有上腹部手术史的腹腔镜胆囊切除术40例分析

Laparascopic cholecystectomy on 40 patients with past upper abdominal operation

目的:探讨有上腹部手术史致腹腔粘连的腹腔镜胆囊切除术(LC)的手术技巧。方法:回顾分析我院40例有上腹部手术史的病例,据原切口的类型采用开放法或闭合法建立气腹,左手单手游离粘连。困难胆囊切除者采用逆行切除或胆囊大部切除术。结果:38例手术成功,2例中转开腹。手术时间30～120分钟,无胆管损伤、邻近脏器损伤、术后出血或胆漏病例。结论:对于有上腹部手术史的病人若方法得当,可以完成LC。

Objective：To discuss the operation skills of laparascopic cholecystectomy on the patients with abdominal adhesion caused by past upper abdominal operation.Methods：40 cases were analyzed retrospectively. To establish pneumoperitoneum according to primary incisions and loosen adhesion. Retrograde or partial cholecystectomy were used to difficult ones.Results：38 cases were given a successful operation,but conversion to laparotomy in 2 cases.Neither injury of bile duct and nearby organs nor bleeding and bile leak happened.Conclusion：Suitable skills will be helpful to the laparascopic cholecystectomy on the patients with past upper abdominal operation.