单极电凝在腹腔镜下胆囊切除术中的应用体会

目的:探讨腹腔镜下胆囊切除术中单极电凝钩的使用技巧及安全性。方法:回顾分析、总结我院2005年1月-2010年12月之间经腹腔镜胆囊术1 452例病例资料。结果:本组23例中转开腹手术,中转率1.6%;2例发生胆汁漏,1例经术后腹腔引流6d治愈,1例经术后引流21d后治愈;5例发生术后创面渗血,经局部引流、静脉使用止血药物处理痊愈,无胆管损伤、胆管狭窄、膈下及腹腔感染等并发症。手术时间25～121min,平均40.5min。结论:熟练掌握单极电凝钩的使用技巧及原则在腹腔镜胆囊切除术中是安全的,且价格低廉,值得基层医院推广。

The Application Experience of Using Electrocautery in Laparoscopic Cholecystectomy

Objective:To discuss the using skills and its safety of electrocautery in laparoscopic cholecystectomy(LC).Methods:Totally 1 452 patients of LC from Jan.2005 to Dec.2010 were analyzed retrospectively in our hospital.Results:In the treatment group,only 23 patients converted to open surgery.Conversive rate was 1.6%.Biliary leakage happened in 2 cases.One of the cases was cured with indwelling abdominal drainage after 6 days.Another was cured by postoperative drainage after 21 days.There were 5 cases of postoperative wound bleed,then cured by local drainage and injecting hemostatic drug.There were no complications of bile duct injury,bile duct stricture,subphrenic and abdominal infection,etc.Surgery time last 25 to 121 minutes,the average was 40.5 minutes.Conclusion:Mastering the use of electrocautery in laparoscopic cholecystectomy is not only safe and effective,but inexpensive,which is worth to promote in primary hospitals.