直视微创无痛技术在胆囊切除术中的应用

The clinical application of minimally invasive and painless cholecystectomy under direct vision

目的:探讨减轻胆囊切除术手术创伤和术后疼痛的方法和技巧。方法:应用冷光源拉钩暴露系列器械、分离钩、钛夹、术后镇痛泵和固定手术步骤、技巧,完成胆囊切除术122例。结果:微小切口(2.5～3.5cm)113例,小切口(4～4.5cm)9例,无死亡病例,胆道微损伤1例,平均手术时间短,术后无痛或微痛。结论:直视下微创无痛胆囊切除术具有手术适应证广、患者创伤轻、痛苦小、术后康复快、安全可靠等优点,值得推广。

Objective ： To explore the methods of reducing trauma in cholecystectomy and techniques of postoperative pain contral. Methods： Cholecystectomy was performed in 122 cases with the application of cold-light retractor, detaching hooks, titanium clips and analgesia pump. The operative procedure and skills are stationary. Results：All the operation were successfully performed, 113 cases with mini-incision（2.5-3.5cm） and 9 cases with small incision（4-4.5cm）. There was no death but one with bile duct injury. The average operative time was shorter and patients feh painless or slightly fainful. Conclusions： Minimally invasive and painless cholecystectomy under direct vision has the advantages of extensive indications, microtrauma and rapid recovery. It＇s safe and worth popularizing.