“三孔一勾到底法”腹腔镜胆囊切除术1260例临床总结

Clinical Summary of 1260 Patients with "Three Holes and One Hook in The End" Laparoscopic Cholecystectomy

目的总结1 260例＂三孔一勾到底法（TOE）＂腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）的经验,探讨其手术方式、技术要点及并发症的预防。方法回顾性分析我院1999年3月至2008年3月期间应用TOE治疗慢性结石性胆囊炎、急性结石性胆囊炎、萎缩性胆囊炎、胆囊息肉等病变1 260例患者的临床资料。结果本组1 260例全部治愈,其中1 252例LC成功（99.37%）,中转开腹8例;无死亡病例,无胆管损伤,术中出血3例,脐部感染2例,胆囊窝积液3例;手术时间8~60 min,平均38.5 min;住院时间3~7 d,平均5 d。1 002例随访1~7年,平均3.5年,未发现胆瘘、胆管残留结石、胆管狭窄等并发症。结论TOE操作规范,手术效果好,并发症少,恢复快,安全有效,值得应用及推广。

Objective To summarize the experiences of ＂three holes and one hook in the end（TOE）＂ laparoscopic cholecystectomy（LC） in 1 260 cases and to investigate the operation procedures,technical points and the prevention of complications.Methods The data of 1 260 patients suffering from chronic calculous cholecystitis,acute calculous cholecystitis,atrophic cholecystitis,gallbladder polyps etc.,who were admitted to this hospital and treated by TOE from March 1999 to March 2008 were included and analysed retrospectively in this study.Results One thousand two hundred and sixty of cases were cured,including 1 252 cases of succeeding LC（99.37%）,conversions to open in 8 cases,no death,no bile duct injury,with intraoperative hemorrhage in 3 cases,umbilicus infection in 2 cases,gallbladder fossa hydrops in 3 cases,with operation time for 8-60 min（mean 38.5 min） and hospitalization for 3-7 d（mean 5 d） after surgery.During the follow up of 1 002 cases for 1 to 7 years（mean 3.5 years）,there were no complications such as bile fistula,bile duct stricture,residual stones of biliary duct,etc..Conclusion TOE is worthy of application and promotion for the excellent effectiveness,few complications,rapid recovery and safety.