腹腔镜胆囊切除术中转开腹手术的原因分析  

Analysis of causes of the conversion to laparotomy during laparoscopic cholecystectomy

作　　者：黄韬[1] 朱红[1] 刘佳[1] 罗彪[1] 

机构地区：[1]四川大学华西医院西藏成办分院普外科,成都610041

出　　处：《中国临床新医学》2013年第10期963-965,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨腹腔镜胆囊切除术(LC)中转开腹手术的原因。方法采用回顾性分析的方法对30例LC中转开腹手术原因进行统计分析。结果中转开腹手术的原因中,手术部位解剖关系不清16例(53.3%),解剖结构异常6例(20.0%),胆囊床广泛渗血不止4例(13.3%),胆囊动脉出血3例(10.0%),肝外胆管损伤1例(3.3%)。结论腔镜手术操作困难时应及时中转开腹手术,以获得最好的远期疗效。术前仔细评估,严格腹腔镜手术指征,术中仔细精准的解剖定位,可以降低中转开腹手术率。Objective To study the causes of conversion to laparotomy during laparoscopic cholecystectomy （LC）. Methods A retrospective analysis was performed on the causes of conversion to laparotomy in 30 patients re- ceived LC. Results The causes of conversion to laparotomy, included obscure anatomical relation in surgical site in 16 cases, accounted for 53.3%; anomolous anatomical in 6 cases, accounted for 20. 0%; widely oozing blood of gallbladder bed in 4 cases, accounted for 13.3% ; bleeding of cystic artery in 3 cases, accounted for 10. 0% ; injury of the extrahepatic bile duct in one case, accounted for 3.3%. Conclusion Conversion to laparotomy should be timely performed when LC meeting difficulties, in order to get tile best long-term curative effect. Preoperative careful evaluation, strictly laparoscopic surgical indications, and intraoperative careful accurate anatomical location, can re- duce the rate of conversion to laparotomy.

关 键 词：腹腔镜胆囊切除术 中转开腹手术 原因分析 

分 类 号：R6[医药卫生—外科学]