19例困难胆囊切除手术体会

目的：总结１２１例胆囊切除术中１９例切除困难的手术经验。方法：分离粘连后切开胆囊底切除胆囊，破坏颈部粘膜，保留浆肌层；保留胆囊床上的胆囊浆肌层，破坏粘膜即“胆囊次全切除术”。结果：无１例出现肝外胆管、血管、十二指肠等损伤。结论：对胆囊病理变化复杂者视病理变化采用不同的术式。

Experience of 19 Cases of Difficult Cholecystectomy

Objective: To summary the experience of 19 cases of difficult cholecystectomy in 121 cases of cholecystectomy. Methods:(1) To isolate the adhesion, to cut the bottom of cholecyst and the remove the cholecyst, then to destroy the neck mucosa of cholecyst and reserve the seromuscle.(2) To reserve the seromuscle of cholecyst and to destroy the mucosacholedochectomy.Results: There was no the injure of exohepaticocholange, vessel and duodenum. Conclusion:It is essential to select a suitable and reasonable method based on the pathology of cholecyst to ensure the operation success.