摘要
目的：探讨腹腔镜胆囊切除术（ LC）中转开腹的原因、时机及并发症的防治。方法：回顾性分析我院2008年7月～2013年7月施行的1492例LC中37例中转开腹的临床资料。结果：LC中转开腹发生率为2．48％，其原因包括急性炎症期胆囊、胆囊萎缩、胆囊周围炎症粘连，胆囊三角解剖不清，不能处理胆囊颈部结石嵌顿，术中无法控制的出血，胆管损伤、胃肠道损伤，胆肠内瘘，Mirizzi 综合征，胆囊癌等。结论：正确掌握中转开腹的时机是降低LC手术并发症的关键。术前对LC难易程度的准确评估、适应症的严格把握和提高腹腔镜技术水平可降低LC中转开腹的发生率。
Objective：To investigate the risk factors,timing of conversion to laparotomy and prevention of the complications during laparoscopic cholecys-tectomy（LC）.Methods：The clinical data were reviewed in 37 of 1 492 cases undergone LC requried conversion to laparotomy in our hospital during July 2008 and July 2013.Results：2.48% of the LC required conversion to open surgery.The risk factors were associated with acute inflammation of the gall-bladder,atrophy of the gallbladder,adjacent adhesion caused by tissue inflammation,unclearly defined Calot′s triangle,failure removal of the stone（s） at the neck of the gallbladder due to incarceration,inability to control the intraoperative bleeding,damaged bile duct or gastrointestinal tract,biliary enteric fistula,Mirizzi syndrome,gallbladder carcinoma and the like.Conclusion：It is critical to reduce the complicaitons of LC by right timing of conversion to open surgery.Besides,careful preoperative evaluation on the degree of difficulty and surgical indications as well as skillful performance can reduce the inci-dence of LC to open surgery.
出处
《皖南医学院学报》
CAS
2014年第5期415-417,共3页
Journal of Wannan Medical College
关键词
胆囊切除术
腹腔镜
中转开腹
原因与防治
cholecystectomy laparoscopy conversion to laparotomy reasons and preventions
