摘要
目的 :探讨腹腔镜下顺逆结合切除胆囊预防胆管损伤并发症的临床价值。方法 :回顾分析腹腔镜下顺逆结合切除胆囊 1 2 6例的临床资料。 1 2 6例中胆囊结石伴胆囊萎缩 2 9例 ,急性、亚急性胆囊炎 86例 ,胆囊结石伴慢性胆囊炎 8例 ,胆囊息肉 3例。结果 :1例患者并发毛细胆管漏 ,经引流 3d痊愈 ,余患者均顺利恢复 ,无胆管损伤病例 ,无出血、感染及死亡等严重并发症发生。中转开腹 2例 ,1例胆囊结石伴胆囊萎缩 ,1例亚急性胆囊炎。平均手术时间 4 6min ,平均术后住院 4d。结论 :腹腔镜下顺逆结合切除胆囊能提高腹腔镜胆囊切除术的成功率 ,减少了腹腔镜下胆囊切除术胆管损伤并发症的发生 ,特别是在Calot三角解剖不清及变异时。
Objective:To explore the clinical value of combination of antero and retro grade technique in laparoscopic cholecystectomy for prevention of complicationof of bile duct injuries.Methods:The clinical data of 126 patients with combination of antero and retro grade technique in laparoscopic cholecystectomy was analyzed retrospectively,126 patients included fibrosis gallbladder with gallstone,29 cases;acute cholecystitis with gallstone or subacute cholecystitis with gallstone,86 cases;chronic cholecystitis with gallstone,8 cases;polyps of gallbladder,3 cases.Results:There was one operative complication of bile leakage in all patients.The pationt was cured with drainage.No death or serious complication including infection and bleeding occurred.2 cases were converted to the open procedure,which included fibrosis cholecystitis with gallstone,1 case;subacute cholecystitis with gallstone,1 case.The average operative time was 46 minutes,the mean hospitalization after operation was 4 days.Conclusions:It is helpful using application of combination of antero and retro grade technique in laparoscopic cholecystectomy,and it can also reduce the injury of bile duct,especially for the patients with unclear discrimination of Calot's triangle and anatomical variation of Calot's triangle.
出处
《腹腔镜外科杂志》
2004年第2期106-108,共3页
Journal of Laparoscopic Surgery
