非气腹腹腔镜胆囊切除术的临床应用

Clinical application of gasless laparoscopy in cholecystectomy

目的探讨非气腹腹腔镜胆囊切除手术的临床应用。方法对376例近期未发作的胆囊结石、急性胆囊炎或慢性胆囊炎急性发作不超过72小时的患者行腹腔镜手术治疗,随机分为CO2气腹组(对照组)172例,非气腹组(实验A组)125例,低气压组(实验B组)79例,并对手术情况及并发症进行对比分析。结果376例患者均顺利完成手术,成功率100%,无血管损伤、脏器穿孔、胆道损伤、胆漏或者中转开腹等并发症发生。实验A组、实验B组和对照组比较手术时间无显著差异性,实验B组与实验A组比较平均体质指数有显著差异性。结论非气腹、低气压辅助腹腔镜胆囊切除术安全可行,效果和气腹腹腔镜胆囊切除术相当。

Objective To investigate the clinical application of gasless laparoscopy in laparoscopic cholecystectomy. Methods 376 patients with stable cholecystolithiasis, acute cholecystitis or chronicity cholecystitis episoded acutely in 72 hours with laparoscope operation were analyzed. The patients were randomly divided into CO2 pneumoperitoneum group （n=172, control group）, and gasless group （n=125, test group A）. The obese patients of the group A added 6rnmHg hypobaria （n=79, test group B）. Results All the patients were successfully operated without complications. Time of the operations is not significant different among the three groups. Conclusion Comparing to laparoscopic cholecystectomy, gasless laparoscopy and low pressure of pneumoperitoneum in laparoscopic cholecystectomy are safe and reasonable.