复杂情况下腹腔镜胆囊切除术的方法

【目的】探讨腹腔镜下复杂困难胆囊切除的经验和手法技巧。【方法】全麻下头高足低位，对68例胆囊三角严重粘连，如瓷瓶胆囊，急性坏疽性胆囊炎，萎缩性胆囊炎，胃癌术后胆囊炎等复杂困难情况，进行精细解剖胆囊三角，规范手术操作。【结果】本组68例行胆囊切除52例，胆囊次全切除16例，无一例中转开腹，置腹腔引流管61例，恢复良好。【结论】精确处理胆囊三角是腹腔镜下复杂困难胆囊切除术成功的关键。

Mathods of laparoscopic cholecystectomy in complicated and difficult circs

To study the mathods of laparoscopic cholecystectomy in complicated and difficult circs.68 cases,such as porcelain bottle gall bladder, acute and nerosis cholecystitis,atrophic cholecystitis, cholecystitis after radical gastrectomy, were applied with general anesthesia and were precision handled the Calot triangle.52 of the 68 cases had been operated of LC.16 cases had been operated partly of LC. No one had been turned to OC(open cholecystectomy).61 cases had been drainaged.All cases cured well.Conclusion]The precision handling the Calot triangle is the key of laparoscopic cholecystectomy in complicated and difficult circs.