61例腹腔镜胃手术的经验总结

Brief Summary of Laparoscopic Gastric Surgery.

总结61例腹腔镜胃手术的治疗效果。方法:1992年12月至1999年1月,61例腹腔镜胃手术者中,B-Ⅱ式胃大部切除术17例,B-Ⅰ式胃大部切除术1例,近端胃次全切除术2例,高选择性迷走神经切断术5例,胃造瘘术3例,胃壁良性肿瘤切除术33例。54例行全腹腔镜下胃手术,7例行腹腔镜辅助下胃手术。结果:本组有2例早期胃癌行腹腔镜根治术,至今存活4.6年以上;并发症2例,分别通过再手术和内镜治愈;手术用时35～310min,平均164.2min;术中出血50～500ml,平均218.3ml;住院4～11d,平均6.8d;86％病人于术后48h内恢复胃肠功能;仅4例术后使用止痛剂。结论:只要合理使用、严格掌握手术适应证,腹腔镜胃手术可以取得良好效果。

To summarize the laparoscopic surgery in the patients with gastric disease. Methods: Laparos-copic surgery has been performed on 61 patients with gastric diseases. The procedures performed were: Billroth Ⅱgastrectomy 17 cases; Billroth I gastrectomy 1 case; proximal subtotal gastrectomy 2 cases; highly selective vagotomy 5 cases; gastrostomy 3 cases; and resection of submucosal benign tumor 33 cases. Fifty-four patients had a complete laparoscopic procedure(88.5%), 7 had an assisted laparoscopic procedure(11.5%). The mean op-erative time was 164.2min±93.5min, the mean estimated blood loss was 218.3ml±166.6ml, and the mean hospital stay was 6.8d±2.1d. Results: Two patients had laparoscopic surgery for early gastric cancer, now followed-up for more than 56 months. Two patients had complications(3.3%) which cured by reoperation and endoscopy respectively. Only 4 patients required the use of analgesic. There was no mortality. Conclusions: Under appro-priate indications, laparoscopy could be performed for gastric diseases with excellent results.