胆囊后三角入路三孔法腹腔镜胆囊切除术

Posterior Calot′s triangle approach for three-port laparoscopic cholecystectomy

目的探讨胆囊后三角入路三孔法腹腔镜胆囊切除术(LC)的可行性。方法回顾分析25例胆囊后三角入路三孔法LC的临床资料,主要包括手术时间、出血量及手术并发症。结果 25例手术均获成功,无1例转四孔法,手术时间25～60 min,平均40 min;术中出血量1～10 ml,平均3 ml。全组无胆管损伤、胆漏、出血等严重并发症。25例随访4～13个月,平均7个月,无胆管狭窄及胆系症状。结论胆囊后三角入路有助于解剖和辨认Calot三角内的组织结构,可有效的减少术中出血和胆管损伤等并发症,胆囊后三角入路三孔法腹腔镜胆囊切除术是安全、可行的。

Objective To explore the clinical feasibility of using a posterior Calot′s triangle approach for three-port laparoscopic cholecystectomy（LC）.Methods The clinical data（operative time,blood loss,and complications） of 25 patients who underwent three-port LC with the posterior Calot′s triangle approach were analyzed retrospectively.Results All operations had been performed successfully,and none required conversion to the four-trocar method.The operative time ranged from 25 min to 60 min（mean： 40 min）.The blood loss volume ranged from approximately 1 ml to 10 ml（mean： 3 ml）.There were no reports of severe complications,including bile duct injury,bile leakage,or hemorrhage,for any of the 25 cases.During follow-up（range： 4~13 months;mean： 7 months）,no bile duct stenosis or biliary tract symptoms were reported.Conclusion The posterior Calot′s triangle approach for LC effectively allowed for the identification and separation of anatomical structures in Calot′s triangle,while avoiding injury to the vessels and bile duct.The three-port LC with the posterior Calot′s triangle approach is safe and feasible.