腹腔镜胆囊切除术初期经验

Laparoscopic Cholecystectomy: Experience of Early Practice

腹腔镜胆囊切除术（ＬＣ）以其创伤小、恢复快等优点，已被国内外广泛采用。本文报道施行ＬＣ６３例的体会。本组病例中男２０例，女４３例，平均年龄２３～６４岁，术前均经Ｂ超确诊为慢性胆囊炎并胆囊结石．本组６０例成功施行了ＬＣ，３例因不同原因中转开腹手术。平均手术时间８０±３０ｍｉｎ，平均失血量＜５０ｍＬ；所有病例先后在术后７～２０ｈ起床活动；８～３０ｈ内通气并进食；平均住院４．６ｄ．本文总结了开展ＬＣ初期阶段的经验，对ＬＣ的手术适应证、组织管理、操作技术及注意事项等问题进行了讨论。

aparoscopic cholecystectomy(LC)has rapidly been adopted by surgeons around theworld for its less damage,little pain and shorter duration of hospitalization. 63 cases of LChad been attempted in our department during a 7-month period since October 1992 with 60successful and 3 converted to open surgery because of some different reasons.All the 63 casesare included in the present study.The patients ages ranged from 23 to 64years,20 male and43 female,A deflnite show of chronic cholecystitis with single or multiple galstones obtainedB-mode ultrosound examination from all the cases.The average operating time was 80 ± 30min,the average of intraoperative blood loss was iess than 50 mL,The patients postoperativeprocess were uneventful with ambulizing starting from 7 h to 20 h and eating starfing from 8 hto 30 h respectively.An average of hospitalized duration was 4.6 days.There were no compli-cations in this consecutive series Data and experience within this early stage of our LC practice are thoroughly reviewed.Special problems and key points in the early stage of LC prac-tice and the corresponding countermeasures are put forword.By the way, LC organizationand adiministration,Lc indications,inscrument operation and spetial tecniques in early prac-tice are discussed here in detail.