胆囊壶腹部结石胆囊后三角径路及免钛夹腹腔镜胆囊切除术67例临床分析  

The techniques of laparoscopic operation for calculous cholecystitis in ampullary by posterior triangle of gallbladder and no using titanium clips

作　　者：王永[1] Wang Yong(The Traditional Chinese Medical Hospital of PuKou Distriction,Nanjin 211800,China)

机构地区：[1]江苏南京市浦口区中医院普外科

出　　处：《河南外科学杂志》2019年第6期9-10,共2页Henan Journal of Surgery

摘　　要：目的分析胆囊壶腹部结石胆囊后三角径路及免钛夹腹腔镜胆囊切除术(LC)的方法和效果。方法2013-01—2017-12间,南京市浦口区中医院对67例胆囊壶腹部结石患者,应用胆囊后三角径路及免钛夹技术行LC。回顾性分析患者的临床资料。结果64例成功完成LC,因胆囊三角粘连致密难以解剖,中转开腹3例(4.5%)。术后腹腔置引流管11例,除1例轻度胆漏延迟拔除外,其余皆在72 h内常规拔除。未出现出血、胆管损伤、胆管狭窄、胆总管继发结石、腹腔感染等并发症,患者均痊愈出院。结论在仔细询问病史,结合临床症状体征,完善超声、CT及MRI等影像学检查,对病情进行全面评估的基础上,胆囊后三角径路结合免钛夹技术行LC治疗胆囊壶腹部结石,是安全、可行的术式。Objective Application of posterior tripod approach combined with titanium clip free technique in laparoscopic Cholecystectomy(LC)in the treatment of gallbladder ampullary stones.Methods From 2013-01 to 2017-12,in Pukou District TCM Hospital,Nanjing,a total of 67 patients with an abdominal calculus of the gallbladder were analyzed retrospectively,and the clinical data of the patients were analyzed retrospectively.Results Totally 64 cases LC were successfully,Dissected because of the dense adhesion of gallbladder triangle,and 3 cases(4.5%)were converted to laparotomy.Drainage tube was placed in abdominal cavity in 11 cases after operation,except for 1 case of mild bile leakage and delayed extraction,the rest were treated with routine drainage within 72 hours.There were no complications such as bleeding,bile duct injury,bile duct stricture,choledocholithiasis,abdominal infection and so on.Conclusion On the basis of a comprehensive assessment of the condition,careful inquiry of medical history,combined with clinical symptoms and signs,and comprehensive evaluation of B-ultrasound,CT and MRI imaging data,LC was safe and feasible in the treatment of gallbladder ampullary stones by posterior tripod approach combined with titanium clip free technique.

关 键 词：胆囊壶腹部结石 腹腔镜胆囊切除术 胆囊后三角 免钛夹 

分 类 号：R657.41[医药卫生—外科学]