腹腔镜胆囊切除术5842例临床分析

Clinical analysis of 5842 patients submitted to laparoscopic cholecystectomy

目的探讨LC手术恰当的适应证,正确把握中转开腹指征,预防和处理并发症。方法回顾性分析5842例LC手术的临床资料。结果腹腔镜下完成胆囊切除5661例,中转开腹181例(3.1%),手术并发症13例(0.22%),全部治愈出院。结论应根据医院水平和术者能力掌握手术适应证。术中遇到难以清晰解剖、操作困难的复杂病例,应果断中转开腹,中转开腹不应视为手术并发症。预防损伤是关键,对并发症的处理应根据部位、程度的不同采用不同的方法。重视围手术期每一环节的处理。

Objective To investigate the appropriate adaptation and indications of LC converted to laparotomy, the prevention and treatment of complication. Methods The clinical data of 5842 patients subject to LC were analyzed retrospectively. Results Among the all cases, 5661 cases were operated successfully. 181 patients （3. 1%） were converted to laprotomy. The complications occurred in 13 cases （022 %）. All patients were cured and discharged. Conclusion Indications of LC should be chosen according to hospital technical level and surgeon ability. During operation, when anatomy was not clean and the situation was difficult, the LC shouldbe converted to laparotomy timely. According to the injured site and degree, the complication of LC was treated by various methods. It is important to manage the patients perioperatively.