腹腔镜胃十二指肠溃疡穿孔修补术54例疗效分析

Clinical Efficacy Analysis of Laparoscopic Repair of Perforated Gastroduodenal Ulcer:Review of 54 Cases

目的探讨腹腔镜胃十二肠溃疡穿孔修补术方法的临床效果。方法对54例胃十二指肠溃疡穿孔患者,于脐下缘、左锁骨中线平脐处、右锁骨中线脐水平以上约3cm处、右腋前线肋缘下3cm处分别穿刺置入套管针,先探查吸尽腹腔积液后,用3/0无损伤缝线沿胃十二指肠纵轴方向直接或用附近网膜覆盖固定后间断缝合2～3针修补溃疡穿孔。结果54例患者手术均获成功,手术时间32～75min,平均43.5min,均于术后5～7d出院。结论腹腔镜胃十二指肠溃疡穿孔修补术具有操作方便、创伤小、痛苦轻、并发症少、恢复快等优点。

Objective To explore the technique and clinical efficacy of laparoscopic repair of perforated gastroduodenal ulcer. Methods 54 patients with perforated gastroduodenal ulcer underwent laparoscopic repair. Four Trocars were placed at the umbilicus, left midclavicular line at the level of umbilicus, right midclavicular line at the level of 3cm above umbilicus, and preaxillary line at the level of 3cm below costal margin. Firstly, the abdominal cavity fluid was completely suctioned. Then, the perforation was was throughly explored and the accumulated sutured by 2-3 neddle with 3/0 non suture along the longitudinal axis of gastroduodenum directly or after using an omental patch. All operations were successful. The average operation time was 43.5 min （32-75 min）, and the stay was 5-7 d after operation. Conclusion -damage Results hospital easier to apply, with the advantage of less trauma and pain, fewer complications and quick recovery.