腹腔镜胆囊切除联合手术117例临床报告

目的探讨腹腔镜联合手术的可行性及安全性。方法回顾分析1992年3月至2006年12月间117例腹腔镜联合手术的临床资料;男性39例,女性78例,年龄为25~74岁,其中行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC) 腹腔镜阑尾切除术(laparascopic appendectomy,LA)46例;LC 肝囊肿去顶减压术15例;LC 肾囊肿去顶减压术6例;LC 肝、肾囊肿去顶减压术3例;LC 腹腔镜脾切除、门奇静脉联合断流术7例;LC 腹腔镜胃肠间质瘤切除术6例;LC 腹股沟疝修补术3例;LC 结直肠癌根治术8例;LC 粘连松解术6例;LC 子宫肌瘤剔除术6例;LC 卵巢囊肿剥除术10例;LC 肾脏错构瘤切除术1例。结果手术均顺利完成,中转开腹1例,胆漏1例,无感染、出血和胆道损伤等并发症;术后住院日平均为5.7 d。结论只要严格掌握各自疾病的手术治疗原则及联合手术的适应证,对两种或两种以上腹部病变的腹腔镜联合处理是安全有效的,具有创伤小、痛苦少、恢复快、灵活方便和多病联治的优点。

Clinical report of combined laparoscopic cholecystectomy: Report of 117 cases

Objecive To explore the feasibility and safety of combined laparoscopic cholecystectomy.Methods One hundred and seventeen cases of combined laparoscopic cholecystectomy with other operation were performed during the past fourteen years and the results were analyzed in terms of indications,operation skills and complications.These operations included 46 cases of laparoscopic appendectomy,15 cases of laparoscopic fenestration of liver cyst,6 cases of renal cyst decortication,3 cases of laparoscopic fenestration of liver and renal cyst,7 cases of laparoscopic splenectomy and azygos-portal disconnection,7 cases of laparoscopic resection of gastrointestinal stromal tumors(GISTs),3 cases of laparoscopic Inguinal hernia repair,8 cases of laparoscopic radical resection of colorectal cancer,6 cases of laparoscopic myomectomy,10 cases of shelling out of the ovarian cyst under laparoscope,and 1 case of laparoscopic radical resection of renal angiomyolipoma.Results The combined laparoscopic surgery for 117 patients were all successfu1.Among them,only one case was converted to laparotomy and there was no postoperative complication.The mean hospitalization time was 5.7 days.Conclusions As long as strictly mastering operative indications for the combined laparoscopic surgery,multiple abdominal diseases can be safely,effectively and economically treated,and the patients can be fully benefited from it.