Ann Surg：机器人在医源性胆道损伤的重建与修复中的作用！

2017-07-09 MedSci MedSci原创

目前，医源性胆管损伤（BDI）仍然是开放性手术与腹腔镜胆囊切除术的主要关注点。在过去十年中，机器人手术已经应用了许多不同的程序，显示出了其技术优势，特别是在显微外科领域。到目前为止，只有很少的文献描述了机器人BDI的重建案例。近期，一项发表在杂志Ann Surg上的研究旨在分析医源性胆道损伤的机器人重建术的围手术期结果，并详细描述了手术细节。此项研究是一项单次外科医生回顾性研究，包括了由医源性BD

目前，医源性胆管损伤（BDI）仍然是开放性手术与腹腔镜胆囊切除术的主要关注点。在过去十年中，机器人手术已经应用了许多不同的程序，显示出了其技术优势，特别是在显微外科领域。到目前为止，只有很少的文献描述了机器人BDI的重建案例。

近期，一项发表在杂志Ann Surg上的研究旨在分析医源性胆道损伤的机器人重建术的围手术期结果，并详细描述了手术细节。

此项研究是一项单次外科医生回顾性研究，包括了由医源性BDIs引起的机器人辅助胆道重建的14例患者。

共14例患者接受机器人辅助BDI重建。平均手术时间，失血量和住院时间分别为280.6分钟（SD = 132.0），135.0 mL（SD = 169.7），8.4天（SD = 6.7）。开放手术的转换率为0％。长期随访率为85.7％（14例中12例），平均随访时间为36.1个月（SD = 28.1）。大于 30天的并发症发生率为14.3％（n = 2）。这2例患者由于肝-空肠造口术轻度狭窄而呈现胆管炎复发，经肝经皮胆道引流和多次扩张最终治愈。

此项研究表明：机器人辅助BDI重建是可行的、安全的。它保持了微创手术的所有好处，并且似乎在肝门的微细解剖和微缝合中具有技术优势（放大显微镜）。在此项研究中，14例BDI患者采用机器人手术方式进行修复，转换开放手术和再手术率为0％。长期成果评估需要更长时间的跟进和更大规模的系列研究，但初步结果表现出来其具有一定的前景。

原始出处：
Giulianotti PC, Quadri P, et al. Reconstruction/Repair of Iatrogenic Biliary Injuries: Is the Robot Offering a New Option? Short Clinical Report. Ann Surg. 2017 Jun 27. doi: 10.1097/SLA.0000000000002343.

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2017-07-15 天涯183

非常好的文章，学习了，很受益

65 0
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2017-07-11 仁医06

#机器人#

25 0
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2017-07-11 ms3046638856685384

#损伤#

25 0
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createdTime=Tue Jul 11 03:23:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397248, encodeId=485b139e248a8, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue Jul 11 03:23:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583042, encodeId=87b515830425b, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 09 14:57:17 CST 2017, time=2017-07-09, status=1, ipAttribution=)]
2017-07-11 ms6279672939590805

#机器#

20 0
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createdTime=Tue Jul 11 03:23:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397248, encodeId=485b139e248a8, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue Jul 11 03:23:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583042, encodeId=87b515830425b, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Jul 11 03:23:00 CST 2017, time=2017-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220681, encodeId=ef21220681fb, content=太好了，期待中, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Mon Jul 10 10:01:56 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220504, encodeId=d6c9220504fc, content=学习了受益匪浅, 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likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Sun Jul 09 16:22:00 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220355, encodeId=df3722035509, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Sun Jul 09 15:11:11 CST 2017, time=2017-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220348, encodeId=fcbd22034828, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 09 14:57:17 CST 2017, time=2017-07-09, status=1, ipAttribution=)]
2017-07-10 清风拂面

太好了，期待中

60 0
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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 09 14:57:17 CST 2017, time=2017-07-09, status=1, ipAttribution=)]
2017-07-10 130****4638

学习了受益匪浅

59 0
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2017-07-09 lyh994

稳，准，细，智能，人类五官的延伸

39 0
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2017-07-09 忠诚向上

好好的看看有进步

45 0
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2017-07-09 楠博One

学习谢谢分享

19 0
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2017-07-09 天涯183

非常好的文章，学习了，很受益

17 0