腹腔镜胃十二指肠穿孔修补术55例总结

Laparoscopic repair in 55 patients with gastric and duodenum perforation

目的 :总结腹腔镜下胃、十二指肠穿孔修补术的经验。方法 :对 5 5例胃、十二指肠穿孔患者施行腹腔镜修补术。结果 :5 0例十二指肠穿孔 ,行腹腔镜穿孔修补术 ;5例胃穿孔 ,中转开腹行胃大部切除术 ;平均住院 8 5d ,无术中及术后并发症。胃切除病理 :胃溃疡穿孔 4例 ,胃癌穿孔 1例。结论 :腹腔镜十二指肠穿孔修补术具有安全、可靠 ,患者康复快和痛苦小等特点 ;而胃穿孔由于有胃溃疡恶变或原发胃癌的可能 ,故是否行穿孔修补术应该慎重 ,年轻患者可行修补术 ,术后随访 ;对 4 0岁以上的患者 。

Objective:To study the experience of laparoscopic repair in gastric and duodenum perforation.Methods:55 patients with gastric and duodenum perforation were performed laparoscopic repair.Results:50 patients with duodenum perforation were safely operated. And 5 patients with gastric perforation were converted to open for partial gastrectomy. The mean time of hospitalization was 8.5 days. There was no intraoperative and postoperative complication. Pathological examination: Showed 4 patients with perforation of gastric ulcer and one with perforation of gastric carcinoma.Conclusions:Laparoscopic repair is one of the safe, quick recovery and little sufferment treatment for duodenum perforation, but it should be done with great care in repairing gastric perforation for malignant change of gastric ulcer and primary gastric carcinoma. Young patients may be done by this treatment, and should be followed up after operation; patients over 40 years had best accept partial gastrectomy.