98例腹腔镜胆囊切除术临床探讨

目的探讨腹腔镜胆囊切除术（LE）的适应证、手术操作要点、并发证及临床效果。方法选择近年来本院行腹腔镜胆囊切除术的患者98例，对其临床资料进行回顾性总结分析。结果本组所有病例均治愈，无手术死亡病例。LC成功切除胆囊94例（95．9％）；中转开腹手术4例（4．1％），手术时间22—155min，平均（53．5±5．0）min，术后住院时间3～7d，平均4．0d。12例术后放置腹腔引流管。2例发生并发症，其中切口感染1例，出血1例。结论腹腔镜胆囊切除术具有创伤小、出血少、手术时间短、术后恢复快等优点，但临床仍有一定的并发症发生率，严格掌握手术适应证、规范手术操作方法、正确把握中转手术指征及放置腹腔引流管是预防并发症的关键措施。

Clinical approach to 98 case of laparoscopic cholecystectomy

Objective approach to the indication,key point of procedure, complication and efficacy of laparoscopic cholecystectomy（LC）. Methods Clinical data of 98 cases of LC of the hospital in recent years were summarized and analyzed retrospectively. Results All cases recovered successfully without death. Among which 94 （95. 9% ） cholecysts were removed under laparoscope; 4 （4. 1% ） converted to laparotomy, the duration of procedure were 22 - 155 min,average 53.5 ± 5.0 min, postoperative time of hospitalization were 3 - 7 d, aver- age 4. 0 d. Peritoneal cavity drainage was placed in 12 cases. 2 complications were observed,with postoperative infection and bleeding each. Conclusions LC advantages in minimal trauma and bleeding, short procedure time and quick recovery, but incidence for complications remained. Strict indication of operation, regulated procedure, proper conversion to laparotomy, and complete drainage is the key to prevent complications.