复杂类型腹腔镜胆囊切除术576例分析

目的：总结复杂类型腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）的经验,探讨复杂类型LC的安全性和临床特点。方法：回顾分析1993年6月至2009年12月为576例患者施行复杂类型LC的临床资料。结果：576例患者中,539例顺利实施LC,中转开腹37例,67例次发生不同情况的术后并发症,均治愈,无不良后果。结论：术前对手术难度充分评估、合理把握手术时机,术中精细操作、果断中转开腹是减少复杂类型LC并发症的前提;术后严密观察病情、积极处理并发症是避免后遗症的关键;复杂类型LC是安全可行的。

Analysis of 576 cases of complicated laparoscopic cholecystectomy

Objective:To summarize the experience of complicated laparoscopic cholecystectomy(LC),explore the safety and clinical feature of complicated LC.Methods:The clinical data of the 576 cases of complicated LC from Jun.1993 to Dec.2009 were retrospectively analyzed.Results: Among the 576 patients,539 cases of LC were successful,37 cases were converted to open cholecystectomy.Various postoperative complications were found in 67 cases,all recovered without side effects.Conclusions:Thorough preoperative evaluation,proper operation opportunity,refined manipulation and prompt conversion to open surgery are the preconditions for decreasing complications of complicated LC.Close observation of illness and energetic treatment for complications are significant for avoiding the sequelae.LC is a safe and feasible operation for complicated cholecystectomy.