低压辅助悬吊式经脐入路腹腔镜胆囊切除11例报告.docVIP

低压辅助悬吊式经脐入路腹腔镜胆囊切除11例报告【摘要】 目的 研究低CO2气腹压辅助腹壁悬吊经脐入路行腹腔镜胆囊切除术可行性和临床安全性。方法 辅助6 mm Hg CO2气腹，腹壁悬吊经脐入路建立操作空间及通道，常规腹腔镜胆囊切除，标本从脐部取出，检查无出血及胆漏，未放置引流管，缝合切口恢复脐部正常形态。结果 11例患者中除1例术中钛夹滑脱致胆囊动脉出血，气腹压增大至14 mm Hg成功止血完成手术外，余10例均顺利完成手术，胆囊切除时间36～48 min，平均42 min，术中出血10～30 ml，平均18 ml。术后无出血、胆漏、邻近脏器损伤等并发症发生，未用止痛药物，腹壁无明显手术瘢痕，术后3～5 d痊愈出院。结论 该项技术安全可行，更具微创美容优势，值得临床进一步探索。 【关键词】 低CO2气腹压； 悬吊式腹腔镜； 经脐入路腹腔镜； 腹腔镜胆囊切除术 Application of low pressure pneumoperitoneum combined with suspended and transumbilical endoscopic surgery in laparoscopic cholecystectomy:report of 11 cases YAO Jian. Sichuan Luzhou People’s Hospital，Luzhou 646000，China 【Abstract】 Objective To evaluate feasibility and clinical safety of suspended and transumbilical endoscopic surgery in laparoscopic cholecystectomy. Methods To assisted the 6 mm Hg CO2 pneumoperitoneum，and establish operational space and access for the suspended and transumbilical endoscopic surgery in laparoscopic cholecystectomy. Gallbladder removed from the umbilicus by routine laparoscopic cholecystectomy with no bleeding or bile leakage，not draft tube placed. Then umbilical incision was sutured to restore the normal shape. Results Ten cases were performed successfully. Only another one case was successfully performed after stanching，in which the titanium clip slippage caused the bleeding of cystic artery and increase of abdominal pressure to about 14 mm Hg. The cholecystectomy operating time was 36-48 min （average 42 min） with 10-30 ml （average18 ml） of blood loss. No bleeding，bile leakage，damage to adjacent organs or other complications occurred postoperatively. No pain medications was used with no abdominal scar. The patient discharged from the hospital on the 3-5 days post-operation. Conclusion Suspended and transumbilical endoscopic surgery in laparoscopic cholecystectomy is feasibility and safety，with more minimally invasive cosmetic advantage. It is worthy of further exploration. 【Key words】 Lower CO2 pneumoperitoneum pressure； Suspension laparoscop