经腹腔镜修补胃十二指肠溃疡穿孔体会

Experience on Laparoscopic Repair of Gastroduodenal Ulcer Perforation

目的:探讨在基层医院腹腔镜下修补胃十二指肠溃疡穿孔的安全性、可行性及疗效。方法:回顾分析本科2006年1月-2014年1月收治腹腔镜下修补胃十二指肠溃疡急性穿孔65例的临床资料。结果:64例患者腹腔镜下修补成功,另有1例因十二指肠球后穿孔操作困难即中转开腹完成手术,腹腔镜下修补手术时间为(65±25)min,手术后住院时间(7±2)d。全部患者无术后修补失败而再漏、出血、腹腔及穿刺孔的感染,以及肠粘连梗阻或胃十二指肠梗阻等并发症,穿刺孔一期愈合,患者均痊愈出院,出院后继续经消化内科规范治疗。结论:经腹腔镜修补胃十二指肠溃疡急性穿孔具有手术创伤小、术后痛疼轻、出血少、美容、腹腔干扰轻、冲洗彻底、肠道排气早、恢复快及感染并发症少,并兼顾明确诊断与治疗等优点,并且安全可靠,操作简单,便于在基层医院推广。

Objective：To investigate the repair safety,feasibility and efficacy of gastric ulcer perforation in the primary hospital laparoscopic.Method：The clinical data of 65 cases of laparoscopic repair of acute perforated gastric ulcer from January 2006 to January 2014 were retrospectively analyzed.Result：64 patients under laparoscopic repair were successful,one case of duodenal perforation after ball completed laparotomy due to operational difficulties,laparoscopic surgical repair time was（65±25）min,hospital stay after surgery was（7±2）d.All patients had no further leakage after repair failure,bleeding,infection of the abdominal cavity and puncture holes,and adhesions gastroduodenal obstruction obstruction or other complications,and all were primary healing,patients were cured and were given gastroenterology standard treatment after discharge.Conclusion：Laparoscopic repair of acute perforated gastric ulcer have little surgical trauma,light postoperative pain,less bleeding,beauty,light abdominal interference,wash thoroughly, early intestinal exhaust,rapid recovery and less concurrent infection disease,and definite diagnosis and treatment,etc. It is safe,reliable,simple operation,it is easy to popularize in primary hospitals.