腹腔镜在腹部手术史病例中的应用(附256例报告)

目的：总结有腹部手术史的患者行腹腔镜手术的经验。方法：避开原有切口选择第l戳孔，必要时采用开放法置入穿刺鞘，注重粘连区的分离技巧。结果：256例中254例成功完成手术，其中腹腔镜胆囊切除术225例。Lc 胆总管探查取石术12例，阑尾切除术5例，肠粘连松解术4例，卵巢囊肿8例，因局部严重粘连中转开腹2例，全部病例无手术并发症。结论：有腹部手术史的腹腔镜手术具有创伤小，痛者轻，恢复快，不影响切口愈合等优越性。

LAPAROSCOPY IN PATIENTS WITH HISTORY OF ABDOMINAL OPERATION WITH A REPORT OF 256 CASES

Objective:To summarize the experiences of the laparoscopy for patients with history of abdominal operation. Methods:Two hundred and fifty-six cases were performed laparosc opy, in which the pr imitive incision was avoided and the first stab was choosen, if necessary openi n g method can be used to insert the trocar, and the adhesive' tissue was disected skillfully.Results:Of the 256 cases, 254 cases were operated successfully.Among them 225 cases had laparoscopic cholecystectomy(LC), 12 cases h ad LC+laparoscopic choledochotomy with exploration, 5 cases had appendecto my, 4 cases had lysis of intestinal adhesion, 8 cases had oophorocystectomy, 2 c ases changed to laparotomy . All the patients recovered without any complication .Conclusions:The laparoscopy in the patient with history of abdominal operation has many advantages such as little suffering and injury , fast recovery, not affecting healing of incision , and so on.