摘要
目的 探讨多次上腹部手术后腹腔镜胆囊切除术 (LC)的可行性及特点。 方法 连续进行 35例多次 (≥ 2次 )上腹部手术后LC。 结果 LC成功 2 1例 ,成功率 6 0 0 % (2 1 35 )。 2次上腹部手术后LC成功率 6 2 5 % (2 0 32 ) ,3次上腹部手术后LC成功率为 1 3。 14例中转开腹 ,中转率 4 0 0 % ,平均手术时间 6 8 7min ,中转率与手术时间均明显高于同期无上腹手术病史患者。无手术并发症发生。 结论 多次上腹部手术史不应成为LC的禁忌证 ,但手术难度加大 ,中转率增高 ,手术时间延长 ,对手术医师的要求较高。
Objective To evaluate the feasibility and characteristics of laparoscopic cholecystectomy (LC) in patients with multiple (≥2) previous upper abdominal surgeries. Methods 35 patients who had undergone multiple different kinds of upper abdominal surgery were given LC and were reviewed. Results LC were successfully performed in 21 of the 35 patients (60.0%). The rate of success in patients with 2 times of upper abdominal surgery was 62.5% (20/32). It was only 1 case out 3 cases (33.3%) in patients with 3 times of upper abdominal surgeriy. 14 out of 35 patients (40.0%) were converted into open cholecystectomy. The median operative time was 68.7 minutes. The rate of convertion was higher, and the median operative time was longer than that of those patients without previous upper abdominal surgery at the same period. no complication occurred. Conclusions Multiple previous upper abdominal surgeries should not be regarded as a contraindication to LC. But the operation is very difficult with higher conversive rate and longer operative time.
出处
《中国微创外科杂志》
CSCD
2002年第1期32-33,共2页
Chinese Journal of Minimally Invasive Surgery
