张茂林. 腹腔镜胆囊切除术的困难原因分析及其处理[J]. 蚌埠医学院学报, 2012, 36(7): 832-834.
    引用本文: 张茂林. 腹腔镜胆囊切除术的困难原因分析及其处理[J]. 蚌埠医学院学报, 2012, 36(7): 832-834.
    ZHANG Mao-Lin. The difficult causes and practicable approach during laparoscopic cholecystecomy[J]. Journal of Bengbu Medical College, 2012, 36(7): 832-834.
    Citation: ZHANG Mao-Lin. The difficult causes and practicable approach during laparoscopic cholecystecomy[J]. Journal of Bengbu Medical College, 2012, 36(7): 832-834.

    腹腔镜胆囊切除术的困难原因分析及其处理

    The difficult causes and practicable approach during laparoscopic cholecystecomy

    • 摘要: 目的:探讨腹腔镜胆囊切除术(LC)困难的原因及其处理方法。方法:对48例困难LC的术前临床资料、术中遇到的困难及处理方法进行回顾分析。结果:46例成功完成LC,术中中转开腹2例;术后有1例发生胆漏,行二次手术探查,为胆囊管处钛夹脱落,予结扎胆囊管、冲洗腹腔,放置腹腔引流管;全部治愈,无远期并发症发生。结论:LC的困难原因较多,术前进行综合评估并做好术前准备,术中采用合理的操作方法,正确掌握中转开腹指征,能减少中转开腹及严重并发症的发生。

       

      Abstract: Objective:To explore the difficult causes and the practicable approach during laparoscopic cholecystecomy(LC).Methods:Forty-eight cases performed difficultly LC were analyzed retrospectively the preoperative clinical data,the intraoperative difficulties and strategies.Results:Among 48 cases,46 cases with the successful LC,2 cases transited to the open-cholecystectomy.In the perioperative period,1 case suffered from the biliary leakage undergone a second surgery exploration,and the reason was conformed to be linked with the fall off-titanium clamp.After the process of the ligation of bile duct,peritoneal rinse with saline and the placement of the drainage tube,the patient was cured without long-term complications.Conclusions:Multiple causes are linked with the difficult LC.It might be helpful to reduce the transition to the interim abdominal open and severe complications by the comprehensive clinical assessment and careful preparations before the operation,and the choice of appropriate management strategies and the accurate grasp of transit open indications in the perioperative period.

       

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