单孔腹腔镜胆囊切除术在有腹部手术史患者中的应用  

Application of single-port laparoscopic cholecystectomy in patients with history of abdominal surgery

作　　者：刘鹏[1] 马凯[1] 王晓宇[1] 张凯[1] 闫军[1] LIU Peng;MA Kai;WANG Xiao-yu(Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学,山西太原030001

出　　处：《腹腔镜外科杂志》2019年第4期289-292,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨Hasson法建立气腹行单孔腹腔镜胆囊切除术在有腹部手术史患者中的应用优势及操作技巧。方法:回顾分析2011年11月至2018年10月为117例合并腹部手术史患者行单孔腹腔镜胆囊切除术的临床体会。结果:113例成功完成手术,4例因腹腔内粘连严重无法显露术野及胆囊三角中转开腹,成功率96.6%。术后患者恢复良好,切口美观隐蔽,无网膜损伤及相关并发症发生。结论:Hasson法建立气腹行单孔腹腔镜胆囊切除术,可灵活选取切口部位直视下开腹,避免了粘连肠管网膜的损伤,有效松解腹腔粘连带,对于有腹部手术史的胆囊良性疾病患者是安全、可行、微创、美观的治疗选择。Objective: To investigate the application advantages and operational skills of the establishment of pneumoperitoneum by Hasson method and single-port laparoscopic cholecystectomy in patients with history of abdominal surgery. Methods: Retrospective analysis was made on the clinical experience of 117 patients with history of abdominal surgery who underwent single-port laparoscopic cholecystectomy from Nov.2011 to Oct.2018. Results: Of the 117 patients,113 patients were successfully operated,the surgical field and gallbladder triangle of 4 patients could not be exposed because of severe intraperitoneal adhesions and the 4 patients were converted to open surgery,the success rate was 96.6%.The patients recovered well after operations,the incision healing was cosmetic and concealed,and there was no omentum injury or related complications. Conclusions: Establishment of pneumoperitoneum by Hasson method and single-port laparoscopic cholecystectomy can flexibly select the incision site to avoid the injury of adhesive intestine and omentum,and effectively release the adhesive band for the patients with benign gallbladder disease and history of abdominal surgery.It is a safe,feasible,minimally invasive and aesthetic surgical treatment option.

关 键 词：胆囊切除术 腹腔镜 单孔 Hasson法 腹部手术史 

分 类 号：R657.4[医药卫生—外科学]