基层医院行腔镜胆囊切除术66例体会

目的：总结基层医院行腹腔镜胆囊切除术（ LC）的体会。方法对2010-10～2013-09在该院因复杂胆囊病变施行LC手术的66例患者的临床资料进行回顾性分析。结果本组64例在腹腔镜下完成手术，2例患者中转开腹，术后胆漏1例，再次手术。66例患者均顺利康复出院。结论基层医院行LC手术初期必须加强基本功训练，严格选择病例及适应证；术中精心操作，处理好胆囊动脉及胆囊管，遇到困难可采取及时中转开腹手术等措施，确保手术安全；术后严密观察，发现问题及时处理。

Application of laparoscopic cholecystectomy in basic level hospitals: reports of 66 cases

Objective To summarise the experience of laparoscopic cholecystectomy （ LC） in primary hospi-tal.Methods From October 2010 to September 2013 , clinical data were retrospectively analyzed in 66 patients un-dergoing LC on complex cystic lesions and curative effect in our hospital .Results The operations on 64 cases were sucessful , two cases was converted to laparotomy;one patient had postoperative bile leakage and received reoperation , and sixtysix patients were smoothly discharged .Conclusion The basic skills training about LC should be strengthened beat the beginning; Cases and indications should be selected scrupulously; The operation must be performed carefully, and the gallbladder artery and cystic duct should be protected; To ensure the safety of LC , some other measures can be taken in case of difficulty , for instance, timely conversion to laparotomy and so on .The postoperativel condition should be observed , in order to finely treat the possible problems .