腹腔镜下全小肠探查及腹腔镜辅助下小肠部分切除术  

Laparoscopic Exploration Partial Resection of Thesmall Bowel

作　　者：梁久银[1] 侯辉[1] 李凯琅[1] 但震宇[1] 李勇[1] 李婧[1] 王涛[1] 陈新[1] 

机构地区：[1]全国武警腹腔镜外科中心武警安徽省总队医院外三科,合肥230041

出　　处：《中国微创外科杂志》2010年第1期67-68,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜下全小肠探查及小肠部分切除的临床价值。方法回顾性分析1996年10月～2008年3月17例全小肠探查及其中4例行小肠部分切除术的临床资料。结果17例腹腔镜下探查均顺利完成。4例腹腔镜辅助下小肠部分切除(胃切除术后小肠粘连成角1例;疑小肠肿瘤1例,术后病理为结核性肉芽肿;胆囊结石同时患小肠梗阻1例;末端回肠克罗恩病1例)。探查出阳性结果未手术2例(末端回肠先天性狭窄1例择期手术,多发性肠息肉并多发性肠套迭1例拒绝手术)。余11例均在镜下顺利分离肠粘连。13例随访8个月～5年,平均3年,11例肠粘连松解术后,腹痛症状未再复发,1例克罗恩病、1例末端回肠结核性肉芽肿无不适症状。结论腹腔镜下全小肠探查对小肠疾病诊断安全、快速、可靠,定位准确,发现病灶后可在腹腔镜辅助下小肠部分切除,使诊治一体化。Objective To explore the value of laparoscopy in exploration and partial resection of the small.Methods The clinical data of 17 patients,who received laparoscopic total small bowel exploration from October 1996 to March 2008 were analyzed retrospectively.Four of the patients underwent laparoscopy-assisted partial small bowel after the exploration.ResultsLaparoscopy total small bowel exploration was completed in the 17 patients successfully.In the 4 patients who underwent partial resection of the small bowel,one patient was diagnosed with small bowel adhesion after gastric resection,one had tuberculous granuloma that was suspected as tumor preoperatively,one showed cholecystolithiasis complicated with small bowel obstruction;and the other was confirmed as having terminal ileum Crohn＇s disease.In the other 13 patients,two were found positive results by laparoscopic examination but didn＇t receive treatment immediately（one of them had congenital terminal ileum stricture and was submitted to selective operation;the other patient was diagnosed with multiple polyps complicated with multiple entembole but refused operation）.In the remaining 11 patients,the adhesion of the small bowel was separated successfully by laparoscopy.The patients were followed up for 8 months to 5 years,during the period,no patients complained symptoms of the original diseases.Conclusion Laparoscopic exploration is a safe,quick,reliable,and accurate method for detecting lesions in the small bowel.

关 键 词：腹腔镜 小肠探查 小肠部分切除术 

分 类 号：R656.7[医药卫生—外科学]