困难类型腹腔镜胆囊切除术的处理方法

Methods of Difficult Laparoscopic Cholecystectomy

[目的]探讨困难类型腹腔镜胆囊切除术的处理方法。[方法]回顾分析2004年来116例因Mirizzi综合征、腹部手术史伴腹腔严重粘连、Calot三角严重粘连、合并肝硬化等困难类型腹腔镜胆囊切除术的临床资料。[结果]除3例中转开腹(占2.58%)外,余均用腹腔镜成功完成手术。[结论]对于困难类型腹腔镜胆囊切除术,只要处理方法适当,并不增加中转开腹率和并发症的发生率。

[Objective]To approach the methods of difficult laparoscopic cholecystectomy. [Methods ] The clinical data of 116 patients with Mirizzi syndrome, severe adherence of abdominal cavity and Calot＇triangle,liver cirrhosis underwent difficult laparoscopic cholecystectomy since 2004 were retrospectively analyzed. [Results]Except 3 patients treated by abdominal operation, other patients were treated by laparoscopic choiecystectomy successfully. [Conclusion]The rates of open operation midway and complications are not increased in difficult iaparoscopic choiecystectomy as long as dealing with them properly.