Vascular Closure Staple（VCS）を用いた腹腔鏡下総胆管直接閉鎖術

Laparoscopic Primary Closure of Common Bile Duct using Vascular Closure Staple (VCS)

　近年，腹腔鏡下手術においても総胆管直接縫合閉鎖術が施行されるようになったが，高度の手技を要することなどから，いまだに普及しているとは言い難い．今回われわれは，本来血管吻合用でクリップが内腔に露出しない特徴をもつVascular Closure Staple（VCS）を用いて腹腔鏡下総胆管直接閉鎖術を試みたので，その手技に関し報告する．これまで計8例において本法を施行したが，VCSによる腹腔鏡下の総胆管閉鎖は，今後，腹腔鏡下用の器具の改良や再発結石への関与などの検討が必要と思われるが，手技も容易で手術時間の短縮や合併症の軽減に有効となり得る可能性があると思われた．

Recently, the repairing of common bile duct in laparoscopic surgery in patients with common bile duct stones is performed regularly. However, the problem with laparoscopic suturing of bile duct is that it is difficult and prolongs operation time. We performed common bile duct repair by using non perforating Vascular Closure Staple (VCS) clips made of titanium which were initially developed for vascular anastomoses, and the effective-ness of VCS was evaluated in this study. We believe that VCS clip is easy and useful for laparoscopic closure of common bile duct.