三孔法腹腔镜胆囊切除的临床分析

目的分析讨论三孔法腹腔镜胆囊切除术治疗胆囊良性疾病。方法对1480例胆囊良性疾病进行三孔法腹腔镜胆囊切除术,并对203例病例术中局部喷洒医用生物蛋白胶,并观察其术后腹腔引流情况。结果1480例中1450例顺利完成三孔法腹腔镜下胆囊切除术,23例转为四孔法,7例术中转开腹手术。平均手术时间33.7分钟(15~90分钟);术后平均住院天数3.7天(3~11)天。术后并发症及术后出血4例,占0.27%(4/1480);胆漏3例,占0.20%(3/1480);剑下切口感染11例,占0.74%(11/1480)。用胶组术后第1、2、3天腹腔引流量明显少未用胶组,有统计学意义(P<0.05)。结论三孔法腹腔镜胆囊切除术对大多数胆囊良性疾病的治疗来说是安全的、可行的;医用生物蛋白胶的应用有助于减轻术后的创伤渗出,促进恢复。

The clinical analysis of laparoscopic cholecystectomy by three pores and the application of biomedical fibrin glue

Objective To access the treatment of benign gallbladder diseases by laparoscopic cholecystectomy with three pores.Methods Laparoscopic cholecystectomy with three pores was performed on 1480 patients,and biomedical fibrin glue was used in 203 patients then observe the volume of drainage after operation.Results Laparoscopic cholecystectomy with three pores was performed successfully in 1450 cases,23 cases were converted into four pores and 7 cases were converted to open operation.The mean operation time was 33.7min(15-90min),and the mean hospital stay was 3.7days(3-11 days).In the complications,there were 4 bleeding cases,3 bile leakage cases and 11 incision infection cases.The drainage volume of biomedical fibrin glue group is less than that of the control one(P<0.05).Conclusion The treatment of benign gallbladder diseases by laparoscopic cholecystectomy with three pores is safe and applicable.Biomedical fibrin glue is helpful to reduce exudates and to promote recovery.