CAJ | 학술논문

目的分析腹腔镜胆囊切除术中转开腹的原因.方法回顾并分析本院1600例腹腔镜胆囊切除术中31例中转开腹的原因.结果主动中转开腹病例19例,主要原因为胆囊三角严重粘连,胆囊萎缩及胆道变异,被动中转开腹病例12例,主要原因为术中大出血及胆道损伤,31例均治愈.结论充分认识胆囊动脉变异和胆道变异,不断提高的手术操作技巧可减少手术并发症,降低中转开腹率,但在遇到意外情况或手术难度极大时应适时主动中转开腹以避免严重并发症.
목적 분석복강경담낭절제술중전개복적원인.방법 회고병분석본원1600례복강경담낭절제술중31례중전개복적원인.결과 주동중전개복병례19례,주요원인위담낭삼각엄중점련,담낭위축급담도변이,피동중전개복병례12례,주요원인위술중대출혈급담도손상,31례균치유.결론 충분인식담낭동맥변이화담도변이,불단제고적수술조작기교가감소수술병발증,강저중전개복솔,단재우도의외정황혹수술난도겁대시응괄시주동중전개복이피면엄중병발증.
l:Aim To analyze the reasons for conversion to open laparotomy in the procedure of laparoscopic cholecystectomy(LC).Methods A retrospective analysis was performed on 1600 patients who underwent LC.Among them,31 cases converted to open laparotomy in operation.Results 19 cases converted to open laparotomy actively because of adhesions of Calot's triangle,atrophic gall bladder and variation of biliary tract.12 cases converted to open laparotomy passively because of bleeding and injury of biliary tract.These patients were all cured.Conclusion It is necessary to have a full realization of variation of artery and biliary tract,and improving the techniques of operation can reduce the surgical complications and rate of conversion to open laparotomy.But we should make open laparotomy actively in accident or difficult surgery to avoid serious complications.