中西医结合小切口胆囊切除术2010例报告

SMALL INCISION CHOLECYSTECTOMY(SICI) OF COMBINED CHINESE AND WESTERN MEDICINE REPORT OF 2010 CASES

本文报告1988～1997年施行中西医结合小切口胆囊切除术2010例。采用右上腹经腹直肌切口长3～5厘米。不切断肌肉．用两个窄“S”拉钩显露胆囊三角，分清关系后．预置胆囊管结扎线，防止结石进入总管。结扎胆囊动脉．然后从胆囊底进行剥离．若胆囊积液应先抽吸液体，以免影响操作。术后6小时服中药，次日下床活动并进食无糖流汁。本术式成功率100％，手术时间短，皮肤切口用创可贴两张粘合。术者站在左侧．不需特殊照明。本法创伤小，胃肠扰乱少，疼痛轻微，恢复快，不禁食，应用中药缩短了病程；伤口不缝合，病员乐于接受，优于传统大切口胆囊切除术。与胸腔镜胆囊切除术相比，虽则均为微小创伤，但腹腔镜胆囊切除术指征严格，需要在全麻下进行，并作人工气腹，并发症多而严重，有失败之可能，同时设备昂贵，一般医院不能开展，要有经验的外科医生操作。本法可在一般医院广泛推行。

2010 cases with gallstone using SICT during 1988-1997 are reported. SICT method: transrectus incision, 3-5cm long (the musclewas not cut off ), exposed gallbladder triangle by a pair of stype retractors, pre-placed a ligature on the duct to prevent stones from commombilc duct; ligated the artery of gallbladder, and detached the bladder from the base. If there was dropsy il must be sucked first in case of misoperation. The patient took a dose of herbal medicine 6 hours aftcr operation, and started to take non sugar fluid and exercise slightly next morning. This method. with a successful rate of 100%, tooka very short time, and the skin incision could be simply closed by two pleces of adhesive sterile plasters. In surgery, the operator stood on the left side, so it needed no spe cial illumination. The method is superior to conventional large incision, with slight pain, small incision unnecessary of suture. less gastrointestinal interference and quick recovery. The administration of Chinese herb medicine can shorten the course of disease, so patients are willing to accept. Compareed SICT with celioscopy, the latter has strict criterion, under general anesthesia and oxyperitoneum.which may result in serious complications or even failure. Furthermore, celioscopy is too expensive for most hospitals.