摘要
目的总结腹腔镜胆囊切除术(1aparoscopic cholecystectomy,LC)中转开腹的原因并探讨其防治措施.方法1998年7月～2004年8月共行462例LC,中转开腹21例(14.5%),回顾性分析其临床特点及治疗效果.结果术中发现右肝管被夹闭1例,胆漏3例,术野不清出血明显17例,予中转开腹进一步处理,均痊愈出院.结论熟悉各种解剖变异、规范精细操作、适时中转开腹是预防LC并发症的关键;胆囊周围粘连严重、解剖困难、出血不易控制、损伤周围脏器、胆囊癌变等情况是中转开腹手术的适应证.
Objective To investigate the causes and the prevention of conversion to open surgery during laparoscopic cholecystectomy(LC). Method 21 cases converted to open surgery among 462 cases of LC from July 1998 to August 2004, the clinical features and therapeutic effects were retrospectively reviewed. Result Causes of conversion included right hepatic ductal accidentally clipped in 1 case, bile leakage in 3 cases, blurred operative field due to hemorrhage in 17 cases. All the cases cured after being treated by open surgery. Conclusion Clear understanding of anatomic variation, refined manipulation, and promptly conversion to open surgery are essential in preventing the complications of LC. Open surgery should be converted to in case that severe adhesion, difficult dissection, uncontrollable bleeding, iatrogenic injury of surrounding organs, and suspected malignance are encountered.
出处
《中国现代手术学杂志》
2005年第3期213-215,共3页
Chinese Journal of Modern Operative Surgery
