腹腔镜胆囊切除术中转开腹的原因分析(附11例报告)

AN ANALYSIS ON THE CAUSES OF CHANGING OPERATION PROGRAM FROM LAPAROSCOPIC ORERATION TO LAPARATOMIC OPERATION DURING CHOLECYSTECTOMY

目的:探讨腹腔镜胆囊切除术(LC)中转开腹的原因以及预防。方法:回顾分析11例LC中转开腹的临床资料。结果:LC中转率为2.12％,术中出血是腹腔镜手术开展初期的常见原因,胆管损伤为LC的严重并发症,中转原因还包括胆囊萎缩、胆囊炎症重、胆囊三角解剖关系不清及胆汁性腹膜炎等。结论:LC手术难度超出手术者安全有效的操作能力时,应果断中转开腹以减少手术并发症的发生。

Objective: To explore the causes and preventive methods for the changing of laparascopic cholecystectomy (LC)to laparatomic operation. Method:Data of 11 patients with laparoscopic cholecystectomy changed to the laparatomic operation was retrospective analyzed. ReSults:The results showed that 2.12% patients were changed operation program from LC to laparato-my during the operation. Bleeding was the commonest cause and bile duct injury was the serious complication for LC. Other causes may include gallbladder atrophy, serious gallbladder inflammation .unclear anatomical relation in gallbladder triangle and biliary peritonitis, etc. Conclusion: When operators encounter difficulty which is hard to be tackled during LC operation, an immediate termination and change to laparatomy is necessary for preventing complications.