小切口胆囊切除27650例临床应用综合评价

Comprehensive evaluation about clinical application of 27650 cases of minicholecystectomy

目的综合评价小切口胆囊切除（MC）临床应用及治疗结果。方法对本院1990年3月至2008年6月期间，27650例小切口胆囊切除术（minicholecystectomy，MC）回顾分析。其中，小切口胆囊切除加胆总管探查3200例。应用纤维胆道镜行胆总管探查2924例，选择1432例一期缝合胆总管。对MC临床应用治疗结果作出综合评价。结果有1．7％的病例延长切口，平均手术时间为30min，出血量为20ml，24h胃肠功能恢复率为94．5％。绝大多数患者术后第2天能下床活动，进食流质，平均术后5d出院，疤痕细，切口皮肤不缝合，遗留疤痕细小美观，手术效果满意。结论只要严格掌握适应证，术前严格的常规检查，应用MC系列器械，规范MC是一种简便、安全、低创的术式，其临床应用价值值得推广及认可。

Objective To made the comprehensive evaluation about the clinical application of minicholecystectomy （MC）. Methods We have studied 27650 cases of MC and made a clinical clinical analyses. Among thease cases ,3200 cases were performed MC and exploration of common bile duct, choledochofiberoscopy was used in 2924 cases, common bile duct was sutured in 1432 cases without T tube drainage. Results only 1.7% of all cases was extended incision, the average operation time is 30 min, the volume of blood loss is the 20 ml,94.5% of all cases restore stomach and intestines function in 24 hours, most patients can get out of bed after the second postoperative day, the scar was thin,the effect was satisfied. Conclusion MC is one kind of simple mad safe operation for mild trauma and should be widely used. as long as the operation was applied strictly according to operation indication under preoperative routine inspection, its clinical application value is worth promoting and the approval.