腹腔镜胆囊切除术中转开腹156例临床分析

Clinical analysis of conversion of laparoscopic cholecystectomy to open cholecystectomy in 156 cases

目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中转开腹的原因,评估LC术前难易的程度及怎样减少LC手术并发症。方法回顾分析我院2000年5月至2005年8月间5100例LC中156例中转开腹的临床资料。结果LC中转开腹发生率为3.06%,其原因为胆囊周围严重粘连,近期急性发作,Calot三角严重充血水肿,解剖不清。结论胆囊周围粘连严重,近期急性发作,应慎重选择LC。掌握好中转开腹的时机及处理方法,是降低LC手术并发症的有效措施。

To explore and discuss the causes of conversion of laparoscopic cholecystectomy to open cholecystectomy and to judge the degree of operative difficulty and how to decrease the incidence of complications after LC. Methods The clinical data of LC of 156 patients in 5 100 cases were retrospectively analyzed. Results The main causes of the conversion during the operation were the recent onset of cholecystitis, adhesion around gallbladder,unclear discrimination of Calot＇S triangle. Conclusion If the patients have the history of recent acute outbreak and adhesion around gallbladder, it must be careful to select LC. To decrease incidence of complications of LC, it＇s an important step that surgeons should take the correct opportunity of the conversion during the operation.