腹腔镜胆囊切除中转开腹手术23例原因分析

目的：探讨腹腔镜胆囊切除（ LC）中转开腹的原因及防治措施。方法对2005年1月至2010年12月收治的607例接受LC患者中中转开腹手术23例（3．79％）的临床资料、中转开腹原因进行回顾性分析。结果中转开腹的原因为胆囊周围粘连11例、胆囊三角解剖结构不清5例、胆囊动脉出血2例、胆管损伤2例、解剖变异2例、胆囊癌1例，开腹手术均获成功。结论熟悉各种肝胆管解剖变异、严格掌握适应证、规范操作、熟练操作技术是减少LC中转开腹手术的关键。

Causes of laparoscope cholecystectomy converted to open laparotomy

Objective To explore the causes and preventive measures of laparoscope cholecystectomy （LC） converted to open laparotomy.Methods A retrospective analysis of the clinical data in 23 cases （3.79%） from the 607 cases of laparoscope chole-cystectomy conversed to laparotomy from January 2005 to December 2010, was made in our study .Results The conversion was due to following causes：pericholecystic adhesion （11 cases）, calot′s triangle unclear （5 cases）, cystic artery hemorrhage （2 cases）, bile duct lesion （2 cases）, anatomic variation （2 cases）, carcinoma of gall bladder （1 case）.Laparotomy was successfully used in all the cases.Conclusion Full awareness of anatomic variation , good knowledge of LC indications and skillful manipulation were the key to the reduction of converted laparotomy .