腹腔镜胆囊切除术7032例临床分析

Clinical analysis of 7032 cases receiving laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术的手术原则及并发症的预防。方法收集我院1995～2005年完成的7032例腹腔镜胆囊切除术的临床资料，分析行腹腔镜胆囊切除术的原发疾病种类及术后并发症。结果7032例腹腔镜胆囊切除术病人中最多的原发疾病为胆囊结石合并慢性胆囊炎，手术后并发症中，术后胆管损伤9例，发生率0．07％，术后出血4例，发生率0．06％，术后胆漏3例，发生率0．04％。结论腹腔镜胆囊切除术充分体现了微创外科的优点，但其操作仍较复杂，实行严格的岗前培训和准人制可避免并发症的发生。

Objective To investigate the rule for laparoscopic cholecystectomy （LC） and pre vention of its complication. Methods The clinical data of 7032 patients receiving LC in our hospital from 1995 to 2005 were retrospectively analyzed to determine the types of primary diseases and the postoperative complications. Results The most frequent primary disease for LC was gallstone with chronic cholecystitis （82. 9%）. The rate of conversion to laparotomy was 0. 5% （37 cases）. Bile duct injury occurred in 5 cases （0. 07%）. Postoperative cavity bleeding was found in 4 cases （0. 06%） and bile leakage in 3 （0. 04% ）. Conclusion LC is suitable for most gallbladder diseases. However, its procedure is still complicated and incidence of the complication of bile duct injury is high. Favorable results seem to depend on multiple training of LC procedure.