有腹部手术史的腹腔镜手术应用分析(附78例报告)

Laparoscopy in patients with history of abdominal operation:with an analysis of 78 cases

目的 :总结有腹部手术史的患者行腹腔镜手术的经验。方法 :避开原有切口选择第 1戳孔 ,必要时采用开放法置入穿刺鞘 ,注重粘连区的分离技巧。结果 :78例中 77例成功完成手术 ,其中腹腔镜胆囊切除术 (LC) 6 8例 ,LC +胆总管探查取石术 2例 ,阑尾切除术 3例 ,肠粘连松解术 3例 ,十二指肠球部溃疡穿孔修补术 1例 ,因局部粘连严重中转开腹 1例 ,全部病例无手术并发症。结论 :有腹部手术史的腹腔镜手术具有创伤小 ,痛苦轻 ,恢复快 。

Objective:To summarize the experiences of the laparoscopy for patients with history of abdominal operation.Methods: 78 cases were performed laparoscopy,in which the primitive incision was avoided and the first stab was chosen,if necessary,opening method can be used to insert the trocar,and the adhesive tissue was disected skillfully.Results :Of the 78 cases,77 cases were operated successfully.Among them 68 cases had laparoscopic cholecystectomy(LC), 2 cases had LC+laparoscopic choledochotomy with exploration,3 cases had appendectomy,3 cases had lysis of intestinal adhesion, 1 case had repair of peptic ulcer perforation, 1 case changed to laparotomy.All the patients recovered without any complication.Conclusions:The laparoscopy in the patients with history of abdominal operation has many advantages such as little suffering and injury,fast recovery,not affecting healing of incision,and so on.