有上腹部手术史的腹腔镜胆囊切除术探讨

目的:探讨有上腹部手术史的腹腔镜胆囊切除术(LC)的临床经验。方法:对87例有上腹部手术史的腹腔镜胆囊切除术的临床资料进行回顾性分析。结果:84例顺利完成腹腔镜手术,3例中转开腹手术,其中因气腹建立困难1例,胆囊三角区解剖不清2例,所有病人恢复顺利,行LC术后2～4d出院,中转开腹5～7d出院。结论:只要术前充分准备和评估,灵活选择穿刺孔,有效的腹腔粘连松解,术者具备高超的腔镜操作技术和丰富的胆道手术经验,有上腹部手术史的LC术是安全,可行的。

Laparoscopic Cholecystectomy After Operation on Abdominal Region

Objective: To Discuss the clinical experience on laparoscopic cholecystectomy after operation in abdominal surgeries.Methods: The clinical data of 87 cases undergone after the previous abdominal surgeries laparoscopic cholecystectomy were retro-spec-tively analyzed.Results: Laparoscopic cholecystectomy was successfully accomplished in 84 cases.The 3 cases were converted to open operation.Among these unsuccessful cases,1 cases had difficulty in pneumoperitoneum,unclear anatomy of cholecyst triangle were 2 case.All patients recoverd smoothly.Patiens with laparoscopic cholecystectomy discharged after 2 ~ 4d,and converted to open opera-tion after 5~7d.Conclusion: Laparoscopic cholecystectomy to patient underdoing operation in abdominal surgeries is safe and practicable.As long as the preoperative preparation and evaluation,flexible choice puncture hole,effective celiac adhesion loose solution,excellent Laparoscopic operation technology and rich experience in surgery to performer.