腹部手术史患者行腹腔镜胆囊切除术的手术技巧

目的:讨论腹部手术史患者行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的手术技巧。方法:回顾分析2004年7月至2011年9月为57例有腹部手术史的胆囊结石患者在全麻下行三孔法LC的临床资料。结果:57例均成功完成LC1,例术后合并胆总管结石,经ERCP取石后治愈。无胆管损伤、胆漏、出血等并发症发生。43例术后随访1～6个月,无手术并发症发生。结论:术者具有娴熟的腹腔镜外科技术,精细、规范地操作,有腹部手术史患者行LC是安全可行的,值得提倡与推广。

The techniques of laparoscopic cholecystectomy for patients with history of abdominal operation

Objective:To discuss the techniques of laparoscopic cholecystectomy(LC) for patients with history of abdominal operation.Methods:The clinical data of 57 cases with history of abdominal operation treated by three trocars LC from Jul.2004 to Sep.2011 were retrospectively analyzed.Results:All the operations were successfully performed without biliary injury,bile leak and hemorrhage.1 case of complication with common duct calculi was cured by ERCP.No complication was found during 1-6 months follow-up in 43 cases.Conclusions:On base of the fine surgical techniques and standardized operation by a skilled laparoscopic surgeon,it is feasible to perform LC for patients with history of abdominal operation and should be worth advocating and promoting.