CAJ | 학술논문

目的腹腔镜急性胃、十二指肠溃疡穿孔修补术的临床经验.方法 2003年6月～2007年12月,对13例急性胃、十二指肠溃疡穿孔患者施行腹腔镜溃疡穿孔修补术.结果 13例中十二指肠球部溃疡穿孔5例,幽门管溃疡1例,胃窦部溃疡穿孔7例,穿孔直径为0.3～0.7 cm,腹腔内积液600～1200 mL.手术时间80～180 min,除1例病检胃癌,改开放手术外,其余12例手术均获成功,术后恢复顺利,切口甲级愈合10例,乙级愈合2例.住院天数7～10 d.随访1年,胃镜检查溃疡均愈合,无再穿孔、腹腔感染、肠粘连、肠梗阻等并发症发生.结论腹腔镜手术治疗急性胃、十二指肠溃疡穿孔,与开腹手术同样安全且有效.胃溃疡穿孔患者术中需快速病理检查,若为恶性病变应中转开腹.
목적 복강경급성위、십이지장궤양천공수보술적림상경험.방법 2003년6월～2007년12월,대13례급성위、십이지장궤양천공환자시행복강경궤양천공수보술.결과 13례중십이지장구부궤양천공5례,유문관궤양1례,위두부궤양천공7례,천공직경위0.3～0.7 cm,복강내적액600～1200 mL.수술시간80～180 min,제1례병검위암,개개방수술외,기여12례수술균획성공,술후회복순리,절구갑급유합10례,을급유합2례.주원천수7～10 d.수방1년,위경검사궤양균유합,무재천공、복강감염、장점련、장경조등병발증발생.결론 복강경수술치료급성위、십이지장궤양천공,여개복수술동양안전차유효.위궤양천공환자술중수쾌속병리검사,약위악성병변응중전개복.
Objective To summarize the clinical experience of laparoscopic repair of acute perforation for gastroduodenal ulcer. Methods From June 2003 to December 2007, 13 patients underwent laparoscopic repair of pedorated peptic ulcers. Results Five patients were suffered from pedorated duodenal bulbar ulcer, one patient was suffered from pyloric canal ulcer, and seven patients were suffered from perforated gashie antrum ulcer. The diameter of the perforation was 0. 3-0. 7cm, peritoneal fluid 600-1200ml, the operafive time was 80-180min, only one was shifted to open surgery diagnosed gastric cancer by pathology examination, another twelve laparoscopic operations were successful. Postoperative recovery was smooth, ten surgical incisions were class A healing and two were class B healing, the length of hospitalization were 7-10 days after surgery. With one year followed-up, all deers had healed well by Gastroscopy, we hadn't found reperforation, abdominal infection, ankylenteron, ileac passion ect. operative complications. Conclusions Laparoscopic repair of acute perforated gastroduodenal ulcer is as safe and effective as the open repair. We must do intraoperative rapid pathologic examination, if it was malignant disease we shifted to open surgery.