腹腔镜胆囊次全切除术168例报告  

Laparoscopic Subtotal Cholecystectomy:Report of 168 Cases

作　　者：嵇武[1] 李令堂[1] 丁凯[1] 汪志明[1] 王丹[1] 彭丽娜[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,南京210002

出　　处：《中国微创外科杂志》2008年第4期372-374,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜胆囊次全切除术(laparoscopic subtotal cholecystectomy,LSC)的可行性和技术特点。方法对168例因各种原因无法完成腹腔镜胆囊切除术的患者转行LSC,方法包括从分离Calot三角开始和从切开Hartmann袋减压、取石开始。结果5例中转开腹行胆囊次全切除术;122例在胆囊管和胆囊动脉夹闭后行胆囊大部切除;41例先在Hartmann袋处切开胆囊,然后寻找、夹闭胆囊管和胆囊动脉或缝扎胆囊颈部,再行胆囊大部切除。手术时间(65.5±15.2)min,术中出血量(71.5±15.5)ml,术后恢复进食时间(20.4±6.3)h,出现局部并发症7例(4.2%),术后住院时间(4.2±2.6)d。105例随访(25.5±6.5)月,消化不良5例,右肩牵涉痛3例,右上腹部不适9例。结论对于复杂胆囊炎,LSC是可行的,术者要熟练掌握LSC的技术特点,正确处理好出血和胆漏是LSC成功的关键。Objective To investigate the feasibility and technique of laparoscopic subtotal cholecystectomy(LSC).Methods Totally 168 patients were converted to LSC because of failure in laparoscopic cholecystectomy(LC).During the LSC,the Calot s triangle was separated and then the Hartmann s pouch was incised to decreased the intracystic pressure for the removal of the stones.Results Among the cases,5 patients were converted to open surgery for subtotal resection of the gallbladder.LSC was completed after clipping the ...

关 键 词：腹腔镜胆囊切除术 胆囊炎 腹腔镜胆囊大部切除术 

分 类 号：R657.42[医药卫生—外科学]