腹腔镜胆囊切除即刻中转开腹手术临床分析(附236例报告)

CLINICAL ANALYSIS OF IMMEDIATE LAPAROTOMY SECONDARY TO LAPAROSCOPIC CHOLECYSTECTOMY

目的 :总结腹腔镜胆囊切除术 (LC)即刻中转开腹手术的临床经验。方法 :回顾分析 1 1 4 36例LC即刻中转开腹的临床资料。结果 :LC即刻中转开腹手术的发生率为 2 .0 6 % ,主要原因是急性胆囊炎、近期有急性胆囊炎发作史 ,胆囊周围粘连、胆囊颈部结石嵌顿、Calot三角解剖不清、难以辨认胆囊管 ,胆总管损伤。结论 :正确掌握中转开腹的时机是降低LC手术并发症的有效措施。提高腹腔镜基本技术 。

Objective:To investigate the causes and the experiences of the immediate laparotomy secondary to laparoscopic cholecystectomy. Method:Eighteen thousand and fofy-six cases of laparoscopic cholecystectomy were analyzed to discuss the immediate laparotomy during the laparoscopic cholecystectomy. Results:The occurrence rate of the immediate laparotomy secondary to laparoscopic cholecystectomy was 2.41% with the main causes as following: the history of acute cholecystitis and recent acute outbreak of chronic cholecystitis, the adhesion around the gallbladder, the stone incarceration on the neck of the gallbladder, the unclear discrimination of the Calot's triangle and the injury to the choledochus.Conclusion:Proper choice of immediate laparotomy secondary to laparoscopic cholecystectomy may reduce the complications of the laparoscopic cholecystectomy. It may decrease the occurrence of the operation change with the improving skills of the laparoscopy, good controlling of the indications and necessary assistance examinations.