有腹部手术史腹腔镜胆囊切除术的临床分析

Clinical analysis of laparoscopic cholecystectomy for patients with history of abdominal operation

目的:探讨有腹部手术史患者行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的手术方法及安全性。方法:回顾分析2002年1月至2008年5月我院为有腹部手术史的22例患者行LC的临床资料。结果:21例LC成功,1例发生空肠损伤中转开腹行胆囊切除+空肠修补术,无手术死亡病例。结论:有腹部手术史的LC安全可行,选择适当部位开放法建立气腹、小心分离腹腔粘连、手术医师的默契配合及丰富的腹腔镜手术经验是确保手术成功的关键。

Objective：To study operative methods and security of laparoscopic cholecystectomy（LC） for patients with history of abdominal operation. Methods ： The clinical data of 22 cases with history of abdominal operation treated by LC from Jan. 2002 to May 2008 were analyzed retrospectively. Results ：Twenty-one cases were operated successfully, only one case converted to open cholecystectomy plus jejunal repair because of jejunal damage. There was no surgery-related death. Conclusions ： It was safe and feasible to perform LC for patients with history of abdominal operation. Choosing proper place to make incision for creating pneumoperitoneum openly, careful separation of abdominal adhesion,tacit cooperation between doctors and abundant laparoscopic operative experiences are key for successful operation.