Objective To review the complex situation,surgical experience,and surgical technique of laparoscopic cholecystectomy (LC).
Methods The clinical data of 86 patients who underwent LC in our hospital and the consulting hospitals from February 2005 to April 2011 were retrospectively analyzed.According to the complicated conditions,the different surgical techniques were applied during LC such as lamellar dissection,aspirater stripping method,laparoscopic suture,and intraoperative cholangiography.
Results The operation time was (68±23)min (25-210 min),blood loss was (55±13)ml (15-200 ml).LC was successfully performed in 84 of 86 cases.Only two patients received transferring laparotomy because of scar tissue in Calot triangle that was hard to dissect.No severe complications occurred,such as biliary leakage,bleeding after operation,stricture of bile duct,retained calculus,and so on.All the patients were cured before discharge.
Conclusion Lamellar dissection,aspirater stripping method,and laparoscopic suture combined with the view of laparotomy can be used to deal with complicated LC successfully.
Citation:
ZOU Honglei,ZHANG Dumin,DU Juan. Complex Situations and Management Strategies During Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(2): 204-207. doi:
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陈瑾,贾忠 . 吸刮式 “冷分离 ”法在腹腔镜胆囊切除术中的应用体会[ J]. 医学研究杂志,2006,35(5):81-83..
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张勇.后侧分离半体解剖在困难腹腔镜胆囊切除术中的应用[ J]. 中国内镜杂志,2008,14(6):667-668..
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龚义伟,李海滨,黄志红 .腹腔镜胆囊切除术中 Calot三角复杂情况的处理体会[ J]. 微创医学, 2007,2(5):479-480..
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李映东,张鹏,谭政华 .困难的腹腔镜胆囊切除术的原因及其对策[ J]. 中国内镜杂志, 2007,13(3):318-320..
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龚建平,韩本立,周永碧,等 .胆囊管异常汇合的诊断及其在腹腔镜胆囊切除术中的意义[ J].中国普外基础与临床杂志 , 2001,8(2):85-87..
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吴品飞,陈汝岱,顾勇劲.腹腔镜胆囊切除术 5 000例临床分析[ J]. 实用医学杂志,2008,24(20):3544-3546..
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唐水平.困难胆囊腹腔镜切除 50例报告[ J].华北国防医药 , 2009,21(2):49-50..
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- 1. 黄志强 .当今胆道外科的发展与方向[ J].中华外科杂志 , 2006,44(23):1585-1586..
- 2. 贺更生,丁成明,李翀 ,等 .腹腔镜胆囊切除术中的困难原因分析与处理[ J]. 中国内镜杂志 , 2010, 16(7):725-728..
- 3. 姜朝晖,方旭东,方晓明,等 .腹腔镜胆囊切除术治疗合并肝硬化的胆囊结石 49例报告[ J].肝胆胰外科杂志, 2008, 20(2):141-142..
- 4. 梁久银 . 腹腔镜胆囊切除术中复杂胆囊的技术对策[ J]. 中国微创外科杂志,2006,6(10):730-731..
- 5. 何利 . 腹腔镜胆囊切除术复杂情况分析与手术技巧[ J]. 局解手术学杂志,2008,17(5):320-321..
- 6. 郐占波,于程远 .腹腔镜胆囊切除术手术技巧与并发症的预防[ J].腹腔镜外科杂志,2006,11(4):342-343..
- 7. 张国伟, 周杰 . 腹腔镜胆囊切除术治疗胆囊颈管嵌顿结石的手术技巧及治疗体会[ J]. 腹腔镜外科杂志,2010,15(10):766768..
- 8. 金昆,李圆 .残余胆囊 15例病因及诊治分析[ J].南京医科大学学报 (自然科学版 ), 2006, 26(1):71-72..
- 9. 舒晔,周总光,解蓉,等 .腹腔镜胆囊切除术细小胆管损伤的诊断与处理[ J]. 中国普外基础与临床杂志,2001,8(2):88-90.
- 10. 袁伟忠 . 腹腔镜胆囊切除术中复杂因素处理的体会[ J].东南大学学报 (医学版 ),2005,24(4):267-268..
- 11. 陈瑾,贾忠 . 吸刮式 “冷分离 ”法在腹腔镜胆囊切除术中的应用体会[ J]. 医学研究杂志,2006,35(5):81-83..
- 12. 张勇.后侧分离半体解剖在困难腹腔镜胆囊切除术中的应用[ J]. 中国内镜杂志,2008,14(6):667-668..
- 13. 萨本仲, 陈扬, 陈晖, 等 . 困难腹腔镜胆囊切除术 70例的操作技巧探讨[ J]. 福建医药杂志,2009,31(5):64-65..
- 14. 龚义伟,李海滨,黄志红 .腹腔镜胆囊切除术中 Calot三角复杂情况的处理体会[ J]. 微创医学, 2007,2(5):479-480..
- 15. 李映东,张鹏,谭政华 .困难的腹腔镜胆囊切除术的原因及其对策[ J]. 中国内镜杂志, 2007,13(3):318-320..
- 16. 龚建平,韩本立,周永碧,等 .胆囊管异常汇合的诊断及其在腹腔镜胆囊切除术中的意义[ J].中国普外基础与临床杂志 , 2001,8(2):85-87..
- 17. 吴品飞,陈汝岱,顾勇劲.腹腔镜胆囊切除术 5 000例临床分析[ J]. 实用医学杂志,2008,24(20):3544-3546..
- 18. 唐水平.困难胆囊腹腔镜切除 50例报告[ J].华北国防医药 , 2009,21(2):49-50..