两孔法腹腔镜胆囊切除术中紧贴胆囊壁处理胆囊动脉的体会

Experience of gallbladder artery treatment during laparoscopic cholecystectomy by two holes method

目的 总结两孔法腹腔镜胆囊切除术中可吸收夹夹闭胆囊动脉的方法与经验。方法 回顾性分析208例两孔法腹腔镜胆囊切除术中可吸收夹夹闭胆囊动脉的临床资料。结果 可吸收夹夹闭胆囊动脉198例,术中、术后无出血,8例因术中胆囊动脉变异需再次夹闭,2例因动脉断裂中转开腹。手术时间15~55 min,术中出血量5~20 m L,术后住院3~5 d,无手术并发症。结论 两孔法腹腔镜胆囊切除术中在胆囊外膜下处理胆囊动脉的方法可有效防止胆管和血管损伤,更符合安全、微创的理念,是一种合理的手术方式,值得在临床推广。

Objective To summarize the methods and experience of laparoscopic cholecystectomy for the closure of the gallblad- der arteries during laparoscopic cholecystectomy for two well laparoscopic cholecystectomy. Methods The clinical data of 208 cases of two ports laparoscopic cholecystectomy by clamping the cystic artery admitted was retrospectively analyzed. Results 198 cases were no bleeding in the middle of or after operation using the clip. 8 cases due to intraoperative gallbladder arterial variability were needed to clamp again. Two cases were converted to laparotomy for arterial rupture. The operation time was 15 - 55 min, the amount of bleeding was 5 - 20 mL, the hospital stay was 3 - 5 days, and there were no complications. Conclusion Two ports laparoscopic cholecystectomy using biologically cystic artery bleeding by clamping is safe and reliable.