腹腔镜胆囊切除术302例临床体会

Clinical Experience on 302 Cases of Laparoscopic Cholecystectomy

目的:探讨腹腔镜胆囊切除术(LC)临床应用价值及并发症原因、预防对策。方法:选择我院2005年1月～2009年12月住院择期行腹腔镜胆囊切除术患者302例的临床资料回顾性总结,并结合文献分析。结果:全组手术时间30min,平均;全组无死亡病例,成功297例,中转开腹7例;发生胆管损伤16例,术后胆漏4例,术中腹腔内出血4例,胆总管残留结石2例,均经相应处理治愈。结论:LC是一种微创手术,具有诸多优点,但稍有不慎便可引起严重的并发症,严格掌握LC手术适应证,围术期严格操作规程,适时果断中转开腹是保证LC安全的重要措施。

Objective：Probe into clinical practical value of Laparoscopic Cholecystectomy（LC） and reasons and preventive measures of complications.Methods：Choose retrospective summary of clinical materials of 302 patients who had received laparoscopic choleeystectomy from January 2005 to December 2009 in our hospital and make analysis with literature.Results：Operation time for all the groups lasted 30 minutes;there were no dead cases while 297 cases were successful and 7 case was transferred to laparotomy; 16 patients suffered from bile duct injuries,4 suffered from postoperative bile leakage,4 intraoperative bleeding in enterocoelia,2 choledocho remnant calculus,and all of above were cured after corresponding treatment.Conelusion：LC,as a minimum invasive operation,had numerous advantages,but it could lead to severe complications in careless case.To master strictly surgical indications of LC operation,conduct perioperative operating instructions strictly and transfer to laparotomy resolutely in proper time were significant measures to ensure the security of LC.