腹腔镜胆囊切除术中转开腹109例原因探讨

Causes of laparoscopic cholecystectomy convertion to laparotomy:a report of 109 cases

目的:探讨腹腔镜胆囊切除术(LC)中转开腹的原因及如何把握中转时机和降低中转开腹率的措施。方法:对109例LC中转开腹的临床资料进行回顾性分析。结果:被迫性开腹病例术后恢复快,无严重并发症发生;强迫性开腹病例术后恢复慢,有严重并发症发生。结论:根据术中的具体情况和术者的实际水平,适时中转开腹,是保证患者安全和手术质量的重要措施;术前对病变进行仔细评估和提高术者的技术水平是降低中转开腹的关键。

Objective To study the causes of laparoscopic cholecystectomy （LC） convertion to laparotomy, and how to seize the opportunity to laparotomy and seek the measures to decrease the percentage. Method The clinical data of 109 cases of LC convertion to laparotomy was analyzed retrospectively. Results The cases that were difficult to treat safely and effectively under the laparoscopic because of complex diseases recovered well after conversion operation without serious complications; the cases that had to be transferred to emergency laparotomy as a result of technical complications recovered slowly and there were serious complications. Conclusion According to the specific circumstances in surgery and the actual level of operators, timely conversion tolaparotomy was an important measure to ensure patients＇s safety and quality of surgery. The careful pre -operative evaluation and the increasing technical level of operators are key factors in reducing the rate of eonvertion to laparotomy.