摘要
目的探讨腹腔镜胆囊切除术（laparoscopic cholecystoctomy，LC）中转开腹的原因，评估LC术前难易的程度及怎样减少LC手术并发症。方法回顾性分析我院576例LC术中即刻中转开腹46例的中转开腹原因、操作方法和疗效。中转原因：胆管损伤3例，出血2例，腹腔、胆囊周围粘连19例，胆囊三角解剖不清14例，胆囊十二指肠瘘2例，Mirizzi综合征型5例，胃肠道损伤1例。结果中转开腹手术均获成功，无并发症。随访1～2年，无胆道狭窄。结论重视术前对胆囊病变程度的判断以及术中采取预防措施可减少中转开腹。
Objective To explore and discuss the causes of conversion of laparoscopic cholecystectomy to open cholecystectomy. To evaluate the degree of operative difficulty and how to decrease the incidence of complications after LC. Methods We retrospectively reviewed 576 cases of LC,46 of which underwent an immediate conversion to open surgery. Causes of conversions, surgical techniques, and curative outcomes were analyzed. The clinical data revealed a bile duct injury in 3 cases,bleeding in 2 case, severe adhesion in abdominal cavity or between the gallbladder and neighboring tissues in 19 cases disturbed anatomy and adhesion in the region of the Calot＇s triangle in 14 cases,cholecystoduodenal fistula in 2 cases, and Mirizzi syndrome（type Ⅱ） in 5 cases. Gastrointestinal injury in 1 case. Results The conversion to open surgery was successfully completed in all the 25 cases. No complication was encountered follow-up examinations for 1 - 2 years showed no bilc duct stenosis. Conclusion Proper preoperative patient selection and use of intraoperative preventive measures are helpful to minimize the possibility of conversion to open surgery.
出处
《微创医学》
2008年第3期201-203,共3页
Journal of Minimally Invasive Medicine
