腹腔鏡的胆嚢摘出術および経胆嚢管的結石砕石術 (LTCL) に於けるレーザーの役割

抄録

Since July 1990, 750 consecutive patients with gallstones have undergone laparoscopic cholecystectomy. The overall results were satisfying, emphasizing the safety and efficacy of the new procedure laparoscopic cholecystectomy. 670 of 750 patients have undergone ablation of gall bladder by Nd-YAG laser and other 80 patients by electric cautery. In fundamenntal experiment, laser effected narrow and deep denaturalization, but on the other hand electric cautery effected wide and shallow denaturalization. In clinical data there was no significant difference between laser and electric cautery, but by laser we could ablate gall bladder more delicately than by electric cautery and then we think in cases of chronic severe cholecystitis we had better use laser because it is necessary to distinguish exact layer of ablation. Forty patients with common bile duct stones have undergone laparoscopic transcystic cholangioscopic lithotripsy (LTCL). In power of lithotripsy Alexandrite laser was inferior to Electrohydraulic lithotripsy (EHL), but in safty Alexandrite laser was superior to EHL.