臨床外科64巻13号

2009年12月発行

特集 内視鏡下手術―もう一歩のステップアップのために

胆道疾患に対する腹腔鏡下手術

著者： 森俊幸¹ 青木久恵¹ 杉山政則¹ 跡見裕¹

所属機関： ¹杏林大学医学部外科

ページ範囲：P.1689 - P.1695

要旨：比較的炎症の少ない胆囊に対して胆摘が必要な際には，腹腔鏡下胆囊摘出術（以下，ラパコレ）が第一選択の術式であることに異論は少ない．従来，急性・慢性胆囊炎は技術的難度の高さから，本術式の相対・絶対禁忌とする論調も過去にはあったが，現在では，これらの胆囊炎もすべてラパコレでよいと考えられるようになった．特に急性胆囊炎では，発症後早期の手術が勧められている．肥満や妊娠・高齢者などもラパコレの禁忌とはならないが，Mirizzi症候群に対しては，ラパコレを行わないとする見解が多い．炎症の少ない胆囊では，単一創から器械で手術を行うsingle port surgeryが普及してきている．

参考文献

1）Zucker KA, Flowers JL, Bailey RW：Laparoscopic management of acute cholecystitis. Am J Surg 165：508-514, 1993

2）Unger SW, Edelman DS, Scott JS, et al：Laparoscopic treatment of acute cholecystitis. Surg Laparosc Endosc 1：14-16, 1991

3）Luján JA, Parrilla P, Robels R, et al：Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis：a prospective study. Arch Surg 133：173-175, 1998

4）Kiviluoto T, Sirén J, Luukkonen P, et al：Randomized trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet 351：321-325, 1998

5）Lo CM, Liu CL, Fan ST, et al：Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg 227：461-467, 1998

6）Johansson M, Thune A, Blomqvist A, et al：Management of acute cholecystitis in the laparoscopic era：results of a prospective, randomized clinical trial. J Gastrointest Surg 7：642-645, 2003

7）Berbig R, Muller C：The gallbladder with severe pathologic changes：a contraindication for laparoscopic choledcystectomy? Helv Chir Acta 58：983-986, 1992

8）Carmody E, Arenson AM, Hanna S：Failed or difficult laparoscopic cholecystectomy：can preoperative ultrasonography identify potential problems? J Clin Ultrasound 22：391-396, 1994

9）Sakuramoto S, Sato S, Okuri T, et al：Preoperative evaluation to predict technical difficulties of lapsroscopic cholecystectomy on the basis of histological inflammation findings on resected gallbladder. Am J Surg 179：114-121, 2000

10）Kwon AH, Inui H, Imamura A, et al：Preoperative assessment for laparoscopic cholecystectomy：feasibility of spiral computed tomography. Ann Surg 227：351-356, 1998

11）Cornell CM, Clarke R：Vicarious calcification involving the gallbladder. Ann Surg 149：267-272, 1959

12）Etala E：Cancer de la vesicula biliar. Prensa Med Argent 49：2283-2299, 1962

13）Welch NT, Fitzgibbons RJ Jr., Hinder RA：Beware of the porcelain gallbladder during cholecystectomy. Surg Laparosc Endosc 1：202-205, 1991

14）Towfigh S, McFadden DW, Cortina GR, et al：Porcelain gallbladder is not associated with gallbladder carcinoma. Am Surg 67：7-10, 2001

15）Shimizu M, Miura J, Tanaka T, et al：Porcelain gallbladder：relation between its type by ultrasound and incidence of cancer. J Clin Gastroenterol 11：471-476, 1989

16）Stephen AE, Berger DL：Carcinoma in the porcelain gallbladder：a relationship revisited. Surgery 129：699-703, 2001

17）Kwon AH, Inui H, Matsui Y, et al：Laparoscopic cholecystectomy in patients with porcelain gallbladder based on the preoperative ultrasound findings. Hepatogastroenterology 51：950-953, 2004

18）Kuroki T, Tajima Y, Matsuzaki S, et al：Pre-and intraoperative evaluation of biliary system for successful laparoscopic cholecystectomy in porcelain gallbladder patients. Hepatogastroenterology 49：621-624, 2002

19）Moser JJ, Baer HU, Glättli A, et al：Mirizzi syndrome-a contraindication for laproscopic surgery. Helv Chir Acta 59：577-580, 1993

20）Sare M, Gürer S, Taskin V, et al：Mirizzi syndrome：choice of surgical procedure in the laparoscopic era. Surg Laparosc Endosc 8：63-67, 1998

21）Chowbey PK, Sharma A, Mann V, et al：The management of Mirizzi syndrome in the laparoscopic era. Surg laparosc Endosc Percutan Tech 10：11-14, 2000

22）Yeh CN, Jan YY, Chen MF：Laparoscopic treatment of Mirizzi syndrome. Surg Endosc 17：1573-1578, 2003

23）Ouchi K, Mikuni J, kakugawa Y：Laparoscopic cholecystectomy for gallbladder carcinoma：results of Japanese survey of 498 patients. J Hepatobiliary Pancreat Surg 9：256-260, 2002

24）Whalen GF, Bird I, Tanski W, et al：Laparoscopic cholecystectomy does not demonstrably decrease survival of patients with serendipitously treated gallbladder cancer. J Am Coll Surg 192：189-195, 2001

25）Weinstein D, Herbert M, Bendet N, et al：Incidental finding of gallbladder carcinoma. Isr Med Assoc J 4：334-336, 2002

26）Wibbenmeyer LA, Wade TP, Chen RC, et al：Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder. J Am Coll Surg 181：504-510, 1995

27）Weiland ST, Mahvi DM, Niederhuber JE, et al：Should suspected early gallbladder cancer be treated laparoscopically? J Gastrointest Surg 6：50-56, 2002

28）Fontes PR, de Mattos AA, Eilers RJ, et al：Laparoscopic cholecystectomy in patients with liver cirrhosis. Arg Gastroenterol 20：212-216, 2002

29）Poniachik J, Castro S, Madrid AM, et al：Laparoscopic and classic cholecystectomy in patients with liver cirrhosis. Rev Med Chil 130：1343-1348, 2002

30）Goldstein SL, Matthews BD, Sing RF, et al：Lateral approach to laparoscopic cholecystectomy in the previously operated abdomen. J Laparoendosc Adv Surg Tech A11：183-186, 2001

31）Popken F, Küchle R, Heintz A, et al：Laparoscopic cholecystectomy in high risk patients. Chirurg 68：801-805, 1997

32）Salameh JR, Franklin ME Jr：Acute cholecystitis and severe ischemic cardiac disease：is laparoscopy indicated? JSLS 8：61-64, 2004

33）Saxe A, Lawson J, Phillips E：Laparoscopic cholecystectomy in patients aged 65 or older. J Laparoendosc Surg 3：215-219, 1993

34）Sperlongano P, Pisaniello D, Parmeggiani D, et al：Laparoscopic cholecystectomy in the mobidly obese. Chir Ital 54：363-366, 2002

35）Unger SW, Unger HM, Edelman DS, et al：Obesity：an indication rather than contraindication to laparoscopic cholecystectomy. Obes Surg 2：29-31, 1992

36）Conron RW Jr, Abbruzzi K, Cochrane SO, et al：Laparoscopic procedures in pregnancy. Am Surg 65：259-263, 1999

37）Wongworawat MD, Aitken DR, Robles AE, et al：The impact of prior intra-abdominal surgery on laparoscopic cholecystectomy. Am Surg 60：763-766, 1994

38）Karayiannakis AJ, Polychronidis A, Perente S, et al：Laparoscopic cholecystectomy in patients with previous upper and lower abdominal surgery. Surg Endosc 18：97-101, 2004

39）Kwon AH, Inui H, Imamura A, et al：Laparoscopic cholecystectomy and choledocholithotomy in patients with a previous gastrectomy. J Am Coll Surg 193：614-619, 2001

40）Kumar SS：Laparoscopic cholecystectomy in the densely scarred abdomen. Am Surg 64：1094-1096, 1998

41）Novitsky YW, Kercher KW, Czerniach DR, et al：Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy：results of a prospective randomized trial. Arch Surg 140：1178-1183, 2005

42）Franklin ME Jr, Jaramillo EJ, Glass JL, et al：Needlescopic cholecystectomy：lessons learned in 10 years of experience. JSLS 10：43-46, 2006

43）Hong TH, You YK, Lee KH：Transumbilical single-port laparoscopic cholecystectomy：scarless cholecystectomy. Surg Endosc 23：1393-1397, 2009

44）Horgan S, Mintz Y, Jacobsen GR, et al：NOTES：transvaginal cholecystectomy with assisting articulating instruments. Surg Endosc 23：1900, 2009

45）Abe N, Takeuchi H, Ueki H, et al：Single-port endoscopic cholecystectomy：a bridge between laparoscopic and translumenal endoscopic surgery. J Hepatobiliary Pancreat Surg 2009 Apr 17［Epub ahead of print］

46）Martin DJ, Vernon DR, Toouli J：Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev CD003327, 2006

47）Rhodes M, Sussman L, Cohen L, et al：Randomised trial of laparoscopic exploration of common bile duct versus postoperative endoscopic retrograde cholangiography for common bile duct stones. Lancet 351：159-161, 1998

48）Kang CM, Chi HS, Kim JY, et al：A case of robot-assisted excision of choledochal cyst, hepaticojejunostomy, and extracorporeal Roux-en-y anastomosis using the da Vinci surgical system. Surg Laparosc Endosc Percutan Tech 17：538-541, 2007

49）Woo R, Le D, Albanese CT, et al：Robot-assisted laparoscopic resection of a type Ⅰ choledochal cyst in a child. J Laparoendosc Adv Surg Tech 16：179-183, 2006