腹腔镜外科杂志2017，Vol.22Issue(9)：681-684,4.DOI:10.13499/j.cnki.fqjwkzz.2017.07.681
单孔双视免气腹腹腔镜胆囊切除术的临床应用体会
Single-port double-view gasless laparoscopic cholecystectomy
俞兆祉 1朱雪峰 1吴一峰 1吴铁 1杨寅熙 1李旻昊1
作者信息
- 1. 无锡市第九人民医院,江苏 无锡,214062
- 折叠
摘要
Abstract
Objective:To investigate the clinical efficacy of one-port double-view pneumoperitoneum-free laparoscopic chole-cystectomy ( ODPLC) .Methods:From Nov.2013 to May 2016 ,167 patients with benign lesions of gallbladder underwent ODPLC .The length of right paramedian incision was 2 cm to 2.5 cm under xiphoid process ,cystic duct and cystic artery was dissected with suction stripper,clipped respectively and then cut off .Left fingers peeled the clearance along the gallbladder and liver gently ,while the right fin-gers lifted the cystic duct and rotated it softly ,and the completion of cholecystectomy needs the cooperation of both hands .Laparoscopic exploration of common bile duct with choledochoscopy via common bile duct incision was performed in patients with choledocholithiasis . Primary suture of common bile duct was performed in 11 cases,and T tubes were placed in 5 cases.Results:All the 167 operations gained success ,however , due to deep sites and serious adhesion in 5 patients with choledocholithiasis , the incision was extended to 3.5 cm.The average surgery time was (40.0 ±8.9 ) min.Intraoperative bleeding was (20.5 ±4.6) ml.Patients suffered from slight incision pain without complications such as bleeding or bile leakage .Three cases of gallbladder fossa hydrops recovered after conserva-tive treatment.Patients who underwent simple cholecystectomy were discharged from hospital after 3 to 4 d,while it extended to 7 d in patients with choledochotomy .The T tube was removed until no residual calculus was found by choledochoscopy three months later .Post-operatively,all the patients recovered well after a follow-up for 8 to 12 months.Conclusions:ODPLC indicates a wide-ranging indica-tion,safety,feasibility and satisfied results ,and is worthy of clinical application .关键词
胆囊切除术,腹腔镜/免气腹/单孔双视Key words
Cholecystectomy,laparoscopic/Gasless/Single-port double-view分类
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俞兆祉,朱雪峰,吴一峰,吴铁,杨寅熙,李旻昊..单孔双视免气腹腹腔镜胆囊切除术的临床应用体会[J].腹腔镜外科杂志,2017,22(9):681-684,4.
