经自然管壁内镜手术胆囊切除术动物实验.pdfVIP

经自然管壁内镜手术胆囊切除术动物实验 孙刚，李 闻，孙国辉，王向东，孟江云，杜红，杨云生 解放军总医院消化科，北京100853 摘要：目的探讨单孔腹腔镜辅助下自然管壁内镜手术(NOTES)胆囊切除术的操作方法、可行性及安全性。方法采用成年 杂种犬模型10只。先后完成内镜下胃造口术、腹腔探查、经脐单孔腹腔镜辅助下月H囊暴露及内镜下胆囊切除术。术后钛 夹闭合胃壁切口，常规应用抗生素3d，半流食饲养。2周后处死模型解剖，观察胆囊切除术后改变。结果8只模型胆囊切 术中肝脏出血应用电凝止血4次，钛夹闭合1次；胆囊及胆囊管残端漏各1次，用钛夹闭合成功。存活两周模型解剖胃壁 造口完整闭合，腹腔无脓肿。结论杂种犬能较好模拟人体进行内镜月日囊切除术研究。经脐戳孑L辅助经胃途径胆囊切除术 是可行的，具有一定的安全性，目前的器械和设备尚不能满足NOTES技术需要，还有待研发。 关键词：模型，动物；胆囊切除术，腹腔镜；经自然管壁内镜手术 中图分类号：R32 文献标识码：A 14-03 文章编号：1005一l139(2011)02—01 Naturalorificetranslumenal model endoscopiccholecystectomy：Animal SUN Wen，SUNGuo-hui，WANG Gang，LI Xiang-dong，MENGJiang—yun，DUHong，YANGYun—sheng of and PLAGeneral 100853，China DepartmentGastroenterologyHepatology，ChineseHospital，Beijing author：YANG Corresponding Yun—sheng．Email：sunny888@medmail．com．cn To the and ofnaturalorificetranslumenal Abstract：0bjectivestudymanipulation，feasibilitysafety endoscopic inanimalmodels．MethodsTen in wereinvolvedthis mongreldogs study．Endoscopic oriflee were incisionon wallwasclosedandantibioticswere single endoscopiccholecystectomyperformed．Thegastric routinely used．neanirealswerefedwith weeksafter animalsweresacrificedtoobservethe semi．1iquiddiet．TwO operation．the changes rateof occurredafter Ofthe10 survivedfor2weeksafter withaSuccess 80％(8／10)，l cholecystectomy．Resuitsdogs．8 operation died 1 died1 weekafter duetoabdominalabscess．The timeWas80 40- duringoperation．and operation averageoperation min(range 4 with and w