腹腔镜胆囊切除术中转开腹30例临床分析

Analysis of 30 cases of secondary iaparotomy in laparoscopic cholecystectomy

目的:探讨腹腔镜胆囊切除术中转开腹原因。方法:回顾分析1102例腹腔镜胆囊切除术的临床资料。结果:腹腔镜胆囊切除术成功率97.3%,中转开腹30例,占2.7%,其中胆囊急性化脓性炎症及胆囊萎缩致Calot三角解剖不清22例,出血4例,胆管损伤2例,胆囊癌2例。结论:腹腔镜胆囊切除术中转开腹原因依次为Calot三角解剖不清、出血、胆管损伤、胆囊癌。严格腹腔镜手术程序可降低严重并发症发生率。

Objective： To study the causes leading to conversion of laparoscopic cholecystectomy into open cholecystectomy. Methods： One thousand one hundred and two cases of laparoscopic cholecystectomy were reviewed retrospectively. Result： In the 1 102 cases of laparoscopic cholecystectomy 30（2.7%） covert to laparotomy, including 22 cases of disclearance of anatomic structure of Calot triangle resulting from acute suppurative cholecystitis and atrophical gall bladder, 4 of bleeding, 2 of injury of bile duct, 2 of gall bladder carcinoma. The success ratie of laparoscopic cholecystectomy was 97. 3%. Conclusion： The major cause of the conversion to laparotomy in laparoscopic cholecystectomy were disclearance of anatomic structure of Calot triangle, bleeding, injury of bile duct and gall bladder carcinoma, the major complication can be reduced by strict procedures of laparoscopic cholecystectomy.