有上腹部手术史患者行腹腔镜胆囊切除术的手术体会

Laparoscopic cholecystectomy for patients with a history of upper abdominal operation

目的:分析有上腹部手术史患者行腹腔镜胆囊切除术的可行性及临床疗效。方法:将55例有上腹部术史行腹腔镜胆囊切除术患者定为观察组,回顾性总结其手术要点;将同期60例无上腹部手术史行腹腔镜胆囊切除术患者定为对照组,比较两组患者手术成功率、手术时间、留置引流率、手术并发症率及平均住院时间。结果:观察组53例患者在腹腔镜下治疗成功,2例中转开腹,所有患者均无出血、胆漏、内脏及胆道损伤等并发症;与对照组相比,手术时间、手术并发症率无统计学差异(P>0.05)。留置引流率及平均住院时间多于对照组,差异具有统计学意义(P<0.05)。结论:腹腔镜胆囊切除术具有创伤小、痛苦轻、康复快等优点,对有胆囊手术史患者亦安全有效。

Objective：To investigate the possibility and safety of laparoscopic cholecystectomy （LC） for the patients who had the history of operation in upper abdomen. Methods： The observation group was 55 cases patients with a history of upper abdominal operation, and summarized the operation points. Control group was 60 cases patients without a history of upper abdominal operation. Compared with the success rate, the time of the operation, lien drainage rate, surgical complications and average rate hospital stay between two groups. Results： 53 cases successd, 2 cases transformed Open surgery, and all patients had No complications in observation group. Compared with control group, the time of the operation and surgical complication rate was no statistical difference （P〉0.05）. Lien drainage rate and the mean hospital stay had statistical difference （P〈0.05）. Conclusions： LC is Small trauma, pain light, quicker recovery. To patients who had the history of operation in upper abdomen is safe and effective.