摘要
目的探讨腹腔镜下采用上腹部带血管蒂的肝圆韧带或大网膜修补上消化道穿孔的临床应用。方法回顾性分析2012年2月～2015年2月行腹腔镜上消化道修补术的86例患者临床资料,其中十二指肠球部前壁穿孔55例,胃窦部前壁穿孔26例,胃底5例。采用网膜修补35例,带蒂的肝圆韧带修补51例。结果本组所有病人均顺利完成腹腔镜手术,无中转开腹。术后3～5 d恢复肠蠕动,停止胃肠减压,开放流食观察24 h无异常后拔除腹腔引流管。术后8～10 d出院。所有病例无肠瘘、出血和腹腔脓肿出现。穿孔修补术后常规按消化性溃疡规则药物治疗6～8周,术后2个月复查胃镜,见溃疡愈合或基本愈合。结论腹腔镜行上消化道穿孔修补术安全,有效。肝圆韧带作为上腹部较为游离的韧带,在腹腔镜上消化道穿孔修补术中与网膜一样是很好的生物补片材料。
Objective To explore the application of ligamentum teres hepatis repair or greater omentum repair for upper gastrointestinal perforation. Methods The clinical data of 86 patients with upper gastrointestinal perforation who underwent laparoscopic treatment from February 2012 to February 2015 were analyzed retrospectively. The perforation located anterior wall of duodenal ampulla in 55 cases,anterior wall of gastric antrum in 26 cases and gastric fundus in 5 cases. Among them,35 cases were repaired with omentum,and 51 cases were repaired with pedicle ligamentum teres hepatis. Results All cases were successfully completed the laparoscopic surgery without conversion to laparotomy. The gastrointestinal function was restored 3 to 5 days after the surgery,and discharged from the hospital 8 to 10 days after the surgery. No complication as intestinal fistula,hemorrhage and peritoneal abscess was found in all cases. The ulcer was achieved healing or almost healing after regular pharmacotherapy for 6 to 8 weeks. Conclusions The laparoscopic repair is a safe and effective surgery for upper gastrointestinal perforation. The ligamentum teres hepatis can be used as valuable as the omentum in the laparoscopic repair of upper gastrointestinal perforation.
出处
《中国现代手术学杂志》
2016年第1期16-18,共3页
Chinese Journal of Modern Operative Surgery
关键词
腹腔镜检查
肝圆韧带
网膜
穿孔
消化道
上
修补
laparoscopy
round ligament of liver
omentum
perforation
digestive tract
upper
repair
