腹腔镜手术治疗阑尾周围脓肿31例

Laparoscopic Surgery in the Treatment of Periappendicural Abscess:a Report of 31 Cases

目的 探讨腹腔镜阑尾周围脓肿清除联合阑尾切除术的可行性.方法 2010年3月～ 2012年12月行腹腔镜阑尾周围脓肿清除联合阑尾切除术治疗阑尾周围脓肿31例,腹腔镜下腹腔探查,清除脓肿,寻找阑尾,处理阑尾残端.结果 31例均行脓肿清除联合阑尾切除,无中转开腹.手术时间40 ～120 min,平均55 min.无出血、肠漏、切口感染、门静脉炎等并发症发生.病理结果均为急性坏疽性阑尾炎.术后7～12 d出院.31例随访6个月,无残端炎、腹痛发生.结论 腹腔镜阑尾周围脓肿清除联合阑尾切除术治疗阑尾周围脓肿技术可行.

Objective To explore the feasibility of laparoscopic clearance of periappendiceal abscess and appendectomy.Metbods A total of 31 patients with periappendicural abscess underwent laparoscopic clearance of periappendiceal abscess and appendectomy.After abdominal exploration,abscess was cleared and appendiceal stump was handled under laparoscope.Results All the 31 cases went through clearance of periappendiceal abscess combined with appendectomy successfully,without conversion to open surgery.Operation time was 40-120 min（mean,55 min）.No bleeding,intestinal fistula,incision infection,portal vein thrombosis or other complications occurred.Pathological results showed all cases were acute gangrenous appendicitis.All the patients were discharged from hospital 7-12 d postoperatively.The 31 cases were followed up for 6 months,and no stump inflammation or abdominal pain was found.Conclusion Laparoscopic clearance of periappendiceal abscess combined with appendectomy in the treatment of appendiceal abscess is feasible.