改良三孔法腹腔镜胆囊联合阑尾切除术的临床体会(附48例报告)  

The experience of 48 cases of modified 3-port laparoscopic cholecystectomy and appendectomy

作　　者：李伟学[1] 李中明[1] 卢开刚[1] 邱佑斌[1] 曾涛[1] 田宋君[1] 王斌[1] 

机构地区：[1]武汉科技大学附属汉阳医院,湖北武汉430050

出　　处：《腹腔镜外科杂志》2014年第9期717-720,共4页Journal of Laparoscopic Surgery

摘　　要：目的：探讨改良三孔法腹腔镜胆囊联合阑尾切除术的应用价值。方法：回顾分析2005年5月至2012年8月施行的48例改良三孔法腹腔镜胆囊联合阑尾切除术的临床资料。结果：48例均顺利完成手术,手术时间平均（65±12）min;出血量平均（15±10）ml,无一例中转开腹。术后分别发生胆漏1例、脐部切口感染1例,2例患者均于3-5 d内恢复正常;腹腔引流管术后2-5 d拔除,住院时间均与同时期单纯腹腔镜胆囊或阑尾切除手术患者相近。术后46例患者获得随访,随访2-12个月,患者均恢复良好。结论：选择合适的病例,应用改良后的操作方法行三孔法腹腔镜胆囊联合阑尾切除术是安全、有效、可行的,充分体现了微创技术在多器官联合手术中的优越性,具有良好的临床效益、经济效益、社会效益,尤其对于基层医院、初学者具有一定的指导意义。Objective： To explore the application value of modified 3-port laparoscopic cholecystectomy and appendectomy.Methods： Retrospective analysis was made on the clinical data of 48 cases of modified 3-port laparoscopic cholecystectomy and appendectomy from May 2005 to Aug. 2012. Results： All cases were completed successfully without conversion to laparotomy. The mean operation time was（ 65 ± 12） min and the mean blood loss was（ 15 ± 10） ml. 1 case of postoperative bile leakage and 1 case of umbilical incision infection were found,and these two patients recovered in 3-5 d. Abdominal drainage tube was removed in 2-5 d. Hospital stay was similar with that of laparoscopic cholecystectomy or laparoscopic appendectomy during the same period. 46 cases were followed up postoperatively with the duration of 2 ~ 12 months,and all patients recovered well. Conclusions： It is safe,effective and feasible to apply improved 3-port laparoscopic cholecystectomy and appendectomy for selected appropriate patients. It also fully embodies the advantages of minimally invasive techniques in multiple-organ combined operation. This improved method has good clinical benefits,economic benefits and social benefits,and has guiding significance for the grass-roots hospitals and beginners.

关 键 词：胆囊切除术 腹腔镜 阑尾切除术 改良 三孔法 

分 类 号：R657.4[医药卫生—外科学] R656.8[医药卫生—临床医学]