胆囊后-前三角解剖法在腹腔镜胆囊切除术中的应用

目的探讨胆囊后-前三角联合解剖法在腹腔镜胆囊切除术中的应用价值。方法回顾性分析2011年4月-2013年12月苏州大学附属第三医院收治的250例腹腔镜胆囊切除术患者的临床资料,包括手术时间、出血量和手术并发症。结果 246例手术成功,手术时间25~120 min,平均42 min。术中出血量5~80 ml,平均20 ml。其中2例各因合并胃癌和胆囊结肠瘘中转开腹手术,2例行腹腔镜下胆总管切开取石术。全组术后均无腹腔出血、胆漏及胆道狭窄等严重并发症。结论胆囊后-前三角解剖法有助于辨认Calot三角内的解剖结构,可有效减少术中出血和胆管损伤,安全可行。

Clinical application of posterior-anterior cystohepatic triangle dissection in laparoscopic cholecystectomy

Objective To investigate the value and clinical application of posterior-anterior cystohepatic triangle dissection in laparoscopic cholecystectomy （LC）.Methods The medical records of 250 patients who underwent LC were reviewed.The clinical data,including oper-ating time,amount of bleeding,and surgical complications,were retrospectively analyzed.Results LC was successfully completed in 246 cases.The operating time ranged from 25 min to 120 min,with a mean of 42 min.The amount of bleeding ranged from 5 ml to 80 ml,with a mean of 20 ml.Two cases were converted to open surgery due to gastric carcinoma or cholecystocolonic fistula,and 2 cases underwent laparoscopic common bile duct exploration.There was no report of severe complications in the entire group,such as abdominal hemorrhage,bile leakage,and biliary stricture.Conclusion With proper identification of the anatomical structure,it is safe and feasible to perform LC by dissection of the posterior-anterior cystohepatic triangle,which effectively helps avoid hemorrhage and bile duct injury during operation.