困难腹腔镜胆囊切除术78例手术体会

摘要

Objective To study the surgical techniques for complicated laparoscopic cholecystectomy ( LC ).Methods The clinical data of 654 patients undergoing LC between January 2006 and May 2010 were retrospectively reviewed for the analysis of surgical techniques in complicated cases.Results LC was completed in 73 patients but converted to open procedure in five patients.Postoperative bile leak occurred in one patient and resolved with conservative treatment.No other complications were noted.Conclusion Intraoperative cautious management, careful dissection and appropriate techniques enable the completion of LC in most complicated cases.It is advisable that immediate conversion be done to minimize the risks of complications.%目的 探讨困难腹腔镜胆囊切除术(LC)的手术方法.方法 回顾性分析2006年1月至2010年5月本院654例患者行LC的临床资料,其中78例术中操作困难,总结操作困难的各种原因,探讨各种困难情况下的手术技巧.结果 73例在腹腔镜下完成手术,5例中转开腹;术后胆漏1例,保守治愈,余均无严重并发症发生.结论 术中谨慎操作,仔细解剖,采用适当的手术技巧,多数手术可顺利完成,遇复杂情况果断中转开腹是避免严重并发症的明智之举.