Treatment of Small Bowel Disease: Current Status of Laparoscopic Surgery Hirotoshi Hasegawa 1 , Yoshiyuki Ishii 1 , Takashi Endo 1 , Tsuyoshi Okabayashi 1 , Shun Imai 1 , Hiroki Ochiai 1 , Yuko Kitagawa 1 1Department of Surgery, Keio University School of Medicine, Tokyo Keyword: Crohn病 , 腹腔鏡下手術 , Vienna分類 , 開腹移行 , 手術適応 pp.521-526
Published Date 2008/4/24
DOI https://doi.org/10.11477/mf.1403101324
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 We describe the current status and the indications for laparoscopic surgery for Crohn's disease. The Vienna Classification was applied to compare laparoscopic surgery with open surgery and postoperative complications. The conversion rate and major and total complications in the B3L3/4 subgroup were significantly greater than in the other subgroups. Multivariate analysis showed that B3L3/4 were the only predictive factors for total complications. However, the incidence of major and total complications in the B3L3/4 subgroup did not differ between the open and laparoscopic surgery groups. Laparoscopic surgery for Crohn's disease is the first procedure of choice in all uncomplicated cases (B2L1-4, B3L1/2). For patients in the complicated group (B3L3/4), laparoscopy is also feasible and justified, but the surgeon must be aware of the higher rate of conversion.

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