腹腔镜、胃镜联合治疗胃穿孔的临床应用

The clinical application of laparoscope combined with gastrofiberscope in treating acute gastric perforation

目的:探讨胃镜、腹腔镜联合诊治胃穿孔的可行性及应用价值。方法:回顾分析应用腹腔镜、胃镜联合治疗19例胃穿孔患者的临床资料。术中同时观察胃腔内、腔外病变,修补穿孔。结果:17例手术获得成功,2例术中发现肿瘤或溃疡恶变而中转开腹。手术时间平均100 min,3～5天进流质饮食,术后7～8天出院,无并发症发生。结论:胃镜、腹腔镜联合诊治胃穿孔安全、可行,具有定位准确、患者创伤小、康复快、脏器干扰小等优点,值得临床推广应用。

Objective：To explore the feasibility and clinical value of laparoscope combined with gastrofiberscope in treating acute gastric perforation.Methods：Nineteen patients with acute gastric perforation were diagnosed and treated by laparoscope combined with gastrofiberscope.Results：Seventeen cases were performed successfully while 2 cases were converted to open procedure because of the suspicion of malignant diagnosis.The average operative time was 100 min.Liquid diet was given from 3 to 5 d after operations.The mean duration of hospitalization was 7-8 d.No postoperative complication was recorded.Conclusions：It＇s safe and feasible to diagnose and treat gastric perforation with laparoscope combined with gastrofiberscope.This technique has advantages of precise location,less invasion,better recovery and less disturbance to cavity organs.It can be clinically used widely.