腹腔镜胃十二指肠溃疡穿孔修补术64例临床分析

目的总结腹腔镜胃十二指肠溃疡穿孔修补术治疗急性胃、十二指肠溃疡穿孔的临床经验。方法2006年6月～2009年3月64例急性胃十二指肠溃疡穿孔患者施行腹腔镜消化性溃疡穿孔修补术。结果64例中十二指肠球部溃疡穿孔48例,胃窦部溃疡穿孔16例,穿孔直径0.5～0.8cm,手术时间40～60min,手术均获成功,术后患者疼痛轻微,均未使用止痛剂。术后康复顺利,术后住院5～10d,平均6.5d,切口均甲级愈合,痊愈出院。出院后予以内科根除幽门螺杆菌、口服H2受体拮抗剂治疗。结论腹腔镜手术治疗急性胃、十二指肠溃疡穿孔,与开腹手术同样安全有效。胃溃疡穿孔患者术中需快速病理检查,若为恶性病变应中转开腹。

CLINICAL ANALYSIS OF 64 CASES OF LAPAROSCOPIC REPAIR OF ACUTE PERFORATION OF GASTRODUODENAL ULCER

Objective To summarize the clinical experience of laparoscopic repair of acute perforation of gastroduodenal ulcer. Methods From June 2006 to March 2009,64 patients underwent laparoscopic repair of perforated peptic ulcers. Results 48 patients were suffered from perforated duodenal bulbar ulcer,and 16 patients were suffered from perforated gastric antral ulcer. The diameter of the perforation was 0.5 - 0.8cm, the operative time was 40 - 60min, all laparoscopic operations were successful without any operative complications. Slight incisional pain and administration of postoperative pain medication was not used. Postoperative recovery was smooth, the length of hospitalization were 5 to 10 days after surgery,the average time were 6.5 days. All the patients were discharged after their incision was healed by first intention. Conclusion Laparoseopic repair of acute perforated gastroduodenal ulcer is as safe and effective as the open repair.