【摘要】 目的:探讨有腹部手术史患者行腹腔镜胆囊切除术(LC)的安全性及可行性。方法:回顾分析我院2006年1月～2008年12月对229例有腹部手术史患者行LC的临床资料,总结手术操作要点。结果:成功完成223例,中转开腹6例(其中2例中转开腹与原手术所致腹腔粘连有关、4例中转开腹与原手术因素无关);小肠损伤1例,经中转开腹修补治愈。结论:有下腹部手术史者行LC不受原手术所致腹腔粘连的影响;有中、上腹部手术史者行LC,只要掌握操作要点是安全可行的,但术者需要有一定的腹腔镜操作水平及经验;同时有下腹部和中、上腹部手术史者,肠管与后期手术切口粘连机率增大,第一穿刺点盲穿时,应加以重视。更多还原

【Abstract】 Objective:To investigate the feasibility and safety of laparoscopic cholecystectomy(LC)for the patients with previous abdominal operation.Methods :The clinical data were analyzed retrospectively in 229 patients with a history of abdominal operation undergone LC between Jan.2006 and Dec.2008.Results :LC was successfully accomplished in 223 cases.Six were referred to open cholecystectomy,in which 1 case underwent injury in the small intestine but was cured by surgical revision.Conclusion:The patients with previous abdominal operation may safely receive LC.The procedure is free from the restriction of adhesion of intestines due to previous hypogastric surgery,and yet,great care must be taken when performing the insert blindly in the A passage for those with history of surgical procedure in lower and middle-upper abdominal region.更多还原