基层医院腹腔镜胆囊切除术中转开腹原因分析

Analysis of laparoscopic cholecystectomy in primary hospitals conversion to laparotomy

目的探讨基层医院腹腔镜胆囊切除术（laparoseopiccholecysteetomy，LC）中转开腹手术的原因。方法回顾分析2005年10月-2013年3月胆囊疾病患者行LC中转开腹手术的病例资料。结果1650例LC中转病例31例，中转率为1．88％，术后患者均顺利出院，无死亡病例。结论胆囊炎行LC中转开腹手术的主要原因为发生胆囊三角致密性粘连、解剖不清、胆囊周围严重粘连、出血及胆道损伤。及时中转开腹，把握中转开腹时机是降低并发症的有效措施。

Objective To explore the reasons of conversion to laparotomy during laparoscopic cholecystectomy operation in primary hospital. Methods A retrospective analysis of data from October 2005 to March 2013 gallbladder disease in patients with tap- aroseopic cholecystectomy converted to laparotomy operation cases. Results 31 cases of laparoscopic cholecystectomy conversion in 1650, the conversion rate was 1.88%, postoperative patients were discharged, no deaths. Conclusion The main reason of cholecys- titis underwent laparoscopic cholecystectomy conversion to open operation for gallbladder triangle tight adhesion, unclear anatomy, severe adhesion around gallbladder and bile duct injury, hemorrhage. Timely conversion to open laparotomy, grasp the opportunity is ef- fective measures to reduce the complications.