脐周三孔法腹腔镜胆囊联合阑尾切除术42例

摘要

Objective-To-evaluate-the-feasibility-of-the-transumbilical-triple-hole-laparoscopic-cholecystectomy-combined-with-appendectomy-.-Methods-From-March-2012-to-December-2012,-a-total-of-42-cases-subject-to-transumbilical-triple-hole-laparoscopic-cholecystectomy-combined-with-appendectomy-in-this-hospital-were-retrospectively-analyzed-.Under-general-anesthesia-,-the-patients-were-maintained-at-recumbent-position-,-with-a-pneumoperitoneum-pressure-of-12-14-mm-Hg.With-the-navel-as-the-center-,-10-mm,-5-mm,-and-10-mm-trocars-were-introduced-at-5,-8,-and-1-o’-clock-direction-along-the-circumference-of-periumbilical-skin-fold-,-respectively-.After-observation-and-exploration-,-cholecystectomy-and-appendectomy-were-successively-performed-.-Results-All-the-patients-were-successfully-treated,-without-any-complications.The-operation-time-was-60-130-min-(mean,-78-min).A-follow-up-observation-for-2--12-month-(-mean,-7-month-)-was-conducted-in-40-cases.No-obvious-scars-or-complications-were-noted-.-Conclusions-Transumbilical-triple-hole-laparoscopic-cholecystectomy-combined-with-appendectomy-is-a-safe-and-feasible-operation-.-This-method-can-be-carried-out-at-large-scale-in-hospitals-as-improved-alternative-of-cholecystectomy-combined-with-appendectomy-.%目的：探讨脐周三孔法腹腔镜胆囊联合阑尾切除术的可行性。方法2012年3～12月行脐周三孔腹腔镜胆囊联合阑尾切除术42例。全身麻醉。采用平卧位，气腹压力12～14 mm Hg（1 mm Hg＝0．133 kPa）。以脐为中心，沿脐周皮肤皱褶线画圆，从5、8、1点方向分别置入10、5、10 mm trocar，入镜观察胆囊和阑尾情况，先行胆囊切除后再行阑尾切除术。结果42例采用普通腹腔镜器械经脐周行三孔胆囊切除联合阑尾切除术取得成功。手术时间60～130 min，平均78 min。40例术后随访2～12个月（平均7个月），腹壁瘢痕不明显，无并发症发生。结论脐周三孔腹腔镜胆囊联合阑尾切除术安全可行，在有条件的医院可以作为腹腔镜胆囊切除联合阑尾切除的改进术式推广。