高龄患者腹部手术后腹腔镜胆囊切除术13例临床分析

Clinic analysis on laparoscopic cholecystectomy in 13 patients with previous abdominal surgery

目的探讨高龄患者腹部手术后行腹腔镜胆囊切除术的可行性。方法回顾性分析13例高龄腹部手术史病人行腹腔镜胆囊切除术的资料,避开原有切口选择四戳孔法和三戳孔法,必要时采用开放法置入穿刺鞘,注重腹腔内粘连区的分离技巧。结果该组13例中11例成功完成手术,中转开腹2例,无手术并发症。结论严格注意适应证,具备熟练的操作技能,有腹部手术史的高龄患者行腹腔镜胆囊切除术是安全可行的。

[Objective] To explore the efficient and clinical character of laparoscopic cholecystectomy in elderly patients with previous abdominal surgery. [Methods] Restropetive analysis of 13 patients of laparoseopic cholecystectomy in elderly patients with previous abdominal surgery. The fourth trocar and three-trocar techniques were performed in which the primitive incision was avoided. If necessary, opening method was used to insert the trocar, and the adhesive tissue was separated skillfully. [Results] Of the 13 cases, 11 cases were operated successfully with laparoseopic cholecystectomy, 2 cases changed to laparotomy. All the patients recovered without any complications. [Conclusions] The perfect skill in operation and assurance of indication, Laparoscopic cholecystectomy is safe and efficient in elderly patients with previous abdominal surgery.