困难腹腔镜胆囊切除术的应用体会(附300例报告)

Experience of complicated laparoscopic cholecystectomy:with a report of 300 cases

目的:总结困难腹腔镜胆囊切除术的操作技巧。方法:回顾分析为255例急性胆囊炎、胆囊三角粘连、胆囊颈部结石嵌顿、腹腔内粘连等胆囊病变患者行腹腔镜胆囊切除术(laparoscop ic cholecystectomy,LC)的临床资料。结果:中转开腹15例,胆总管损伤1例,术后胆漏3例,胆总管残石1例,胆囊窝积液18例,胰腺炎1例,所有病例均痊愈出院。结论:经验丰富的固定的腹腔镜胆囊治疗小组施行困难LC是安全、有效、可行的。

Objective：To discuss the operative skills for complicated laparoscopic cholecystectomy（LC）.Methods：The clinical data of patients with acute cholecystitis,gallbladder triangle adhesion,gallbladder neck calculi incarceration,intra-abdominal adhesion who underwent LC was analyzed retrospectively.Results：All patients recovered after operation.15 cases were converted to open surgery,1 case got common bile duct injury.The postoperative complication 3 cases of bile leakage,1 cases of residual stone,18 cases of gallbladder fossa hydrops,and 1 case of pancreatitis.Conclusions：LC for complicate gallbladder diseases is feasible,safe and effective in experienced surgeon.