有上腹部手术史患者的腹腔镜胆囊切除术探讨

Laparoscopic cholecystectomy for patients with a history of upper abdominal operation

目的探讨有上腹部手术患者腹腔镜胆囊切除术(LC)的可行性、安全性。方法连续观察57例有上腹部手术史的胆囊结石患者,对治疗结果进行回顾性分析,并就操作技巧进行探讨。结果LC成功55例,成功率为96.5%,2例中转剖腹手术,中转率为3.5%,平均手术时间为40～130min,明显高于同期无上腹部手术史患者,LC完成及中转剖腹手术患者均无相关手术并发症发生。结论有上腹部手术史患者行LC是安全可行的,但其手术难度加大,手术时间延长,手术医师需要较高的操作技术。

[objective] To investigate the possibility and safety of laparoscopic cholecystectomy （LC） for the patients who had the history of operation in upper-abdomen. [Methods] By the continuous observation on 57 cholecystolithiasis patients with operation on upper abdominal region, a retrospective analysis of therapeutic result was made, and the technical skill was researched. [Result] LC was successfully performed in 55 of all the patients （96.5%）. Two of the patients （3.5%） were transformed to open chol＇ecystectomy. The mean operation time was 40～130 rain minutes. The transform rate was higher, and the mean operation time was longer than those without pervious upper abdominal surgery at the same period in our department. None had opration-related complications. [Conclusion] LC is feasible and safe for the patients who have the history of operation in upper-abdomen. But LC is more difficult with longer operation time which requires better skill of doctors.