胆囊三角冰冻的腹腔镜胆囊切除术

Laparoscopic Cholecystectomy for Frozen Calot''''s Triangle

摘要:

目的：探讨胆囊三角冰冻的腹腔镜胆囊切除术的手术方法及手术安全性，方法：在常规解剖胆囊三角失败后改为逆行切除，应用腹腔镜逆行胆囊切除的方法对27例因胆囊三角冰冻性粘连，常规解剖胆囊三角失败的胆囊结石病人进行胆囊切除。结果：27例病人中3 病人中转开腹，占11．1％，其余病人腹腔镜手术成功，所有病人术后恢复顺利，无并发症发生，结论：因反复炎症，使胆囊在三角发生冰冻性粘连，腹腔镜逆行胆囊切除是一种安全有效的方法。

Abstract:

Objective:To evaluate the method and security of laparoscopic cholecystectomy for frozen Calot's triangle.Methods:Laparoscopic retrogressive cholecystectomy was performed after conventional dissecting the gallbladder triangle had not succeed.Gallbladder was separated on the surface of gallbladder board.After isolating the body of gallbladder.Calot's triangle might be stretched by pulling the gallbladder.Therefore,the cystic duct became easier and safer to dissect.In addition,cystic duct was often shorter,and thicker due to inflammation.As a result,the outer diameter of cystic duct was too large to be clipped,therefore the cystic duct had to be tied first with silk thread.Before cystic duct was ligated,the cystic duct must be checked with laparoscopic clamp by clipping it to confirm that no stones exist in cystic duct.Cholangiograph was performed via cystic duct if necessary.Conclusions:Laparoscopic retrogressive cholecystectomy was a safe and effective method for frozen Calot's triangle due to repeating inflammation.