腹腔镜胆囊切除中转开腹29例分析

目的 :探讨腹腔镜胆囊切除术 (LC)患者中转开腹的原因、时机和处理原则。方法 :回顾分析 2 9例LC患者中转开腹的临床资料。结果 :2 9例开腹原因是胆管损伤、胆漏 3例 ,胆囊萎缩、炎症粘连 1 1例 ,出血 6例 ,胆囊管解剖异常或不清 3例 ,Mirizzi综合征、胆总管残石及肠损伤各 2例。患者均得到及时、正确的治疗 ,未造成严重后果 ,无死亡病例。结论 :LC有时会出现较严重的并发症 ,及时发现、诊断和适时中转开腹十分重要。

The analysis of 29 cases of conversion from laparoscopic cholecystectomy to laparotomy

Objective:To explore the reasons,timing and principles of the conversion from laparoscopic cholecystectomy(LC) to laparotomy.Methods:The clinical data of 29 patients was analyzed retrospectively.Results:Among the reasons of the conversion from LC to laparotomy,bile duct injury and/or bile leakage was in 3 cases,gallbladder atrophy or inflammation and its surrounding adhension in 11 cases,massive bleeding in 6 cases;undiscrimination of the cystic duct or its anatomical abnormality in 3 cases,mirizzi syndrome in 2 cases,residual stones in common bile duct in 2 cases and bowel injury in 2 cases.All patients got timely and proper treatment without serious consequences and death.Conclusions:Complications may arise during or after LC.It is important to prevent,find and diagnosis the complications timely and convert to laparotomy at the right moment.