胆囊动脉免夹腹腔镜胆囊切除术(附168例报告)

目的:探讨腹腔镜胆囊切除术(LC)中应用单极电凝而免于钛夹钳夹胆囊动脉的可行性及临床应用价值。方法:168例病例采用2人3孔法完成LC,胆囊管残端钳夹钛夹1枚,单极电凝仔细解剖胆囊三角,组织边凝边切,胆囊动脉“骨骼化”后分段电凝后中间电切离断而不用钛夹钳夹。结果:手术时间10~20m in,平均15m in,手术中出血量5~20m l,平均12.5m l。无副损伤及中转开腹病例。结论:2mm以下的胆囊动脉仅用单极电凝止血而免于钛夹钳夹是安全的。

Laparoscopic cholecystectomy without clamping cystic artery:with a report of 168 cases

Objective:To investigate the feasibility and clinical application value of electric coagulating cystic artery but not titanium clips in laparoscopic cholecystectomy(LC).Methods:168 patients were operated LC with 3 holes by 2 persons.The stump of cystic duct was clamped with 1 titanium clip,Calot triangle was dissected with monopole electrocautery,tissue around gallblader was electric coagulated and dissected step by step,we cut the cystic artery at the middle site with electrocautery,not clamped with titanium clips,after it was skeletonized and electric coagulated in segmentation.Results:The operations were completed between 10 minutes and 20 minutes,averaged 15 minutes.The bleeding volume in operations was between 5ml and 20ml,averaged 12.5ml.There was no side injury in any patient and none was open abdomen during LC.Conclusions:It is safe to electric coagulate cystic artery which diameter is less than 2mm only with monopole electrocautery but not clamped with titanium clips.