腹腔镜胆道手术中非预见性腹腔粘连的处理

Management of unpredictable intraabdominal adhesion in laparoscopic biliary tract operation

目的 探讨腹腔镜胆道手术中非预见性腹腔粘连的特征及处理方法。方法 在 93例腹腔镜胆道手术中联合行腹腔粘连松解术。结果 所有病例均在腹腔镜下完成手术 ,除一例术中出现小肠损伤外 ,无其它术中和术后并发症。随访 2～ 18个月 ,5 7例有慢性腹痛病史者中 ,31例 (5 4 .4 % )腹痛消失 ,2 0例 (35 .1% )腹痛有不同程度的减轻。结论 腹腔镜胆道手术中对非预见性腹腔粘连的处理能有效改善病人术后的生活质量 ,其手术操作过程并不复杂 ,也未增加病人的创伤 ,能充分体现腹腔镜技术微创的优越性。

Objective To investigate the character isties and management of unpredictable intraabdominal adhesion in laparoscopic biliary tract operation.Methods Laparoscopic biliary tract operation combined with adhesiolysis were performed in 93 patients.Results All procedures were performed under laparoscopy,accompanied with small bowel injury in 1 patient and no complication occurred in the others.During the follow up period for 2 to 18 months,57 patients with chronic abdominal pain,abdominal pain disappeared completely in 31 patients(54.4%) and released to various degree in 19 patients(35.1%).Conclusion Therapy of unpredictable intraabdominal adhesion in laparoscopic biliary tract operation can improve postoperative life quality of patients, and the procedures are neither complex nor more painful to the patients.