复杂腹腔镜胆囊切除术客观量化分析

Complex laparoscopic cholecystectomy objective quantitative analysis

目的 对复杂性腹腔镜胆囊切除术（Laparoscopic Cholecystecomy,LC）进行较为客观的量化分析、分类,并总结出新的易懂实用的手术安全操作方法原则和注意事项来更好的指导临床工作和临床教学.方法 回顾分析237例复杂性腹腔镜下结石性胆囊炎胆囊切除术的临床资料.结果 237例患者中,除7例中转开腹外,手术均顺利完成.结论 LC手术关键在于正确的安全的解剖胆囊三角,在坚持传统的＂三管一壶腹＂原则的基础上,更应该尊重客观实际,既要考虑到胆囊三角中可能存在各种变异情况,也要考虑在病理条件下胆囊、胆囊管的原有解剖结构可能和已经发生的改变所造成的影响;在确认和离断胆囊管和胆囊动脉时,要坚持无分支原则,从而减少和避免手术并发症.

Objective To complexity of Laparoscopic cholecystectomy , LC ） for a more objective quantitative analysis, classification, and summarize the new understandable practical operation safety operation method principles and precautions to better guide clinical work and clinical teaching. Methods A retrospective 237 patients complexity laparoscopic cholecystectomy calculous cholecystitis sex of clinical data. Results 237 patients, except 7 cases were converted to open outside, are performed successfully completed. Conclusion LC key lies in the right safe operation of anatomical gallbladder triangle in insisting the traditional ＂three tube a ampullary＂ principle, on the basis of more should respect the objective reality, both must consider gallbladder triangle may be present in all kinds of variations, also want to consider in pathology condition gallbladder, gallbladder is in charge of the original anatomical structure may and has changes caused by the influence ; In confirmation and from broken cystic duct and the gallbladder arteries, insist the principle, thus unbranched to reduce or avoid surgical complications.