经脐腹腔镜胆囊切除术14例报告

目的:探讨经脐腹腔镜胆囊切除术的安全性与可行性。方法:经脐置入10mm、5mm及3mm Trocar,分别置入30°腹腔镜及加长器械行胆囊切除术。腹腔镜下结扎或用圈套器结扎胆囊管及胆囊动脉。结果:14例胆囊结石患者均成功实施腹腔镜胆囊切除术,其中11例合并慢性胆囊炎,2例胆囊颈部结石嵌顿合并慢性胆囊炎急性发作,1例合并急性坏疽性胆囊炎、胆囊积脓。腔内打结法结扎胆囊动脉6例,结扎胆囊管5例,余均用圈套器套扎胆囊动脉及胆囊管。手术时间45~170min,平均90min,出血5~120ml,平均15ml。无术后出血、胆漏、切口感染等并发症发生。结论:经脐腹腔镜胆囊切除术安全可行,可完成较困难的胆囊切除术,且具有很好的腹壁"无疤痕"效果。

Transumbilical laparoscopic cholecystectomy:a report of 14 cases

Objective:To evaluate the feasibility of transumbilical laparoscopic cholecystectomy by using three Trocars within umbilicus.Methods:Three Trocars(10mm,5mm and 3mm in diameter) were placed around umbilicus.Longer instruments and 10mm 30° laparoscope were used.Cystic duct and artery were ligated by endoloop or endoscopic knotting.Results:All of the 14 patients with cholecystolithiasis were successfully operated,among which 11 cases with chronic cholecystitis,2 cases of incarcerated stone with acute episodes,and one empyema of gallbladder.The average operative time was 90min(45-170min),the average amount of bleeding was 15ml(5-120ml).Cystic artery were ligated by endoscopic knotting in 6 cases,and cystic duct in 5 cases.The others were ligated by endoloop.Conclusions:Transumbilical laparoscopic cholecystectomy is feasible and safe without obvious abdominal scars,and can accomplish complicated cholecystectomy.