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首页> 外文期刊>Surgical Endoscopy >Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery.
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Cholecystoenteric fistula (CF) is not a contraindication for laparoscopic surgery.

机译：胆囊肠瘘不是腹腔镜手术的禁忌症。

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BACKGROUND: Cholecystoenteric fistula (CF) is a rare complication of cholelithiasis. The aim of this study was to evaluate the safety and risk of complications when the laparoscopic approach is applied in patients with CF. METHODS: A questionnaire was mailed to all surgeons with experience of >100 cholecystectomies working in Naples, Italy, and the neighboring area. RESULTS: Between February 1990 and May 1999, 34 patients presented with cholecystoenteric fistula (0.2% of >15,000 laparoscopic cholecystectomies performed in the same period). These patients were allocated into two groups: the LT group (those who underwent laparotomic conversion after the diagnosis of CF), which consisted of 20 patients, four men and 16 women, with a mean age of 66.5 +/- 9.3 years (range, 46-85) and the LS group (laparoscopically treated patients), which consisted of 14 patients, three men and 11 women, with a mean age of 65.6 +/- 8.8 years (range, 51-74). They types of CF observed were as follows: in the former group of patients, cholecystoduodenal fistulas (n = 11, 55%), cholecystocolic fistulas (n = 5, 25%), cholecystojejunal fistulas (n = 3, 15%), and cholecystogastric fistulas (n = 1, 5%); in the latter group, cholecystoduodenal fistulas (n = 8, 5.1%), and cholecystocolic fistulas (n = 4, 28.6) and cholecystojejunal fistulas (n = 2, 14.3%). Stapler closure of CF was done in four LT patients and three LS patients with cholecystoduodenal fistula; it was also done in three LT patients and three LS patients with cholecystocolic fistula. Hand-sutured fistulectomy was performed in six LT patients and three LS patients with cholecystoduodenal fistula, in two LT patients with cholecystocolic fistula, and in all patients with cholecystojejunal or cholecystogastric fistula. There were no deaths or intraoperative complications in either group. One patient in the LT group developed a bronchopneumonia postoperatively. Postoperative hospital stay was significantly longer in LT patients-17 +/- 4 vs 3+/-1 days (p < 0.001). CONCLUSION: Cholecystoenteric fistula is an occasional intraoperative finding during laparoscopic cholecystectomy. The results of this study, which are based on the collective experiences of 19 surgeons, illustrate the growing success of the laparoscopic approach to this condition, including a decreasing rate of conversion to open surgery over the last 3 years.
机译：背景：胆囊肠瘘是胆石症的一种罕见并发症。这项研究的目的是评估腹腔镜手术在CF患者中的安全性和并发症风险。方法：向所有在意大利那不勒斯及周边地区工作超过100例胆囊切除术经验的外科医生寄出了调查问卷。结果：在1990年2月至1999年5月之间，有34例胆囊肠瘘（在同期进行的15,000例腹腔镜胆囊切除术中占0.2％）。这些患者分为两组：LT组（诊断为CF后进行了腹腔镜手术的患者），由20例患者组成，其中4例男性和16例女性，平均年龄为66.5 +/- 9.3岁（范围46-85岁）和LS组（经腹腔镜治疗的患者），其中14例，男3例，女11例，平均年龄65.6 +/- 8.8岁（范围51-74）。他们观察到的CF的类型如下：在前一组患者中，胆囊十二指肠瘘（n = 11，55％），胆囊球囊瘘（n = 5、25％），胆囊空肠瘘（n = 3，15％）和胆囊胃瘘（n = 1，5％）;在后一组中，胆囊十二指肠瘘（n = 8、5.1％），胆囊球囊瘘（n = 4、28.6）和胆囊空肠瘘（n = 2、14.3％）。在4例LT患者和3例LS胆囊十二指肠瘘患者中完成了CF的吻合钉闭合术;在3例LT患者和3例LS患者中有胆囊球囊瘘。对6例LT患者和3例LS胆囊十二指肠瘘患者，2例LT胆囊管瘘患者以及所有胆囊空肠或胆囊胃瘘患者进行了手工缝合的瘘管切除术。两组均无死亡或术中并发症发生。 LT组的一名患者术后出现支气管肺炎。 LT患者的术后住院时间显着延长，分别为17 +/- 4天和3 +/- 1天（p <0.001）。结论：胆囊肠瘘是腹腔镜胆囊切除术中偶尔出现的术中发现。这项研究的结果基于19位外科医生的集体经验，说明了腹腔镜手术在此情况下取得的成功，包括过去3年中转为开放手术的比率不断下降。

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