困难腹腔镜阑尾切除术46例临床分析

目的探讨困难腹腔镜阑尾切除术（Laparoscopic appendectomy，LA）的方法。方法回顾分析笔者所在医院2004年10月至2009年4月行困难LA46例患者的临床资料。结果46例患者均在腹腔镜下完成阑尾切除术，无1例中转开腹，无严重并发症发生。手术时间50～120min，平均75min。术后平均住院5．1d。结论腹腔镜阑尾切除术具有创伤小、疼痛轻、恢复快及住院时间短等优点，尤其适合于肥胖、老年人及诊断未明的腹膜炎患者。术中仔细操作，重视腹腔引流，可降低并发症的发生率。

Clinical analysis of 46 cases with difficult laparoscopic appendectomy

Objective To explore the surgery of laparoscopie appendectomy in difficulty. Methods The clinical data of 46 cases from Oct. 2004 to Apr. 2009 were analyzed retrospectively. Results The procedure was successfully performed in all cases, without conversion to open abdominal operation and severe complications. The duration of operation was 50 - 120 min,averaged 75 min. Average length of postoperative hospitalization was 5.1 d. Conclusion Laparoscopic appen- dectomy has the advantages of little hurt,gentle painess, quick recovery and short hospitalization. It is especially suitable for fat, aged and undefinidy peritonitis. Operating carefully and paying attention to abdominal drainage can decreace the rate of complication.