YAGレーザーを用いた胆嚢摘出術

抄録

We performed 215 laparoscopic cholecystectomies with YAG laser on the patients with cholelithiasis, choledocholithiasis, cholecystic polyp and cholecystic benign tumor since April in 1991. The male was 37% (80 cases) and the female was 63% (135 cases). The average of the age of the patients was 50.8±12.4 years old (mean±SD). We tried to do the intraoperative choledochography in all cases to avoid the intraoperative misorientation in the biliary tract and to ensure the safety on the operation. We didn't get the intraoperative choledochography in the early 6 cases, but we could do the intraoperative choledochography in 100% of the recent 105 cases. The average of the operation time was 136±49min in the first 40 cases, 94±30min in the following 40 cases and 105±64min in the latest 135 cases (mean±SD, respectively). And the average of the amount of laser work was 2944±2167 joule, 1327±667 joule and 1570±1161 joule (mean±SD, respectively). We had 7 cases with severe adhesion around the gallbladder and with thick wall of gallbladder, but completed the laparoscopic cholecystectomy with the dissection of gallbladder from the fundus (so called von Fundus aus). We recognized the sharp dissection with YAG laser especially in these 7 cases, but we never forget we had the laser tip broken during the operation in 2 cases of the above 7 cases. In conclusion, laparoscopic cholecystectomy with YAG laser may be accepted much more commonly as a less invasive surgical therapy in the near future.