摘要
为了探讨提高腹腔镜胆囊切除术（ＬＣ）成功率，减少并发症，总结１００００例ＬＣ手术经验，对其中３２６例（３．２６％）中转开腹手术的原因进行了分析。结果显示：因胆囊区致密性粘连实施ＬＣ困难而中转开腹者２５２例；肝外胆管损伤２９例；十二指肠损伤３例；出血３６例；其它原因６例。提示在实施困难ＬＣ时，不必一味追求“三管一壶腹”的解剖关系，本着“伤胆”不“伤管”的原则，可于胆囊颈部解剖予以横断切除之，肝下间隙安置引流管；熟练掌握ＬＣ基本操作技术是提高ＬＣ手术成功率、减少并发症的重要手段。
In order to explore the successful rate and reduce the complications of laparoscopic cholecystectomy (LC), we summarized our experiences of 10000 cases of LC and analysed the reasons for changing to laparotomy in 326 cases. Of them the reasons included the compact adhesion (252 cases), bleeding (36 cases), bile duct injury (29 cases), duodenum injury (3 cases) and others (6 cases). We believe that if there are difficulties during LC, the exact anatomical relation of 'three vessels and one ampulla' always should not be stuck to. According to the principle of 'preferring to injury the gallbladder rather than the bile duct', it is effective methods to cut off the gallbladder at the neck of gallbladder and put a drainage tube on the subhepatic space.
出处
《中国普通外科杂志》
CAS
CSCD
1998年第3期146-148,共3页
China Journal of General Surgery
关键词
胆结石
腹腔镜术
胆囊切除术
中转开腹术
Cholelithiasis Laparoscopy Cholecystectomy Change to laparotomy
