三孔法超声刀腔镜胆囊切除术体会

目的 探讨使用超声刀行三孔法腹腔镜胆囊切除术(LC)的方法和体会.方法 对430例急、慢性胆囊良性疾病使用超声刀行三孔法LC病例进行回顾性分析,经脐部10 mm孔、剑突下10 mm孔及右上腹5 mm孔实施手术.结果 420例成功施行三孔法LC,6例中转四孔法LC,4例中转开腹胆囊切除手术；全组患者均痊愈出院,无严重并发症发生,仅2例剑突下切口感染,换药引流后痊愈.结论 在四孔法LC操作熟练的基础上选择恰当病例开展三孔法超声刀LC安全可行,更加微创美观.

Surgical experiences of laparoscopic cholecystectomy with three-porta using harmonic scalpel:report of 430 cases

Objective To explore the method and experience of laparoscopic cholecystectomy(LC) with Three-porta using harmonic scalpel.Methods From Jun.2006 to Oct.2011,430 patients with acute or chronic cholecystitis underwent LC with Three-porta method using harmonic scalpel.The clinical data of the patients were analyzed retrospectively.Results All of the 430 patients were cured.Three-porta LC was completed in 420 of them with a success rate of 97.67%.while 6 cases(1.40%)were converted to LC with four-porta,4 cases(0.93%)switch to cholecystectomy through laparotomy because of frozen Calot′s triangle and gallbladder atrophy.The average durations of the operations for LC with three-porta were 35min.The blood loss during the operations were 2 ml.The average length of hospital stay was 4.5 days.No biliary duct injury and other severe complications occurred in all cases.Conclusions The method of LC with three-porta using harmonic scalpel is safe and reliable.