腹腔镜辅助的胃大部切除术(附4例报告)

Laparoscopic-assisted subtotal gastrectomy:with a report of 4 cases

目的 :探讨腹腔镜辅助的胃大部切除的手术方法。方法 :选择胃平滑肌瘤、胃癌各 1例 ,十二指肠球部溃疡 2例 ,在腹腔镜下用超声刀离断胃周韧带与血管 ,辅以约 6cm的小切口进行胃大部切除胃肠吻合术 ,合并胆囊结石的 2例同期完成腹腔镜胆囊切除术。结果 :4例手术均获成功。结论 :腹腔镜辅助的胃大部切除术难度较大 ,用超声刀完成手术具有止血可靠 ,切割精确的优点 ,若掌握得当 ,手术是安全可行的。辅以小切口完成胃肠的离断与吻合 ,可减少手术难度 。

Objective:To explore the subtotal gastrectomy with the laparoscopy assisted.Methods:1 case with gastric leiomyoma,1 case with gastric cancer and 2 cases with duodenal ulcer were selected.Perigastric ligaments and vessels were broken off with ultrasonic scalpel under laparoscopy.Then with the incision of 6cm,subtotal gastrectomy and gastroenterostomy were performed,while laparoscopic cholecystectomy was completed in 2 cases associated with cholecystolithiasis. Results:The surgery of 4 cases was successfully.Conclusions:Laparoscopy assisted subtotal gastrectomy has some difficulties.Ultrasonic scalpel has advantages of certain hemostasis and accuratel yincision so that if it is propenly applied,the operation is safe and feasible.The gastroenterotomy and gastroenterostomy performed with the small incision can reduce the difficulty and expedditure in surgery.