{"created":"2023-05-25T05:25:46.078731+00:00","id":4250,"links":{},"metadata":{"_buckets":{"deposit":"c81ca0ad-09f1-4623-976c-301d4b8fd175"},"_deposit":{"created_by":17,"id":"4250","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4250"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004250","sets":["29:31:124:125"]},"author_link":["13472","13475","13478","13481","13465","13474","13477","13471","13480","13466","13473","13482","13476","13468","13467","13470","13469","13479"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A clinical study on a difficult case of laparoscopic cholecystectomy"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"フククウキョウカ タンノウ テキシュツジュツ コンナン ショウレイ ニ カンスル ケントウ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-02-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"47","bibliographicPageStart":"43","bibliographicVolumeNumber":"36","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"背景：胆石性胆嚢炎に対する胆嚢摘出術はそのほとんどが腹腔鏡下で行われているが、開腹手術への移行が必要となるような手術困難症例も散見される。そこで今回我々は、腹腔鏡下胆嚢摘出術における手術困難症例について検討した。\n方法：2012年から2016年までに胆嚢摘出術を施行した192例のうち、最初から開腹した例、他手術を併施した例、単孔手術例を除外した173例を対象とした。開腹移行または手術時間が150分以上となった症例を胆摘困難症例（困難群）と定義し、それ以外の症例（非困難群）の２群間に分けてそれぞれ年齢、性別、術前治療の有無やその種類、初診時・術前血液検査所見、手術時間、出血量、術後在院日数、術後合併症の有無などにつき比較検討した。\n結果：胆摘困難症例は42例（24.3％）で、開腹を要したのは10例（5.8％）であった。困難群ではPercutaneous transhepatic gall bladder drainage（以下、PTGBD）施行例が多く（26.19％ vs. 10.69％，p＝0.013）、また術中出血量が多く（74±133ml vs. ６±27ml, p＝0.002）、術後在院日数が長く（7.2±4.1日 vs. 4.7±1.8日，p<0.001）、術後合併症が多かった（19.05％ vs. 2.29％, p<0.001）。\n結論：術前PTGBD施行例においては、胆摘困難症例である可能性を念頭に置いた術者の選定や、術前の説明が必要であると考えられた。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"13471","nameIdentifierScheme":"WEKO"}],"names":[{"name":"アシトミ, ユウヤ"}]},{"nameIdentifiers":[{"nameIdentifier":"13472","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ワタナベ, トシヒロ"}]},{"nameIdentifiers":[{"nameIdentifier":"13473","nameIdentifierScheme":"WEKO"}],"names":[{"name":"サトウ, タミエ"}]},{"nameIdentifiers":[{"nameIdentifier":"13474","nameIdentifierScheme":"WEKO"}],"names":[{"name":"スガワラ, シュウイチロウ"}]},{"nameIdentifiers":[{"nameIdentifier":"13475","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ヒライ, イチロウ"}]},{"nameIdentifiers":[{"nameIdentifier":"13476","nameIdentifierScheme":"WEKO"}],"names":[{"name":"キムラ, 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