经腹腔镜溃疡穿孔修补术

LAPAROSCOPIC TREATMENT OF PERFORATED PEPTIC ULCER

本文介绍应用腹腔镜行溃疡穿孔修补的四种方法。这些技术包括应用原型腹腔镜持针器修补法，新型缝合器—ＥｎｄｏＳｔｉｔｃｈ修补法、纤维蛋白封闭剂修补法和ＺＴ胶修补法，初步经验表明这四种术式都有效。我们认为没有合并其他并发症的胃十二指肠前壁溃疡穿孔不需要剖腹手术，可经腹腔镜手术修补。至于哪一种方法最好，应根据医生的技巧、病人的全身情况、经济情况以及医院的设备条件进行选择。应用ＥｎｄｏＳｕｔｕｒｅ修补，缝合结扎操作简单容易，但费用较高。纤维蛋白封闭剂和ＺＴ胶修补法不需缝合，技术要求低，但前者费用较高。无论哪种修补方法，我们都强调胃管与腹腔管引流。

our methods of repair perforated peptic ulcer under laparoscopy were described.These techniques includeusing prototype laparoscopic suturing instrument,a new suturing instrument endo stitch, fibrin sealant andZT sealant(made in China).Our initial experience indicated all of these methods were effective and safe. Wesuggest the repair of perforated peptic ulcer without other complication of peptic ulcer by laparoscopic meansshould be first selected. of the methods, which is better,is the selection which is based on several conditions,including patient’s general conditions and economics,a skillful surgeon and instruments. Repair using endo-stitch which makes the suture and intracorporeal knotting easy, accute and secure,but costs more. Using fib-rin sealant and ZT sealant needs no sutures,That makes the operation more simple and easier,but the formercosts more also.