腹腔镜胆囊切除术中转开腹分析

目的 探讨腹腔镜胆囊切除术（Laparoscopic Cholecystectomy,LC）中转开腹原因及如何避免中转开腹.方法 回顾分析2006年11月～2010年11月笔者所在医院共行三孔或四孔法LC 789例中14例中转开腹患者的临床资料,探讨中转的原因.结果 本组中转率为17.7%,14例均完成相应手术,1例术后并发胆漏,均痊愈出院.结论 LC中转开腹原因有胆囊周围及Calot三角严重粘连、解剖变异、术前漏诊误诊等.严格掌握适应证,提高操作水平,可降低中转开腹率.把握中转时机可减少并发症的发生.

Analysis on conversion to laparotomy in laparoscopic cholecystectomy

Objective To study the cause and prevention of conversion to laparotomy during laparoscopic cholecystectomy （LC）. Methods The clinical data of 14 cases of LC conversion to laparotomy out of 789 cases from NOV 2006 to NOV 2010 was analyzed retrospectively, the reasons were discussed. Results The total conversion rate was 1.77% （ 14/ 789 ）. 14 cases were cured successfully by open surgery and discharged smoothly, 1 case of postoperative biliary leakage. Con- clusion The major causes of conversion to laparotomy were severe adhesion around the gallbladder and Calot triangle,anatomy anomatiesand pre - operative misdiagnosis and so on. Conversion rate can decrease if operative skills are improved, arid LC indications are controlled strictly. Grasping the opportunity of conversion to laparotomy can reduce the complications.