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目的探讨腹腔镜辅助下胃癌D2根治术合并胆囊切除的可行性及临床效果。方法回顾性分析2004年6月至2007年10月行腹腔镜辅助下胃癌D2根治术59例中合并胆囊切除术6例患者的临床资料。结果本组59例患者均在腹腔镜辅助下完成胃癌D2根治术,其中远端胃大部切除术30例,近端胃大部切除术18例,全胃切除术11例,无中转开腹,无手术死亡。其中因胆囊结石合并腹腔镜胆囊切除术6例,此6例平均手术时间(335±73)min,术中平均出血量(147±85)ml,平均下床时间(36±14)h,平均胃肠道功能恢复时间(69±28)h,术后平均住院日(12.5±3.8)d。术后随诊3～40个月,平均10.7个月,无胆囊切除相关并发症。结论对合并胆囊结石或慢性胆囊炎的胃癌患者,在腹腔镜辅助下行胃癌D2根治术合并胆囊切除术安全、可行,同时具备创伤小,恢复快等优点。
Objective To investigate the feasibility and clinical effect of laparoscopic-assisted D2 radical gastrectomy combined with cholecystectomy. Methods The clinical data of 59 patients with cholecystectomy and 6 patients undergoing laparoscopic-assisted D2-radical resection from June 2004 to October 2007 were analyzed retrospectively. Results The group of 59 patients underwent laparoscopic D2 radical mastectomy with distal gastrectomy in 30 cases, proximal gastrectomy in 18 cases and total gastrectomy in 11 cases without conversion to open laparotomy , No surgery died. Among them, 6 patients underwent laparoscopic cholecystectomy due to gallstones, the average operation time was (335 ± 73) min, average blood loss during operation was (147 ± 85) ml, mean bed ambulation time was (36 ± 14) h, mean Gastrointestinal function recovery time (69 ± 28) h, average postoperative hospital stay (12.5 ± 3.8) d. Followed up for 3 to 40 months, an average of 10.7 months, no complications associated with cholecystectomy. Conclusions For patients with gastric carcinoma complicated with gallstones or chronic cholecystitis, laparoscopic assisted D2 radical gastrectomy combined with cholecystectomy is safe and feasible, and has the advantages of less trauma and faster recovery.