摘要
目的探讨逆行切除法在困难型腹腔镜胆囊切除术中的应用意义。方法在１９９８年１０月至２０００年４月间，用逆行法切除非急诊的困难型胆囊共６３例，其中萎缩性胆囊炎６例，充满型胆囊结石９例，嵌顿性胆囊结石１７例，亚急性胆囊炎２６例，胆囊管过短 ５例。结果 ５８例通过逆行法完成腹腔镜胆囊切除术（９２％）。中转开腹 ５例（８％），其中萎缩性胆囊炎 １例，充满型胆囊结石 ２例，嵌顿性胆囊结石 ２例。平均手术时间 ３６ ｍｉｎ。术后的平均住院天数 ２． ８ ｄ。手术并发症： １例戳孔血肿继发感染（经换药后痊愈）。无胆管损伤。结论逆行切除法对困难型ＬＣ的完成有帮助，能提高成功率。也有助于降低胆管损伤的发生。
Objective: To approach the significance of using fundus - down approach in difficult laporoscopic cholecygstectomy (LC). Methods: From Oct. 1998 to Apr. 2000, 63 patients with difficult LC, which included fibrosis gallbladder, 6 cases; stone - filled gallbladder, 9 cases; impacted stone, 17 cases; subacute chdecystitis, 26 cases; and short cystic duct, 7 cases, were operated with fundus - down approach. non - emergently. Results: 58 cases were operated by fundus-down approach (92 % ) success. 5 cases (8 % ) were converted to the open procedure, which included fibrosis gallbladder, 1 case; stone - filled gallbladder, 2 cases; impacted stone, 2 cases. The average operative time was 36 minutes. The mean hospitalization time after operation was 2. 8 days. There was one wound infection secondary to hemotoma (treated by wound care). No injuries to the binary tract occurred. Conclusion: It is helpful using fundus - down approach in difficult LC, and it can also reduce the injury of bile duct.
出处
《中国临床医学》
2000年第3期264-265,共2页
Chinese Journal of Clinical Medicine
