腹腔镜胆囊、子宫联合切除术围手术期的处理(附78例报告)

The perioperative management of laparoscopic cholecystectomy combined with laparoscopic hysterectomy:with a report of 78 cases

目的:探讨腹腔镜胆囊、子宫联合切除术围手术期的处理措施。方法:回顾分析78例腹腔镜胆囊、子宫联合切除术的临床资料。78例中腹腔镜胆囊切除术联合腹腔镜子宫次全切除术45例,联合腹腔镜辅助阴式子宫切除术11例,联合全子宫切除术22例。结果:78例联合手术均获成功。手术时间(120.1±56.3)min,术中出血(288.1±102.5)ml,术后住院(6.1±2.0)d。无中转开腹及胆道、输尿管、膀胱损伤。结论:正确把握手术适应证,术前充分准备,熟练掌握操作技巧,术后妥善处理,腹腔镜子宫、胆囊联合切除术安全可行。

Objective ：To explore perioperative management of laparoscopic cholecystectomy （LC） combined with laparoscopic hysterectomy （LH）. Methods：The clinical data of 78 patients who underwent LC and LH simultaneously were retrospectively analyzed, The procedures were LC ＋ laparoscopic subtotal hysterectomy in 45 cases, LC ＋ laparoscopic assisted vaginal hysterectomy in 11 cases, LC ＋ laparoscopic total hysterectomy in 22 cases. Results： All procedures were successful. The operative time was （ 120.1 ± 56.3 ） min, blood loss in operation was （288.1 ± 102.5 ） ml, the postoperative hospital stay was （6.1 ± 2.0） d. There were no conversion to open surgery or complications related to the injury of bile duct, ureter or bladder. Conclusions：With strict enrollment criteria, careful preoperative preparation, skillful operative technique, and proper postoperative management, the LC combined with LH is safe and feasible.