissection began at the cystic duct in 11 dogs (73%). In three cases (20%), the SPAS procedure was converted to a laparotomy; two of these conversions were elective, and one was emergent. The risk of conversion was affected by the experience of the surgeon (odds ratio = 0.53; P = .0105), and the rate of conversion was reduced when a cannula was added at the beginning of the procedure ( P = .022). Fourteen dogs were discharged from the hospital. One dog died after being discharged due to severe cholangiohepatitis, and another dog died due to leakage of a gastrostomy tube. Conclusions The use of SPAS for cholecystectomy in dogs has an acceptable outcome. The experience gained by the surgeon and the addition of a cannula reduced the risk of conversion. Clinical Relevance/Impact Laparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.
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