【摘要】 目的:探讨基层医院腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中转开腹的原因,术前评估LC难易度及减少LC并发症的措施。方法:回顾分析1998年7月至2009年2月我院施行的568例LC中27例患者中转开腹的临床资料。结果:LC中转开腹率4.75%,其中因腹腔、胆囊周围及胆囊三角区严重粘连、急性炎症术野渗血致解剖不清主动中转24例,占88.89%;胆囊床出血、胆囊动脉出血、横结肠损伤各1例被动中转3例,占11.11%。结论:萎缩性胆囊炎、急性炎症发作>72h、胆囊壁明显增厚应慎选LC,掌握中转开腹时机,是降低LC严重并发症的有效措施。更多还原

【Abstract】 Objective:To investigate the reasons of laparoscopic cholecystectomy conversion to laparotomy,procedures of preoperative evaluation of operative difficulty and prevention of complications.Methods:Of 568 patients who underwent LC from Jul.1998 to Feb.2009,27 cases converted to laparotomy.The clinical data of these 27 cases were retrospectively analyzed.Results:The conversion rate of LC was 4.75%.24 cases(88.89%) positively converted because of severe adhesion of abdominal cavity,area around gallbladder and Calot triangle,and errhysis caused by acute inflammation.3 cases(11.11%) passively converted for hemorrhage of gallbladder bed,cystic artery and injury of transverse colon.Conclusions:For patients with atrophic cholecystitis,acute inflammation lasted >72h,increased width of gallbladder wall,LC should be cautiously chosen,and the feasible measure of decreasing serious complications of LC is mastering the opportunity of conversion to laparotomy.更多还原