急诊腹腔镜胆囊切除术中复杂情况处理的探讨

Discussion on complex situation in the process of operation of emergency laparoscopic cholecystectomy

目的：探究分析进行急诊腹腔镜胆囊切除术过程中出现复杂情况的处理手段。方法：选择行腹腔镜胆囊切除术患者共36例,以回顾性的方法对患者的临床资料进行分析。结果：所有患者平均手术时间为50 min;术中平均出血量为30 ml;患者引流管留置时间在（1~3）d之间,引流量为（30~300）ml,平均引流量为100 ml;所有患者没有出现中转开腹手术以及死亡的情况;1例患者出现术后发热,对症治疗后痊愈。结论：在急诊腹腔镜胆囊切除术过程中有可能会出现较为复杂的情况,这个时候要求术者对于胆道系统解剖要有全面的认识以及熟悉的手术操作技巧,这个是面对此类问题的最好保障。

Objective To explore and analyze the method for complex situation in the process of operation of emergency laparoscopic cholecystectomy.Method Clinical data of 36 cases of laparoscopic cholecystectomy with difficult operation resection were analyzed retrospectively.Results Of all the patients,average operation time was 50 minutes; the mean intraoperative bleeding was 30 ml; indwelling time of patients with drainage tube was in（ 1-3） days,drainage for（ 30-300） ml,average flow rate was 100 ml; all patients were without conversion to open operation and death.Postoperative fever occurred in 1 patient; after the symptomatic treatment was healed.Conclusion In the emergency laparoscopic cholecystectomy may appear more complex situations during the surgery,at this time,surgeons need to have comprehensive understanding to biliary anatomy and be familiar with the operation skills,this is the best guarantee to face such problems.