有腹部手术史者行电视腹腔镜胆囊切除60例报告

目的:研究有腹部手术史患者行电视腹腔镜胆囊切除术的措施和要点。方法:LC前有腹腔手术史肠粘连60例,通过切口或穿刺建立气腹,对不能暴露温氏孔和Calot三角的患者多行胆囊切除术。结果:57例安全地施行了LC,仅3例中转剖腹手术,无1例发生并发症。结论:时有腹部手术史的患者行LC安全有效,施行LC有赖于扎实的外科基本功和熟练的腹腔镜操作技术。

Laparoscopic cholecystectomy on 60 patient with prior abdominal surgery

Objective:To study indications and key factors of laparoscopic cholecystectomy on patient with prior abdominal surgery. Methods: 60 cases with prior abdominal surgery were selected according to the preoperative determination of adhesion in abdominal cavity. Pneumoperitoneum was done by normal puncture on abdominal wall or through an open incision, anterograde removed of gallbladder or converted to laparotomy when no exposure of wen' s hole and calot triangle. Major resection of gallbladder was performed when cystic duct can not be dissected in calot triangle. Results: 57 of the cases underwent LC with safety. Only 3 patients received conversion surgery, no complication or death wad found in all the cases. Conclusion: LC is safe and effective for patients with prior abdominal surgery on the condition that surgeon has a good mastery of indications, key factors and specific techniques of LC.