中国普通外科杂志2017，Vol.26Issue(2)：157-165,9.DOI:10.3978/j.issn.1005-6947.2017.02.005
腹腔镜胆囊切除术中转开腹的临床分析:附39例报告
Clinical analysis of conversion from laparoscopic to open cholecystectomy: a report of 39 cases
罗东 1刘国栋 1唐能 1纪连栋 1李宜雄1
作者信息
- 1. 中南大学湘雅医院普通外科,湖南长沙410008
- 折叠
摘要
Abstract
Objective:To analyze the reasons for conversion from laparoscopic cholecystectomy (LC) to open surgery and the related factors.Methods:The clinical data of 3 849 patients undergoing LC from January 2010 to December 2015 were retrospectively analyzed.Results:Among the 3 849 patients,39 cases (1.01％) were converted to open surger and there was no significant difference in conversion rates among years during 2010 to 2015 (P=0.982).The reasons for open conversion included unclear anatomy of Calot's triangle in 16 cases,severe abdominal or pericholecystic adhesions in 14 cases,Mirrizi syndrome in 3 cases,cystic artery bleeding in 2 cases,and bile leakage,common bile duct injury,cholecystoduodenal fistula and gallbladder cancer in 1 case each.Thirty-three patients underwent early open conversion,and 6 patients underwent intermediate or late conversion,and the open conversions in 5 cases in the latter were performed due to intraoperative complications that included cystic artery bleeding in 2 cases,obscure Calot's triangle after gallbladder rupture and resultant dense adhesions in 1 case,common bile duct injury in 1 case and bile leakage in 1 case.Gender,age and course of disease were influential factors for conversion of LC (allP＜0.05).The incidence of short-term postoperative complications of conversion of LC by senior surgeons was significantly lower than that by junior surgeons (P=0.043).Conclusion:There is a certain conversion rate during LC,difficulties in dissection of Calot's triangle and severe abdominal or pericholecystic adhesions are main reasons for open conversion,and early open conversion is recommended in those with relevant influential factors to ensure surgical safety.关键词
胆囊切除术,腹腔镜/中转开腹手术/手术中并发症Key words
Cholecystectomy, Laparoscopic/Conversion to Open Surgery/Intraoperative Complications分类
医药卫生引用本文复制引用
罗东,刘国栋,唐能,纪连栋,李宜雄..腹腔镜胆囊切除术中转开腹的临床分析:附39例报告[J].中国普通外科杂志,2017,26(2):157-165,9.
