胃大部切除术后腹腔镜胆囊切除术临床探讨

Laparoscopic cholecystectomy after subtotal gastrectomy

目的探讨胃大部切除术后腹腔镜胆囊切除的可能性及手术方法与技巧。方法 48例胃大部切除术采用闭合法建立气腹,分离粘连,暴露胆囊全貌及Calot三角顺行或逆行切除胆囊。结果 48例中LC成功46例,中转开腹2例,全组无明显出血,胆道损伤和胆汁漏等并发症发生。结论部分胃大部切除术后胆囊良性疾病LC术可行。

Objective To investgate the practicability and technical skill of laparoscopic cholecystectomy（LC） for patients with a history of subtotal gastrectomy.Methods LC was performed in 48-patients with benign diseases of gallbladder after subtotal gastrectomy.Pneumoperitoneum was formed by closed-method.Under laparoscope,intraperitoneal adhesion was loosened;the anatomical position of gallbladder and Calot＇s triangle were exposed clearly.Finanally,the cholecystectomy was conducted though routire LC.Results 46 cases were successful in 48 cases with Laparoscopic Cholecystectomy.There was no hemorrhage bile duct injure or cholorrhea and open cholecystectomy（OC） was done in another two because of mistaking cystis duct with adhesive band.Conclusion LC is to test considered first in the treatment of benign diseases of gallbladder such as cholecystolithiasis and cystic polyps after subtotal gastrectomy and the curative effects and the same as those of routine LC.