摘要
目的 探讨腹腔镜胆囊切除术 (LC)的风险防范措施 ,提高手术质量。方法 对 30 8例LC术前手术难易程度的评估、胆道系统的解剖和病理改变、术中处理及治疗结果进行回顾性分析。结果 手术难度 1级占 53 % ,2级占 31 % ,3级占 1 6 % ;胆囊广泛粘连占 1 3 3 % ;异常胆囊管占 5 1 % ,其中类Mirizzi综合征变异有 3例 ;单支胆囊动脉占 70 2 % ,多支胆囊动脉占 1 3 6 % ,胆囊动脉缺如或Calot′s三角炎症分辨不清占 1 6 2 % ;30 4例成功施行LC术 ,仅 4例中转开腹胆囊切除 ,中转率为 1 3 %。本组患者全部治愈出院 ,术后住院平均 3 1d ,未发生任何并发症。结论 必须高度重视围手术期的处理和手术难度的评估 ,熟悉胆道系统的解剖及变异 ,具有娴熟的腹腔镜外科操作技巧 。
Objective\ To control the risks during laparoscopic cholecystectomy (LC) to improve the operative quality.Methods\ 308 cases were retrospectively analyzed. Results\ The rates of operative difficulty type 1 to 3 were 53%,31% and 16% respectively.Serious adhesion around gallbladder presented in 13.3% cases,anomalies of cystic duct were found in 5.1%, among them 3 cases with Mirizzi syndrome-like variation;only one cystic artery presented in 70.2%,more than one artery in 13.6%,absence of the cystic artery or inflammation within Calot′s triangle obscuring the anatomy presented in 16.2%.304 cases underwent LC successfully,and only 4 cases were converted to open cholecystectomy during LC.All the cases had good outcome without any complication,and the mean postoperative hospital stay was 3.1 days.Conclusions\ In order to keep away the risk during LC efficiently,surgeon must be aware of anatomy and variation of biliary system and proficient in laparoscopic surgical technique.
出处
《医师进修杂志》
北大核心
2003年第4期11-13,共3页
Journal of Postgraduates of Medicine
关键词
腹腔镜胆囊切除术
风险防范
解剖变异
病例报告
laparoscopic cholecystectomy
estimation
operative risk
anatomy variation
