摘要
目的探讨有上腹部手术史患者实施腹腔镜胆囊切除术(LC)的手术方法及可行性。方法回顾性分析2003年4月—2006年3月有上腹部手术史的32病人,在全身麻醉下采用开放式建立气腹,按常规4孔法进行LC,术后常规在小网膜孔处置腹腔引流管。结果32例中成功行LC27例,总成功率为84.4%。中转剖腹胆囊切除术5例,中转率为15.6%。同期无腹部手术史的中转开腹率为4.5%。中转原因有因建立气腹困难1例,腹腔内粘连严重无法显露术野1例,胆囊周围粘连包裹、显露胆囊和Calot三角困难3例。全组病人术后恢复良好,未出现严重并发症。结论既往有上腹部手术史的病人仍可首先应用LC,但应从宽掌握中转开腹指征,确保手术安全。
Objective To investigate the probability and character of laparoscopic cholecystectomy in the patients with previous upper abdominal surgery. Methods Data about laparoscopic cholecystectomy in 32 patients with previous upper abdominal surgery from April 2003 to Mach 2006 were retrospectively analyzed. Results Laparoscopic cholecystectomy was successfully performed in 27 of the 52 patients, and the other five ones turned to laparolomy （ 15.6% ）. All the patients recovered without any complications. Conclusion Laparoscopic cholecystectomy is a safe and effective method to the patients with previous upper abdominal surgery, and it may act as the first-choice for them.
出处
《临床军医杂志》
CAS
2006年第6期692-694,共3页
Clinical Journal of Medical Officers
关键词
腹腔镜
胆囊切除术
再手术
laparoscopy
cholecystectomy
abdominal surgery
