腹腔镜消化性溃疡穿孔修补术23例

目的探讨腹腔镜消化性溃疡穿孔修补术的方法和治疗效果. 方法应用腹腔镜对23例消化性溃疡穿孔(十二指肠穿孔17例,胃窦部前壁穿孔5例,胃体部小弯侧穿孔1例)行穿孔修补﹑腹腔引流术. 结果手术均获成功,无手术并发症.3个月后胃镜复查,13例使用丝线者均有缝线外露,10例使用可吸收外科缝线者无缝线外露.随访6～27个月,平均18个月,3例十二指肠球部穿孔者仍有轻度嗳气,返酸,余无明显症状,无再穿孔. 结论腹腔镜消化性溃疡穿孔修补术安全可靠,术后继续正规内科治疗,效果满意.

Laparoscopic repair of peptic ulcer perforation in 23 cases

Objective To study techniques and effects of laparoscopic repair for peptic ulcer perforation. Methods A total of 23 cases of peptic ulcer perforation (the duodenum, 17 cases; the anterior wall of the gastric antrum, 5 cases; the lesser curvature of stomach, 1 case) underwent laparoscopic repair and abdominal drainage. Results All the operations were successfully accomplished without complications. Gastroscopy at 3 months after operation showed visible threads in 13 patients with silk suture sewn, and no threads in 10 patients with absorbable suture sewn. Follow-up for 6~27 months (mean,18 months)found a mild belching and acid regurgitation in 3 cases of duodenal bulb perforation. No re-perforation occurred. Conclusions Laparoscopic repair is a safe and reliable method for peptic ulcer perforation. Postoperative standard medical treatment is required for satisfactory outcomes.