以隐匿瘢痕实施腹腔镜胆囊切除术的临床应用

【摘要】 目的 探索隐瘢痕腹腔镜胆囊切除术的临床应用。方法 胆囊良性病变患者35例。于脐孔下缘作一1.0cm切口,穿入10mm Trocar作为主操作孔。于右下腹部阴毛内或女性妊娠纹内做1个5mm切口,穿入5mmTrocar,插入5mm腹腔镜,于右锁骨中线与肋缘下交界处做1个3mm切口,穿入3mmTrocar,置入3mm无损伤抓钳辅助牵拉胆囊。解剖胆囊三角,分别夹闭胆囊管、胆囊动脉并离断,用电钩以电切、电凝的方式将胆囊从胆囊床分离,从脐部切口取出标本。皮内缝合脐部切口,肋缘下及下腹部戳孔用胶布拉拢覆盖。结果 手术全部成功,手术时间35～55min,平均45min。术后无出血、胆漏等并发症发生。术后住院1～3d。随访1～3个月,戳孔均愈合良好,腹部手术瘢痕不明显。患者对手术结果满意。结论 隐瘢痕腹腔镜胆囊切除术是一种外观效果好、安全、可行的手术方式。更多还原

【Abstract】 Objective To explore the clinical application of scar-hidden laparoscopic cholecystectomy. Methods Thirty-five patients with benign gallbladder disease were enrolled in this study. An incision of 10 mm was made in umbilicus for operative instruments. Another incision of 5 mm was made in the right lower abdomen in pubic hair or female striae gravidarum for 5 mm laparoscope. Another incision of 3 mm was made in the junction of the right midclavicular line and the costal margin for a grasper assisted pulling gall bladder. Dissecting the calot’s triangle, clipped and cut the cystic duct and vessels, followed by dissecting gallbladder bed using an electric hook. Finally, after the gallbladder was removed out through the umbilicus, the incision in the umbilicus was closed with intradermal suturing, while the incisions in under costal margin and lower abdominal were just pulled together by adhesive plaster without suturing. Results All the operations were successfully performed. Mean operative time was 45 min( 35-55 min). No postoperative complications occurred. The postoperative hospital stay was 1-3 d. All patients were very satisfactory with the cosmetic results after 1-3 months follow-up for scars were invisible. Conclusion Scar-hidden laparoscopic cholecystectomy has the advantage of good cosmetic results, safe and feasible.更多还原