文献詳細
文献概要
坂の上のラパ肝・胆・膵・11
腹腔鏡下総胆管拡張症手術
著者: 大目祐介1 本田五郎1
所属機関: 1新東京病院 消化器外科
ページ範囲:P.1357 - P.1369
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◆先天性胆道拡張症の病態と治療を理解する.
◆胆管の壁構造を知る.
◆鈍的剝離を中心に胆管のSS-inner layer(SS-I)を露出して膵内胆管の剝離を進める.
◆膵内胆管の剝離はnarrow segmentを露出するレベルまで行う.
◆胆管空腸吻合は後壁を連続縫合,前壁を結節縫合で行う.
◆先天性胆道拡張症の病態と治療を理解する.
◆胆管の壁構造を知る.
◆鈍的剝離を中心に胆管のSS-inner layer(SS-I)を露出して膵内胆管の剝離を進める.
◆膵内胆管の剝離はnarrow segmentを露出するレベルまで行う.
◆胆管空腸吻合は後壁を連続縫合,前壁を結節縫合で行う.
参考文献
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2)日本膵・胆管合流異常研究会,日本膵・胆管合流異常研究会診断基準検討委員会:先天性胆道拡張症の診断基準2015.胆道29:870-873,2015
3)Ishibashi H, Shimada M, Kamisawa T, et al;Japanese Study Group on Congenital Biliary Dilatation(JSCBD):Japanese clinical practice guidelines for congenital biliary dilatation. J Hepatobiliary Pancreat Sci 24:1-16, 2017
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13)日本肝胆膵外科学会:胆道癌取扱い規約 第6版,金原出版,2013
14)山本 淳,大目祐介,土井愛美,他:腹腔鏡下胆管空腸吻合法.北島政樹(監):消化管吻合法バイブル.医学書院,2018,pp 192-195
15)Honda G, Ome Y, Kawamoto Y, et al:Basic knowledge of and a small trick for atraumatic needle driving in laparoscopic suturing. J Hepatobiliary Pancreat Sci 2020(in press)
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