基层医院腹腔镜胆囊切除术1 696例的治疗体会

目的:探讨腹腔镜在基层医院普及开展的可行性和主要并发症的预防.方法:回顾分析1999年6月至2006年5月我院1 696例腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床资料.结果:1 696例LC成功 1 635例,中转开腹61例,中转率3.6%,发生并发症17例,其中胆管损伤1例,腹腔内出血2例,胆漏2例,腹腔感染1例,胆管残石3例,遗漏腹腔内病变6例,上消化道出血2例.结论:LC在基层医院的开展日益成熟,成为治疗胆囊良性疾患的"金标准".术前注意鉴别诊断,术中操作轻柔,辨明胆囊三角结构,能避免严重并发症的发生.

The experience of 1 696 laparoscopic cholecystectomies in primary hospital

Objective:To investigate the feasibility of laparoscopic cholecystectomy(LC) in primary hospital,and summarize the complications and corresponding precautions.Methods:The data of 1 696 LC performed from June 1999 to May 2006 were retrospectively analyzed.Results:Sixty-one patients were converted to open procedure and the conversion rate was 3.6%.1 635 patients underwent LC successfully.The complications included 1 case of bile duct injury,2 cases of intraabdominal hemorrhage,2 cases of bile leak,1 case of intraabdominal infection,3 cases of retained calculi in biliary tract,and 6 cases of omitting the lesions in abdominal cavity.Conclusions:LC has become the gold standard for benign gallbladder disease in primary hospital.The attention must be paid to preoperative differential diagnosis,intraoperative careful operation,and distinguishing calot' triangle in order to avoid severe complication