高原地区电视腹腔镜胆囊切除术临床应用

Clinical application of television abdominoscope cholecystectomy in high altitude district

我院 1 997年首家引进电视腹腔镜手术系统 ,学习和借鉴目前国内腹腔手术方式 ,并运用于高原临床外科 ,研究探讨该项技术在西藏高原低氧特殊环境下临床应用可行性、优越性及其疗效。对 72例年龄2 0— 65岁世居藏族胆囊结石患者在气管插管全麻下进行腹腔镜胆囊切除手术。结果 62例完成镜下手术 ,占85% ,1 1例中转剖腹手术 ,中转率为 1 5% ,手术并发胆管损伤 2例 ,其发生率为 2 8% ,手术时间最长 2 0 0min ,最短 4 0min ,平均手术时间 97min ,术中出血量 5ml—80ml,平均 1 5ml,术后住院时间 7— 1 0d ,平均 8 5d ,全组治愈出院 ,无输血及死亡 ,术后满意度达 97% ,结论该项手术不仅达到开腹手术的效果 ,并具有其独特的优点 ,值得推广应用。

Objective:To study and probe the feasibility、superiority and curative effect of abdominoscope technic in Tibet high altitude hypoxia environment. Methods:72 cases of native Tibetan(age 20-65)cholelithiasis patients were performed abdominoscope cholecystectomy under trachel intubation anesthesia. Results:62 cases of operation were accomplished under abdominoscope,account for 85%;11 cases change to laparotomy,change rate 15%;2 cases with complication of bile duct injury,incidence rate 2.8%;operative time 40-200min,average time 97min;amount of operative bleeding 5-80ml,average 15ml;hospitalization time after operation 7-10 days,average 8.5days.72 cases were all cured and discharged without blood transfusion or death,postoperative satisfaction rate 97%. Conclusion:Television abdominoscope cholecystectomy not only reached the effect of laparocholecystectomy but also with it's distinctive characteristics,this operative method is worth using and spreading.