论文部分内容阅读
目的探讨腹腔镜胆囊大部分切除术(laparoscopic subtotal cholecystectomy, LSC)的适应证、手术方法及临床应用价值。方法回顾分析总结本科自2012年7月~2013年9月28例腹腔镜胆囊大部分切除术的原因、方法和体会。结果28例手术顺利完成,手术平均时间75.8min，术中平均出血量60.5mL，肠蠕动平均恢复时间34 h，开始进食平均时间16~24 h，腹腔引流管平均留置时间为69.6 h，术后平均住院时间7.6d。术后无出血及肝外胆道损伤，随访6个月~1年，无症状复发，效果满意。结论在复杂型胆囊结石，选择行LSC是一种切实有效、并发症少、术后恢复快的手术方式，既能达切除胆囊之目的，且还能避免临近脏器之损伤(如肝外胆道、右肝管、胃肠道等)，不失为复杂型胆囊手术治疗的一种较好的选择。“,”Objective To investigate laparoscopic subtotal cholecystectomy (laparoscopic subtotal cholecystectomy, LSC) indications, operation methods and the clinical application value. Methods Retrospective analysis method, summarizes the reasons of undergraduate since 2012 July to 2013 September 28 cases of laparoscopic subtotal cholecystectomy and experience. Results The 28 cases of operation is completed, the average operation time 75.8min, average blood loss was 60.5mL, the average recovery time of intestinal peristalsis is 34 h, began to eat the average time of 16 ~ 24 h, the average time was 69.6 h tube indwel ing drainage of abdominal cavity, postoperative hospitalization was 7.6d. No postoperative bleeding and bile duct injury, fol owed up for 6 months to 1 years, no recur ence of symptoms, satisfactory. Conclusion In the complex type of cholecystolithiasis, selection for LSC is an ef ective, fewer complications, faster postoperative recovery operation, can reach the goal of cholecystectomy, and can avoid damage to adjacent organs (such as the extrahepatic bile duct, right hepatic duct, the gastrointestinal tract), a good choice for operation it is the complex of gal bladder.