胃切除术后胆囊结石腹腔镜治疗28例临床分析

Clinical Analysis of 28 Cases of Laparoscopic Treatment of Cholecystolithiasis after Gastrectomy

目的:探讨腹腔镜治疗胃切除术后胆囊结石的疗效、手术方式的变化。方法:对江苏大学附属人民医院2013年5月-2014年11月的28例进行腹腔镜治疗的胃切除术后胆囊结石患者的临床资料进行回顾性分析。结果:建立气腹28例,中转开腹4例;术后并发胆漏1例,腹腔出血2例,切口感染1例,胆管炎及胆管狭窄0例,失访4例。结论:术前充分评估腹腔粘连,严格掌握适应证,腹腔镜治疗胃切除术后胆囊结石无明显严重并发症,且具有腹腔镜手术创伤小的优势,显著提高患者生活质量。

Objective：To investigate the outcome and modus operandi＇s deviation of Laparoscope（LC） for cholecystolithiasis with a history of Gastrectomy.Method：From May 2013 to November 2014,there were 28 patients of cholecystolithiasis with a history of Gastrectomy given the LC operations,whose clinical data had been collected and analyzed.Result：Pneumoperitoneum were created in all 28 cases,the modus operandi in 4 cases had been changed to laparotomy replacing LC,after the operations,there was one case having bile leakage,two case with abdominal hemorrhage,one case with wound infection,and 4 cases lost to follow-up,but none had cholangitis or bile duct stricture.Conclusion：Before the surgery,with estimation of the abdominal adhesion,and stick to indication,there are no severe complication of the Laparoscope（LC） for cholecystolithiasis with a history of gastrectomy,patients can benefit with the minor wound of LC and increase the quality of life.