腹腔镜下修补急性胃十二指肠溃疡穿孔的治疗体会

Laparoscopic neoplasty of 72 cases of acute gastroduodenal ulcer perforation

目的总结腹腔镜下急性胃十二指肠溃疡穿孔修补术的临床经验。方法回顾分析72例胃十二脂肠溃疡穿孔修补术中应用腹腔镜的临床资料,72例胃十二指肠溃疡穿孔中,十二指肠球部溃疡穿孔50例,胃幽门管穿孔8例,胃窦部前壁穿孔9例,胃体部小弯侧穿孔5例。病理检查18例中良性穿孔16例,癌性穿孔2例。结果72例中70例获成功,2例癌性溃疡中转开腹,无手术并发症发生,无死亡病例。良性溃疡患者术后平均8d出院,出院后均继续服用抗溃疡抗菌药物。结论腹腔镜胃十二指肠溃疡穿孔修补术治疗急性胃十二指肠溃疡穿孔具有独特的优势,效果肯定,安全可靠,具有良好的临床应用价值。

[Objective] To summarize the clinical experience of laparoscopic neoplasty in acute gastroduodenal ulcer perforation. [Methods] The clinical data of 72 eases of acute gastroduodenal ulcer perforation was analyzed retrospectively. 50 eases were perforation in the duodenobulbar ulcer, 8 eases were pyloric canal perforation, 9 eases were perforation in the anterior wall of gastric antrum, and 5 eases were perforation in the lesser curvature side of stomaeh body. [Results] 70 eases with acute gastroduodenal ulcer perforation were successfully operated by la-paroseopy, except that perforation ease of gastric carcinoma was converted to open for radical gastrectomy. No complications occurred and operative mortality was zero in this group. The benign ulcers patients were discharged after 8 days , and all to take antiulcer and antibacterial drug after discharged. [Conclusions] Laparoscopic neoplasty of acute gastroduodenal ulcer perfofration has distinct superiority to treat acute gastroduodenal ulcer perforation. The effect is confirmed, and the method is safety and reliable, and can be applied clinically successfully.