再次腹腔镜手术临床研究

CLINICAL STUDY ON REPEAT LAPAROSCOPIC OPERATIONS

腹腔镜胆囊切除术（LC）后胆漏出血再次腹腔镜手术两个医院共31例（30例成功，l1转开腹）。同期同原因10例开腹病人作为对照，统计学处理两组在手术时间（min）、输液天数（d）、抗生素应用天数（d）、胃肠恢复（h）、住院天数（d）分别为：（40．04±1540）min、（13．10±23．83）min；（3．20±1．87）d、（7．39±2．36）d（2.18±1．25）d、（6.12±2．08）d（24．08±11.76）h、（49．05±20．80）h；（12．31±4．02）d、（16．07±5．04）d差异非常显著（P＜00.1）。认为再次腹腔镜手术诊治LC后并发症是可行的，能使大部分患者免于开腹之苦。对再次腹腔镜手术适应症、禁忌症、注意事项及预防LC并发症进行了讨论。

The bile fistula and bleeding of 31 post laparoscopic cholecystectomy (LC) patients in two hospitals were treatedby repeat laparoscopic operations. Thirty operations were successful, and one case was changed to laparotomy. Theresults of the repeat laparoscopic operations were contrasted with the results of ten laparotomy cases from the samePeriod and with the same cause. The operation time (minutes), transfusion (dosage), antibiotic (dosage), gastrointestinal recovery time (hours), and hospital stay (days) of the repeat laparoscopy group and the laparotomy groupwere 40.04±15.40, l35.10±23.83;3.20±1. 87， 7.39±2. 36;2. 18±1. 25, 6. 12±2.08;24.08±11. 76， 49.05± 20. 80;and 12. 31±4.02, 16.70±5.04, respectively. The differences were statistically significant (P <0. 01). Repeat laparoscopic operations treated the post LC complications, allowing the patients to avoid the trauma oflaparotomy. The indications, contraindications, and points for attention in repeat laparoscopic operations, as well asmethods to prevent LC's complications are discussed.