腹腔镜胆囊切除术中转开腹的原因分析  

The Causes Resulting in Conversion to Laparotomy from Laparoscopic Cholecystectomy

作　　者：刘玉海[1] 涂从银[1] 汪宏[1] 

机构地区：[1]安徽医科大学附属合肥市第一人民医院普外2科,安徽合肥230061

出　　处：《实用临床医学（江西）》2006年第6期67-68,共2页Practical Clinical Medicine

摘　　要：目的:分析腹腔镜胆囊切除术(LC)中转开腹的原因及预防措施。方法:对14例LC中转开腹的临床资料进行回顾分析。结果:534例LC中,腹腔镜胆囊切除术成功率97.4%,中转开腹14例,占2.6%。其中被迫性中转开腹9例,占1.7%(胆囊局部粘连严重)。强迫性中转开腹5例,占0.9%(出血1例,胆瘘1例,施夹器故障1例,十二指肠损伤1例,结肠损伤1例)。结论:强调重视胆管和胆囊血管畸形,对胆囊急性炎症水肿或重度萎缩致Calot三角区三管结构关系不清的病例,果断AICL处理是LC避免损伤胆管、血管并发症的有效措施之一。严格手术程序可降低严重并发症发生率。Objctive：To investigate the causes resulting in conversion to laparotomy in laparoscopic cholecystectomy and their prevention. Methods.Fourteen laparotomy in laparoscopic choleeystectomy cases were reviewed retrospectively. Results. In 534 cases of laparoscopic cholecystectomy, 14 （2.6%） wer.e converted to laparotomy. The success rate was 97.4%. The materials reveal severe adhesion in 9 cases（1.7%）,bleeding in 1 case,biliary fistula in 1 case,clip appliers defect in 1 case,duodenum injure in 1 case, and colon injure in 1 ease. Conclusion. Bile duct and cholecyst vasculae malformation should be emphasized. AICL is a good measure to avoid injure of bile duct when cholecyst adhesion, the major complication can be reduced by strict procedures of lapamscopic cholecystectomy.

关 键 词：腹腔镜胆囊切除术 中转开腹 原因 

分 类 号：R657.4[医药卫生—外科学]