循Laennec膜腹腔镜胆囊切除术治疗术前诊断为胆囊癌前病变患者的安全性与可行性分析OA

Objective:To explore the feasibility and safety of laparoscopic cholecystectomy(LC)via the Laennec membrane approach in the treatment of gallbladder premalignant lesions.Methods:A retrospective analysis was performed on the clinical data of 48 patients with preoperative diagnosis of gallbladder premalignant lesions who underwent LC from Jan.2019 to Dec.2024.During the opera-tion,the gallbladder serosa was completely dissected from the liver along the Laennec membrane.The operation time,intraoperative blood loss,drainage tube removal time,hospital stay,postoperative pathological results,and postoperative complications including bleeding,bile leakage and abdominal effusion were recorded and analyzed in detail.All patients were followed up for 1 month after surgery.Results:All 48 operations were successfully completed.The operation time was(44.6±22.4)min,the blood loss was(47.5±47.2)mL,the drainage tube indwelling time was(2.5±1.2)d.The hospital stay ranged from 3 to 7 d,with an average of(5.0±1.0)d.Only one patient developed a small amount of hematoma in the gallbladder fossa postoperatively.Postoperative pathological results included 26 cases of cholecystolithiasis with chronic cholecystitis,4 cases of cholecystolithiasis and chronic cholecystitis with focal mild epithelial dysplasia,13 cases of cholesterol polyps,2 cases of adenomatous polyps with focal high-grade intraepithelial neoplasia,and 3 cases of focal adenocarcinoma(T1a).Conclusions:LC via the Laennec membrane approach is safe and feasible for the treatment of gallbladder premalignant lesions.It can completely resect gallbladder lesions and avoid the risks of tumor residual and dissemination caused by incomplete resection or gallbladder rupture in conventional surgery.