腹腔镜胆囊切除术中转开腹原因及预防措施

Causes of the Conversion to Laparotomy and Prevention Measure in Laparoscopic Cholecystectomy

目的:探讨腹腔镜胆囊切除术中主动中转开腹的原因及预防措施。方法:回顾性分析我院642例腹腔镜胆囊切除中转开腹的原因。结果:630 例在腹腔镜下完成,中转开腹 12 例,中转开腹率1.9%,其中腹腔粘连严重7例,术中胆囊动脉出血、止血困难3 例,胆道损伤 2 例。结论:在腹腔粘连严重,出血、止血困难及胆道损伤等情况时主动中转剖腹手术。

Objective:To verify causes of the conversion to laparotomy and prevention measure in laparoscopic cholecystectomy. Method: The authors reviewed 642 cases laparoscopic cholecystectomy in our hospital. Result: 630 cases were accomplished under laparoscopic cholecystectomy, 12 cases of them were converted to laparotomy, the occurrence rate of the converted to laparotomy was 1.9% ,7 cases of them was seriously adhesion in abdomen,3cases of gallbladder artery bleeding in operating and hemostasis was difficulty, 2 cases injury of bileduct. Conclusion: The major causes of the conversion to laparotomy during laparoscopic cholecystectomy are severe adhesion, bleeding and injury bileduct.